How to Promote Blood Donation? The Case of the Blood Donor Association of Cantabria (Spain)

Abstract

The present case study focuses on the application of social marketing principles to the promotion of blood donation. In this regard, many lives depend on the availability of safe blood supplies for transfusions and medical procedures, and the voluntary contribution of people is key to the success of the blood donation system. Specifically, we introduce the demographic profile of blood donors in Spain, paying special attention to the younger segment as a relevant target in promoting donations. We also detail the restraints and motivations that guide people’s behaviour regarding blood donation. Later, we describe the actions carried out by the Blood Donor Association of Cantabria (i.e. the main non-profit association in charge of creating the permanent blood bank in this geographical region) to promote voluntary donations, paying special attention to young people and experienced donors. The case study ends with conclusions and discussion questions.

FormalPara Learning Objectives

• Define the importance of blood donation as a prosocial behaviour.

• Analyse factors influencing donor behaviour.

• Analyse how social marketing can be applied to promote blood donation.

• Describe the actions carried out by the Blood Donor Association of Cantabria in terms of convenience and communication, specifically targeted to young people.

Introduction

Blood is necessary for life. For surgery and/or transplants, hospitals require blood to be successful. Many lives depend on the availability of safe blood supplies for transfusions and medical procedures (Lemmens et al. 2009). The necessity is permanent, so the contribution of people is key for a reliable, constant supply and for satisfying a demand that otherwise could not be met.

There are three main sources for collecting blood (World Health Organization (WHO) 2017): (a) replacements that come from relatives of the patient, (b) paid blood donations and (c) voluntary unpaid blood donations. According to the WHO, the last source is the most important as it is the only system that ensures a reliable supply of safe blood for patients whose lives depend on it. In fact, the challenge of the WHO is to get all countries in the world to implement fully voluntary, non-remunerated blood donations in the short term. In the same vein, the Council of Europe has presented several reports with measurements to guarantee the self-sufficiency of the European Community by means of unpaid blood donations. Although most European countries report collecting blood from 100% (or almost 100%) voluntary, non-remunerated donors (WHO 2017), there are still some exceptions. For instance, in Germany some organizations offer a reimbursement for whole-blood donors to cover their expenses. On the contrary, in Spain any type of payment has been forbidden since 1985, and blood donation constitutes a totally anonymous, voluntary and free act. The implementation of this non-remunerated system forces the development of awareness programmes to attract new donors and retain existing ones; this is where social marketing comes into play.

Furthermore, young people’s attitude towards donating has been recently identified as a significant challenge to the stability of the voluntary donation system established in most developed countries. In this regard, the willingness of the younger age groups to donate is significantly lower than older age groups, while these older people are entering the age when they need to receive (rather than give) donations (Solomon 2012). Thus, young prospective donors, with their long-term donation potential, constitute an especially attractive target for blood collection agencies (Hupfer 2006). For this reason, the identification and development of good social marketing campaigns oriented to this group are especially useful.

Based on this information, the present case study considers the Spanish context and analyses the application of social marketing principles to blood donation. In this regard, Spain maintains record numbers of transplants and organ donations, and its donation system has been a world leader for the last 26 years (National Transplant Organization 2017). In the case of blood donation, the Spanish rate has always remained close to the value recommended by the WHO (i.e. at least 40 donations per 1000 inhabitants to be self-sufficient in national blood supplies). These good results are supported in a very effective donation system, frequent awareness campaigns and, above all, much solidarity.

More precisely, the case focuses on presenting the social marketing actions implemented by the “Asociación-Hermandad de Donantes de Sangre de Cantabria” [i.e. Blood Donor Association of Cantabria (Spain)]. This association is the main non-profit organization in charge of creating the permanent blood bank in this geographical region, and it provides an interesting example of an organization strongly committed to the promotion of voluntary donations among young donors.

Throughout the case study, the demographic profile of national and regional donors, as well as motivations and restraints of common people regarding blood donation, will be shown as a first approximation to the topic. Later in the chapter, the social marketing actions carried out by the Blood Donor Association of Cantabria will be described. Specifically, and taking into account the importance of attracting young people to ensure the replacement of generations, the current case study details some of the most relevant marketing strategies targeted to this group. Results that measure the success of the social marketing strategy of the organization will also be shown. Finally, the chapter ends with the proposition of a set of discussion questions that will allow the reader to delve more deeply into the work of the Blood Donor Association of Cantabria, as well as reflect on social marketing and its applicability to blood donation.

Market Segmentation and Factors Affecting Blood Donation

Market segmentation is defined as the division of a market into distinct subsets of customers having similar needs and wants, each of which can be reached with a different marketing mix (Kotler 1994). The advantage of segmentation is that it allows an organization to tailor a marketing mix to the needs and wants of homogeneous subsets of customers that are not shared by the general consumer (Mowen and Minor 1998).

