A randomized control trial to increase return behavior of first-time donors using implementation intention and commitment techniques

Background: For blood establishments it is important that blood donors donate blood for a longer period of time. Unfortunately, many donors stop donating blood in the beginning of their donor career. It is therefore desirable that donors are well informed about, and agree with the blood donation invitation policy before their first donation. In this study new donors received an information sheet about the invitation policy, wherein two different manipulation techniques were used: implementation intentions and explicit commitment. Implementation intentions are said to delegate control of goal-directed behavior to situational cues, thereby eliciting these responses automatically. In addition, explicit commitment is defined as the binding of a person with a specific behavior. Aim: This study aims to increase return behavior of first-time donors using implementation intention and commitment techniques Methods: The study sample consisted of 503 new donors who came to the blood bank for their medical check-up. The medical check-up consisted of a medical questionnaire and three blood samples. The information sheet for this study was handed out after the medical questionnaire and consisted of information about the invitation policy. In the implementation intention condition donors had to read the information sheet, and then fill out their donation preferences (e.g. preference for day and time). In the commitment condition donors had to read the information, sign their name and date the information sheet. All new donors were randomly assigned to one of five experimental conditions: standard procedure (control group), standard procedure plus information sheet, standard procedure plus information sheet with implementation intentions, standard procedure plus information sheet with explicit commitment, standard procedure plus information sheet with implementation intentions and explicit commitment. The outcome variable was visiting the blood bank for a first donation after a first appeal to donate blood. Differences between conditions were tested with Chi square tests and statistical significance was considered when P < 0.05. Results: A total of 320 (63.6%) first-time donors visited the blood bank after the first appeal to donate blood. Compared to the control group (return rate 60.6%), all other conditions increased the return rate of donors. The return rate of donors in the information sheet condition was 61.2%; in the information sheet plus implementation intentions return rate was 62.5%; the return rate in the information sheet plus explicit commitment was 64.8%; the information sheet plus implementation intentions and explicit commitment condition was most effective with 68.6%. Chi square tests revealed that all effects were not significant compared to the control condition (P>0.05). Conclusions: This study showed that when donors had to both fill out their donation preferences, and sign the information sheet, the return rate for their first blood donation increased with 8%. It seems that donors who actively fill in and agree with the blood donation invitation policy are more willing to return for their first blood donation. Further research should investigate whether these effects sustain when donors are appealed to donate blood for the second and third time