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Christopher France, PhD, a Professor in the Department of Psychology at Ohio University, is studying ways to prevent reactions that keep first time blood donors from becoming repeat donors. by Craig Butler |
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Christopher France, PhD, is the Editor-in-Chief of the Journal of Behavioral Medicine and a professor of psychology at Ohio University. CAF spoke with him recently about this study. CAF: You are working on an NIH-funded grant to study "Prevention of adverse reactions in novice blood donors." Can you tell us a little about how you became interested in this area? France: I first became interested in this topic some 15 years ago when, as a donor myself, I observed young donors reacting and then expressing their concerns about returning again in the future. I am trained as a clinical health psychologist (with specific expertise in cardiovascular physiology as well as treatment of phobias and other anxiety disorders) and I knew that there were behavioral approaches that could help reduce reactions. So I began to do research that looks at various ways to help make the donation experience more pleasant. Can you tell us a little bit about this study? Why is it necessary, how is it set up, how long will it last, what do you hope to discover, etc. Severe and potentially dangerous shortages in the blood supply are common. This problem is expected to worsen as the population ages (increasing demand) and more and more stringent restrictions are placed on blood donor eligibility (decreasing supply). A crucial component of the effort to meet the increasing demand for blood is the ongoing recruitment of new donors. Ideally, new recruits would become lifelong donors, contributing up to six times per year and hundreds of units of blood in a lifetime. Unfortunately, less than half of all novice donors will ever provide a second donation. Because the experience of vasovagal reactions (e.g., dizziness, weakness, lightheadedness) is one of the strongest predictors of attrition in novice donors, prevention of such reactions may be a particularly efficient and enduring method of enhancing the nation’s blood supply. The long-term objective of our research is to provide blood collection agencies with simple and inexpensive strategies that can be used to prevent vasovagal reactions and enhance donor retention. The specific aim of the current grant is to evaluate the combined effects of two particularly promising vasovagal prevention strategies – acute water loading and applied muscle tension. We will compare vasovagal reactions to blood donation and repeat donation behavior in 400 first-time donors randomly assigned to either no intervention, water loading alone, or a combination of water loading and applied muscle tension. Participants will be recruited and tested at American Red Cross fixed and mobile blood donation clinics held in rural and urban settings. Vasovagal reactions will be measured using on-site donor and phlebotomist ratings as well as donor ratings obtained 24 hours later. Using the American Red Cross national donor database, subsequent donation history will be tracked during a two-year follow-up period. We hypothesize that participants in the active treatment groups will experience less adverse reactions and will be more likely to return to provide a new donation as compared to participants who provide a standard donation. The study will take five years to complete, including 2-3 years to recruit the donors and then two years to track follow-up donation behavior. From your previous experience, can you tell us what you think are some of the reasons that first time donors do not come back and become repeat donors? Our research has been focused on the experience of vasovagal reactions (e.g., dizziness, weakness, lightheadedness) as one of the strongest predictors of attrition in novice donors; however, there are certainly other reasons that donors do not return. For example, research has shown that donors report issues of "lack of convenient donation centers or blood drives" and "lack of time" as being important deterrents to giving blood again. Clearly, the best approach to encouraging repeat donation is to make each experience as pleasant as possible and then making it as easy and efficient as possible to give. How do you think blood collections facilities/agencies will be able to use the information gained from the study? The information that we are gathering is specifically designed to be easy to incorporate into the current blood donation process. In fact, we are currently working with blood collection agencies who have already incorporated these procedures with little difficulty. The purpose of this study is to show how effective the interventions are individually or in combination, and in so doing we hope to be able to convince more blood collection agencies of the benefit of including these approaches. Is there anything else you’d like to share about your work? I would note that a primary goal of our work is to let new donors, or those who have thought about giving blood but have shied away from the activity out of fear, know that there are lots of things that they can do to make the experience as pleasant as possible. For example, to help manage anxiety they can do various things to distract themselves (e.g., read a books or magazine, do a crossword puzzle, listen to music, etc.). And to help prevent feeling lightheaded during or after donation they can be sure to eat well the day of the donation, get a good night's sleep the night before, hydrate themselves with a 16 oz. beverage about 20-30 minutes before they get into a donation chair and learn about using a muscle tensing technique while in the donation chair. This combination of activities can help new donors cope with the experience better and increase their chance of having a satisfying experience that they want to repeat. Finally, I would encourage donors to remind themselves before, during, and after the donation that they are helping to save a life! CAF congratulates Dr. France on being awarded federal funding for this study and hope that its findings will ultimately lead to an increase in repeat blood donors. |
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