Skip to main content

Motivation for blood donation among African Americans: developing measures for stage of change, decisional balance, and self-efficacy constructs

Abstract

Despite a specific need for transfused blood among African Americans due to higher rates of sickle cell disease, African Americans donate blood significantly less frequently than their White counterparts. This study describes the development and validation of culturally adapted measures of the transtheoretical model (TTM) constructs of Stage of Change, Decisional Balance, and Self-efficacy applied to blood donation in an African American sample. Exploratory and confirmatory analyses produced one pros and two cons scales for the Decisional Balance Inventory, and one scale for the Situational Self-efficacy Measure. Expected patterns for the Decisional Balance and Self-efficacy Scales by Stage of Change were found, but only the pros and one cons scale varied significantly. Results provide support for use of the TTM applied to blood donation and have important implications for development of effective assessment and intervention tools to increase blood donation among the African American population.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  • American Red Cross. (n.d.) Retrieved January 4, 2009, from http://www.givelife2.org/donor/faq.asp.

  • American Sickle Cell Anemia Association. (n.d.) Retrieved August 30, 2004, from http://www.ascaa.org/FAQs.asp.

  • Anatchkova, M. D., Rossi, J. S., & Redding, C. (2003). The transtheoretical model: Bridging cultural boundaries. Annals of Behavioral Medicine, 25, S163. doi:10.1207/S15324796ABM2503_02.

    Article  Google Scholar 

  • Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215. doi:10.1037/0033-295X.84.2.191.

    PubMed  Article  CAS  Google Scholar 

  • Bandura, A. (1982). Self-efficacy mechanism in human agency. The American Psychologist, 37, 122–147. doi:10.1037/0003-066X.37.2.122.

    Article  Google Scholar 

  • Bane, C. M., Ruggiero, L., Dryfoos, J. M., & Rossi, J. S. (1999). Development of a pregnancy tailored decisional balance measure for smoking cessation. Addictive Behaviors, 24, 795–799. doi:10.1016/S0306-4603(98)00131-2.

    PubMed  Article  CAS  Google Scholar 

  • Bentler, P. M. (1993). EQS: Structural equation program manual. Los Angeles: BMNP.

    Google Scholar 

  • Claster, S., & Vichinsky, E. P. (2003). Managing sickle cell disease. British Medical Journal, 327, 1151–1155. doi:10.1136/bmj.327.7424.1151.

    PubMed  Article  Google Scholar 

  • Comrey, A. L. (1988). Factor-analytic methods of scale development in personality and clinical psychology. Journal of Consulting and Clinical Psychology, 56(5), 754–761. doi:10.1037/0022-006X.56.5.754.

    PubMed  Article  CAS  Google Scholar 

  • Custer, B., Johnson, E. S., Sullivan, S. D., Hazlet, T. K., Ramsey, S. D., Hirschler, N. V., et al. (2004). Quantifying losses to the donated blood supply due to donor deferral and miscollection. Transfusion, 44, 1417–1426. doi:10.1111/j.1537-2995.2004.04160.x.

    PubMed  Article  Google Scholar 

  • DiClemente, C. C., Prochaska, J. O., & Gibertini, M. (1985). Self-efficacy and the stages of self-change of smoking. Cognitive Therapy and Research, 9, 181–200. doi:10.1007/BF01204849.

    Article  Google Scholar 

  • Ferguson, E., & Bibby, P. A. (2002). Predicting future blood donor returns: Past behavior, intentions, and observer effects. Health Psychology, 21(5), 513–518. doi:10.1037/0278-6133.21.5.513.

    PubMed  Article  Google Scholar 

  • Ferguson, E., & Chandler, S. (2005). A stage model of blood donor behaviour: Assessing volunteer behaviour. Journal of Health Psychology, 10(3), 359–372. doi:10.1177/1359105305051423.

    PubMed  Article  Google Scholar 

  • Ferguson, E., France, C. R., Abraham, C., Ditto, B., & Sheeran, P. (2007). Improving blood donor recruitment and retention: Integrating theoretical advances from social and behavioral science research agendas. Transfusion, 47, 1999–2010. doi:10.1111/j.1537-2995.2007.01423.x.

