Terminal progress report of the Altruistic blood donor program dissemination

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Center for Advanced Computation

UNIVERSITY OF ILLINOIS A I UHBAINA-OHAMI-'AIUlN

URBANA, ILLINOIS 61801

CONFERENCE ROOM

ENGINEERING LIBRARY
UNIVERSITY OF ILLINOIS

URBANA, ILLINOIS

"HSHissiaseiHs

JUN :> a 1976

WBSB&ffiD

CAC DOCUMENT NO. 196

Terminal Progress Report
of the

ALTRUISTIC BLOOD DONOR PROGRAM DISSEMINATION

by
John Morrow Hackmann

May 14, 1976

Supported by the Illinois Regional Medical Program
Contract US IRMP HEW SUBC/OG-58

Findings and conclusions do not necessarily represent the views of IRMP

Morrow Hackmann, Co-principal Investigator
Search Associate, Center for Advanced Computation

RxXt+J) ClRt^ZyJ^^

Richard C. Roistacher, Co-principal Investigator
Assistant Professor, Center for Advanced Computation

Table of Contents

Summary 1

Organization of This Report 3

Objectives 4

Evaluation

Church-Congregation-Based Donor Recruitment and

Donation Scheduling 5

Pledge Cards for Vacation Period Donations 7

Annotated Bibliography of Blood Donor Recruitment

Literature 8

Fol low-Up Study of Repeat Student Donors After

Graduation from College 11

Model Blood Program for College Campuses 13

Campus Blood Programs in Illinois 13

Evaluative Measures of Performance in Blood Collection:

Blood Program Effectiveness and Efficiency 14

Consulting 16

Documents 17

Dissemination 19

Regionalization 20

Project Continuation 21

Recommendations and Comments 22

List of Tables

Table I. Pledge Card Distribution in Illinois 9

Table II. Campuses and Drawing Agencies Cooperating in the

Pledge Card Project 10

Table III. Campus Blood Programs in Illinois 15

Table IV. Documents 18

Summary

The purpose of the Altruistic Blood Donor Program Dissemination was
to stimulate an increase in the amount of blood donated by volunteers on
campuses and other sites in Illinois. The methods used to achieve the in-
crease were to be such that the higher and more timely donation patterns
would persist after termination of funding by the Illinois Regional Medical
Program, thus permanently improving the Illinois blood supply which has ex-
perienced chronic seasonal shortages and high donor recruitment costs.

To this end, documents were to be prepared and disseminated and within
available resources methodology was to be designed and research conducted.
This has been done. The model campus program pioneered new techniques and
increased its total draw from 5098 pints in 1974-75 to 7878 in 1975-76. The
model pledge card project was extended to a number of campuses. 1286 pledges
to donate blood were obtained and distributed at the Christmas period and
4266 pledges have been obtained, to date, for the summer. This keeps student
donors in the blood donation pool during the two worst supply periods of the
year.

Consulting has taken place with six campuses, three of which have already
implemented expanded blood programs and two of which have consequently been
able to reduce financial burdens on blood recipients.

More than 5500 copies of three documents have been printed and are being
distributed. Other manuals and papers are in preparation. Distribution in-
cludes 41 Illinois campus ministries, most Illinois blood agencies, and 890
Illinois church congregations.

Data have been collected describing blood programs on Illinois and Big Ten
campuses; on hospital and blood bank practices in Illinois; on whether pledge
card collection for vacation periods affects campus bloodmobiles. A typology

-2-

of donor programs, intervention strategies and schedules for the various
types of situation identified, and measures of effectiveness and efficiency
in blood programs have been developed. An annotated bibliography of the
blood donor motivation literature has been prepared. This work forms a
base on which future workers in this field can build.

A pilot project involving church congregations in blood donor recruit-
ment and donation scheduling was designed and implemented. Seventeen congre-
gations in one county are participating at this writing. It appears likely
that this program may become a national project of one of the major Protestant
denominations; since it emphasizes ecumenical cooperation, this should allow
effective national exposure of the program, for which a comprehensive manual
has been developed and printed.

The Blood Donor Research Group will continue to work on these projects
in Illinois and to expand its efforts to other parts of the nation within
the limitations of future funding.

-3-

Organization of This Report

Several specific objectives of this project were identified in the project
proposal. Others were incorporated into the project as it progressed. The
original and added objectives will be listed in the section on Objectives
and then discussed individually in the section on Evaluation. The impact
on health care in the region and the continuation of activities originated
and fostered by the project will be discussed in the section on Regionaliza-
tion. Future activities of the Blood Donor Research Group and suggestions
for other workers in this area appear in the concluding section, Recommenda-
tions and Comments.

