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Blood Donation Across The Life Course: �Influence Of Life Events on Donor Lapse

KUP Mohd Noor Azlan Sariman

Unit Kutipan Darah

22/08/2023

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Introduction

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Prosocial behavior

Defined as the desire to benefit others rather than oneself. �Evolves over time as a result of life circumstances.
About 20,000 Dutch donors, or 5% of the total number of donors, stop giving blood every year for reasons other than health problems (Klinkenberg et al., 2018).

Time constraints and decreased social interactions are strongly linked to life events such as childbirth and changing jobs (Piersma et al., 2017)

Having young children �(Einolf.,2018; �Nesbit et al., 2012)

Work related event (Lancee et al., 2014; Oesterle et al., 2004)

The purpose of prosocial behavior is to benefit the community, not merely oneself. For instance, unpaid labor, charitable donations, and organ and blood donations.
Change also occurs throughout the life span as a result of life events.
every year, 5% of the Dutch donor population (approximately 20,000 donors) withdraw from the donor pool due to non medical reasons
Previous research demonstrated that having small children is typically a barrier to volunteering, while work-related events have a less significant impact on volunteering, although both full-time employment and job loss were found to diminish volunteer rates among men.
Furthermore, previous donor studies have shown that nonmedical, self-reported reasons to stop donating blood, such as time constraints and decreased social connections, are significantly related to life events such as childbirth and changing jobs.
The main problem with these studies is that they mostly used cross-sectional data, which measures donation behavior and intentions at one point in time. This ignores the fact that people and their behavior can change over time.
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Introduction cont..

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According Wilson and Musick (1997) the theory of volunteering that life events affecting prosocial behavior are the result of changes in human capital (time availability, health conditions) and social capital (social connections).

Human capital: collection of people's individual assets or resources that enable certain behaviors.

Those with more money, time, and health resources are more likely to donate blood than those with fewer resources. (Wilson and Musick, 2008)

Social capital: set of people's social connections within their social network and the behavioral norms that emerge from them.

When donors are exposed to blood donation norms, such as talking about blood donation and knowing other blood donors, they may become regular donors to avoid the higher cost of not complying with these norms.

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Objectives

To determine if changes in the work and family domains, as well as health-related life events in the family, influence blood donation over the life span.
To investigate whether life events affect blood donor lapse and to what extent changes in available time, health, and social connections explain these effects.

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HYPOTHESIS

Changes In Health Of Family Member

Hypothesis 1a: Donors who experienced a health-related event in the family are more likely to lapse compared to donors who did not experience a health-related event in the family.

Hypothesis 1b: After experiencing a health-related event in the family, donors find it more difficult to plan a donation, explaining why these donors are more likely to lapse.

Hypothesis 2a: Donors who experienced a health-related event in the family are less likely to lapse compared to donors who did not experience a health-related event in the family.

Hypothesis 2b: After experiencing a health-related event in the family, donors talk about donation more often and know more other donors, explaining why these donors are less likely to lapse.

Childbirth

Hypothesis 3a: Donors who experienced childbirth are more likely to lapse compared to donors who did not experience childbirth.

Hypothesis 3b: After childbirth, donors find it more difficult to plan a donation and perceive themselves to be less healthy, explaining why these donors are more likely to lapse.

Hypothesis 3c: Childbirth has a larger effect on

the lapsing risk in women than men.

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Hypothesis cont..

Labour Market Transitions

Hypothesis 4a: Donors who started a job or lost their job are more likely to lapse compared to donors who remained unemployed or kept their job, respectively.

Hypothesis 4b: After starting a job, donors have

a higher number of working hours and find it

more difficult to plan a donation, explaining why

these donors are more likely to lapse.

Hypothesis 4c: After losing a job, donors perceive themselves to be less healthy, talk about blood donation less often, and know fewer other donors, explaining why these donors are more likely to lapse

Hypothesis 5a: Donors who started a job or lost their job are less likely to lapse compared to donors who remained unemployed or kept their job, respectively.

Hypothesis 5b: After losing a job, donors have a lower number of working hours and find it less difficult to plan a donation, explaining why these donors are less likely to lapse.

Hypothesis 5c: After starting a job, donors talk about blood donation more often and know more other donors, explaining why these donors are less likely to lapse.

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Data & Methods

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Database: Dutch blood donor database & two waves of the Donor InSight study, with a total of 20,560 blood donors.�

Statistical analyses:

Logistic regression analyses using Stata 15 (College Station, TX: StataCorp LLC).

Estimate the effect of life events (health- related events in family, childbirth and labor market transitions) on blood donor lapse, adjusted for sociodemographic variables.
Examine the interaction between donor gender and childbirth to determine if it impacts blood donor lapse differently in men and women.
Mediation analyses: To determine the extent to which blood donation costs and social network influences may shed light on the impact of life events on blood donor lapse.

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Results

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Life Events & Dutch Donors

x̄ age= 46.7 years, SD=12.28.
♀ = 52.8%(10,854) , ♂ = 47.2% (9,706)
25.3% (5,197 donors) lapsed during the 24 months after DIS-II
Health related events were reported the most often, followed by childbirth, losing a job and starting a job.
Total of 58.5% �(12, 036) of blood donors experienced one life event of interest.

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Results cont..

