Blood Donor Competence, Autonomy and Relatedness Enhancement (Blood Donor CARE)

 描述(申请人提供)：首次献血占献血总量的31%。不幸的是，大多数年轻的和首次献血的人不会回来再次献血，只有2%的20岁以下的首次献血者继续成为承诺的献血者。因此，我们的血液供应高度依赖必须不断更换的年轻献血者。除了巨大的持续招聘成本外，未能留住首次献血者对健康也有重要影响，因为重复献血者不太可能因健康状况不佳和传播艾滋病毒和肝炎等感染而被推迟。因此，出于健康、安全和经济原因，迫切需要新的方法来加强新献血者的留存。目前的应用程序通过在新献血者中促进再次献血的内在动机来检验一种创新的、理论驱动的保留方法。自我决定理论(SDT)提出，人们更有可能坚持内部动机而不是外部动机的行为，相当多的研究支持这样的概念，即在各种健康背景下，更多的内化动机与更好的坚持有关。在献血方面也有类似的发现，在献血背景下，衡量献血者身份内在化的程度与献血意愿和未来献血行为都是正相关的。在先前工作的基础上，我们建议测试一种多成分干预，旨在提高SDT中有助于内部动机(即能力、自主性、关联性)的一种、两种或全部三种基本人类需求。采用完全析因设计，首次捐献者将被随机分配到满足一项、两项或全部三项基本需求的对照条件或干预措施中。我们的主要结果衡量标准将是在一年的后续时期内的捐赠尝试。其他结果测量将包括捐赠能力、自主性和关联性的变化，以及计划行为理论的关键结构(态度、主观规范、感知行为控制、意图)。我们的主要目标是确定干预条件是否单独或结合在一起，增加了明年尝试捐赠的可能性。我们的第二个目标是考察特定于干预的能力、自主性和关联性的增加，作为增强供者留存的潜在中介。最后，一个探索性的目标将检验一个动机的综合模型，该模型将自主性视为对行为的更接近的、情景水平的决定因素(即态度、主观规范、感知的行为控制和意图)的中介影响。该项目具有重要的意义、创新性和及时性，因为它开发了一种急需的、新的方法来保留首次捐赠者，同时检查了从未在捐赠背景下测试过的特定的、理论驱动的干预机制。这项研究将通过开发可广泛传播的有效干预措施来促进安全和稳定的国家血液供应，从而对公共卫生产生重要影响。

 DESCRIPTION (provided by applicant): First-time donors provide 31% of all blood donations. Unfortunately, the majority of young and first-time donors do not return for a repeat donation, and only 2% of first-time donors under the age of 20 go on to become committed blood donors. Hence our blood supply is highly reliant on young donors who must constantly be replaced. In addition to enormous ongoing recruitment costs, failure to retain first-time donors has important health implications, as repeat blood donors are less likely to be deferred for poor health and to transmit infections such as HIV and hepatitis. Accordingly, for health, safety, and economic reasons there is a critical need for novel approaches to enhance the retention of new blood donors. The current application examines an innovative, theory-driven approach to retention by promoting intrinsic motivation to donate again among new blood donors. Self-determination theory (SDT) proposes that people are more likely to persist with behaviors that are internally versus externally motivated, and considerable research supports the notion that more internalized motivation is associated with better adherence in a variety of health contexts. Similar findings have also been reported in the blood donation context where measures of the extent to which a donor identity has been internalized are positively related to both donation intention and future donation behavior. Based on our prior work, we propose to test a multi-component intervention designed to enhance one, two, or all three of the fundamental human needs that contribute to internal motivation according to SDT (i.e., competence, autonomy, relatedness). Using a full factorial design, first-time donors will be randomly assigned to a control condition or an intervention that addresses one, two, or all three of the fundamental needs. Our primary outcome measure will be donation attempts in the one-year follow-up period. Additional outcome measures will include changes in donation competence, autonomy, and relatedness as well as key constructs from the Theory of Planned Behavior (attitude, subjective norm, perceived behavioral control, intention). Our primary aim is to determine whether the intervention conditions, alone and in combination, increase the likelihood of a donation attempt in the next year. Our second aim is to examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. Finally, an exploratory aim will examine an integrative model of motivation that views autonomy as a mediating influence on the more proximal, situational-level determinants of behavior (i.e., attitude, subjective norm, perceived behavioral control, and intention). This project is significan, innovative, and timely as it develops a much-needed, new approach to first-time donor retention while examining specific, theory-driven intervention mechanisms that have never been tested in the donation context. This study will have an important public health impact by developing efficient interventions that can be widely disseminated to promote a safe and stable national blood supply.