-4-

Objectives

The central objectives of the project were met. Some change of focus
occurred as a consequence of the time lag between planning and funding and
as consequences of our experience with the project. That experience sugges-
ted areas of great promise related to the proposed work but not explicitly
identified in the proposal. The project was expanded to include:

° a church-congregation-based program of donor recruitment and donation
scheduling

0 a State-wide project to collect donation pledges from student donors
to help avert vacation period blood shortages

° an annotated bibliography of blood donor recruitment research

° a follow-up study of repeat college donors who have graduated.

Planned objectives that were met will be discussed under these headings:

0 a model blood program for college campuses

° campus blood programs in Illinois: a data base

° evaluative measures of performance in blood collection: blood program
effectiveness and efficiency

° documents

0 dissemination

° consulting

One objective was not met:

0 initiating new blood programs on Illinois campuses.

-5-

EVALUATION

Each objective will be discussed, including rationale and results, in
the order given on the previous page.

1. Church-Congregation-Based Donor Recruitment and Donation Scheduling

Blood donation can be an altruistic act and a blood donation program
can be a community service project for groups with ethical concerns. These
seemed ideal beginning points for establishing blood donation programs run
by church congregations. Besides providing members with opportunities to
express community and humanitarian concerns, the project also helps es-
tablish and strengthen ecumenical cooperation when executed as developed
by the Blood Donor Research Group.

The approach developed by the BDRG includes a feature which proved
rewarding to churches participating in the pilot project and made their ef-
forts more reliable and cooperation with them less costly for the blood agency:
blood program coordinators in each church are responsible for donation scheduling
on a year-around basis, not just for recruitment of the donors. Thus the bank
staff do not have to call the donors, and can count on help in all seasons,
including the winter and summer vacation periods.

In the pilot program, seventeen churches including all major denomina-
tions have taken the project to the point of producing pints. We estimate
that in two years this program, which has the support of the Champa ign-Urbana
Ministerial Association and Council of Congregations, will be meeting more
than half the blood needs of Champaign County. Reduced agency costs consequent
to the efforts of the church coordinators in scheduling the donations will be
passed on to the citizens of the County and others using County hospitals. We

-6-
have been informed that the Board of the Champaign County Blood Bank will
entertain a motion at their July meeting to end the $10 nonreplacement fee
currently in effect. One of the factors leading to this motion is the pros-
pect of strong continuing community support for the Bank evidenced by the
church congregation project.

An estimated 2000 pints per year have not been replaced or supplied
under blood assurance programs by the Champaign County Blood Bank. Thus
some $20,000 in non-insured charges will end if the fee is abolished. We
believe that a disproportionate fraction of this burden has been falling
on the elderly and on high users of blood.

This project has had the full cooperation of the Blood Bank, especially
Charles Drummond, manager, and Dr. Ben Williams of the Regional Health
Resource Center, the parent organization of the Champaign County Blood Bank.

Charlie Sweitzer, Associate Pastor at the McKinley Memorial Church and
Foundation in Champaign, has helped the Group disseminate our manual,
"Your Congregation and Blood Donation -- A Manual", to the 490 Presbyter-
ian and approximately 400 Disciples of Christ congregations in the State of
Illinois. Thus nearly every community in Illinois will receive at least one
copy of this comprehensive how-to-do-it manual. Since the manual emphasizes
ecumenical cooperation in building a reliable, steady, year-around stream of
blood donations, we expect this dissemination of the manual to reach a very
large number of Illinois church congregations.

The Midwest Regional Board of the Health, Education and Welfare Associa-
tion, United Presbyterian Church, is considering adoption of the congregation-
based blood program as a major project. National distribution is also planned
through Presbyterian Youth Ministries and women's groups of the church. Nearly
2000 copies of the church program manual will have been distributed by June 1,
1976.

-7-
The pilot program suggests that the program appears to have excellent
initial acceptance by pastors and congregations and by blood bankers. Of
all programs developed this year under Regional Medical Program funding,
this one seems most likely to gain national attention and acceptance.

2. Pledge Cards for Vacation Period Donations

The Group initiated a system for collecting, sorting, and distributing
pledges by college students to give blood in their home communities over
summer and winter academic holidays. Cards were collected State-wide, with
cooperation of the Mobile Blood Bank Council of Chicago, the Chicago Regional
Blood Program, the four Red Cross Regional Blood Programs serving Illinois,
and other Illinois blood agencies.

A trial program targeted on the Christmas, 1975, period involved six
campuses and generated 1286 pledges. Of these, 728 cards were forwarded to
eleven downstate blood agencies, 445 to Chicago area blood agencies, and 20
were sent to the Greater New York Blood Program. Other out-of -State cards
were too scattered to justify distribution.

Criticism of the method used to divide Chicago area pledges among the
various blood agencies operating in the metropolitan region led to an improved
plan for handling the summer period pledges. Distribution problems and the
inevitable confusion of a pilot project made it inopportune to require agencies
to report the disposition of Christmas-season pledges. These data are being
requested for the summer project, however. This will allow us to determine
how many of the pledges are being translated into actual donations.

