Engaging an untapped demographic in blood donation
Over the past decade, the inventory of blood in the U.S. has been falling. Supply further evaporated as COVID-19 hit, cancelling blood drives and making it more difficult to recruit donors. Blood inventories are now routinely at critical inventory levels.
Bridging our Introduction to Design in Health and Fieldwork in Design courses, we initially set out to address the challenge of rebuilding and maintaining the country’s blood inventory. Our research ultimately guided us to focus more locally and within a younger demographic, prototyping a mobile bus model built around convenience, a social experience, and motivational incentives.
MY ROLE
Design research, synthesis, ideation, photography
TEAM
Bonnie Du, Emily Rowe
DATES
Fall 2020
As an incentive to donate, the local blood bank began testing all donations for COVID-19 antibodies.
Donors noted the experience itself was overall a positive one (even when this donor passed out in the chair!)
RESEARCH
We began with extensive research on the history of blood donation in the U.S., the stakeholders involved, and donor demographic trends. We found that one in three Americans is eligible to donate blood, but only one in 30 actually donate. Our local blood bank informed us they need 200 donations per day to maintain an adequate supply—which was difficult to meet even before the pandemic hit.
Notably, we discovered that younger, first-time donors haven’t been replenishing the donor pool as Baby Boomers age out of donating. In the long term, this demographic shift will put the blood supply in a perilous position.
19
interviews conducted
6
pints of blood donated
1
virtual blood drive held
In our primary research, we sought to more deeply understand current blood donation experiences and sentiment, particularly among the seemingly absent younger population. Across more than eight hours of interviews, we heard from 19 non-donors, donors, phlebotomists, and a blood transfusion recipient. We coordinated a blood drive, accruing six pints of blood as a result of our humble research efforts alone.
Our research methods included:
Participatory research of first-time and repeat donor experience through participation in our team’s blood drive
In-depth interviews with four donors, nine non-donors (ages 17-31), two phlebotomists, and one blood transfusion recipient
Donor auto-ethnography and journey mapping by our team, with two successful in-clinic blood donations and one unsuccessful attempt in a mobile bus clinic
Concurrent think-aloud protocol with potential donors as they made a blood donation appointment to understand their decision-making process
Directed storytelling with interviewees, asking them to share about a time they donated something
Artifact analysis of social media posts and campaigns around individuals’ charitable giving
Analogous research into another societal participatory activity with low youth engagement: voting
Our initial research focused on the donation experience itself. The feedback was extremely positive—even when one donor passed out! So we made a presumptive leap. Our hunch was that we should focus on getting people in the door in the first place. If we could get people to the donation phase, they would likely donate again in the future (with enough reminders of course). So we moved our focus upstream to donor recruitment, and reframed our problem accordingly.
Problem reframe: How might we revitalize the nation’s blood inventory by increasing visibility and engaging an untapped younger demographic?
MORE RESEARCH
With a more honed scope of focus, we spent time peeling back the layers of the cultural and social factors of donation more broadly—and then sought to apply some of those findings to blood donation specifically. We did this through artifact analysis and analogous research.
Artifact analysis: The “Boards”
In interviewing a group of three college students about the culture of donating among their peers, they emphasized the power of social media among their age group. In particular, they noted digital nudges shared through “boards” on Instagram posts and stories. We had to ask for clarification. These empty boards have spots that get filled as one’s friends donate to a cause, and the board gets reposted with every new donation, tagging the donor’s Instagram handle. The interactions at play are peer pressure, transparency, and creating a feedback loop.
“If I see an empty board, it’s a sad situation,” noted one student.
Analogous research: Civic engagement
We noted the stark parallels between blood donation habits and engagement (or lack thereof) in voting among the U.S. population. As with blood donation, there is no single fix for civic engagement. Rather, we need simultaneous efforts on a short, medium, and long-term timeline. Those include: providing immediately actionable information on why it’s important and how to do something (e.g., how to register, fill out a ballot); creating the path of least resistance (e.g., automatic voter registration at age 18); and reimagining early education. Also, people love “I voted!” stickers. Noted.
