The relation between blood donor recruitment and donor diversity and loyalty in the Netherlands

Background and Objectives
Blood donor populations have been susceptible to change, often showing a trend towards feminization while remaining ethnically homogeneous, leading to an underrepresentation of young men and ethnic minorities. The aim of our study was to examine whether recruitment strategies are related to donor diversity and loyalty of specific demographic groups in the Netherlands.

Materials and Methods
Analyses were conducted using the Dutch blood donor database on whole‐blood donors registered between 2013 and 2017 (n = 155 054). Chi‐squared tests were used to study relationships between donor characteristics (i.e., sex, age, and Duffy‐negative antigen as proxy for donors from African descent) and recruitment strategies; linear and Cox regressions were used to study relationships between recruitment strategies, and number of donations and length of the donor career, respectively.

Results
Most donors were recruited via other donors (44·6%) or became donor on their own initiative (28·4%). Young men were often recruited by other donors and Duffy‐negative donors were often recruited via missing minorities campaigns. Donor‐recruits‐donor was associated with the highest number of donations; telephone recruitment was associated with the lowest number of donations. Although telephone recruitment was associated with the longest donor careers, it also showed the largest proportional stopping prevalence. Student recruitment and missing minorities campaigns were associated with the shortest donor careers.

Conclusion
Our results showed proportional differences in how people from different sex, age and ethnicity are recruited, and how recruitment relates to donor loyalty. We advocate for more personalized, evidence‐based recruitment and retention strategies.