    PubMed  Article  Google Scholar 

  • Giles, M., McClenahan, C., Cairns, E., & Mallet, J. (2004). An application of the theory of planned behavior to blood donation: The importance of self-efficacy. Health Education Research, 19, 380–391. doi:10.1093/her/cyg063.

    PubMed  Article  CAS  Google Scholar 

  • Gillespie, T. W., & Hillyer, C. D. (2002). Blood donors and factors impacting the blood donation decision. Transfusion Medicine Reviews, 16, 115–130. doi:10.1053/tmrv.2002.31461.

    PubMed  Article  Google Scholar 

  • Glynn, S. A., Kleinman, S. H., Schreiber, G. B., Zuck, T., Combs, S. M., Bethel, J., et al. (2002). Motivations to donate blood: Demographic comparisons. Transfusion, 42, 216–225. doi:10.1046/j.1537-2995.2002.00008.x.

    PubMed  Article  Google Scholar 

  • Godin, G., Conner, M., Sheeran, P., Belanger-Gravel, A., & Germain, M. (2007). Determinants of repeated blood donation among new and experienced blood donors. Transfusion, 47, 1607–1615. doi:10.1111/j.1537-2995.2007.01331.x.

    PubMed  Article  Google Scholar 

  • Godin, G., Sheeran, P., Conner, M., Germain, M., Blondeau, D., Gagne, C., et al. (2005). Factors explaining the intention to give blood among the general population. Vox Sanguinis, 89, 140–149. doi:10.1111/j.1423-0410.2005.00674.x.

    PubMed  Article  CAS  Google Scholar 

  • Greene, G. W., Rossi, S. R., Rossi, J. R., Velicer, W. F., Fava, J. L., & Prochaska, J. O. (1999). Dietary applications of the stages of change model. Journal of the American Dietetic Association, 99, 673–678. doi:10.1016/S0002-8223(99)00164-9.

    PubMed  Article  CAS  Google Scholar 

  • Hall, K. L., Robbins, M. L., Paiva, A., Knott, E., Harris, L., & Mattice, B. (2007). Donation intentions among African American college students: Decisional balance and self-efficacy measures. Journal of Behavioral Medicine, 30, 483–495. doi:10.1007/s10865-007-9121-8.

    PubMed  Article  Google Scholar 

  • Hall, K. L., & Rossi, J. S. (2004a). Examining the transtheoretical model using meta-analytic procedures and integrative analyses. In S. Keller & W. F. Velicer (Eds.), Research on the transtheoretical model: Where are we now, where are we going? (pp. 56–58). Lengerich: Pabst Science Publishers.

    Google Scholar 

  • Hall, K. L., & Rossi, J. S. (2004b). A meta-analysis of the magnitude of the effect in self-efficacy across adjacent stage transitions for 24 health behaviors: Informing interventions. Annals of Behavioral Medicine, 26, S133.

    Google Scholar 

  • Hall, K. L., & Rossi, J. S. (2008). Meta-analytic examination of the strong and weak principles across 48 health behaviors. Preventive Medicine, 46, 266–274. doi:10.1016/j.ypmed.2007.11.006.

    PubMed  Article  Google Scholar 

  • Hargreaves, M. K., Schlundt, D. G., Buchowski, M. S., Hardy, R. E., Rossi, S. R., & Rossi, J. S. (1999). Stages of change and the intake of dietary fat in African–American women: Improving stage assignment using the eating styles questionnaire. Journal of the American Dietetic Association, 99, 1392–1399. doi:10.1016/S0002-8223(99)00338-7.

    PubMed  Article  CAS  Google Scholar 

  • Hawkins, D. S., Hornsby, P. P., & Schorling, J. B. (2001). Stages of change and weight loss among rural African American women. Obstetrics Research, 9, 59–67. doi:10.1038/oby.2001.8.

    Article  CAS  Google Scholar 

  • Horn, J. L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30(2), 179–185. doi:10.1007/BF02289447.

    PubMed  Article  CAS  Google Scholar 

  • Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. doi:10.1037/1082-989X.3.4.424.

