Beliefs underlying blood donors’ intentions to donate during two phases of an avian influenza outbreak

Using a Theory of Planned Behavior (TPB) framework the current study explored the beliefs of current blood donors (N = 172) about donating during a low and high-risk phase of a potential avian influenza outbreak. While the majority of behavioral, normative, and control beliefs identified in preliminary research differed as a function of donors’ intentions to donate during both phases of an avian influenza outbreak, regression analyses suggested that the targeting of different specific beliefs during each phase of an outbreak would yield most benefit in bolstering donors’ intentions to remain donating. The findings provide insight in how to best motivate donors in different phases of an avian influenza outbreak.     

Predicting the retention of first-time donors using an extended Theory of Planned Behavior

BACKGROUND: Donor retention is vital to blood collection agencies. Past research has highlighted the importance of early career behavior for long‐term donor retention, yet research investigating the determinants of early donor behavior is scarce. Using an extended Theory of Planned Behavior (TPB), this study sought to identify the predictors of first‐time blood donors' early career retention. STUDY DESIGN AND METHODS: First‐time donors (n = 256) completed three surveys on blood donation. The standard TPB predictors and self‐identity as a donor were assessed 3 weeks (Time 1) and at 4 months (Time 2) after an initial donation. Path analyses examined the utility of the extended TPB to predict redonation at 4 and 8 months after initial donation. RESULTS: The extended TPB provided a good fit to the data. Post‐Time 1 and 2 behavior was consistently predicted by intention to redonate. Further, intention was predicted by attitudes, perceived control, and self‐identity (Times 1 and 2). Donors' intentions to redonate at Time 1 were the strongest predictor of intention to donate at Time 2, while donors' behavior at Time 1 strengthened self‐identity as a blood donor at Time 2. CONCLUSION: An extended TPB framework proved efficacious in revealing the determinants of first‐time donor retention in an initial 8‐month period. The results suggest that collection agencies should intervene to bolster donors' attitudes, perceived control, and identity as a donor during this crucial post–first donation period.     

Right here, right now: the impact of the blood donation context on anxiety, attitudes, subjective norms, self-efficacy, and intention to donate blood

BACKGROUND: While research has established the role of anticipated emotions in augmented Theory of Planned Behavior (TPB) models of donor behavior, research has yet to consider the impact of immediate emotions that may be triggered by the blood donor context on respondents' intentions to donate blood. This study explored the impact of blood donor paraphernalia on respondents' positivity toward blood donation and on the interrelationships typically observed in TPB blood donation studies. STUDY DESIGN AND METHODS: Seventy‐six participants were randomly allocated to complete TPB questionnaires assessing attitudes, subjective norm, and self‐efficacy along with intention to donate blood in either an affectively “hot” (blood donation paraphernalia) or a cold (control) condition. Anxiety about donating blood was also assessed. RESULTS: Respondents in the affectively hot condition reported significantly greater anxiety about donating blood along with less positive attitudes, weaker subjective norms, lower self‐efficacy, and lower intention to donate than respondents in the cold control condition. In support of extant TPB research, correlational analyses indicated that the relationships between attitudes, self‐efficacy, and intention were not impacted upon by condition. CONCLUSION: Blood donation paraphernalia induces anxiety in donors and results in diminished positivity toward donating. An awareness of what donors experience as a function of the context of blood donation may allow blood services to effectively intervene to bolster donors' positivity toward blood donation at the point where donation can take place.     

Predicting blood donation intentions and behavior among Australian blood donors: testing an extended theory of planned behavior model

BACKGROUND: Donor retention poses a significant problem to blood collection agencies around the world. Previous research using an augmented theory of planned behavior (TPB) approach has demonstrated that attitude, subjective norm, self-efficacy, moral norm, anticipated regret, donation anxiety from prior blood donations, and self-identity as a blood donor predicts experienced donors' intentions and that intentions, self-efficacy, moral norm, and anticipated regret may impact upon people's actual blood donation behavior.
STUDY DESIGN AND METHODS: Established blood donors (n = 263) completed questionnaires assessing standard TPB constructs, anticipated regret, moral norm, donation anxiety, and self-identity as a blood donor. Three months later, a second questionnaire assessing blood donation behavior in the intervening 3 months was mailed and returned by 182 donors.
RESULTS: With structural equation modeling, the final augmented TPB model provided an excellent fit to the data and included a direct path from intention to behavior and indirect paths to behavior through intention for attitude, self-efficacy, and anticipated regret. Moral norm, donation anxiety, and donor identity indirectly predicted intention through attitude. In total, 51 percent of the variance in donors' attitudes, 86 percent of variance in donors' intentions, and 70 percent of the variance in donors' behavior were accounted for in the final model.
CONCLUSION: An augmented TPB framework proved efficacious in determining the predictors of the intentions and behavior of established blood donors. Further, this framework highlighted the importance of considering in the future how donors' motivations for donating blood may evolve as a function of the number of prior donations.     

