Feasibility of Expert System to Promote African American Blood Donation for SCD

该项目旨在开发和测试一种创新的个性化干预措施的可行性，以提高非裔美国人的献血率。红细胞输注用于治疗和预防镰状细胞病（SCD）的一些并发症。然而，由于多次输血，高比例的SCD患者变得对血型抗原免疫。由于血型抗原在种族群体中更常见，因此需要专门来自非洲裔美国人供体的血液制品来治疗SCD患者。人们已经做出了各种努力来增加献血，但很少有强有力的理论基础或经验评估。本研究的主要具体目的是开发和研究基于行为改变的跨理论模型（TTM）的个性化干预的可行性，以提高非裔美国人的献血率。TTM是一种经过经验验证的理论，它包含了一个人做出决定或改变行为的准备。为了实现这一目标，将首先与纽约市的150名非洲裔美国人一起制定和完善基于TTM的增加献血的措施。然后，这些测量数据将为专家系统干预的开发提供规范，以增加献血。专家系统干预将通过提供给研究参与者的报告提供规范性（以及随后的自我）反馈，并辅以阶段匹配的献血自助手册。将利用焦点小组来评估干预材料的内容、格式和质量。一旦开发出来，纽约市的50名非洲裔美国人将参加一项可行性研究，为献血提供定量和定性评估的新专家系统干预。然后将对专家系统进行改进。一旦开发，可行性测试和完善，TTM献血干预措施对提高NYCMA非洲裔美国人献血率的有效性可以在未来的随机试验中进行评估。这种基于理论的干预措施可能对增加非裔美国人献血的努力产生重大影响，这反过来又会影响SCD患者的生活。 公共卫生相关性：该项目将通过开发理论驱动的定制专家系统干预来解决SCD患者输血的抗原匹配血液库存有限的问题，以提高非裔美国人的低献血率。虽然在镰状细胞病的背景下，本文提出的干预措施的开发和可行性测试将针对并侧重于非洲裔美国人，但我们的经验强烈表明，这种方法可以很容易地适应其他人群，以解决更大的血液短缺问题。

DESCRIPTION (provided by applicant): The proposed project is designed to develop and test the feasibility of an innovative, individualized intervention to increase blood donation rates among African Americans. Red blood cell transfusions are used to treat and to prevent some of the complications of Sickle Cell Disease (SCD). However, as a result of multiple transfusions, a high proportion of SCD patients become immunized against blood group antigens. As blood group antigens are more common within racial groups, a demand exists for blood products specifically from African American donors to treat patients with SCD. A variety of efforts to increase blood donation have been developed, but few have had strong theoretical bases or have been empirically evaluated. The primary specific aim of this study is to develop and examine the feasibility of an individually tailored intervention based on the Transtheoretical Model (TTM) of behavior change to increase the blood donation rate among African Americans. The TTM is an empirically validated theory that incorporates a person's readiness to make a decision or change a behavior. To achieve this aim, TTM-based measures for increasing blood donation will first be developed and refined with 150 African Americans in the New York City. These measurement data will then provide the norms for the development of an expert system intervention to increase blood donation. The expert system intervention will provide normative (and subsequently ipsative) feedback via reports delivered to study participants complemented by a stage-matched self-help brochure for blood donation. Focus groups will be used to assess the content, format and quality of the intervention materials. Once developed, fifty African Americans in New York City will participate in a feasibility study for new expert system intervention for blood donation providing both quantitative and qualitative assessments. Refinements to the expert system will then be made. Once developed, feasibility tested and refined, the efficacy of the TTM blood donation intervention on increasing blood donation rates in African Americans in NYCMA can be evaluated in a future randomized trial. This theory-based intervention can have significant implications for the efforts to increase blood donation among African Americans, which in turn impact the lives of SCD patients. Public Health Relevance: This project will address the issue of limited inventories of antigen-matched blood for transfusion for SCD patients by developing a theory-driven tailored expert system intervention to increase the low blood donation rate among African Americans. While development and feasibility testing of the intervention proposed here will be targeted and focused on African Americans in the context of sickle cell disease, our experience strongly suggests that this methodology can easily be adapted to other populations to address the larger blood shortage issue.