Preventing Adverse Reactions in Novice Blood Donors

描述(申请人提供)：严重的和潜在危险的血液供应短缺是很常见的。随着人口老龄化(需求增加)和对献血者资格的越来越严格的限制(供应减少)，这一问题预计会恶化。目前正在招募新的献血者，这是满足日益增长的血液需求的努力的一个重要组成部分。理想情况下，新兵将成为终身献血者，每年最多捐献6次，一生献血数百个单位。不幸的是，只有不到一半的新手捐赠者会提供第二次捐赠。由于血管迷走神经反应的经历(例如头晕、虚弱、头晕)是新手献血者损耗的最强预测因素之一，因此预防此类反应可能是增强国家血液供应的一种特别有效和持久的方法。我们的长期目标是为采血机构提供简单和廉价的策略，可以用来防止血管迷走神经反应和加强献血者的留存。本提案的具体目的是评估两种特别有希望的血管迷走神经预防策略--水负荷和施加肌肉张力--的综合效果。我们将比较400名首次献血的献血者的血管迷走神经反应，并重复献血行为，这些献血者被分配到积极治疗(献血前的水负荷和献血过程中的肌肉紧张)和安慰剂治疗(献血前的肌肉紧张)。参与者将在美国红十字会在农村和城市举办的固定和流动献血诊所接受招募和测试。血管迷走神经反应将使用现场供者和抽血者评分以及24小时后获得的供者评分来衡量。利用美国红十字会国家捐赠者数据库，将在两年的随访期内跟踪随后的捐赠历史。我们假设，与安慰剂组的参与者相比，积极治疗组的参与者将经历更少的不良反应，并且更有可能回来提供新的捐赠。这项拟议的研究测试了志愿者献血者可以用来防止晕倒等负面反应的简单策略，这些反应经常会阻止献血者回来。我们工作的长期目标是通过增加献血者的积极性和对终身献血的承诺来解决经常性的血液供应短缺问题。因为我们直接与美国红十字会合作，我们的发现可以很快转化为实践。

DESCRIPTION (provided by applicant): Severe and potentially dangerous shortages in the blood supply are common. This problem is expected to worsen as the population ages (increasing demand) and more and more stringent restrictions are placed on blood donor eligibility (decreasing supply). A crucial component of the effort to meet the increasing demand for blood is the ongoing recruitment of new donors. Ideally, new recruits would become lifelong donors, contributing up to six times per year and hundreds of units of blood in a lifetime. Unfortunately, less than half of all novice donors will ever provide a second donation. Because the experience of vasovagal reactions (e.g., dizziness, weakness, lightheadedness) is one of the strongest predictors of attrition in novice donors, prevention of such reactions may be a particularly efficient and enduring method of enhancing the nation's blood supply. Our long-term objective is to provide blood collection agencies with simple and inexpensive strategies that can be used to prevent vasovagal reactions and enhance donor retention. The specific aim of the current proposal is to evaluate the combined effects of two particularly promising vasovagal prevention strategies - water loading and applied muscle tension. We will compare vasovagal reactions to blood donation and repeat donation behavior in 400 first-time donors assigned to either active treatment (pre- donation water loading and muscle tensing during donation) or placebo treatment (pre-donation muscle tensing). Participants will be recruited and tested at American Red Cross fixed and mobile blood donation clinics held in rural and urban settings. Vasovagal reactions will be measured using on-site donor and phlebotomist ratings as well as donor ratings obtained 24 hours later. Using the American Red Cross national donor database, subsequent donation history will be tracked during a two-year follow-up period. We hypothesize that participants in the active treatment group will experience less adverse reactions and will be more likely to return to provide a new donation as compared to participants in the placebo group. The proposed study tests simple strategies that volunteer blood donors can use to prevent negative reactions, such as fainting, that frequently discourage donors from returning. The long term goal of our work is to address recurrent shortages in the blood supply by increasing donor motivation and commitment to lifelong giving. Because we are working directly with the American Red Cross, our findings can be quickly translated into practice.