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Although altruistic regular blood donors are vital for the blood supply, many become iron deficient from donation-induced iron loss. The effects of blood donation–induced iron deficiency on red cell transfusion quality or donor cognition are unknown. In this double-blind, randomized trial, adult iron-deficient blood donors (n = 79; ferritin < 15 μg/L and zinc protoporphyrin >60 μMol/mol heme) who met donation qualifications were enrolled. A first standard blood donation was followed by the gold-standard measure for red cell storage quality: a 51-chromium posttransfusion red cell recovery study. Donors were then randomized to intravenous iron repletion (1 g low-molecular-weight iron dextran) or placebo. A second donation ∼5 months later was followed by another recovery study. Primary outcome was the within-subject change in posttransfusion recovery. The primary outcome measure of an ancillary study reported here was the National Institutes of Health Toolbox–derived uncorrected standard Cognition Fluid Composite Score. Overall, 983 donors were screened; 110 were iron-deficient, and of these, 39 were randomized to iron repletion and 40 to placebo. Red cell storage quality was unchanged by iron repletion: mean change in posttransfusion recovery was 1.6% (95% confidence interval −0.5 to 3.8) and −0.4% (−2.0 to 1.2) with and without iron, respectively. Iron repletion did not affect any cognition or well-being measures. These data provide evidence that current criteria for blood donation preserve red cell transfusion quality for the recipient and protect adult donors from measurable effects of blood donation–induced iron deficiency on cognition. This trial was registered at www.clinicaltrials.gov as NCT02889133 and NCT02990559.

A greater understanding of young, first-time donor motivators and barriers is needed to address the ongoing challenge of retaining these essential donors.Structured interviews conducted with 508 young, first-time whole blood donors [66.1% female; Mean Age = 19.4 (SD = 2.5) years] were coded to identify reported motivators and barriers. Reported motivators and barriers were then examined for their association with attempted donation behavior over a 14-month follow-up, and for potential sex, race, and ethnic group differences in the frequency of endorsement.Prosocial motivation (e.g., altruism) was the most commonly reported motivator and fear (e.g., fainting, needles) was the most commonly reported barrier. Donation behavior was unrelated to reported motivators, but was significantly related to four reported barriers including fear of fainting/dizziness, fear of needles/pain, having personal commitments that conflict with donating, and perceiving oneself as unsuited to donate for health reasons. Sex, racial, and ethnic differences were noted with respect to the percentages of donors reporting several donation-related motivators and barriers.The present findings identify donation-related barriers that could be important targets to address in the effort to encourage new young donors and to retain these new donors for the long term. Importantly, these data also highlight the importance of considering individual differences in donor motivation as a function of sex, race, and ethnicity.

BACKGROUND: This study aimed to promote competence, autonomy, and relatedness among first-time whole blood donors to enhance intrinsic motivation and increase retention. STUDY DESIGN AND METHODS: Using a full factorial design, first-time donors (N=2,002) were randomly assigned to a no-treatment control condition or to one of seven intervention conditions designed to promote donation competence, autonomy, relatedness, a combination of two (e.g., competence and autonomy), or all three constructs. Participants completed donor motivation measures before the intervention and six weeks later, and subsequent donation attempts were assessed for one year. RESULTS: There was no significant group difference in the frequency of donation attempts or in the number of days to return. Significant effects of group were observed for 10 of the 12 motivation measures, although follow-up analyses revealed significant differences from the control group were restricted to interventions that included an autonomy component. Path analyses confirmed direct associations between interventions involving autonomy and donor motivation, and indirect mediation of donation attempts via stronger donation intentions and lower donation anxiety. CONCLUSION: Among young, first-time, whole blood donors, brief interventions that include support for donor autonomy were associated with direct effects on donor motivation and indirect, but small, effects on subsequent donation behavior.

Background With growing awareness of the prevalence of nonanemic iron deficiency among blood donors, there is a need to explore the extent of potential negative consequences. This study examined the relationship between various measures of iron status, blood donation history, and neuropsychological and psychosocial functioning in healthy young women. Study design and methods Using a cross-sectional design, 160 female undergraduates completed neuropsychology tests and measures of sleep, fatigue, quality of life, and depression before providing a blood sample. Correlational analyses examined the relationship between iron status (ferritin, iron, hemoglobin, and zinc protoporphyrin) and cognitive and psychosocial functioning. Performance on these measures was also examined as a function of recent blood donation history (zero, one, more than one donation in the past year). Results Iron status (low ferritin, iron, or hemoglobin or high zinc protoporphyrin) was not associated with poorer performance on the cognitive tasks. Further, participants who reported donating once in the previous year performed better, rather than worse, than those with no recent donation history on several measures of executive function, even when controlling for ferritin levels. Although there was some evidence of greater fatigue among those who had donated more than once in the past year, this effect was not accounted for by ferritin levels. Conclusion The present findings are consistent with prior evidence that nonanemic iron deficiency is not associated with cognitive impairment or psychosocial dysfunction in healthy young females. Because these results are based on cross-sectional evidence, further study using longitudinal research is needed to confirm these findings.

