AABB News: the Evolution of Donor Recruitment Strategies

January 14, 2021

Note: This article originally appeared in the January 2021 issue of AABB News, a member benefit of AABB. 

By Leah Lawrence
Contributing Writer

In the United States, only about 62.6% of the population is eligible to give blood or platelets, and it is estimated that well under 5% actually do so.1,2 

Research has shown that more people donate blood for the first time after a national disaster,3 but in the face of a more sustained “disaster” like the COVID-19 pandemic, the industry has been forced to re-examine where and how it recruits first-time and repeat donors.

“The emphasis for getting first-time donors was not as imperative pre-COVID as it is now,” said Merlyn Sayers, MBBCh, PhD, of the University of Texas Southwestern Medical Center and president and CEO of Carter BloodCare. “Before, 20% of our blood supply — or even 25% in some parts — was coming from high schools and that has been completely shut down with the pandemic.”

For example, in 2019, the Delmarva Blood Bank recruited about 7,000 donors from college and high school blood drives, but 2020 shutdowns left the blood bank with 43% of pre-pandemic mobile donation levels.4 Similar shortages are being reported around the country, where the loss of high school and college drives has combined with the loss of drives that would have normally taken place at businesses and other organizations now closed by pandemic shutdowns.

This approach has put the blood community in jeopardy, according to John Armitage, MD, CEO of Oklahoma Blood Institute, and reflects a habitual underinvestment in donor recruitment.

“Because we under-invest, many in the industry go for short-term fixes and wonder why we have a long-term problem,” Armitage said. “I am an optimist though and believe that if we want more donors, we can have more. We just have to invest!” 

Make New Friends, Keep the Old

The blood donor pool is aging. According to statistics, about 60% of blood donations are from donors older than 40, and about 45% are from donors older than 50.5

“If you look at the historical blood donor recruitment, it was done through traditional media channels, like television, radio and billboards, as well as telerecruitment, to the existing donor base,” said Michael Parejko, MS, MT, CEO of Mississippi Valley Regional Blood Center.

These traditional strategies should not necessarily be abandoned, according to Parejko, but blood banks must do a better job of leveraging what is called omnichannel marketing, a strategy that integrates different communication channels.

Armitage agreed, adding that many blood banks have only recently developed a social media strategy even though some of these platforms have been in existence for almost a decade.

Leveraging these online “meeting places” is necessary because many of the traditional community venues where blood donations might be promoted have been diminishing, even before the pandemic.

“For example, in the past, maybe a Boy Scout troop leader would discuss the importance of donation, but the Boy Scouts are in decline,” said Armitage. “As the human-to-human touch points go away, we have to become more electronic.”

In recent years, Facebook has added a Blood Donations feature to its platform that notes more than 70 million people have signed up to be blood donors globally.6 How many of those people end up donating is unclear. Facebook has also partnered with AABB to connect people to hospital blood banks. Unfortunately, data has shown that teens — the up-and-coming potential donors — are abandoning Facebook.7

“We have definitely moved to other channels like Facebook to engage donors,” Parejko said. “We are also trying to find key influencers on Facebook, Twitter and Instagram to help spread the word about donation amongst their peers.”

Parejko said the strategy seems to be working well, although they do not have enough data yet to fully draw conclusions.

“Unfortunately, young people are moving away from things like Twitter. They are looking for the next big thing,” Parejko said. “We have to look to things like streaming television or streaming radio. When my daughter was home for Thanksgiving break, and driving her car, she streamed radio from her phone the whole way.”

Successful Strategies

Targeting social media and streaming platforms can recruit first-time donors, but in the COVID-19 era, many blood banks are using the promise of antibody testing to attract first-time donors.

According to Richard R. Gammon, MD, medical director of OneBlood, Orlando, Fla., OneBlood’s initial engagement was dramatically affected during the pandemic.

“One of the new strategies that we have implemented is offering antibody testing,” Gammon said. “Anybody who gives blood gets SARs-CoV-2 antibody testing and we have seen a significant increase in donors after implementing that testing.”

This strategy appears to be working throughout the country. A study from the American Red Cross, which collects blood in 44 states, showed that after antibody testing was initiated in June 2020, the percentage of first-time donors increased from 11% to 17% of donors over a 2-week period.8

Gammon said that OneBlood also gathered video stories from many of their initial convalescent plasma donors and distributed them on traditional and social media platforms.

“We also offered a behind-the-scenes look at how we collect, test and distribute the convalescent plasma,” said Gammon. “To a lot of donors, behind-the-scenes is a bit of a black box area. People do not know where their blood goes after donation. These videos take them to the component processing area, and it is good for the public to see those things.”

Armitage and the team at the Oklahoma Blood Institute took the idea of knowing where the donations go a step further when it created its Thank-the-Donor web-enabled technology that connects blood recipients with their donors while still complying with medical privacy laws. Instead of recruiting first-time donors, this program is designed to get first-time donors to become repeat donors.

“The program connects the recipient back to the individual donor using the bar code on the unit,” Armitage said. “The messages are so powerful and universal.”

