Donor Behaviour

Project leaders: Eva Maria Merz PhD and Prof Wim de Kort MD PhD

Without blood donors there would be no blood to transfuse or blood products to use. Hence, it is crucial that our donor pool is sufficient, healthy and diverse enough to ensure access to every blood type that is needed. Targeted recruitment of donors with specific characteristics is therefore  crucial to meet the demands. In addition, research has shown that the risk of viral infections in repeat donors is much lower than in first-time donors. Therefore retention of donors guarantees a sufficient and healthy blood supply. Recruitment and retention research uses theories and evidence from social and behavioural sciences to study, explain and influence donor behaviour.


Donor InSight, Part 1

Donor InSight (DIS) is a large-scale, longitudinal survey based study, conducted among a random sample of 50,000 whole blood and plasma donors in 2007-2009. The aim of DIS is to understand the characteristics of donors (socio-demographic, lifestyle), their experiences with donation, reasons and motivation for donor return or lapse, their medical history and physical and psychological effects of donation. 31,338 (63%) donors participated and the majority gave permission for linking their DIS data to donation records and medical records and to be contacted for future studies. Some examples of publications that resulted from the DIS study are:

Furthermore, the DIS results are an important source of information for improvements to the blood supply. A better understanding of donor characteristics and motivation contribute to a more efficient and focused strategy regarding donor recruitment and retention. Knowledge of donation experience and health effects of donation contributes to keeping donors healthy and reducing the number of deferred and lapsing.

Donor InSight, Part 2 (follow up)

In order to investigate changes in donor behaviour and motivation, lifestyle, health, etc., again 50,000 questionnaires were sent out in 2012-2013. All still eligible participants from DIS-1 (n=29,532) and a new random sample of 20,468 donors were contacted. In total, 34,823 (69.7%) donors participated. The questionnaires have been processed and the data will be available to use after data cleaning.
See website

Blood Match

Blood-match-availability: Donor recruitment and retention in minority populations.

Donors matching patients who are negative for common blood group antigens, or who have an uncommon combination of alloantibodies are most likely to be found in ethnic minority populations. For example, certain rare blood types (e.g. U-, Fy-(a-b-)) are more common in populations from African origin. Like in many countries, minority populations are underrepresented in the Dutch donor population. Barriers that are often mentioned by members of minority populations include religious and/or spiritual beliefs, lack of knowledge about blood donation and medical practice, distrust toward the transfusion practice, feeling of social exclusion or discrimination, and fear. So far this knowledge has not been used to target recruitment strategies on. In the Netherlands, a broad variety of ethnic minority populations exist, but frequencies of their blood types may differ from textbook knowledge due to evolving and mixing of subpopulations. This highlights the need to increase the variety of blood types in our donor base by 1. identifying ethnic minority populations to focus on in terms of rare blood type prevalence and 2. subsequently developing effective and efficient recruitment and retention strategies for these specific populations.

The primary objectives of the proposed study are twofold:
2.1. Analysis of blood group antigen frequencies in Dutch ethnic minority populations.
2.2. Development, implementation and evaluation of effective and efficient recruitment and retention strategies for ethnic minority populations that are most relevant in terms of rare blood type matching.

Secondary objectives are:

Blood Match – Availability will start in September 2014 and will run for 4 years.

Optimizing whole blood donation by younger inexperienced donors

In order to maximize blood donor commitment and safeguard the blood supply it is increasingly  recognized that blood agencies must optimize the blood donor experience and take measures to minimize failed collections and complications of blood donation.
The success and duration of the collection will be analysed, as well as the donor’s experience and the occurrence of vasovagal or other complications. For this, participating donors will be sent an email giving them access to a short online questionnaire (if requested a questionnaire will be sent by post instead) a few days after their donation. Moreover the routinely recorded data in eProgesa on the donation and any complications will be analyzed in the study centers as well as in collection centers in other regions of the country. For all participating donors as well as for donors in the other regions, return up to 1 year after the index donation will be analyzed.

Donor Careers

To effectively recruit and retain blood donors, two main questions need to be addressed: what characterizes our (non-)donor population, and what motivates or hinders these (non-)donors to give blood? These questions are definitely not new, as researchers in the 1970s already tried to define sets of typical blood donor characteristics. Although these studies gave useful insights in donors and their motivations, the research methods were static, without taking in mind that people and their behaviour might change.

In our view, the so called ‘donor careers’ (donor behaviour during an individuals’ life) are essential in addressing the right people at the right time. For example, donors who give blood for the first-time are more likely to be motivated by peer pressure from friends and family than experienced donors, while these experienced donors are more likely to be motivated by a sense of ‘blood donor identity’. They feel that donating blood is a part of the self and has become more of a habit. These changing motivations during the donor career ask for more personalized recruitment and retention campaigns.

To get a better understanding of donor behaviour over time, we wonder what influences motivational change. Recent studies show that some of the most important reasons for donors to lapse or reduce their donation frequency are health reasons related to childbirth, time constraints due to work, study or family responsibilities, and changing jobs.

It might be possible that these life events cause trigger a specific individual motivation to donate. For example, health-related events like the death of a relative might confront someone with the need for blood, increasing the so called ‘awareness of need’ or feelings of social responsibility, making it more likely that a person starts donating or increases his or her donation frequency.

Longitudinal analyses of Sanquin registry data and the Giving in the Netherlands Panel Survey (Centre for Philanthropic Studies, VU Amsterdam) gives us the opportunity to explore this understudied field in blood donor research.

Two main objectives of this project are:

The donor careers project has started in December 2015 and will run for 4 years. The first results are expected mid-2017.

Facilitators and barriers for RhD-immunised women to become and remain anti-d donor

Selection and retention of anti-RhD immunoglobulin (anti-D) plasma donors is important to keep up the national prevention program of RhD-immunisation and subsequent haemolytic disease of the fetus and newborn (HDFN) in RhD-negative pregnant women. The Dutch prevention programme is very successful in reducing complications in pregnancies of RhD-negative women. Anti-D is produced by Sanquin from the plasma of a small group of donors, mostly women who have been RhD-immunised during or after pregnancy. More insight in facilitators and barriers for RhD-immunised women to donate plasma for anti-D production is of utmost importance to retain existing and recruit new anti-D donors and guarantee an ongoing production of anti-D from Dutch voluntary donors.

Donor deferral management: preventing donor loss

This project is relevant for donor management, in the context of donor deferral. We focus on lapsing after deferral and ultimately on donor retention. Donor deferral, especially on-site deferral, is highly undesirable for several reasons. First, deferrals are disappointing and costly for both donors and the blood bank. Second, high deferral rates may jeopardize a stable and sufficient blood supply, because temporarily deferred are at risk of lapsing. Third, the likelihood of being deferred is rather high at the beginning of the donor career. Unfortunately, deferrals at the donor’s first or second donation attempt are most strongly associated with donor lapse. It is unclear which mechanism drives the association between deferral and donor lapse. In order to fill this knowledge gap and develop effective interventions to prevent lapsing after deferral, a thorough investigation of reasons behind and consequences of donor deferral is of utmost importance. Hence, this research proposal focuses on  reducing deferral likelihood by informing the donors, and managing the deferral process in a cost-effective way that deferred donors are more likely to return.


Chicago Study: Personal characteristics and donation

The decision to become a donor of substances of human origin (SOHO), such as blood, plasma or organs, is a very personal one. Donation of SOHO is a very specific form of prosocial behavior, as it involves an invasive procedure which people undergo without any direct benefit to themselves. We studied a general population in Chicago. Read more on the Chicago study website.

Last edited on: 12 October 2017