Background The potential for iron deficiency is a known blood donor health concern and suggests the need to inform donors about the potential risks of low iron levels as well as strategies to address these risks. Study design and methods Frequent (n = 904) and young (n = 629) donors were randomly assigned within risk group to either a control (n = 548) or an intervention (n = 985) group. The control group answered questions at baseline and 6-month follow-up regarding their awareness of the risk of donation-related iron depletion and whether they were taking actions to address their iron status. The intervention group answered the same questions at baseline and follow-up, but after completing the baseline survey, they received information regarding their risk of iron depletion and behaviors they could adopt to mitigate this risk. Intervention group participants were also offered the opportunity to develop an action plan to help them supplement their iron intake. Results The intervention enhanced overall awareness of donation-related iron loss (OR = 1.5, 95% CI 1.171-1.864, p = .001), with no negative impact on retention. Reported iron health behaviors (iron supplementation, speaking with a doctor) showed significant increases when action planning was paired with the educational information. Conclusion These findings suggest that it is possible to increase awareness of donation-related risk for iron depletion without negatively influencing retention, and combining education with encouragement to develop an action plan may increase the likelihood of both retention and behavioral changes to promote healthy iron levels.

BACKGROUND Elevated fear and anxiety regarding donation-related stimuli (e.g., needles, pain, blood, fainting) has been associated with reduced blood donor recruitment and retention. The present longitudinal study tests the notion that this inverse relationship may be accounted for by lower donation confidence and more negative donation attitudes among fearful first-time donors. STUDY DESIGN AND METHODS In a sample of 1479 first-time whole blood donors [67.9% female; mean age = 19.3 (standard deviation (SD) = 2.5) years], path analyses were conducted to examine relationships among donor ratings of fear of blood draw and donation anxiety obtained approximately 1 week after donation, donation confidence and attitudes assessed approximately 6 weeks later, and donation attempts over the 14 months following the original donation. RESULTS Path analyses indicated that both fear of blood draws and donation anxiety were associated with fewer attempted donations, and that these effects were indirectly mediated by a combination of lower donor confidence and more negative donation attitudes. CONCLUSION Because retention of new blood donors is essential to maintain a healthy blood supply, the results of the present study suggest that first-time donors should be assessed for fear and anxiety so that appropriate strategies can be provided to address their concerns, bolster their confidence and attitudes, and ultimately promote their long-term retention.

The Transfusion-Transmissible Infections Monitoring System (TTIMS) combines data from four US blood collection organizations including approximately 60% of all donations to monitor demographic and temporal trends in infectious disease markers and policy impacts.Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) consensus-positive definitions combined serology and nucleic acid testing results. These along with donor and donation characteristics were assembled into a single data set. Overall donation prevalence and demographic subsets were compared pre- and post-implementation of the 2015 change in men who have sex with men (MSM) deferral policy, among other prevalence comparisons.From October 2015 to September 2019, there were 712 HIV-, 1735 HBV-, and 5217 HCV-positive samples identified from approximately 27.5 million donations (9.4 million donors). Prevalences per 100 000 donations were 2.6 (HIV), 6.3 (HBV), and 19.0 (HCV), and the highest for all three agents were in donations from first-time male donors. Two slight but significant increases in HIV prevalence were observed, both for comparisons of Year 1 (pre-MSM policy change) versus Year 4 (post-MSM policy change) for first-time males and first-time females; in contrast, similar comparisons demonstrated decreases in HCV prevalence (all donors and general trends for males and females). Except for HIV, prevalence increased with age; for all agents, prevalence was markedly higher in the south.No major trends were observed over 4 years covering the MSM policy change from indefinite to a 12-month deferral, but ongoing monitoring is warranted. Demographic trends are consistent with those observed in other donor studies and community trends.