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Changes in health of family member
Donors who experienced a blood transfusion in family members had 13% lower odds (OR [95% CI] =.87 [.78,.98], p<0.05). Accept Hypothesis 2a while rejecting Hypothesis 1. Donors who lost a family member had 10% lower odds of lapse (OR [95% CI] =.90 [.83,.98], p<0.05). Accept Hypothesis 2a. No significant relationship was found between talking about donation or knowing more donors and blood transfusions in a family member, serious disease, or the death of the family member. Reject Hypothesis 2b

Childbirth
Donors who had childbirth had 83% higher odds (OR [95% CI] =1.83 [1.63, 2.00], p<0.001). Accept Hypothesis 3a. Childbirth is related to perceiving difficulty planning donation, and childbirth is significantly related to blood donor lapse (OR [95% CI] = 1.8 [1.74, 1.89], p<0.001). Accept Hypothesis 3b. There is no discernible gender difference in lapsing. Reject Hypothesis 3c.

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Results cont..

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Labour market transitions (starting a job)
Donors who start a job have 34% higher odds of lapsing than donors who remain unemployed in the same period. OR [95% CI] = 1.34 [1.02, 1.77], p˂0.05). Accept Hypothesis 4a and reject hypothesis 5a Significant relationship between starting a job with perceived difficulty in planning donations and its relationship with donor lapse OR [95% CI] = 1.56 [1.37, 1.76], p<0.001). Reject Hypothesis 5b Positive relationship between starting a job & increasing working hours, �which is also related to donor lapse. OR [95% CI] = 1.02 [1.01, 1.04], p<0.05). Donors losing a job have 50% higher odds of lapsing than keeping a job �in the same period. OR [95% CI] = 1.50 [1.25, 1.80], p<0.001) Losing a job is significantly related to: decrease perceived health status:�OR [95% CI] = 1.45 [1.25, 1.67], p<0.001). talking less about donations:�OR [95% CI] = 0.79 [0.65, 0.97], p<0.05). knowing fewer others donors:�OR [95% CI] = 0.74 [0.62, 0.89], p<0.01).

Accept Hypothesis 4c

� Hypothesis 4b

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Conclusion

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From Human Capital & Resources Perspective

The continuation of blood donation depends on the availability of time.��The donor's lapse is unaffected by gender after childbirth.��Starting a job has a detrimental influence on blood donation.

Social Capital & Network Perspective

Social pressure and workplace standards are less powerful influences on blood donation than peer pressure from friends and family.��Short- and long-term effects on life events may vary from person to person.

Health Related Events Perspective

Donors who had a blood transfusion or had a family member die were marginally more likely to continue donating.

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Lapsed Donor in PDN

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Year	New Donor	Regular Donor	Lapsed Donor	Total Donor	Percentage
2019	63,861	110,050	25,811	199,722	12.92%
2020	38,374	107,791	24,941	171,106	14.58%
2021	33,769	118,205	22,898	174,872	13.09%
2022	42,461	128,827	32,530	203,818	15.96%

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PDN intervention to maintain regular donor

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UKD was responsible for calling 200 whole blood donors daily.
Registration Unit tasked to SMS all donors for donation reminders
Unit Pendidikan posts blood donation locations daily on Facebook, �Instagram, Twitter, and Telegram.
PRO canvassing through electronic media and influencing virtual netizens
PRO unit educating public on regular donation, hashtag #pendermakonsisten
Annually celebrating whole blood donor day on June 14.
The Donor Bring Donor campaign.
Collaborated with Jasmine Company to provide donors with tokens of gratitude.
Initiates a static donation suite in high-traffic public areas such as Mid Valley Megamall, One Utama, and Putrajaya,
Ensuring donor satisfaction with a comfortable environment, excellent refreshments, parking, Wifi, and welcoming and skilled personnel.

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References

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Einolf, C. J. (2018). Parents’ Charitable Giving and Volunteering: Are They Influenced by Their Children’s Ages and Life Transitions? Evidence From a Longitudinal Study in the United States. Nonprofit and Voluntary Sector Quarterly, 47(2), 395–416. https://doi.org/10.1177/0899764017737870

Klinkenberg, E. F., Romeijn, B., de Kort, W. L., & Merz, E.-M. (2018). Reasons to end the donor career: a quantitative study among stopped blood donors in the Netherlands. Transfusion Medicine, 28(3), 200–207. https://doi.org/10.1111/tme.12442

Lancee, B., & Radl, J. (2014). Volunteering over the Life Course. Social Forces, 93(2), 833–862. https://doi.org/10.1093/sf/sou090

Musick, M. A., & Wilson, J. (2003). Volunteering and depression: the role of psychological and social resources in different age groups. Social Science & Medicine, 56(2), 259–269. https://doi.org/10.1016/S0277-9536(02)00025-4

Nesbit, R. (2012). The Influence of Major Life Cycle Events on Volunteering. Nonprofit and Voluntary Sector Quarterly, 41(6), 1153–1174. https://doi.org/10.1177/0899764011429181

Oesterle, S., Johnson, M. K., & Mortimer, J. T. (2004). Volunteerism during the Transition to Adulthood: A Life Course Perspective. Social Forces, 82(3), 1123–1149. https://doi.org/10.1353/sof.2004.0049

Piersma, T. W., Bekkers, R., Klinkenberg, E. F., De Kort, W. L. A. M., & Merz, E.-M. (2017). Individual, contextual and network characteristics of blood donors and non-donors: a systematic review of recent literature. Blood Transfusion = Trasfusione Del Sangue, 15(5), 382–397. https://doi.org/10.2450/2017.0064-17

Wilson, J., & Musick, M. (1997). Who Cares? Toward an Integrated Theory of Volunteer Work. American Sociological Review, 62(5), 694. https://doi.org/10.2307/2657355