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

 描述（由申请人提供）：首次献血者提供所有献血的31%。不幸的是，大多数年轻人和首次献血者不会再次献血，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年轻的献血者，他们必须不断更换。除了持续的巨额招募费用外，未能留住首次献血者也对健康产生重大影响，因为重复献血者不太可能因健康状况不佳而被推迟献血，也不太可能传播艾滋病毒和肝炎等感染。因此，出于健康、安全和经济原因，迫切需要新的方法来提高新献血者的保留率。目前的应用程序研究了一种创新的，理论驱动的方法，通过促进新献血者再次献血的内在动机来保留。自我决定理论（SDT）提出，人们更有可能坚持内部与外部动机的行为，大量研究支持这样一种观点，即更多的内在动机与各种健康环境中更好的坚持有关。类似的研究结果也被报道在献血的情况下，在何种程度上的捐助者身份已被内化的措施是积极相关的捐赠意向和未来的捐赠行为。基于我们之前的工作，我们建议测试一种多成分干预，旨在增强一种，两种或所有三种根据SDT有助于内部动机的基本人类需求（即，能力、自主性、相关性）。使用全析因设计，首次献血者将被随机分配到一个控制条件或干预措施，解决一个，两个或所有三个基本需求。我们的主要结局指标是在一年随访期内的献血尝试。其他结果指标将包括捐赠能力、自主性和相关性的变化，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组合增加了明年捐赠尝试的可能性。我们的第二个目标是研究干预特定的能力，自主权和相关性的增加，作为增强捐助者保留的潜在调解人。最后，一个探索性的目标将检查一个整合的动机模型，认为自主作为一个中介影响更近的，情境水平的决定因素的行为（即，态度、主观规范、感知行为控制和意图）。这个项目是重要的，创新的，及时的，因为它开发了一个急需的，新的方法来留住第一次捐赠者，同时检查具体的，理论驱动的干预机制，从来没有在捐赠方面进行过测试。这项研究将通过制定有效的干预措施产生重要的公共卫生影响，这些干预措施可以广泛传播，以促进安全和稳定的国家血液供应。

 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.