Background Interventions intended to motivate donors to return can be costly and time consuming. The current study examined the effect of a Web-based automated interview, informed by motivational interviewing and self-determination theory, on donor intention, motivation, and behavior in a sample of highly experienced donors. Study design and methods Approximately 1 week after donating, 1177 highly experienced whole blood donors (mean prior donations, 35.5; mean age, 46.9 years; 66.3% female) participated in a study in which they were randomly assigned to either a donor motivational interview (n = 544) or knowledge interview (n = 633). Measures of donor motivation and psychological need support were obtained before the interviews, and again at postinterview assessments conducted approximately 2 days later and 7 weeks later. Blood center records were used to assess repeat donation attempts for 1 year after the interviews. Results Relative to the knowledge interview, participants in the motivational interview had larger increases in donation intention and self-efficacy from preinterview to the first follow-up. Among women only, the motivational interview was associated with greater competence and relatedness increases at both follow-up assessments. Conclusion An automated motivational interview appears to be a feasible way to promote donation intention and self-efficacy. Although the observed effects were small among highly experienced donors, we are currently assessing the potential effect of this intervention among less experienced donors.

BACKGROUND Previous studies have reported a relationship between blood donation and decreased risk for cardiovascular events, and it has been proposed that this may be due to a lowering of blood pressure among hypertensive individuals who donate on a regular basis. STUDY DESIGN AND METHODS With the use of a retrospective longitudinal analysis, predonation blood pressure readings were examined across consecutive whole blood donations for New York Blood Center donors. With blood pressure levels recorded at the first, second, third, and fourth donations, the sample was divided into three subgroups including high (≥140 mmHg), intermediate (>100 and

BACKGROUND In contrast to standard donor retention strategies (e.g., mailings, phone calls, text messages), we developed a brief telephone interview, based on motivational interviewing principles, that encourages blood donors to reflect upon their unique motivators and barriers for giving. This study examined the effect of this motivational interview, combined with action and coping plan components, on blood donor motivations. STUDY DESIGN AND METHODS The design was to randomly assign blood donors to receive either a telephone-delivered motivational interview with action and coping plan components or a control call approximately 6 weeks after their most recent donation. Participants completed a series of surveys related to donation motivation approximately 3 weeks before telephone contact (precall baseline) and then repeated these surveys approximately 1 week after telephone contact (postcall). RESULTS The sample was 63% female, included a majority (52.6%) of first-time blood donors, and had a mean age of 30.0 years (SD, 11.7 years). A series of analyses of variance revealed that, relative to controls (n = 244), donors in the motivational interview group (n = 254) had significantly larger increases in motivational autonomy (p = 0.001), affective attitude (p = 0.004), self-efficacy (p = 0.03), anticipated regret (p = 0.001), and intention (p =

BACKGROUND: Babesiosis is a potentially life-threatening zoonotic infection most frequently caused by the intraerythrocytic parasite Babesia microti. The pathogen is usually tickborne, but may also be transfusion or vertically transmitted. Healthy persons, including blood donors, may be asymptomatic and unaware they are infected. Immunocompromised patients are at increased risk for symptomatic disease. STUDY DESIGN AND METHODS: All reported community-acquired babesiosis cases in New York from 2004 to 2015 were evaluated, enumerated, and characterized. All potential transfusion-transmitted babesiosis (TTB) cases reported through one or more of three public health surveillance systems were investigated to determine the likelihood of transfusion transmission. In addition, host-seeking ticks were actively collected in public parks and other likely sites of human exposure to B. microti. RESULTS: From 2004 to 2015, 3799 cases of babesiosis were found; 55 (1.4%) of these were linked to transfusion. The incidence of both community-acquired and TTB increased significantly during the 12-year study period. The geographic range of both ticks and tickborne infections also expanded. Among TTB cases, 95% of recipients had at least one risk factor for symptomatic disease. Implicated donors resided in five states, including in 10 New York counties. More than half of implicated donors resided in counties known to be B. microti endemic. CONCLUSION: The increasing incidence of TTB correlated with increases in community-acquired babesiosis and infection of ticks with B. microti. Surveillance of ticks and community-acquired cases may aid identification of emerging areas at risk for Babesia transfusion transmission.