Why don’t young people volunteer to give blood? An investigation of the correlates of donation intentions among young nondonors

BACKGROUND: In the past decade, the number of blood donors has steadily declined in the Netherlands, and young adults are underrepresented among registered donors. An understanding of the correlates of donation intentions among nondonors could facilitate targeting psychological prerequisites of donation decisions in recruitment campaigns. STUDY DESIGN AND METHODS. A cross-sectional study with self-administered questionnaires based on an extension of the Theory of Planned Behavior (TPB; a social cognition model to study the determinants of volitional behavior) was conducted to assess potential cognitive determinants of willingness to donate blood in a student sample. A response rate of 50.5 percent yielded a sample of 311. RESULTS: Just over 7 percent of participants were registered blood donors but most (61.7%) had never seriously considered becoming donors. Self-efficacy (confidence in performing the behavior), attitude (the overall evaluation of the behavior), and personal moral norm (the perceived personal responsibility to perform the behavior) regarding blood donation were the most important correlates of the intention to become a blood donor. In total, 43 percent of the variance in the intentions toward blood donation could be explained by a TPB-based model. CONCLUSION: Among students, determinants of the intention to become a blood donor include self-efficacy, attitude, personal moral norm regarding blood donation, and subjective norm (perceived social support). Future research could establish whether campaigns targeting these psychological prerequisites would be more effective than current strategies.     

Predicting donation among an Irish sample of donors and nondonors: extending the theory of planned behavior

BACKGROUND: Research has indicated the ability of the Theory of Planned Behavior to predict blood donation. This study tested an extended version of the Theory of Planned Behavior (attitude, subjective norm, and perceived behavioral control with the addition of past behavior, moral norm, self-identity, and anticipated regret) in predicting donation intention and behavior among donors and nondonors and if forming implementation intentions improved attendance at a mobile blood donation clinic. STUDY DESIGN AND METHODS: This study used a cross-sectional follow-up design. A questionnaire was distributed to 600 staff and students at the National University of Ireland, Galway, before the arrival of a mobile clinic to Galway city. Half of these participants were invited to make implementation intentions specifying how, where, and when they planned to donate blood. A second questionnaire measuring reported attendance at the clinic was distributed 2 weeks after the first questionnaire. RESULTS: A total of 172 eligible donors returned questionnaires (29% response rate). The extended Theory of Planned Behavior accounted for 51 percent of the variance in intention to donate in the future: anticipated regret, attitude, perceived behavioral control, self-identity, and subjective norm significantly predicted intention. Donors differed from nondonors: they possessed more favorable attitudes toward blood donation, had a greater sense of donor identity, and believed more strongly in a moral obligation to donate blood than nondonors. Those who made implementation intentions were no more likely to donate that those who had not. CONCLUSION: Owing to the different factors influencing the donation decision for donors and nondonors, separate strategies to promote donation should be designed for these subgroups, targeting the elements most pertinent to each group.     

Blood donors' helping behavior is driven by warm glow: more evidence for the blood donor benevolence hypothesis

BACKGROUND: The benevolence hypothesis (both donor and recipient gain) suggests that blood donors, compared to non–blood donors have a general altruistic motivational preference based on warm glow (i.e., “I donate because it makes me feel good”). With objective behavioral economics tests of altruism and warm‐glow giving, this paper offers the first direct experimental test of this hypothesis. The prediction that blood donors will be motivated in general by warm glow was compared to predictions from other theoretical models: strong reciprocity and empathy. STUDY DESIGN AND METHODS: Four experiments and one prospective study examined blood donors' and nondonors' motivations for general charitable giving and blood donation. Variants of the dictator game (DG; a charity DG [CDG] and a warm‐glow version of a CDG) were used to provide objective measures of altruism. RESULTS: Blood donors gave less than nondonors on the CDG, but gave more on the warm‐glow version. Blood donors' actual donations (in the CDGs and blood donation) were associated with feelings of warm glow. There was no evidence that blood donors were motivated by strong reciprocity or empathic concerns. CONCLUSIONS: This paper offers objective behavioral evidence that blood donors' charitable giving and blood donation, compared to non–blood donors, is more strongly motivated by warm glow. This provides additional support for the benevolence hypothesis of blood donation.     

