ISBT Science Series (2021) 16, 60–67

© 2020 International Society of Blood Transfusion

ORIGINAL ARTICLE DOI: 10.1111/voxs.12583

Influence of peer-derived donor recruitment on the youth

perception on blood donation among college students
Arwa Z. Al-Riyami,1,2 Munther Draz,3 Fatma Al-Haddadi,3 Aisha Al-Kabi,3 Abdullah AlManthari,3
Sathiya Murthi Panchatcharam2 & Hilal Al-Sabti2
1
Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
2
Oman Medical Specialty Board, Muscat, Oman
3
College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman

Abstract
Background Donor recruitment and retention pose an ongoing challenge to the
blood banks. One approach to improve the effectiveness of recruitment strategies
is to target influencing factors. A league is conducted yearly at the Sultan
Qaboos University (SQU) to encourage blood donation. This study aims at assess-
ing the youth perception towards blood donation at SQU and non-SQU students.
Study design and methods A comprehensive voluntary survey was developed to
assess perception of students attending SQU and non-SQU colleges. Student
demographics, donation experience and factors influencing donation decisions
were assessed. The analysis was performed using IBM SPSS Statistics 22.0. A
total of 600 college students filled the survey (43
5%; n = 261 males, 56
5%,
n = 339 females). Half of the surveyed college students believed they have
enough knowledge on blood donation. SQU students reported greater influence
of peers (84% vs. 60
7%, P < 0
001), personal knowledge (82
3% vs. 74
7%,
P = 0
029) and personal experiences (79
3% vs. 69%, P = 0
005). They also
reported more commitment to the society (90
3% vs. 78%, P < 0
001) and altru-
ism (89
3% vs. 71%, P < 0
001). SQU students reported lower rates of fear from
needles (18% vs. 32%, P < 0
001) and from seeing blood (15
7% vs. 29
3%,
P < 0
001).
Conclusion Sultan Qaboos University students reported higher rates of motivating
and lower rates of discouraging factors towards blood donation. These results
highlighted the positive impact and important role of the youth in promoting
Received: 27 June 2020,
blood donations among themselves. Distinct promotion strategies should be
revised 11 September 2020,
accepted 21 September 2020,
adopted to increase blood donation among the youth.
published online 23 October 2020 Key words: altruism, donor perception, Oman, youth.

for new blood donors because of increasing demands

Introduction
whereas the blood supply is declining. Motivation and
In many countries worldwide, blood banks and transfusion recruitment of first-time donors remain a daily challenge.
services struggle with maintaining a sufficient blood donor Moreover, there is a decrease in the number of eligible
pool to meet existing demands. There is a continuous need donors due to the stricter rules and enhanced screening for
transfusion-transmitted infections. Therefore, the develop-
ment of strategies to recruit first-time donors is crucial. In
Correspondence: Arwa Z. Al-Riyami, Department of Hematology, Sultan
particular, the recruitment of young donors is especially
Qaboos University Hospital, Muscat, Oman. P.B box; 38, Al Khod, Postal
code 123
important since they generally have good health. Different
E-mails: [email protected]; [email protected] strategies exist to motivate individuals to donate blood for

60
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Youth perception on blood donation 61