BACKGROUND Increasing repeat blood donation behavior is a critical public health goal. According to self-determination theory, the process of developing internal motivation to give blood and an associated self-identity as a blood donor may be promoted by feelings of “relatedness” or a connection to other donors, which may be enhanced through social relations and interactions. OBJECTIVE The purpose of this report it to describe the development and pilot testing of a social networking-based (Facebook) intervention condition designed to increase feelings of relatedness via virtual social interaction and support. METHODS To develop the intervention condition content, images, text, polls, and video content were assembled. Ohio University college students (N=127) rated the content (82 images/text) presented by computer in random order using a scale of one to five on various dimensions of relatedness. Mean ratings were calculated and analyses of variance were conducted to assess associations among the dimensions. Based on these results, the relatedness intervention was adapted and evaluated for feasibility, acceptability, and preliminary efficacy among 24 first-time donors, aged 18 to 24 years, in a 30-day pilot trial. Paired t-tests were conducted to examine change over time in relatedness and connectedness. RESULTS The intervention condition that was developed was acceptable and feasible. Results of the uncontrolled, preintervention, and postintervention evaluation revealed that feelings of individual-level relatedness increased significantly after the intervention. CONCLUSIONS By promoting first-time blood donor relatedness, our goal is to enhance internal motivation for donating and the integration of the blood donor identity, thus increasing the likelihood of future repeat donation. CLINICALTRIAL ClinicalTrials.gov NCT02717338; https://clinicaltrials.gov/ct2/show/NCT02717338 (Archived by WebCite at http://www.webcitation.org/6ymHRBCwu)

BACKGROUND Based on the hypothesis that self-determined motivation is associated with an increased likelihood of future behavior, the present study examined the ability of a motivational interview to promote internal motivation for giving blood and future donation attempts. STUDY DESIGN AND METHODS A sample of 484 recent whole-blood and double red blood cell donors (62.4% female; age = 30.2 ± 11.8 years) were randomly assigned to either a telephone-delivered motivational interview or a control call approximately 6 weeks after donating. Several weeks before the call and again 1 week after the call, participants completed the Blood Donor Identity Survey, a multidimensional measure of donor motivation, to derive indices of amotivation, external motivation, and internal motivation to give blood. Repeat donation attempts were tracked using blood center records. RESULTS Relative to controls, participants in the motivational interview group showed a shift toward more self-determined motivation, as indicated by significant decreases in amotivation (p = 0.01) and significant increases in external (p = 0.009) and internal (p = 0.002) motivation. Furthermore, those with initially high levels of autonomous motivation were more likely to make a donation attempt in the subsequent year if they completed the motivational interview (71.1%) versus the control call (55.1%). CONCLUSION Motivational interviewing is a potentially useful strategy to enhance retention of existing blood donors, particularly among those who express a greater sense of internal motivation for giving.

Background Evidence indicates that donor identity is an important predictor of donation behavior; however, prior studies have relied on diverse, unidimensional measures with limited psychometric support. The goals of this study were to examine the application of self-determination theory to blood donor motivations and to develop and validate a related multidimensional measure of donor identity. Study Design and Methods Items were developed and administered electronically to a sample of New York Blood Center (NYBC) donors (n = 582) and then to a sample of Ohio University students (n = 1005). Following initial confirmatory factor analysis (CFA) on the NYBC sample to identify key items related to self-determination theory's six motivational factors, a revised survey was administered to the university sample to reexamine model fit and to assess survey reliability and validity. Results Consistent with self-determination theory, for both samples CFAs indicated that the best fit to the data was provided by a six-motivational-factor model, including amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic regulation. Conclusion The Blood Donor Identity Survey provides a psychometrically sound, multidimensional measure of donor motivations (ranging from unmotivated to donate to increasing levels of autonomous motivation to donate) that is suitable for nondonors as well as donors with varying levels of experience. Future research is needed to examine longitudinal changes in donor identity and its relationship to actual donation behavior.

Background The Theory of Planned Behavior has been widely used in blood donation research, but the lack of uniform, psychometrically sound measures makes it difficult to draw firm conclusions or compare results across studies. Accordingly, the goal of this study was to develop such measures of donation attitude, subjective norm, perceived behavioral control, and intention. Study Design and Methods Exploratory and confirmatory factor analyses (CFAs) were conducted on survey responses collected from college students (n = 1080). The resulting scales were then administered to an independent sample of experienced donors (n = 433) for additional CFAs and to test whether the Theory of Planned Behavior model provided a good fit to the data. Results CFAs conducted on both samples support the use of six-item scales, with two factors each, to measure donation attitude, subjective norm, and perceived behavioral control and a single-factor three-item scale to measure donation intention. Further, structural equation modeling of these measures revealed that the Theory of Planned Behavior provided a strong fit to the data (comparative fit index, 0.976; root mean square error of approximation, 0.041; standardized root mean square residual, 0.055) and accounted for 73.7% of the variance in donation intention. Conclusion The present findings confirm the applicability of the Theory of Planned Behavior to the blood donation context and more importantly provide psychometric support for the future use of four brief measures of donation attitude, subjective norm, perceived behavioral control, and intention.