Communicating the move to individualized donor selection policy: Framing messages focused on recipients and safety

Background

Men-who-have-sex-with-men (MSM) have been deferred from donating blood. However, recent evidence supports the adoption of donor screening based on individuals' sexual behavior over population-based criteria. We explore how best to frame communications about adopting this change to minimize any potential negative consequences (e.g., reduced donor numbers). We examine the effectiveness of risk (emphasizing safety vs. emphasizing low risk), and focus (donor vs. recipient) frames on intentions to donate blood (approach) or feeling deterred from donating (avoid), and mechanisms linked to under-reporting sexual behavior.

Study Design and Methods

We conducted a 2 (risk frame: risk vs. safety) by 3 (focus: donor vs. recipient vs. both) between-subjects online experiment (n = 2677). The main outcomes were intentions to donate and feelings of being put-off/deterred from donating (both for self and others). We also assessed the extent that forgetting, embarrassment/shame, and question irrelevance were perceived to be associated with under-reporting sexual behavior.

Results

Frames that focused on safety or a recipient resulted in people reporting being less deterred from donating. Regardless of frame, people from ethnic minorities were more likely to feel deterred. Embarrassment/shame followed by forgetting and perceived irrelevance were the main reasons for under-reporting sexual behaviors, especially in ethnic minorities, and smartphones were perceived as an acceptable memory aid for sexual behavior.

Discussion

Blood services moving to an individualized policy should frame donor selection in terms of safety and/or a recipient focus, explore sensitivities in ethnic minority communities, consider ways to normalize reporting sexual behavior, and use smartphones as a memory aid.     

Using the Theory of Planned Behaviour to predict exercise intention in obese adults.

The purpose of this cross-sectional study was to use Ajzen's Theory of Planned Behaviour (TPB) as a theoretical framework for understanding the intention to be physically active among a group of obese individuals. Individuals (n = 96) classified as obese (BMI > or = 30 kg/m2) completed a self-administered questionnaire assessing intention to be physically active and its theoretically related variables. The TPB explained 66% of the variance in physical activity intentions. Significant independent predictors of intention were perceived behavioural control (beta = .40) and attitude (beta = .36). The consideration of past behaviour (beta = .32) explained an additional 7% of the variance. These findings support the idea that, in designing interventions for obese individuals, nurses should focus on developing skills to overcome barriers to physical activity and on developing a positive attitude towards this behaviour.     

Practice nurses' intentions to use clinical guidelines

BACKGROUND: Evidence indicates that, although nurses are increasingly using clinical guidelines to ensure higher quality of care, there is a wide variance in their adherence to them. The utility of the Theory of Planned Behaviour (TPB) has not been previously investigated in explaining this variance in community nursing. AIM: This paper reports a study whose primary aim was to examine the utility of the TPB in explaining variations in practice nurses' intentions to offer smoking cessation advice in accordance with coronary heart disease guidelines. METHODS: A cross-sectional survey using a postal questionnaire was carried out. A 52-item questionnaire was administered to 48 practice nurses in England. The questionnaire was designed to assess the components of the TPB, and included measures of intentions to offer smoking cessation advice, self-reported past behaviour, attitudes, subjective norms, perceived behavioural controls (PBCs), behavioural beliefs and evaluations, normative beliefs and motivation to comply, and control beliefs and evaluations. RESULTS: The TPB explained up to 40% of variance in intentions to offer smoking cessation advice. Attitudes and PBCs were the most important predictors of intention. Among other elements of the TPB, indirect attitudes and indirect PBCs made significant positive contributions to explaining variance in intention. DISCUSSION: Future trials of interventions to increase practice nurses' adherence to clinical guidelines could attempt to address the elements identified in this study as important factors. Further studies are required to examine the utility of the TPB in predicting practice nurses' behaviour.     

Predicting intentions to obtain a Pap smear among African American and Latina women: testing the theory of planned behavior.