SYNTHESIS
We produced weekly field notes to capture important quotes, emerging themes, and notable photos as a measure of our progress and ongoing synthesis. By placing a focus each week on one of the human factors (physical, social, cognitive, cultural) of blood donation, we were able to develop a well-rounded view of the issue.
Our notes from the field poster capturing findings about the social factors of blood donation, featuring one of our favorite quotes: “We can’t let the Boomers show us up!”
We articulated three key insights about behaviors and attitudes regarding blood donation:
01
The collective nature of blood donation, paradoxically, may be at odds with individualistic tendencies in the U.S.
02
The social aspects of the blood donation experience draw people in and are paramount to growing a donor base.
03
Among the younger demographic, activation energy—not apathy—is a primary barrier to donation.
“It would definitely be better with friends. You’d have someone to compare the experience with.”
— Non-donor, 26
“It’s an old person’s game.”
— Phlebotomist, on donor demographics
IDEATION
As we moved into ideation, we were guided by the insights we had unearthed around social factors, visibility, and inspiring action. How do young people interact with the world and their peers? Where are they spending their time, and what are they doing in those spaces? What do they care about? And perhaps most importantly, what catalyzes them into action around a cause?
We began brainstorming by considering: how might we…
increase visibility into the process and status of blood donations on an individual and broader scale?
National live database, blood donation tracking, altering mobile bus locations
devise new incentive structures for donors?
Referral programs, offer routine lab testing or genetic testing options, luxury spa experience
expand the reach of donor recruitment through new and/or improved communication channels?
Digital campaigns and partnerships, TikTok challenges, dating service
be as inclusive as possible, given blood donation’s exclusionary impact in certain communities?
PROTOTYPING
We found ourselves with a myriad of potentially impactful concepts, including an in-depth communications and social media strategy for the blood bank, but ultimately decided to move forward with something more physical and experiential. Using our local blood bank’s existing mobile bus drives as a starting point (involving an Airstream affectionately nicknamed the “Bloodstream”), we prototyped a neighborhood bus model with enhanced interior design.
Initial prototype of a neighborhood bus model with enhanced interior design. Includes plant decor, personalized speakers, and photo booth.
We then thought more about how to target a young demographic specifically, expanding the locations we would take our bus. To test this idea, we built a Choose-Your-Own-Adventure prototype in the form of a Keynote slide deck (below). Because of COVID-19 constraints, we had to re-think how we would walk our participants through this new experience. For delivery, we first shared it during our interviews, asking them questions about their decision-making and thoughts about the process. We then adapted it to a Google Form survey that could reach a wider audience, guiding their experience and allowing them to offer feedback.
(Walk through our Google Form survey of the prototype yourself here!)
FEEDBACK
There were three main questions we aimed to answer through our prototype: Will this engage young people? Is physical proximity enough? What incentives matter most?
In gathering feedback through interviews and the Google Form survey with 22 responses, we found that initial draws to the mobile bus may differ from the final nudges to actually decide to donate.
The majority of our survey respondents were willing to engage, as most would walk up to the bus and some would donate automatically. As we had anticipated, physical proximity and convenience were the most important to potential participants. But that didn’t mean people would donate automatically. Our most popular final nudges included antibody testing and the possibility of meeting an urgent need.
We found that people wanted clear, upfront expectations: how long will it take? Am I eligible? Are there post-donation limitations? In engaging with the prototype, our respondents transformed it into a more rich social activity than we presented it as. They wondered if they could take a photo donating together with their friends—and even indicated they would wait in a line or donate for the first time if they could do it with people they knew.
If we were to develop a next iteration, we identified a handful of areas for improvement:
Devise a more intentional social experience
Ensure a consistent, reliable schedule for the mobile drives
Clearly signal eligibility requirements and expectations about the process
Create a more overt social media push (e.g., through a referral system, work competitions, gamification)
Nearly every interview and walkthrough of our prototype ended with people becoming inspired to go donate blood. It's really a matter of making blood donation part of the broader conversation. Itching to donate after reading this? If you’re in Austin, make an appointment at We Are Blood today.