the first time and to retain them as active blood donors, each college. The different activities to raise awareness
including personal communication, advertisement via are scored by an independent group of students and the
radio, television (TV), newspaper, posters, other educational representative from the blood bank. Colleges qualified to
materials and online media [1, 2]. It is important to know the final stage of the league championship compete for
and understand what motivating factors encourage people the top three positions. The league ends with a closing
to donate blood to help institutions involved in donor pro- ceremony that announces the winners. This extra-curricu-
motion, recruitment and retention to better understand lar activity is conducted on a yearly basis and is the only
which aspects to focus on in promoting blood donation one of its kind among the universities and colleges in the
[3]. Several factors play a role in the recruitment and the Sultanate of Oman. The colleges that won the first, sec-
willingness of the people to donate blood. Altruism is the ond and third positions in the league in the last years are
major and the most commonly reported reason that moti- summarized in Table S1.
vates one to donate and to continue as an active blood There are no studies to assess perception towards blood
donor [4, 5]. Yet, for first-time donors, direct influence donation among the Omani youth. This study aims at
from friends, peers and relatives is reported to be an assessing the perception towards blood donation among
important motive and has been found to be one of the SQU and non-SQU college students.
main reasons of the first-time donation [6].
A league was initiated at the Sultan Qaboos University
Methods
(SQU) in Muscat, Oman in 2015 with the aim of knowl-
edge dissemination on blood donation and recruiting col-
Design of the survey
lege students, faculty and the public to donate blood at
the SQU Hospital (SQUH) blood bank. During the league A self-administered survey was designed to assess factors
period, nine colleges are enrolled in a competition over a that could affect the perception towards blood donation
2-month period. Each college nominates three student among college students. The survey included six sections
ambassadors to run the blood donation activities in the (Table S2). The first section covered the socio-demo-
college and to recruit blood donors. During the league graphic characteristics of the enrolled student, such as
period, the student set up educational booths in the col- age, gender and year of study. Participants above the age
leges to educate the students and faculty on different of 40 were excluded. The second section included ques-
topics including blood donation eligibility criteria, tempo- tions on blood donation experience. The third section
rary and permanent causes of donor deferral, patients in included questions assessing the participant’s perception
need of blood support, and selection of blood components of self-knowledge on blood donation, while the fourth
based on the ABO blood group system. The students are section assessed the influence of social media. The fifth
given the freedom to select other activities to conduct, and sixth sections focused on the motivating and discour-
speak to radio and TV, and to obtain help from celebrities aging factors towards blood donation. The survey was
to recruit blood donors. Moreover, the students utilize designed in Arabic and English. The research team
social media to educate the public and to recruit donors. reviewed the questions carefully for face validity and
The students are asked to use a hashtag specific to their content validity to ensure that the survey is fully repre-
college in their social media posts to attract followers, sentative of what it aims to measure and that its content
reach the target audience and increase awareness, and effectively captures the needed information. The questions
engagement. During this period, blood donation drives were also checked for common errors and duplications.
are conducted in the university colleges at SQU. More- The survey was reviewed by an independent reviewer for
over, donors are welcomed to donate blood in the SQUH input. The self-administering survey was piloted among
blood bank located in-campus. 45 students (30 SQU and 15 non-SQU college students)
The colleges are evaluated based on different measures for validation and testing for any ambiguities and vague-
including the number of donors recruited from each col- ness before implementation.
lege, and the efforts made by the college students in edu-
cating about blood donation. This includes evaluation of
Ethical consideration
their educational booths for innovative ideas used and
the accuracy of information shared. Moreover, the college Informed consent was obtained from all participants
is evaluated for the degree of utilization of social media before enrolment. The member from the research team
channels to increase awareness on blood donation and explained the aim of the study to the participants. Partici-
recruit donors. The colleges are also asked to submit edu- pation in the study was voluntary and each participant
cational videos for evaluation. Donors recruited to donate was able to withdraw at any time. All participants were
blood at SQUH blood bank and its drives are counted for Omanis and were informed in advance that their

© 2020 International Society of Blood Transfusion, ISBT Science Series (2021) 16, 60–67
 17512824, 2021, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/voxs.12583 by Conestoga College Institute of Technology &Advanced Learning, Wiley Online Library on [30/06/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
62 A. Z. Al-Riyami et al.