Zika virus (ZIKV) is transmitted by Aedes mosquitos and can result in severe congenital and adult neurologic abnormalities. ZIKV has rapidly spread northward through Central America and the Caribbean and autochthonous cases have been identified in the continental United States. High rates of ZIKA RNA positivity were detected in blood donors during previous epidemics. ZIKV transmission by transfused blood from healthy donor components has been a growing concern.Individual-donation aliquots of plasma from volunteer blood donors were tested individually with an investigational Procleix ZIKV assay. Initially reactive samples were tested for ZIKV RNA in plasma and red blood cells (RBCs) and for ZIKV-specific antibodies in serum. A confirmed positive classification required confirmation of RNA and/or detection of ZIKV antibodies in index and/or follow-up samples.Between September 19 and November 30, 2016, a total of 466,834 donations were screened for ZIKV RNA. Five donors (one in approx. 93,000) were reactive for ZIKV RNA by both the Procleix ZIKV assay and supplemental testing. The donations were collected outside areas considered as having active transmission, and all five donors had travel exposures. A lookback case demonstrated no infection despite transfusion of a Zika IgG-positive platelet (PLT) component with probable low levels of ZIKV RNA.This report describes the first ZIKV-positive donors detected outside areas with active transmission. These donors most likely represent travel-acquired "tail-end infections" with prolonged RBC-associated ZIKV RNA. The lack of transmission to the recipient of an apheresis PLT may suggest that these units are not infectious.

The Blood Donor Competency, Autonomy, and Relatedness Enhancement (Blood Donor CARE) project was designed as a practical application of self-determination theory to encourage retention of first-time donors. Self-determination theory proposes that people are more likely to persist with behaviors that are internally-motivated, and that externally-motivated behavior can evolve and become internalized given the appropriate socio-environmental conditions. According to self-determination theory, motivation to engage in blood donation may become increasingly self-determined if the behavior satisfies fundamental human needs for competence (a sense of self-efficacy to achieve specific goals), autonomy (a sense of volitional control over one's behavior), and relatedness (a sense of connection to a larger group). The primary aim of this randomized controlled trial is to examine the effect of competence, autonomy, and/or relatedness interventions on donor retention. Using a full factorial design, first-time donors will be assigned to a control condition or one of seven intervention conditions. Donation competence, autonomy, and relatedness, along with additional constructs associated with return donation, will be assessed before and after the intervention using online surveys, and donation attempts will be tracked for one-year using blood center donor databases. We hypothesize that, compared to the control condition, the interventions will increase the likelihood of a subsequent donation attempt. We will also examine intervention-specific increases in competence, autonomy, and relatedness as potential mediators of enhanced donor retention. By promoting first-time donor competence, autonomy, and relatedness our goal is to enhance internal motivation for giving and in so doing increase the likelihood of future donation.

Previous studies have reported a relationship between blood donation and decreased risk for cardiovascular events, and it has been proposed that this may be due to a lowering of blood pressure among hypertensive individuals who donate on a regular basis.With the use of a retrospective longitudinal analysis, predonation blood pressure readings were examined across consecutive whole blood donations for New York Blood Center donors. With blood pressure levels recorded at the first, second, third, and fourth donations, the sample was divided into three subgroups including high (≥140 mmHg), intermediate (100 and40 mmHg), and low (≤100 mmHg) systolic blood pressure (SBP). In addition, a computational approach was used to estimate regression to the mean effects for donors with high SBP or high diastolic blood pressure (DBP) at their first, second, or third donation.Visual examination of SBP and DBP patterns across donations revealed that, on average, donors with extreme values at one donation had relatively normal values at the other donations. Further, comparison of computed expected versus observed blood pressure decreases supported the notion of a subsequent regression to the mean among donors with elevated SBP or DBP at Donation 1, 2, or 3.Among individuals who are hypertensive at initial donation, reductions in blood pressure at subsequent donations appear to result from regression to the mean as opposed to a salutary physiologic process.