OBJECTIVE: To determine the empirical adequacy of the theory of planned behavior (TPB) to explain Pap smear use intentions in African American and Latina women. METHOD: A correlational design was used, and a convenience sample of 108 African American and 96 Latina adult women were recruited from urban community-based agencies located in a large mid-Atlantic metropolitan area. The Pap Smear Questionnaire (PSQ) was designed and used. The Demographic Assessment Survey collected demographic information (age and socioeconomic status for both groups; and level of acculturation for the Latinas). RESULTS: Direct relationships between attitude and perceived behavioral control and intention to obtain an annual Pap smear were found for African American and Latina women. The subjective norm did not significantly predict intention. Attitude (beta = .58; p < .001) provided the best explanation of intention among African American women to obtain an annual Pap smear, followed by perceived behavioral control (beta = .30; p < .001). Among Latinas, the findings reflected those of the African American sample. However, attitude (beta = .40; p < .001) and perceived behavioral control (beta = .35; p < .001) were weighted similarly. The external variables of age and income had indirect effects on intention for African American and Latina women, respectively. CONCLUSION: The study findings did not support the empirical adequacy of the TPB for either of the ethnic groups. Future studies should test a modified version of the TPB that includes measures of both social support and subjective norms. Direct measure items of subjective norm, group-specific measures of perceptions of control, and other measures of acculturation should be added to the PSQ and further tested.     

Genetic research in the blood bank: acceptability to Northern California donors

BACKGROUND: Blood banks have large altruistic donor populations and existing infrastructure that make them attractive sites for genetic epidemiologic research, but donors' willingness to participate and the impact on blood donation are unknown. STUDY DESIGN AND METHODS: A total of 2162 blood donors in Northern California responded to a cross‐sectional questionnaire in August and September 2007. Participants were asked their likelihood of participation and future blood donation under three different scenarios: identity‐linked genetic research, identity‐unlinked genetic research, and genetic testing as a service. RESULTS: The majority of blood donors indicated that they would be likely or very likely to participate in identity‐linked genetic research (67%) and in identity‐unlinked genetic research (54%). While older donors and more frequent donors were more likely to participate in identity‐linked research, younger, Caucasian, more educated, and more frequent donors were more likely to participate in identity‐unlinked research. Less than 10% of donors indicated they would be less likely to donate blood in the future if genetic research was conducted at blood banks. More than 75% of donors would be interested in genetic testing as an optional service at the blood bank, but more than 20% of donors would be less likely to donate if such a service was offered. CONCLUSION: Overall, we found that the majority of blood donors would be likely to participate in genetic research and that less than 10% would be less inclined to donate if such research was conducted by blood banks.     

Readiness of nursing students to screen women for domestic violence

BackgroundAlthough domestic violence against women is common in Israel and elsewhere, and though medical staff in Israel have a universal obligation to screen women for domestic violence, actual screening rates remain low.ObjectivesTo examine which variables affect nursing students' intention to screen women for domestic violence when providing treatment, and whether the Theory of Planned Behavior (TPB) developed by Ajzen (1991) predicts this intention.DesignThis study is a quantitative cross sectional study.SettingsA large academic nursing school in central Israel.ParticipantsA convenience sample of 200 nursing students who had completed at least one year of studies took part in the study.MethodsStudents completed a questionnaire based on the TPB.ResultsNursing students showed high intention to screen women for domestic violence when providing treatment. Normative beliefs, subjective norms, behavioral beliefs, perceived control, and knowledge were found to affect students' intention to screen women for domestic violence. The opinion of the clinical instructor was most significant for students.ConclusionsThe theoretical model predicted 32% of students' intention to screen women for domestic violence, with normative beliefs being the most significant variable.     

A path analysis of intention to redonate among experienced blood donors: an extension of the theory of planned behavior

BACKGROUND: The need for blood products is constant and unremitting, yet only a small percentage of eligible individuals answer the appeal to donate. Further, most new donors never return to provide a repeat donation. The ongoing need to attract and retain new donors has led to the examination of psychosocial factors that may predict the likelihood of blood donation behavior. By use of regression techniques, prior studies have established that elements of the Theory of Planned Behavior (e.g., attitude, subjective norm, personal moral norm, and perceived control or self-efficacy) can predict intention to donate among nondonors. STUDY DESIGN AND METHODS: Path analysis was used to further examine the utility of the Theory of Planned Behavior in predicting donation intention in a sample of 227 experienced donors who completed an online survey. Experiential measures relating to previous donations, including the experience of vasovagal reactions and overall donor satisfaction, were added to the model. RESULTS: The final model, which provided an excellent fit to the data, characterized 1) three direct pathways from attitude, subjective norm, and self-efficacy to donation intention and 2) four indirect pathways, wherein self-efficacy, personal moral norm, vasovagal reactions, and overall donor satisfaction influence donation intention through attitude. In total, 65 percent of the variance in donation intention and 50 percent of the variance in attitude is accounted for in this model. CONCLUSION: The Theory of Planned Behavior can be used to predict donation intentions among experienced donors. Further, the model's predictive utility is improved by considering the influence of previous donation experiences on donor attitudes.     