participation was voluntary, unpaid and that all data col- while students in their second, third and fourth years
lected would be used for the sole purpose of the research accounted for 19
1%, 20
5% and 17
1% of the total sur-
and will be kept confidential. Ethical approval was veyed students. All participants were in the age group
obtained from the Research Ethics Committee at the Col- 18–25 years. Males reported higher rates of blood dona-
lege of Medicine and Health Sciences at the Sultan tion compared to females (38
3% vs. 17
4%, P < 0
001).
Qaboos University (MREC #1426). First-time donors accounted for 41% and 59% of the
male and female donors respectively. Only 27% of the
cohort have reported donating blood previously, with
Subjects
48% of these donors donated only once, 20
8%, twice,
The survey was distributed over 2 years among college 15
7%, thrice, 5%, four times and 10
7%, more than four
students in different universities and colleges. The study times. The majority of the students (60
4%) reported lack
had two phases over 2 academic years; the first took over of time being the main reason for not returning to donate
between November 2016 and March 2017 and included blood. There was no statistically significant difference
students randomly selected from SQU colleges. The sec- between SQU and non-SQU students concerning the his-
ond phase was from November 2017 to March 2018 and tory of blood donation and the collective number of
included randomly selected students from different non- donations made (Table 1).
SQU colleges; namely the Gulf College, the Middle East Half of the surveyed students believed they have
College, the German University of Technology in Oman, enough knowledge of blood donation (55
3%) (Table 2).
and the Higher College of Technology. Six hundred and There was no statistical difference between male and
seventy male and female college students were invited to female donors in their self-perception (54
8% males,
undertake the survey (310 SQU, 360 non-SQU). Four 56
9% females; P = 0
868). Only 8
4% of the participants
trained medical students distributed the surveys among reported TV and radio as the main sources of their knowl-
the participants and were available to answer any ques- edge. Education on blood donation at school was reported
tions. A paper copy of the survey was given to the stu- by 34% of surveyed college students, while social media
dents by a research team member after describing the and the university were reported as the main sources of
purpose of the research to them. The survey was returned the knowledge by half of the college students for each.
on the same day as much as possible. Total of 300 SQU When comparing SQU and non-SQU college students,
and 300 non-SQU students completed the survey (re- there was no statistically significant difference in self-
sponse rates 96
8% and 83
3% respectively). perception on the degree of background knowledge on
blood donation. However, 72
6% of the SQU students and
24
8% of non-SQU students reported the university as the
Statistical analysis
main source for knowledge (P < 0
001).
Data entry was carried out using EpiData software (ver-
sion 3.1, Christiansen TB and Lauritsen JM. (Ed.). Odense
Table 1 General characteristics of the surveyed college students.
Denmark, EpiData Association, 2010) and statistical anal-
ysis was performed using IBM SPSS software (version SQU Non-SQU
25.0, IBM Corp, Armonk, NY, 2017). Descriptive statistics (n = 300) (n = 300) Total
such as percentages and frequencies were used to measure
the demographic variables and responses to knowledge Variables n % n % n % P-value
and attitude questions. Analytical statistics were applied
Have you ever donated blood
to investigate the association between perception of self- Yes 76 25
3 83 27
7 159 26
5 0
579
knowledge and attitude with the demographic variables. No 224 74
7 217 72
3 441 73
5
Categorical variables were presented as proportions. The How many times have you donated blood?
Chi-square test was used to assess for any statistical sig- Once 37 48
7 39 47
0 76 47
8 0
598
nificance between the SQU and non-SQU groups of stu- Twice 13 17
1 20 24
1 33 20
8
dents. A P-value of <0
05 was considered statistically Thrice 15 19
7 10 12
0 25 15
7
significant for all analyses. Four times 4 5
3 4 4
8 8 5
0
>4 times 7 9
2 10 12
0 17 10
7
How many times do you donate blood in a year?
Results Once 55 72
4 57 78
1 112 75
2 0
041
Twice 3 3
9 9 12
3 12 8
1
A total of 600 college students were surveyed (males
3–4 times 17 22
4 6 8
2 23 15
4
43
5%; n = 261; females 56
5%, n = 339). The majority >4 times 1 1
3 1 1
4 2 1
3
of the students were in their first year of study (24
8%),

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Youth perception on blood donation 63