    Article  Google Scholar 

  • Jackson, D. N. (1970). A sequential system for personality scale development. In C. D. Speilberger (Ed.), Current topics in clinical and community psychology (Vol. 2, pp. 61–96). New York: Academic Press.

    Google Scholar 

  • Jackson, D. N. (1971). The dynamics of structured personality tests. Psychological Review, 78, 229–248. doi:10.1037/h0030852.

    Article  Google Scholar 

  • Knight, G. P., Virdin, L. M., Ocampo, K. A., & Roosa, M. (1994). An examination of the cross-ethnic equivalence of measures of negative life events and mental health among Hispanic and Anglo-American children. American Journal of Community Psychology, 22(6), 767–783. doi:10.1007/BF02521558.

    PubMed  Article  CAS  Google Scholar 

  • Levesque, D. A., Gelles, R. J., & Velicer, W. F. (2000). Development and validation of a stages of change measure for men in batterer treatment. Cognitive Therapy and Research, 24(2), 175–199. doi:10.1023/A:1005446025201.

    Article  Google Scholar 

  • Marcus, B. H., Bock, B. C., Pinto, B. M., Forsyth, L. H., Roberts, M. B., & Traficante, R. M. (1998). Efficacy of an individualized, motivationally-tailored physical activity intervention. Annals of Behavioral Medicine, 20, 174–180. doi:10.1007/BF02884958.

    PubMed  Article  CAS  Google Scholar 

  • Marshall, S. J., & Biddle, S. J. H. (2001). The transtheoretical model of behavior change: A meta-analysis of applications to physical activity and exercise. Annals of Behavioral Medicine, 23, 229–246. doi:10.1207/S15324796ABM2304_2.

    PubMed  Article  CAS  Google Scholar 

  • Masser, B. M., White, K. M., Hyde, M. K., & Terry, D. J. (2008). The psychology of blood donation: Current research and future directions. Transfusion Medicine Reviews, 22(3), 215–233. doi:10.1016/j.tmrv.2008.02.005.

    PubMed  Article  Google Scholar 

  • McConnaughy, E. A., DiClemente, C. C., Prochaska, J. O., & Velicer, W. F. (1989). Stages of change in psychotherapy: A follow-up report. Psychotherapy (Chicago, Ill.), 26(4), 494–503. doi:10.1037/h0085468.

    Google Scholar 

  • McConnaughy, E. A., Prochaska, J. O., & Velicer, W. F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research, and Practice, 20(3), 368–375. doi:10.1037/h0090198.

    Article  Google Scholar 

  • Moore, R. J. (1991). Promoting blood donation: A study of the social profile, attitudes, motivation and experience of donors. Transfusion Medicine (Oxford, England), 1, 201–207. doi:10.1111/j.1365-3148.1991.tb00034.x.

    CAS  Google Scholar 

  • National Blood Data Resource Center. (2001). Comprehensive report on blood collection and transfusion in the United States in 1999. Bethesda, MD: National Blood Data Resource Center.

    Google Scholar 

  • New York State Department of Health. (2003). Newborn screening annual report. Wadsworth, NY: New York State Department of Health.

    Google Scholar 

  • Pallonen, U. E., Prochaska, J. O., Velicer, W. F., Prokhorov, A. V., & Smith, N. F. (1997). Stages of acquisition and cessation for adolescent smoking: An empirical integration. Addictive Behaviors, 23, 303–324. doi:10.1016/S0306-4603(97)00074-9.

    Article  Google Scholar 

  • Piliavan, J. A., & Callero, P. L. (1991). Giving blood: The development of an altruistic identity. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Piliavin, J. A. (1990). Why do they give the gift of life: A review of research on blood donors since 1977. Transfusion, 30, 444–459. doi:10.1046/j.1537-2995.1990.30590296381.x.

    PubMed  Article  CAS  Google Scholar 

  • Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390–395. doi:10.1037/0022-006X.51.3.390.

    PubMed  Article  CAS  Google Scholar 

  • Prochaska, J. O., Diclemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. The American Psychologist, 47, 1102–1114. doi:10.1037/0003-066X.47.9.1102.