The frequency of positive test results for transfusion-transmitted infections (TTIs) among blood donors is an important index of safety; thus, appropriate monitoring is critical, particularly when there are changes in policies affecting donor suitability.Testing algorithms from three large blood systems were reviewed and consensus definitions for a surveillance-positive result for hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and human T-cell lymphotropic virus (HTLV) established. In addition, information on each donation, including donor demographics and location, was collected. Combined data were analyzed to characterize the epidemiology of TTIs by person, place, and time.Data from 14.8 million donations were collected for 2011 to 2012, representing more than 50% of the US blood supply. Surveillance-positive rates per 10,000 donations were as follows: HBV, 0.76; HCV, 2.0; HIV, 0.28; and HTLV 0.34. Rates did not vary between the 2 years, although there was variation within a year. With the exception of HTLV, rates were higher among males, and all rates were higher among first-time donations. Window-period donations (those positive only in nucleic acid tests) were infrequent (HBV, 13; HCV, 60; HIV, 14) during the 2-year period. Frequencies of surveillance-positive results varied by donor age and residence location.We demonstrated that standardized data from multiple major US blood systems can be combined and analyzed for change. However, TTI frequencies are low, impacting their sensitivity to change. Furthermore, observed fluctuations in TTI frequencies may be secondary to changes in blood donor demographics rather than necessarily reflecting the immediate impact of policy modification.

Background: Increasing repeat blood donation behavior is a critical public health goal. According to self-determination theory, the process of developing internal motivation to give blood and an associated self-identity as a blood donor may be promoted by feelings of “relatedness” or a connection to other donors, which may be enhanced through social relations and interactions. Objective: The purpose of this report it to describe the development and pilot testing of a social networking-based (Facebook) intervention condition designed to increase feelings of relatedness via virtual social interaction and support. Methods: To develop the intervention condition content, images, text, polls, and video content were assembled. Ohio University college students (N=127) rated the content (82 images/text) presented by computer in random order using a scale of one to five on various dimensions of relatedness. Mean ratings were calculated and analyses of variance were conducted to assess associations among the dimensions. Based on these results, the relatedness intervention was adapted and evaluated for feasibility, acceptability, and preliminary efficacy among 24 first-time donors, aged 18 to 24 years, in a 30-day pilot trial. Paired t-tests were conducted to examine change over time in relatedness and connectedness. Results: The intervention condition that was developed was acceptable and feasible. Results of the uncontrolled, preintervention, and postintervention evaluation revealed that feelings of individual-level relatedness increased significantly after the intervention. Conclusions: By promoting first-time blood donor relatedness, our goal is to enhance internal motivation for donating and the integration of the blood donor identity, thus increasing the likelihood of future repeat donation. Trial Registration: ClinicalTrials.gov NCT02717338; https://clinicaltrials.gov/ct2/show/NCT02717338 (Archived by WebCite at http://www.webcitation.org/6ymHRBCwu)

First-time blood donors are essential to the US donor pool, providing nearly a third of all donations. Unfortunately, there are a wide variety of obstacles to repeat donation and new donors are extremely difficult to retain. Because each donor experiences a unique set of deterrents, we developed a post-donation interview based on motivational interview principles in order to flexibly address individual barriers. The primary aim of this randomized clinical trial is to examine retention of first-time, group O blood donors who are randomly assigned to receive either a telephone-delivered interview with motivational and action planning components or a standard-of-care control call approximately six weeks after their donation. Measures of donation attitude, perceived behavioral control, intention, and motivational autonomy will be measured before and after the telephone contact using online surveys, and donation attempts will be tracked for one year using blood center donor databases. We hypothesize that, compared to controls, donors who receive the telephone interview will be more likely to make a donation attempt over the following year. In addition, we will examine possible mechanisms of action of the interview using key predictors of donation behavior as described by Self Determination Theory (i.e., motivational autonomy) and the Theory of Planned Behavior (i.e., attitude, perceived behavioral control, and intention). Results of this intervention may help to support a novel strategy to enhance retention of selected blood donors in an effort to better meet the nation's blood supply needs.