In the context of blood donations, profiling and segmentation studies indicate that the majority of donors are male, owing to a higher dropout rate of females, in their mid-30s (or older), and have higher educational, occupational and income levels than non-donors (Grant 2010). As shown in Fig. 1, in the Spanish context, people between 31 and 45 are the most frequent donors (Spanish Federation of Blood Donors 2017). In Cantabria, there is also a high proportion of donors aged 46 and over, while younger donors aged 30 and below only represent 23% of the pool of donors.

Fig. 1

Demographic profile of blood donors in Spain and Cantabria. Source: Compiled by the authors on the basis of the 2016 annual reports of the Spanish Federation of Blood Donors and the Blood Donor Association of Cantabria

Focusing on the region of Cantabria, Fig. 2 shows that the donors’ profile according to age has remained stable during recent years. The youngest segment represents the smallest percentage of donors, whereas the group aged 46 and over has usually been the largest. Furthermore, according to the Blood Donor Association of Cantabria, young people are not very loyal compared to older donors, in the sense that they do not have the habit of donating regularly. These data confirm the need for raising blood donation awareness among young people, attracting this segment and making them loyal to this social activity.

Fig. 2

Profile of blood donors in Cantabria according to age. Source: Compiled by the authors on the basis of the 2013–2016 annual reports of the Blood Donor Association of Cantabria

In order to design appropriate marketing strategies to attract blood donors in general, and younger people in particular, it is important to correctly identify the factors that affect these figures. In this regard, blood donation constitutes a process that tends to generate fear and aversion, which obviously hinders donation levels (Beerli-Palacio and Martín-Santana 2008). Specifically, some barriers identified in previous market research are, among others, fear of needles, fear of feeling dizzy or sick, pain or discomfort, feeling unpleasant seeing blood, previous negative experiences, lack of intimacy in the donation act, schedule conflicts and the extraction location being too far from home (Aldamiz-Echevarría and Aguirre-García 2014). Lack of information, ignorance and being unaware of the need for blood or other aspects of the donation process have also been consistently identified as negative factors in potential donor decision-making (Gillespie and Hillyer 2002).

Some of these impediments are psychological issues, which can be difficult to solve from a marketing point of view. Nonetheless, with a good strategy, acting on trust, convenience and communication, many of the worries that currently hold back blood donation can be overcome. For this purpose, the important thing is to reduce the perceived costs and increase the perceived benefits of donating, placing greater focus on the positive feelings derived from the act of donating blood (Pentecost et al. 2017). With regard to this, solidarity or altruism has been considered the primary motivation to donate blood (Beerli-Palacio and Martín-Santana 2008). However, Misje et al. (2005) point out that the habit of continued blood donation is not exclusively linked to altruistic reasons but also to a combination of other motives that include social reasons (such as the influence of friends and family), strengthening of one’s self-esteem, positive experiences associated with the donation and moral obligation to donate.

All these issues will be considered in the next sections of the case study, where the authors analyse the social marketing actions related to the convenience and communication strategies carried out by the Blood Donor Association of Cantabria to reach young donors in particular.

Social Marketing in the Blood Donor Association of Cantabria

The Blood Donor Association of Cantabria (www.hdsc.org) is the main non-profit association in charge of creating the permanent blood bank in this geographical region. It was created in 1970 with the purpose of “promoting the habits of social solidarity and contributing to stimulate the altruistic donation”, in order to “totally and completely cover (with altruistic donations) the needs of blood and plasma of any health facility in Cantabria”. In December 2016, the association had more than 95,700 members, which represents almost the 20% of the total population of Cantabria. As reward for its important work, it has been recognized with the highest regional distinctions for its extraordinary merits, such as the Golden Medal of Santander City (2002) and the Golden Medal of the Government of Cantabria (2005).

Convenience: How to Break the Barrier of the Distance

Convenience or distribution strategy refers to the process of organizing all the blood donation units. As noted above, possible obstacles to donation could be schedule conflicts or the extraction location being far from home. In order to overcome these potential dissuasive barriers and to avoid long displacements of volunteers, the Blood Donor Association of Cantabria has established a wide network of fixed and mobile units throughout the region. Specifically, the fixed blood donation centre is located in the Bank of Blood and Tissues of Cantabria (located at Marqués de Valdecilla University Hospital in Santander, the capital city of Cantabria). This unit collected 31.7% of the total blood donations in 2017. The other 69.3% of donations were collected by the mobile units (Spanish Federation of Blood Donors 2017). These provide service in various parts of the region, according to a schedule that can be consulted regularly on the Blood Donor Association website. Furthermore, the association has established numerous agreements with private companies and other public institutions to bring blood donation units to their workplaces periodically, making it easier for employees to donate. In the case of young people, the association has established an agreement with the University of Cantabria under which mobile units visit the different university centres regularly (at least three times a year). The university community is informed of these visits through various channels of internal communication (i.e. website, intranet, agenda). The association also displays mobile units in local primary and high schools, where students over 18, teachers and administrative staff can donate (Fig. 3).

