Using multimedia blood donation education materials to enhance individual readiness to donate blood and increase donation behaviors .

To date, the theory of planned behavior (TPB) and expanded constructs such as self-efficacy and anticipated regret are most commonly applied to understanding blood donation behavior. However, the TPB model appears more useful for focusing on single, isolated acts rather than a developmental decision making process. Researchers have begun to apply the transtheoretical model of behavior change (TTM) to conceptualize blood donation behavior and the associated decision-making process. The present study chose to use expanded TPB constructs and the TTM to evaluate the effectiveness of a multi-module blood donation recruitment video (initially utilized by France and colleagues in 2011) as a function of participant stage of change. Given evidence that participants in Action/Maintenance may be motivated differently in their decisions to donate blood, individuals in these stages were excluded. Participants in the Precontemplation, Contemplation, and Preparation stages were randomly assigned to one of three conditions: a study condition involving two of the intervention video modules, a study condition involving all four of the video modules (testimonials, donor concerns, coping strategies for donation, and vignette of donation process), or a control stress management video. Responses to pre- and post-video questionnaires by participants were assessed to determine changes in donation-related attitude, anxiety, self-efficacy, subjective norm, decisional balance, use of processes of change, and donation intention. In addition, donation sign-ups post-intervention and blood drive attendance 30-days after intervention was assessed as a function of stage of change and study condition. Results demonstrated that participants who viewed the four module video, regardless of stage of change, reported the highest increase in blood donation self-efficacy, attitude, intention, and decisional balance-pros whereas emphasis on the cons of donating demonstrated the greatest reduction after viewing the two module video compared to the other conditions. Changes in donation-related anxiety were more complex, with all participants in Preparation reporting an increase in anxiety, but those who viewed the two and four module intervention videos reported less of an increase in anxiety. In regard to blood donation behavior, participants in Preparation stage of change signed up to donate blood post-intervention at the highest rate and reported the highest blood drive attendance at follow-up compared to participants in the other two stages of change. Overall, this study demonstrated that video-based donor educational materials can enhance blood donation attitudes, self-efficacy, and intention, and shift focus of pros and cons of blood donation in a direction that influences increased motivation to donate. Positive change in self-efficacy, in particular, may be especially important in directly affecting intention to donate and predicting future donation attempts. However, the present study also provided mixed evidence that an individual's stage of change will differentially affect their response to blood donation interventions. Changes in anxiety observed among participants in Preparation provide some support for the notion that specific interventions may help attenuate anxiety reactions. Further research is necessary to better understand the potential for tailoring anxiety interventions for those who are seriously considering donating blood. Better understanding of TTM constructs as they apply to the blood donation decision process, how they can inform more effective interventions, and how they may be combined with additional theories such as the health action process approach, may further strengthen the positive influence of blood donor recruitment materials.