    PubMed  Article  CAS  Google Scholar 

  • Prochaska, J. O., Diclemente, C. C., Velicer, W. F., Ginpil, S., & Norcross, J. C. (1985). Predicting change in smoking status for self-changers. Addictive Behaviors, 10, 395–406. doi:10.1016/0306-4603(85)90036-X.

    PubMed  Article  CAS  Google Scholar 

  • Prochaska, J. O., Diclemente, C. C., Velicer, W. F., & Rossi, J. S. (1993). Standardized, individualized, interactive, and personalized self-help programs for smoking cessation. Health Psychology, 12, 399–405. doi:10.1037/0278-6133.12.5.399.

    PubMed  Article  CAS  Google Scholar 

  • Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38–48.

    PubMed  CAS  Google Scholar 

  • Prochaska, J. O., Velicer, W. F., Fava, J. L., Rossi, J. S., Laforge, R. G., & Tsoh, J. Y. (2001). Stage matched expert system intervention for a total population of smokers. Addictive Behaviors, 26, 583–602. doi:10.1016/S0306-4603(00)00151-9.

    PubMed  Article  CAS  Google Scholar 

  • Redding, C. A., Maddock, J. E., & Rossi, J. S. (2006). The sequential approach to measurement of health behavior constructs: Issues in selecting and developing measures. Californian Journal of Health Promotion, 4(1), 83–101.

    Google Scholar 

  • Robbins, M. L. (1998). Applying a readiness model to increasing organ donation and transplantation. Medicine and Health, Rhode Island, 81, 294–296.

    PubMed  CAS  Google Scholar 

  • Robbins, M. L., Levesque, D. A., Redding, C. A., Johnson, J. L., Prochaska, J. O., Rohr, M. S., et al. (2001). Assessing family member’s motivational readiness and decision making for consenting to cadaveric organ donation. Journal of Health Psychology, 6, 523–535.

    Article  Google Scholar 

  • Rosse, W. F., Gallagher, D., Kinney, T. R., Castro, O., Dosik, H., Moohr, J., et al. (1990). Transfusion and alloimmunization in sickle cell disease. The cooperative study of sickle cell disease. Blood, 76(7), 1431–1437.

    PubMed  CAS  Google Scholar 

  • Rossi, J. S., & Redding, C. A. (2001). Structure and function of self-efficacy across the stages of change for ten health behaviors. Annals of Behavioral Medicine, 23, S94.

    Google Scholar 

  • Rossi, J. S., Weinstock, M. A., Redding, C. A., Cottrill, S. D., & Maddock, J. E. (1997). Effectiveness of stage-matched interventions for skin cancer prevention: A randomized clinical trial of high-risk beach bathers. Annals of Behavioral Medicine, 19, S194.

    Google Scholar 

  • Schreiber, G. B., Glynn, S. A., Busch, M. P., Sharma, U. K., Wright, D. J., & Kleinman, S. H. (2001). Incidence rates of viral infections among repeat donors: Are frequent donors safer? Transfusion, 41, 730–735. doi:10.1046/j.1537-2995.2001.41060730.x.

    PubMed  Article  CAS  Google Scholar 

  • Schreiber, G. B., Sanchez, A. M., Glynn, S. A., & Wright, D. J. (2003). Increasing blood availability by changing donation patterns. Transfusion, 43, 591–597. doi:10.1046/j.1537-2995.2003.00388.x.

    PubMed  Article  Google Scholar 

  • Schreiber, G. B., Sharma, U. K., Wright, D. J., Glynn, S. A., Ownby, H. E., Tu, Y., et al. (2005). First year donation patterns predict long-term commitment for first-time donors. Vox Sanguinis, 88, 114–121. doi:10.1111/j.1423-0410.2005.00593.x.

    PubMed  Article  CAS  Google Scholar 

  • Susenbeth, R. (2000). Anwendung des Transtheoretischen Modells gesundheitsfördernder Verhaltensänderung auf HIV-protektiven Kondomgebrauch [Application of the Transtheoretical Model on condom use for HIV prevention]. Unpublished doctoral dissertation, University of Marburg, Marburg.

  • Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). Boston: Allyn and Bacon.

    Google Scholar 

  • Thomson, R. A., Bethel, J., Lo, A. Y., Ownby, H. E., Nass, C. C., & Williams, A. E. (1998). Retention of “safe” blood donors. The retrovirus epidemiology donor study. Transfusion, 38, 359–367. doi:10.1046/j.1537-2995.1998.38498257374.x.

    PubMed  Article  CAS  Google Scholar 

  • US Census Bureau. (2000). Census public law (94-171File). Washington, DC: US Census Bureau.

    Google Scholar 

  • US General Accounting Office. (2002). Public health: Maintaining an adequate blood supply is key to emergency preparedness, testimony by Janet Heinrich (GAO-02-1095T). Washington, DC: US General Accounting Office.

    Google Scholar 

  • Velicer, W. F. (1976). The relation between factor score estimates, image scores and principal component scores. Educational and Psychological Measurement, 36, 149–159. doi:10.1177/001316447603600114.

    Article  Google Scholar 

  • Velicer, W. F., DiClemente, C. C., Prochaska, J. O., & Brandenburg, N. (1985). A decisional balance measure for assessing and predicting smoking status. Journal of Personality and Social Psychology, 48, 1279–1289. doi:10.1037/0022-3514.48.5.1279.

    PubMed  Article  CAS  Google Scholar 

  • Velicer, W. F., Diclemente, C. C., Rossi, J. S., & Prochaska, J. O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behaviors, 15, 271–283. doi:10.1016/0306-4603(90)90070-E.

    PubMed  Article  CAS  Google Scholar 

  • Velicer, W. F., Prochaska, J. O., & Redding, C. A. (2006). Tailored communications for smoking cessation: Past successes and future directions. Drug and Alcohol Review, 25, 49–57. doi:10.1080/09595230500459511.

    PubMed  Article  Google Scholar 

  • Vichinsky, E. P., Luban, N. L., Wright, E., Olivieri, N., Driscoll, C., Pegelow, C. H., et al. (2001). Prospective RBC phenotype matching in a stroke-prevention trial in sickle cell anemia: A multicenter transfusion trial. Transfusion, 41, 1086–1092. doi:10.1046/j.1537-2995.2001.41091086.x.

    PubMed  Article  CAS  Google Scholar 

  • Walcott-McQuigg, J. A., & Prohaska, T. R. (2001). Factors influencing participation of African American elders in exercise behavior. Public Health Nursing (Boston, Mass.), 18, 194–203. doi:10.1046/j.1525-1446.2001.00194.x.

    Article  CAS  Google Scholar 

  • Wu, Y., Glynn, S. A., Schreiber, G. B., Wright, D. J., Lo, A., Murphy, E. L., et al. (2001). First-time blood donors: Demographic trends. Transfusion, 41, 360–364. doi:10.1046/j.1537-2995.2001.41030360.x.

    PubMed  Article  CAS  Google Scholar 

  • Zuck, T. F., Thomson, R. A., Schreiber, G. B., Gilcher, R. O., Kleinman, S. H., Murphy, E. L., et al. (1995). The retrovirus epidemiology donor study (REDS): Rationale and methods. Transfusion, 35, 944–951. doi:10.1046/j.1537-2995.1995.351196110900.x.

    PubMed  Article  CAS  Google Scholar 

  • Zwick, W. R., & Velicer, W. F. (1986). Comparison of five rules for determining the number of components to retain. Psychological Bulletin, 99, 432–442. doi:10.1037/0033-2909.99.3.432.

    Article  Google Scholar 

Download references

Acknowledgments

This research was partially supported by the New York Blood Center.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Caitlin Burditt.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Burditt, C., Robbins, M.L., Paiva, A. et al. Motivation for blood donation among African Americans: developing measures for stage of change, decisional balance, and self-efficacy constructs. J Behav Med 32, 429 (2009). https://doi.org/10.1007/s10865-009-9214-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10865-009-9214-7

Keywords

  • Blood donation
  • Transtheoretical model
  • Stages of change
  • Decisional balance
  • Self-efficacy