Fig. 3

Mobile units of the Blood Donor Association of Cantabria. Source: www.hdsc.org (2018)

Communication: How to Inform and Persuade

When facing its communication strategy to promote donations, the Blood Donor Association of Cantabria faces two main challenges:

• How to effectively reach different targets (i.e. young donors vs experienced donors) with diverse motivations, lifestyles and attitudes towards social marketing (Hupfer 2006; Solomon 2012)

• How to solve seasonal issues of blood donation (Grant 2010), which can jeopardize the stability of the voluntary donation system in the region

Reaching Different Targets

As far as the first challenge is concerned, it is evident that developing an effective way to communicate with people as they reach the age to donate is a critical step to be taken (Solomon 2012) and persuading them to give blood may require specifically tailored marketing communication (Hupfer 2006). Based on this idea, in recent years, the Blood Donor Association of Cantabria has started to design specific communication measures to target the young market segment successfully. Actually, the association differentiates two targets within the youngest segment: (1) the target of “potential donors over 18” and (2) the target of “non-donors under 18”. The Blood Donor Association of Cantabria designs communication activities to both targets, with a special focus on the “non-donor” segment, which is considered the future of blood donation worldwide. In this segment, the communication activities focus on raising awareness among young people who are close to the age of donation.

Communication for Young Donors

The coordinator of all the implemented activities is the Young Donation Network, a project promoted by the Blood Donor Association of Cantabria that aligns with the goals of national and international initiatives such as the National Committee of Young Donors (Spain), the Ibero-American Meetings of Young Donors (international) and the International Youth Committee (international), among others. The project, which was proposed based on the success of a similar initiative carried out in Catalonia (Spain) (www.donantsdesang.cat), is an educational programme for children and young people from ages 6 to 18 to acquire knowledge and values through the promotion of blood donation and the organization of a specific communication campaign for the Blood Donor Association. The idea is based on a learning-service model: “learn by doing service for the community”. First, the students enrolled in the programme identify a problematic situation in their local community to whose improvement they want to commit themselves. To alleviate the social problem, they develop a social project that puts into play their knowledge, skills, attitudes and values. In the specific case of the Blood Donor Association, the social problem refers to the shortage of blood donations in Cantabria, for which the students create a campaign to promote the donation among society that, the hope is, ends with a massive blood collection. The programme consists of four stages:

• Stage 1. Training, in which participants learn concepts related to blood, donations, equality and altruism and acquire knowledge to create their own communication campaign and raise social awareness.

• Stage 2. Creation of materials, in which the educational centre prepares all the materials needed for the communication campaign for blood donation. Specifically, the students work in groups to create logos and slogans to personalize each campaign, design letters to the families of the centre and the neighbourhood, create banners, devise gifts for donors, etc.

• Stage 3. Service, in which children and youngsters put into practice all the knowledge they have learned during the programme. In this stage, they are responsible for raising awareness in their environment with their communication activities. Within the service stage are two key moments: before the donation campaign and the day of the campaign.

• Stage 4. Valuation and acknowledgements. The Blood Donor Association makes a critical reading of the campaign to generate learning and derive improvements from the experience. In addition, participants are identified and recognized. In this sense, recognition is essential to generate commitment and a positive attitude of these young people towards future donation. Finally, the generated resources are given visibility. Specifically, and if the materials are sufficient, award competitions are held with public and media coverage.

Along this line, the role of new communication technologies and social media among young people also represents a great challenge for the communication of the Blood Donor Association. Accordingly, the association has a website that was updated in 2017, on which ample information is displayed such as stories, facts, figures and the importance of donations. On the website, the entire donation process is explained in order to overcome the barrier that a lack of information or awareness about the need for blood represents.

Furthermore, the association is also especially focused on social media as one of the most effective communication channels for reaching young donors. Specifically, the Blood Donor Association is present on four social media platforms: Google Plus, Facebook, Twitter and Instagram. It is vital that the association understand social media as a useful and necessary way of promoting donation. In this regard, sharing an image with friends and family of one in the process of donating blood is the simplest and most practical form of promotion. A phrase, a testimony of someone who has given or received blood, inspires others. As for the content of the posts, most of them are primarily informative, describing how, where and when users can donate at the permanent facilities of the association or the mobile units that travel the region. Emotional messages are also posted through the use of pictures of actual donors along with encouraging messages to promote blood donation.

