What drives the choice to donate blood

A study in collaboration between Avis and the IMT School compares voluntary and paid donors and highlights the motivations behind the donation.

Frank Muckenheim/AGF

Although we tend to take it for granted, the absolute gratuitousness of blood donation, on which the entire transfusion system is based, has only been in force in Italy since 1990. Although 2021 seems to have marked a recovery in the collection in Italy, the Italian Blood Volunteers Association (Avis) records a negative trend in the number of donations, aggravated by the Covid emergency, with a 5 percent drop in the last ten years. Supporting the motivation to donate is therefore a necessary action to ensure that transfusions, which - let us remember - are necessary for many surgical operations and in the treatment of immune diseases, hold up.

A research project at the IMT School has investigated precisely on the dynamics involved in defining donor identity and the tendency to donate regularly, i.e. to behave altruistically. The study, carried out by researchers from the MoMiLab (Molecular Mind Laboratory) and AXES (Laboratory for the Analysis of compleX Economic Systems) units, in collaboration with the Tuscany, Emilia-Romagna, Apulia and Lombardy regional offices of Avis, is the largest in our country on this subject and, for the first time, has made it possible to compare the behaviour of Italian donors, who receive no remuneration for their gesture, with that of Hungarians, a nation where plasma donation does, on the other hand, involve remuneration. 

Comparing donations

The researchers investigated the social and psychological motivations behind donation by means of an online questionnaire and found that different drives are at work in the voluntary and reimbursed donation. The non-reimbursed donation, the one in force in the Italian system, leads to the development in donors of motivations defined by the researchers as intrinsic, i.e. capable of sustaining themselves and with altruistic aims. In the case, on the other hand, of reimbursed donors, as in the Hungarian system considered in the study, the altruistic drive is eroded and diminishes over time.

In fact, the data collected show that in countries that provide for the recognition of benefits, an interest mainly linked to obtaining material benefits ends up being created, without any real personal motivation on the part of donors. This lack makes the system fragile in the long run, and exposes it to economic and market dynamics. In the United States, for example, during the pandemic, plasma donations decreased as soon as the Biden administration introduced cheaper subsidies than reimbursements for plasma donations. In contrast, the same emergency situation can generate opposite effects in countries where donation is free. Another study study carried out by researchers at the IMT School and just published in the journal Social Science and Medicine shows that in Tuscany blood donations have increased, reversing the decline observed in recent years, precisely during the pandemic.

The career of a lifetime

Also influencing motivation is the experience of donors. "The longer the period of time over which donors' 'careers' develop, the greater the number of sources of motivation that sustain them," explains Dario Menicagli, a researcher at Scuola IMT, one of the authors of the study. "In particular, as time goes by, intrinsic motivation is created, i.e. the donation becomes something meaningful, a value consistent with one's personal values." In the sample of reimbursed donors, this type of motivation, on the other hand, reaches a ceiling and then diminishes over time because reimbursement, or at least an external motivation, supplants it and conflicts with the nascent development of motivation within the individual. Living in an environment close to the world of donation would also help to recruit new donors, according to Menicagli: "most donors start their journey because someone in the family, or among those close to them, already had an experience of donation, and so they become its promoters."

Understanding what motivates and drives people to donate can also help design specific interventions. By obtaining the motivational profiles of donors, for example, it is possible to construct communication aimed at specific target groups and different age groups. "The aim is not so much to create new donors as to strengthen motivation in those who already donate, particularly young people," Menicagli continues. On the subject of studying and promoting altruistic behaviour, especially in young people, the IMT School is engaged in various initiatives. The School's research groups, in collaboration with the Game Science Research Centre, have produced a board game, Captain AVIS, which aims to introduce primary school children to the world of donation.

Marco Maria Grande

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