Table 2 Source of knowledge and Influence of social media

SQU Non-SQU
(n = 300) (n = 300) Total

Variables n % n % n % P-value

Do you think that you have enough background knowledge about blood donation? 175 58
3 157 52
3 332 55
3 0
163
What is the main source of your knowledge on blood donation?
School 47 26
9 66 42
0 113 34
0 0
004
University 127 72
6 39 24
8 166 50
0 <0
001
Social media 98 56
0 70 44
6 168 50
6 0
048
TV or radio 15 8
6 13 8
3 28 8
4 1
000
Family/relatives 38 21
7 33 21
0 71 21
4 0
894
Friends/peers 49 28
0 18 11
5 67 20
2 <0
001
Educational material 41 23
4 15 9
6 56 16
9 0
001
Internet 47 26
9 27 17
2 74 22
3 0
036
Have you ever seen an advertisement for blood donation drives in social media? 288 96
0 270 90
0 558 93
0 0
006
Which of the following social media channels in which you saw an advertisement to the advertisement of a blood drive?
Whats App 57 60
6 93 63
3 150 26
9 0
685
Twitter 60 63
8 31 21
1 91 16
3 <0
001
Instagram 36 38
3 57 38
8 93 16
7 1
000
Facebook 8 8
5 14 9
5 22 3
9 1
000
YouTube 4 4
3 28 19
0 32 5
7 0
001
Kik 1 1
1 4 2
7 5 0
9 0
651
Snapchat 4 4
3 28 19
0 32 5
7 0
001
Email 20 21
3 12 8
2 32 5
7 0
006
Others - - 1 0
7 1 0
2 1
000
Do you donate blood more frequently when you see these advertisement of blood donation drives 68 72
3 94 64
4 162 67
5 0
591
rather compared to donation in other times?
Have you ever donated blood as a response to request for blood donors seen on social media? 133 44
3 89 29
7 222 37
0 <0
001

TV, Television.

The majority of the surveyed students (93%) are social as a motivating factor to donate blood. The influence of
media users who have seen an advertisement for blood peers and parents was reported by 72
3% and 58
8% of
donation in the different social media accounts (96% SQU the surveyed college students, respectively. Fears from the
vs. 90% non-SQU, P = 0
006). Whatsapp, Instagram and needles and from seeing blood was reported by 25% of
twitter were the commonest social media channels in the surveyed college students as discouraging factors of
which students have seen an advertisement (26
9%, blood donation. Moreover, fear from post-donation side
16
7% and 16
3% respectively). The majority of the stu- effects was reported by 36
5%. Female donors reported to
dents (67
5%) who reacted to an advertisement for blood a higher extent that the feeling of need for blood donors
donation drives on social media accounts reported donat- (92
6% females vs. 84
3% males, P = 0
001) and the own
ing blood more frequently when seeing such advertise- self-perception of personal knowledge (83
2% females vs.
ments compared to donation at other times (72
3% SQU, 72
4% males, P = 0
002) had a great impact on their
64
4% non-SQU, P = 0
591). Responding to requests for decision to donate blood. There was no difference
blood donors seen on social media was reported by between genders in the rest of the motivating and dis-
44
3% of SQU and 29
7% of non-SQU students couraging factors.
(P < 0
001) (Table 2). There was a statistically significant difference in the
The majority of the college students (89%) felt that motivating and discouraging factors between SQU and
there is a continuous need for blood donors, while 84
2% non-SQU students (Table 3). SQU students reported higher
agreed that blood donation is one of the commitments rates of feeling of the continuous need of donors, com-
towards the society. Feeling of satisfaction after donation mitment to the society, altruism and satisfaction after
and altruism were reported by 88
2% and 80
2% of the blood donation. SQU students reported higher influence
surveyed college students. Self-perception of personal from peers’ motivation compared to non-SQU students
knowledge was reported by 78
5% of the college students (84% vs. 60
7%, P < 0
001). While non-SQU students

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64 A. Z. Al-Riyami et al.

Table 3 Reported motivating and discouraging factors

SQU Non-SQU
(n = 300) (n = 300) Total
Parameter Variables n (%) n (%) n (%) P-value

Motivating factors Feel of continuous need for donors 283 (94
3) 251 (83
7) 534 (89
0) <0
001
Feeling of satisfaction 286 (93
5) 243 (81) 529 (88
2) <0
001
Commitment to the society 271 (90
3) 234 (78) 505 (84
2) <0
001
Altruism 268 (89
3) 213 (71) 481 (80
2) <0
001
Personal knowledge 247 (82
3) 224 (74
7) 471 (78
5) 0
029
Personal experience 238 (79
3) 207 (69) 445 (74
2) 0
005
Peers’ motivation 252 (84) 182 (60
7) 434 (72
3) <0
001
Parents’ motivation 159 (53) 194 (65) 353 (58
8) 0
005
Personal experience 238 (79
3) 207 (69) 445 (74
2) 0
005
Discouraging factors Fear from needles 54 (18) 96 (32) 150 (25
0) <0
001
Fear from seeing blood 47 (15
7) 88 (29
3) 135 (22
5) <0
001
Fear from post-donation side effects 102 (34) 117 (39) 219 (36
5) 0
235