One example is an email that includes a picture of a child who had recently undergone surgery with a message from their parent that said, in part, “Your blood donation helped bring my child out of surgery to be able to see another day. Your sacrifice has provided him the opportunity to continue being a 10-year-old, to run, play, jump on the trampoline, hug his siblings and friends, and so much more. I cannot imagine what would have happened if there had not been blood available to replace what he lost.”

At the 2020 AABB Annual Meeting, Armitage presented data on this program showing that 60% of donors who received an appreciation message became repeat donors, compared with 50% for unthanked donors, a 20% increase.9

“I do not have the adjectives to fully endorse the value of a program like this,” said Sayers. “This is not the blood program saying ‘thank you,’ but a very personal message from the transfusion recipient.”

Carter Bloodcare also participates in a Thank-the-Donor program.

“For a lot of people, donating blood can be a bit of an inanimate experience,” Sayers said. “You have to have a heart of stone not to be moved by these messages.”

The Future

Looking forward, technology will likely play an even greater role in donor recruitment and retention. At Mississippi Valley, Parejko has begun to try to harness technology in a more targeted manner. The Mississippi Valley Regional Blood Center is one of the first organizations to begin to employ Environmental Systems Research Institute (ESRI) marketing data as a benefit of its membership in the Blood Centers of America (BCA).

ESRI provides tools for direct marketers to identify and analyze current and prospective  customers, in this case, donors. In a program it calls GOLD, BCA leverages a geographic information system (GIS) for gathering, managing and analyzing data to help its members make smarter decisions with actionable intelligence.

“It works with the idea that near things are more closely related than further things,” said Hunter Shaffer, director of research and innovation at BCA. “If you picture a neighborhood and donors that live it in, that neighborhood will look different socioeconomically, racially and  geographically than another neighborhood.”

GOLD can be used, for example, to calculate the density of first-time donors in a given area. The GIS can be used to connect origins to destinations for existing and new donors by measuring travel time or distance and using that data to help blood centers calculate the distance donors are willing to travel to donate. Finally, the program can be used for residential analysis. This information can help donor centers better understand who their donors are and where their donors are to create specific marketing campaigns.

“We are taking this data and appropriately messaging donors based on what we think that individual will respond to,” Parejko said.

Most recently, Parejko has looked at pandemic donors and targeted them based on the fact that they donated during the pandemic.

“We have messaged them and had over 40% return rates during the pandemic,” Parejko said. “Traditionally it is much lower than that for ‘disaster’ donors.”

This program is a perfect example of how the industry has to think nationally but act locally, Parejko said.

“Right now, on a national level, there isn’t a plan. It is more ad hoc on an as-needed basis,” he said. “We need a constant message — a national drum beat — about the need for blood and how it impacts the health care continuum, but we have to implement that message at the local level.”

Parejko also noted the need for greater collaboration between blood banks and local hospitals.

“We have always had a good relationship but it could be stronger,” Parejko said. “The communication about supply and needs that has existed between the blood banks and hospitals since the pandemic began shows that we can have very open communication and work collaboratively.”

Finally, Armitage said that blood banks should have greater outreach to national surgical organizations and greater integration with medical specialties that are transfusion dependent.

“We should have connections to surgeons,” said Armitage. “A surgeon speaks with the family and discusses how the surgery went. They could say something to a family member about possibly donating to replace the blood used during the surgery. It will add 15 seconds of time in the patient’s room but would make a world of difference to have that white coat authority say that donation is important.” 
1. To L, Dunnington T, Thomas C, et al. The United States’ potential blood donor pool: updating the prevalence of donor- exclusion factors on the pool of potential donors. Transfusion. 2020;60:206-215.
2. American Red Cross. Only 3% of People in the U.S. Give this Type of Donation Needed by the Red Cross. https://www.redcross.org/ about-us/news-and-events/press-release/2019/only-3-percent-of- people-give-this-type-of-blood-donation.html. Accessed December 14, 2020.
3. Glynn SA, Busch MP, Schreiber GB, et al. Effect of a national disaster on blood supply and safety. The September 11 experience. JAMA. 2003;289:2246-53.
4. MacArthur R. COVID-19 creates dramatic blood shortage. Cape Gazette. November 16, 2020. https://www.capegazette.com/ article/covid-19-creates-dramatic-blood-shortage/211668
5. Aleccia J. As loyal blood donors age, industry is out for young blood. USA Today. September 24, 2017. https://www.usatoday. com/story/news/health/2017/09/24/loyal-blood-donors-age- industry-out-young-blood/683714001/.
6. Budaraju H. Helping Increase Blood Donations in the US. Facebook. June 12, 2019. https://about.fb.com/news/2019/06/us-blood-donations/
7. Anderson M, Jiang J. Teens, Social Media & Technology. 2018. Pew Research Center. https://www.pewresearch.org/internet/2018/05/31/teens-social-media-technology-2018/
8. Dodd RY, Xu M, Stramer SL. Change in donor characteristics and antibodies to SARS-CoV-2 in donated blood in the US, June-August 2020. JAMA. 2020;324:1677-1679.
9. Armitage J, et al. Increased collections from first time donors who receive gratitude messages from recipients of their blood. P-BB-41. Presented at: 2020 AABB Annual Meeting.