Finally, the young segment is also reached through volunteerism. In this regard, an interesting initiative has been promoted in collaboration with the University of Cantabria that, through its volunteer programme, offers university students the possibility of collaborating with the association in diverse activities such as the following: promoting the blood campaigns that are carried out, distributing information, helping to organize activities, sharing their testimonies in talks at primary and high schools and managing the association’s presence on social media and the Internet.

Communication for Experienced Donors

As far as experienced donors (i.e. those over 30) are concerned, one measure that is reporting interesting benefits to the Blood Donor Association in terms of promotion and communication is the Sports and Solidarity Group, which is an open club that gives an opportunity for all participants to initiative activities. The Sports and Solidarity Group of Blood Donors of Cantabria has carried out various activities for the last 5 years. The club is mainly oriented to hiking, although activities have also been held in spelunking and bicycle rides. Through this club, the association appeals to the group feeling and to the emotional benefits that being part of a collective provides its members. To date, the Sports and Solidarity Group has sponsored more than 50 activities organized by the volunteers themselves, who promotes the Blood Donor Association by wearing promotional T-shirts of the association during the group’s activities. A club mascot has also been created: Gotito (Fig. 4). The Blood Donor Association also participates in solidarity activities with other associations, such as Limones Solidarios (i.e. Solidarity Lemons), Esclerosis Múltiple (i.e. Multiple Sclerosis) and Buscando Sonrisas (i.e. Looking for Smiles), while it also takes advantage of national events to make itself known (e.g. World Book Day, International Human Rights Day and others).

Fig. 4

Gotito. Source: www.hdsc.org (2018)

For the market segment of experienced donors, other promotional activities include the regular publication of the magazine of the Blood Donor Association or collaboration with conventional media (i.e. TV, radio and newspapers) at the regional and local levels (Table 1). The magazine is distributed online through the association website and offline in waiting and consultation rooms at Marqués de Valdecilla University Hospital, at the blood bank and at the different mobile units that visit the region (e.g. at social centres, institutes, universities). The magazine is also available at a number of locations where volunteers are allowed to leave copies. The magazine is published quarterly and provides information on all the activities and collaborations in which the association has participated during each period. Each issue includes a section noting the association’s sponsorship campaigns, whereby members who regularly donate blood accompany first-time donors to provide support and alleviate their possible apprehension to the process.

Table 1 Conventional media that lend their support to the Blood Donor Association of Cantabria

Solving Seasonal Issues

As for the second communication challenge of the Blood Donor Association (i.e. seasonal blood shortages), it is observed that in Cantabria, as in any other developed country, blood demand during the summer or Christmas holidays is usually high due to a greater number of accidents occurring to people who have got out of their daily routines and are engaging in new or different behaviour. However, donors may not be motivated during that time because their attention is diverted to other activities. This suggests an issue of maintaining awareness among donors of the ongoing need for blood donation (Solomon 2012). Relationship and services marketing techniques can be used in this context to raise awareness, overcome ignorance and generate loyalty among donors, as well as to reinforce benefits and demonstrate needs being met among end-users and customers (Grant 2010). Therefore, the communication efforts of the Blood Donor Association of Cantabria are always intensified during these periods of the year. In this regard, not only does the association make special appeals through social media, but when there are specific needs for donations due to blood shortages in Cantabria (or any other region of the country), the association sends out text messages that donors receive on their mobile phones, indicating the specific situation that requires help and the logistics for donating to the specific cause.

Conclusions

Blood is a source of life. Many people depend on the availability of safe blood supplies. Thus, donation, as a free and voluntary act, should be continually promoted. With regard to this, the case study has focused on the awareness actions carried out by the Blood Donor Association of Cantabria, paying special attention to the activities addressed to young people. According to the association, the blood needs of the Cantabria region have always been met up to now. However, it is important to keep working to attract new donors and retain existing ones. The segment of the population under 30 has much potential for growth, so the Blood Donor Association has designed awareness programmes at schools, activities with universities and social media communication, among other measures, whose results are expected to be seen in the short and medium term. With regard to existing donors, the actions are linked to maintain their commitment, with different actions in terms of public relations and advertising.

Discussion Questions

• Is there a blood donor association in your area? Describe the initiatives it carries out to promote blood donation.

• What blood donation figures have been reached in your area in recent years? Compare them with the figures shown in the case.

• What is the level of involvement of young people in blood donation in your area?

• What are some innovative initiatives that could be designed to improve the awareness and participation of young people in blood donation?