reported a greater influence of the parents on their deci- About half of the surveyed students believed that they
sions to donate blood. Moreover, SQU students reported have enough knowledge about blood donation. Knowl-
more influence of their self-perception of personal knowl- edge about blood donation and self-perception of knowl-
edge and personal experiences during previous blood edge may affect intentions to donate blood [10]. A meta-
donations. Concerning discouraging factors, SQU students analysis of publications from developing countries
reported lower rates of fears from needles and from see- revealed the presence of some knowledge gaps regarding
ing blood. blood donation [11]. A study from Saudi Arabia that
investigated public knowledge, attitude and motivations
towards blood donation revealed a mean knowledge per-
Discussion
centage score of 58% among the surveyed subjects, while
This study describes the perception and motives of blood a positive attitude score towards donation was found in
donation among college students in selected colleges in 31% of the subjects [9]. It was reported that the more
Oman. Understanding factors that motivate and discour- educated the person, the more knowledgeable he/she is
age donors from blood donation may help blood banks in on blood donation [4]. Only a third of our survey partici-
developing targeted recruitment campaigns. It is impor- pants reported education at school as the main source of
tant to recruit donors of a young age for several reasons. their knowledge, reflecting the lack of sufficient educa-
Young donors are less likely to have many of the factors tion at schools. Moreover, our results also reflect minimal
that cause deferral of older donors such as illnesses. public education using other media channels such as TV
Moreover, their youth predisposes them to long careers as and radio.
blood donors [7]. In our study, male donors reported a The difference in the source of knowledge between
higher rate for blood donation compared to female SQU and non-SQU college students was interesting. While
donors. The barrier for females to donate blood were SQU students reported the different activities conducted
identified in other publications from the region [8]. In a in the university and social media as the main sources of
study from Saudi Arabia, lower rates of blood donation knowledge, non-SQU students reported social media as
were reported among females. A significantly higher the main source. In addition, SQU students are more
number of females reported an inability to reach the likely to respond to requests for blood donors. This likely
blood bank, to have fears from developing anaemia as a reflects the impact of the activities that are done at the
result of donating blood and to have a less positive atti- university in promoting blood donation during the league
tude towards blood donation [9]. In an Iranian study, dif- period and the increasing role of social media. Social
ficult access to blood donation centres was reported to be media channels are becoming increasingly important for
the most significant inhibitory factor to prevent donors blood banks and transfusion services and appear to be a
from donating blood (41
8%) and was significantly asso- new tool in donor education and recruitment. While 7%
ciated with gender and level of education [4]. There is a of donors reported being attracted to donate blood by
need to assess the causes of the lower donation rate in social media in Germany [12], social media was reported
Omani female donors in future studies. to be the main source by the public in Saudi Arabia,

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Youth perception on blood donation 65