Individuals with sickle cell disease (SCD), thalassemia, and leukemia often require frequent transfusion and run the risk of red blood cell (RBC) alloimmunization. To prevent alloimmunization or when alloimmunization is present, phenotype-matched and antigen-negative RBCs are transfused. To increase the probability of a phenotypic match, donors and recipients should share the same racial and/or ethnic background. Because the majority of patients with SCD are of African and Hispanic or Latino descent, a donor base of racial and ethnic minority donors providing an adequate supply of antigen-negative RBC units that can be phenotypically matched is required to meet the needs of frequently transfused patients.The New York Blood Center began the PreciseMatch program in 2005 to increase donations among African American and Hispanic/Latino donors by 150 incremental units per month. To evaluate the program, we conducted a systematic analysis of program documentation, focus group results, and collections data by race and ethnicity over time.The program achieved 75% of the operationalized goal of a 150-unit-per-month increase; 75% of donors were first-time donors, with deferral rates at new drives as high as 50%. Significant time and effort was involved in cultivating the community connections that facilitated new drives.Although PreciseMatch fell short of targets, it served as a foundation for relationships with diverse communities. Further research is needed to understand better how to increase minority donation using existing infrastructure and in the face of market pressures to collect blood as efficiently as possible.

Emergency admission of a previously healthy child to a pediatric intensive care unit for a sudden critical illness or trauma is extremely stressful for the child and parents. Although nurses expect parents to be highly anxious, this study shows that parental anxiety levels are higher than expected, reaching near-panic levels initially. This article suggests ways nurses can adapt their family strategies to take into consideration parents' potential difficulties concentrating or even asking questions.

Evidence indicates that donor identity is an important predictor of donation behavior; however, prior studies have relied on diverse, unidimensional measures with limited psychometric support. The goals of this study were to examine the application of self-determination theory to blood donor motivations and to develop and validate a related multidimensional measure of donor identity.Items were developed and administered electronically to a sample of New York Blood Center (NYBC) donors (n=582) and then to a sample of Ohio University students (n=1005). Following initial confirmatory factor analysis (CFA) on the NYBC sample to identify key items related to self-determination theory's six motivational factors, a revised survey was administered to the university sample to reexamine model fit and to assess survey reliability and validity.Consistent with self-determination theory, for both samples CFAs indicated that the best fit to the data was provided by a six-motivational-factor model, including amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic regulation.The Blood Donor Identity Survey provides a psychometrically sound, multidimensional measure of donor motivations (ranging from unmotivated to donate to increasing levels of autonomous motivation to donate) that is suitable for nondonors as well as donors with varying levels of experience. Future research is needed to examine longitudinal changes in donor identity and its relationship to actual donation behavior.

Summary.-For two weeks of an introductory psychology course, covering two chapters OF the text, students who were earning a grade of C or below were randomly divided into two groups. A quiz-only control group of 29 students continued to take weekly quizzes throughout the semester, and 27 students who carried out active learning exercises instead of taking the two quizzes. The latter reported that they worked longer than the controls, thought the material was easier, and liked chapters in the cext better. When tested a month later they performed as well as the controls on a test of he chapter's material. Lectures are commonly used by instructors to cover a large amount of material, and the lecture is often followed by easily scored multiple-choice tests. There are, however, several questions concerning this approach which may not encourage long-term retention of the material and may be uninteresting or unmotivating for many students. Proponents of active learning approaches to college teaching (Meyers &Jones, 1993) have argued that the procedure encourages "deeper" processing and is more interesting, but there are not many empirical studies of such effects. To see whether students who were not performing well in a college course would work more, show greater interest, and have more positive attitudes were they given active learning exercises instead of quizzes were the purposes of this work. In a pilot study, half the students in a large lecture course in introductory psychology were assigned active learning exercises which they &d instead of taking weekly quizzes on two chapters, while the other hat£ took weekly quizzes as they had throughout the semester. Later when students were asked to estimate how long they had worked on each chapter and how much they hked each, no significant differences were noted. Examination of the data indicated that many students in the control group were workmg hard enough and hked the material well enough that little significant improvement was possible, but the students who were earning a grade of C or less in the course had room for improvement. We refocused the study of the

West Nile virus (WNV), a single-stranded RNA flavivirus, is primarily spread by the mosquito Aedes albopictus. The only screening test used for WNV is nucleic acid testing (NAT), although IgG and IgM antibody testing may be used for donor counseling. Many donors have low viral copy numbers of circulating WNV, which result in false negative testing by Mini Pool (MP) NAT but can be identified by individual (ID) NAT testing. Switching from MP to ID is typically performed during the mosquito season, from around April through December, which encompasses the earliest and latest known positive donations.

Screening donated blood for human immunodeficiency virus (HIV) is a critical part of maintaining a safe blood supply. There has been an evolution in the efficacy of the testing models used since the introduction of testing in 1985. While HIV is not the most common infection found in donated blood, it is, perhaps, the most serious and is likely to be severely distressing to a donor. Therefore fairly extensive and supportive counseling must be available. Additionally, false reactive screening results must be communicated to donors as well as the possibility of re-entry testing.

