A life course perspective on blood donation: The influence of life events across the donor career

Background All over Europe, blood donor numbers are decreasing. Although this does not pose a short-term threat, since the demand is decreasing too, demographic developments (e.g., ageing and growing diversity within the population) may negatively affect the blood supply on the long-term. Hence, recruitment and retention of blood donors remain an important topic of study. For several decades, researchers have been studying donor behaviour while trying to characterize the ‘typical blood donor’. However, findings on determinants of donor behaviour are inconclusive, with results changing over time and varying within and between countries.Aims We aimed at getting a more thorough understanding of the dynamic nature of blood donor behaviour by adapting a ‘life course perspective’. This approach shifts the focus from the static current state of blood donor behaviour to dynamic donor careers: ‘How does blood donor behaviour and motivations change during the life course, and how do life events impact these behavioural and motivational change?' Previous studies using retrospective, cross-sectional designs indicated that life events might serve as turning points in donor careers. Self-reported reasons for donors to lapse or reduce their frequency of donation include childbirth, time constraints due to work or study, moving and living farther away from a donation centre, and changing job status.Methods For statistical analyses, two data sources were used: 1) Dutch Donor Database (eProgesa), containing information on all donors and their behaviour (e.g., donation frequency, return rates), and 2) Donor InSight (DIS I: 2007-2009; DIS II: 2012-2013), a large-scale survey, including information on donor characteristics, motivations, and life events. The survey data was linked to Donor Database records to describe relationships between life events (occurred between DIS I and DIS II), and blood donor lapse (retrieved from eProgesa at the time of DIS II).Results A total of 22,132 donors participated in both DIS I and DIS II. Of these donors, 22.5% (n=4,983) had stopped donating at the time of DIS II. Preliminary analyses show that donors who, in the period between DIS I and DIS II, were widowed, had a higher chance to stop donating compared to donors who were not widowed in the same time-frame (Exp(B)=2.18, 95%CI=(1.63,2.78), p<.000). Donors who married showed higher stopping risks compared to donors who remained unmarried (Exp(B)=1.29, 95%CI=(1.11,1.51), p=.001). Divorcing had no influence on donors’ stopping risk. Regarding labour market related events, results suggest that donors who lose their job or retire have a higher stopping risk than donors who stayed in their job (respectively Exp(B)=1.69, 95%CI=(1.42,2.01), p<.000; Exp(B)=3.08, 95%CI=(2.84,3.35), p<.000). Donors who found a job had lower stopping risks than donors who remained unemployed (Exp(B)=0.65, 95%CI=(0.50,0.85), p=.001).Conclusions Life events do seem to have an influence on blood donor behaviour. Widowhood, marriage, job loss, and retirement are all associated with a higher stopping risk, while getting a job reduces the risk of stopping. Further analyses will show if, and how, these (and other) life events impact donor frequency and donor motivations, and whether effect vary between donors form different socio-demographic groups.