Nurses' perceptions of severe acute respiratory syndrome: relationship between commitment and intention to leave nursing

Aims. This paper reports a study which aimed to: (1) investigate the relationship between nurses’ commitment to the nursing profession and organization and their intention to leave; (2) investigate nurses’ perceptions of the possibility of acquiring severe acute respiratory syndrome infection and its moderation of their commitment to the nursing profession and the organization and their consequent intentions to leave the profession and the organization following the severe acute respiratory syndrome outbreak. Background. The outbreak of severe acute respiratory syndrome in 2003 resulted in a fatality rate of approximately 11%. Nurses in hospitals caring for patients with severe acute respiratory syndrome maintained close contact with the infected patients. The high risk of infection and death associated with caring for patients with severe acute respiratory syndrome had a great impact on nurse retention in hospitals. Nurse turnover in many countries where these outbreaks occurred has been high since the first outbreak occurred in March 2003. Methods. Three hundred and thirty nurses working at a Taiwan hospital during the time of the severe acute respiratory syndrome outbreak completed the Meyer, Allen & Smith Organizational and Occupational Commitment Scales, Intention to Leave and Perceived Stress of Infection Scales between July and August 2003. Results. All three components of occupational and organizational commitments were negatively associated with nurses’ intentions to leave the nursing profession and the organization. Nurses’ perceptions of the possibility of acquiring severe acute respiratory syndrome infection through caring for these patients had a moderating effect on the relationship between commitment and the intention to leave. Conclusions. Perceived risk to life from infection has a possible influence on the commitment/intention‐to‐leave model in hospital nurses caring for patients with severe acute respiratory syndrome, and this information can inform hospital and nursing managers about nurse retention following a severe acute respiratory syndrome outbreak and the management of commitment in the context of nursing human resources management.     

2017年2月全国突发公共卫生事件及需关注的传染病风险评估

目的 评估2017年2月国内外突发公共卫生事件及需要关注传染病的风险。方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省（直辖市、自治区）疾病预防控制中心专家参与评估。结果 根据既往传染病和突发公共卫生事件监测数据,预计2017年2月为全国总报告事件数较少的月份之一,主要以人感染禽流感、季节性流感、感染性腹泻病等传染病事件为主。人感染H7N9禽流感疫情仍呈现点多、面广的特点。季节性流感、病毒性腹泻等传染病暴发将在开学后出现季节性升高。寨卡病毒病输入我国的风险持续存在,但近期因输入病例引发本地蚊媒传播的风险极低。因燃煤取暖不当导致的非职业性一氧化碳中毒事件正处于高发时段。结论 预计2017年2月我国的突发公共卫生事件数相对较少;需重点关注人感染禽流感,一般关注季节性流感、诺如病毒病、非职业性一氧化碳中毒,了解寨卡病毒病所引发的公共卫生风险。     

Serological studies of piperacillin antibodies

BACKGROUND: Penicillin‐induced immune hemolytic anemia (IHA) is associated with immunoglobulin G antipenicillin detected by testing penicillin‐coated red blood cells (RBCs). Antibodies to piperacillin, a semisynthetic penicillin, would be expected to react similarly; however, antipiperacillin can be detected by testing in the presence of the drug. Piperacillin is commonly used in combination with tazobactam, which causes nonimmunologic protein adsorption onto RBCs. In six cases of piperacillin‐induced IHA, reactivity with piperacillin‐coated RBCs was not similar to reactivity of antipenicillin with penicillin‐coated RBCs. STUDY DESIGN AND METHODS: Antipiperacillin was tested against piperacillin‐coated RBCs prepared using different pH buffers. Plasma from blood donors and sera/plasma from patients were tested with piperacillin‐coated, penicillin‐coated, and uncoated RBCs. Hapten inhibition studies were performed using different concentrations of piperacillin. Donors' plasma were tested in the presence of piperacillin; sera from patients with IHA were tested in the presence of tazobactam. RESULTS: Piperacillin required high pH for binding to RBCs. Agglutination of piperacillin‐coated RBCs was observed in 91 percent of donors' and 49 percent of patients' plasma and was inhibited by piperacillin. In contrast to patients with IHA due to piperacillin, donors' plasma tested in the presence of piperacillin did not react. Tazobactam antibodies were not detected. CONCLUSION: A high percentage of donors' and patients' plasma contain an antibody to piperacillin or a chemically related structure detected by testing with piperacillin‐coated RBCs. A diagnosis of piperacillin‐induced IHA should not be made solely on the reactivity of a patient's plasma/serum with piperacillin‐ or piperacillin/tazobactam‐coated RBCs; testing in the presence of piperacillin is more reliable.