Testing blood donors for syphilis, HTLV, and Trypanosoma cruzi (T. cruzi) infection, is mandated by the FDA, though the benefit of testing remains unclear. Syphilis was the first transfusion-transmitted disease for which the blood supply was screened in the US. Human T-cell Lymphotropic Virus (HTLV) is a retrovirus that can be transmitted by transfusion, and donor testing has mitigated the risk since put into place in 1988. Transfusion-transmitted Chagas' disease, which is caused by T. cruzi , has rarely been reported.

HCV is a parenterally transmitted RNA flavivirus, distinguished by a low rate of recognized acute infection and a high rate of chronic infection that results in substantial morbidity and mortality over long periods of observation. Since most infections are asymptomatic, testing the blood supply is critical.

In the US, approximately 15 million units of whole blood are collected each year (~70 million worldwide) from approximately 10 million donors. The blood is processed into blood components (RBCs, platelets, plasma, and cryoprecipitate) and used in the treatment of surgical, obstetric, medical and other patients. The blood donation process is: 1) overseen by a licensed, qualified physician, 2) regulated by the FDA, and 3) designed to provide protection for both the blood donor and the transfusion recipient by ensuring appropriate donor eligibility, donation procedures, and testing.

HBV is a DNA virus from the family Hepadnaviridae. It is transmitted parenterally, sexually, and perinatally. In the US, the estimated risk of TT-HBV is 1 in 250,000 to 488,000. In addition to the donor history questionnaire to eliminate high risk donors, each donation is tested for HBsAg, anti-HBc and HBV NAT. Donors may be permanently deferred if confirmed positive or temporarily deferred based on various testing scenarios.

Chagas disease is a parasitic infection by Trypanosoma cruzi, typically transmitted via infected triatomine bug fecal contamination of bite sites. Other routes of infection include congenital, oral, organ transplantation, and blood product transmission.From 2007 until 2011, New York Blood Center screened donations for the presence of T. cruzi antibodies using a Food and Drug Administration-approved test. Confirmatory testing was performed and recipients of units donated by confirmed-positive donors were investigated via lookback.A total of 204 donors were T. cruzi antibody positive representing 0.019% of all donors during this time period (1,066,516 unique donors screened). Of the enzyme-linked immunosorbent assay-reactive donors, 77 were confirmed positive by radioimmunoprecipitation assay (0.007%). At least 154 units from 29 of the confirmed-positive donors had been transfused to 141 recipients. At the time of lookback, 48 of the 141 recipients were alive and seven underwent T. cruzi screening. Two recipients were found to be immunofluorescence assay (IFA) positive. Both IFA-positive recipients received a leukoreduced apheresis platelet unit (two separate donations) from the same confirmed positive donor, a 72-year-old immigrant from Argentina.Lookback analysis was able to identify the first two cases of probable transfusion-transmitted T. cruzi infection since implementation of the national screening program, which increases the total number of reported cases in the United States to 8.

Blood centers have implemented public health initiatives, including cardiovascular disease (CVD) screening, to improve donor and community health and serve as an incentive to donate.CVD risk screening and counseling were performed at mobile blood drives in diverse neighborhoods. Risk factors were determined by point-of-care testing (total cholesterol, high-density lipoprotein, and hemoglobin A1c levels), interviews, and physical examinations (body mass index, waist circumference, and blood pressure). Results were confidentially relayed to participant by health counselors. A 60-day follow-up survey was sent to some participants.Over 11 months, 2406 participants (44% male; mean age 28 ± 16; 67% minority racial/ethnic group) were screened at 290 mobile drives. A total of 92% of participants had medical insurance. A total of 14% had none, 26% one, 33% two, and 27% three or more risk factors. A total of 72% of teenage participants had at least one risk factor. A total of 18% of participants who were taking medications for risks were poorly controlled. A total of 15% had newly identified risks. A total of 711 participants completed follow-up survey: 21% sought medical care, 51% were motivated to change their lifestyle, 81% were pleased with screening, 48% were more likely to donate, and 62% recommended donation to friends and family because of the screening.CVD risk screening and counseling can occur during a mobile blood drive. A majority of participants screened had risk factors. Follow-up surveys showed that the program was well received. Further studies are planned to evaluate long-term effects of the program on donor health and donor return rates.