regardless of the educational level of the participants campaigns was reported to be preferred by the male ado-
[13]. In our study, 93% of the participants are social lescents in one of the previous surveys [20]. Bednal and
media users who have seen an advertisement for blood Bove reported that first-time donors more frequently
donation on social media. This qualifies social media as a identify perceived need for donation after the occurrence
valuable tool to educate and recruit first-time donors in of a catastrophic event, time off work or school, social
our society. pressure and reputation of blood collection agencies as
The highest motivating factors in the present study motivators of blood donation [14]. There is a need to
were feeling of the continuous need of donors, satisfac- assess the influence of intrinsic and external motivators
tion after donation, commitment to the society and altru- on blood donation in the society in details considering
ism. All of these were reported to be higher among SQU the lack of data on this perspective.
students. Converting positive attitudes towards blood The surveyed donors reported fears from needles, from
donation into the practice of volunteering to donate seeing blood and from post-donation side effects as barri-
blood is a common finding in a meta-analysis of research ers to donating blood. Fear by far is the most common
conducted in developing countries [11]. The decision to deterrent of blood donation in the developing world [11].
donate blood is influenced by many motivators such as Fears from needles and from seeing blood were reported
the desire to help others generally (altruism) and increas- by 18
5% and 17% of participants respectively in an Ira-
ing the welfare of the community [14]. Such prosocial nian study [4]. Other studies reported pain as the deter-
beliefs were rated as the most important motivators in the ring factor of influence in college and high school
donor’s decision to donate blood in many reports [15, students [7, 21]. The idea of phlebotomy may cause fear
16]. First-time donors primarily report external motiva- in the younger donor population because they have over-
tions for blood donation16. Personal values such as feel- all less experience compared to older donors with a his-
ings of moral obligation have also been reported [14]. As tory of medical intervention and the associated
reported by different authors, altruism is the most com- venipuncture procedure [7]. Fears from needles and side
mon general motive for blood donation in developing effects were reported in 24% and two-thirds of partici-
and developed countries and also for continuing to be an pants in a meta-analysis of several studies respectively
active donor [5, 11, 14]. Among Saudis, this was found in [14, 22]. About 12% and 8% of Saudi donors reported
96% of the surveyed public, while it was reported in fears from needles and from seeing blood respectively,
85
6% and 95% of surveyed Iranians from urban Iran and but the donor sample surveyed included older donors [9].
Tahran [4, 8, 9]. A decline in altruism has been suggested High rates of fear from needles and from seeing blood
to contribute to the threat of diminishing blood supplies. were reported among Iranian youth (15–34 years of age)
Sojka et al. reported ‘general altruism’ and ‘social respon- at 62% and 16% respectively [4]. Fears from post-dona-
sibility/obligation’ as the most frequent reasons for con- tion complications were reported in 14
5% of Iranians [8].
tinuing to donate blood among the Dutch blood donors Other types of fears not investigated in our study but
[5]. reported in the literature were fears from getting anaemic
Influence from others can be a driving factor to donate and from becoming infected with HIV [9]. Fear from
blood. Among SQU college students, influence from peers physical harm or infection was the most common deter-
was perceived to play a major role in motivating them to rent among non-donors in nine of eighteen surveys from
donate, although it ranked lower compared to intrinsic developing countries [11]. Actions should be undertaken
motivators such as feel of satisfaction, commitment to the to properly educate the donors to minimize the rates of
society and altruism. Although peers’ motivation was fear and concerns as these can play a significant role in
reported to be higher among SQU students, more than discouraging blood donation.
half of non-SQU students reported it as one of the main Lack of time was reported as the main obstacle for not
motivating factors to donate blood. Friends, relatives and returning to donate blood among our participants. The
peers were found to be one of the main reasons for same observation was reported in Saudi donors where the
donating blood for the first time in many reports [17–19]. most common reasons for not donating blood were the
Sojka et al. reported that for both male and female lack of time and inability to access the blood banks for
donors, the two most commonly reported reasons for donation [9]. Blood banks need to identify measures to
donating blood the first time were ‘influence from a facilitate donation for these students and to increase
friend’ and the ‘media’ [5]. It is also possible that influ- mobile donation drives in-campus.
ence from celebrities that were invited by the students This study has a few limitations. The study did not
during the advertising campaigns for blood donations include medical or nursing colleges outside SQU. That
had played a role in increasing the number of donations. said, this study aimed to assess perception towards blood
The involvement of famous football players in such donation rather than actual medical knowledge, which is

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 17512824, 2021, 1, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/voxs.12583 by Conestoga College Institute of Technology &Advanced Learning, Wiley Online Library on [30/06/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
66 A. Z. Al-Riyami et al.

independent of the educational background of the partici-

pant. Second, the survey did not utilize a standard scale Authors’ contribution
(e.g Likert scale) for assessments of the relative impor- AZR initiated the research idea, performed the literature
tance of the different motivating factors assessed. As a review, and wrote the manuscript. MD, FH, AK, AM dis-
result, when the donors provided several answers, they tributed the survey among the participants and collected
had to define the relative importance among those to the data. SAP performed the statistical analysis. All
determine the most appropriate response. Moreover, the authors reviewed and accepted the manuscript before
study did not assess the difference in the motivating and submission.
discouraging factors between the first-time and repeat
donors. However, this study has several strengths. This is
the first study to assess motivating and discouraging fac- References
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© 2020 International Society of Blood Transfusion, ISBT Science Series (2021) 16, 60–67
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© 2020 International Society of Blood Transfusion, ISBT Science Series (2021) 16, 60–67