The spring project expanded to include sixteen campuses which have blood
programs with the Red Cross Regional Programs and the Mississippi Valley Blood
Bank. At the date of this writing, 4266 pledges have been processed. Some
1603 have been delivered to the Chicago Regional Blood Program and the Mobile

-8-

Blood Bank Council for further sorting.

Champaign County has not had seasonal blood shortages since the initia-
tion of the one-campus pilot project of vacation pledges at the University of
Illinois at Urbana-Champaign three years ago. More than 25% of the county's
blood needs during vacation periods are met by University students and faculty.

The State-wide project, initiated this year and supported by IRMP funds,
will, we hope, be expanded to include more campuses next year. It will be
coordinated by David Eisenman, a member of the Group and Staff Advisor to the
Volunteer Illini Projects Blood Program at the University of Illinois. We
are seeking a way to support the cost of printing, distributing, collecting,
sorting, and forwarding the pledge cards.

Tables I and II provide tabular information about the pledge card pro-
ject carried out this year under IRMP funding.

3. Annotated Bibliography of Blood Donor Recruitment Literature
As the Group worked on the various facets of the "blood problem" it
became clear that the common conception that blood shortages are due to
apathy or lack of incentives for donation is not a useful formulation of
the problem. Creating a plentiful, demand-responsive supply of volunteer
blood has less to do, we believe, with the reasons people give blood than
it does with the resources, approach and philosophy of the blood drawing
agencies. Our approach has been to emphasize the creating of opportunities
for potential donors to become actual donors rather than to try to "motivate"
donors to seek out existing donation opportunities. Motivation research
attracts investigators because it is very interesting intellectually; but
our suspicion is that people will feed back to us "reasons" for blood dona-
tion that we inadvertantly supplied to them. For applied research, designed

Blood Agency

-9-
Table I

Pledge Card Distribution in Illinois

Christmas 1975
Number of Cards

135

74

1173

113

Summer 1976
Number of Cards

Chicago Regional Blood Program * 445 1603

Central Illinois Community

Blood Bank (Springfield) 24 84

Champaign County Blood Bank 419 351 **

Danville Elks Blood Bank 3 15

DeKalb County Blood Bank 6 25

Franklin Hospital - 7

Freeport Memorial Hospital 12 12

Galesburg Regional Red Cross 16 106

Jacob Blumberg Memorial Blood

Bank (Waukegan) - 31

McDonough County Blood Bank/

Peoria Regional Red Cross 2 80

Memphis Blood Center - 1

Mississippi Valley Regional

Blood Bank (Rock Island) 19 34

Northern Illinois Blood Bank 18 63

Ohio Valley Blood Service - 13

Peoria Regional Red Cross 135 885

Saint Louis Regional Red Cross

Subtotal, Agencies Serving
Illinois

Out-of-State Blood Agencies 113 182

Totals 1286 4266

* Includes Aurora and all Chicago area agencies, from Mid-America Red Cross
to hospital blood banks

**From 350 to 450 faculty/staff pledges are expected to arrive by June 1

-10-

Table II

Campuses and Drawing Agencies Cooperating in the
Pledge Card Project

Campuses

Christmas 1975

University of Illinois,

Urbana-Champaign
Rosary College
DePaul University
Bradley University
Loyola University
Illinois Central College

Campus Drawing Agencies
Christmas, 1975

Mid-America Red Cross
Peoria Regional Red Cross
St. Louis Regional Red Cross
Champaign County Blood Bank

Summer 1976

University of Illinois,

Urbana-Champaign
Loyola University
Kankakee Community College
Rosary College
Kaskaskia College
Greenville College
Southern Illinois University,

Carbondale
DePaul University
Carl Sandburg College
Western Illinois University
Northwestern University
Lincoln College
Eastern Illinois University
Quincy College
Blackburn College
Lakeland College
Southern Illinois University,

Edwardsville
Moraine Valley Community College
George Williams College
Illinois State University
Illinois Wesleyan University
Bradley University

Summer 1976

Mid-America Red Cross
Peoria Regional Red Cross
Galesburg Regional Red Cross
St. Louis Regional Red Cross
Champaign County Blood Bank
Blood Services, Chicago
Mississippi Valley Regional Blood
Center

-11-

to increase donations and make them more timely, we found donor identification
and donation scheduling strategies better foci for our efforts. This perspec-
tive seems to be shared by other observers and researchers interested in blood
donation.

There appears to be increased interest in recruitment techniques as
distinct from studies of donor motivation (which are properly a subset of the
recruitment literature). Our own work and that of others, including the American
Blood Commission and the nation's blood agencies, would be facilitated by a
comprehensive review of relevant research, we decided early in the project.

Consequently, all known articles on blood donor recruitment, including
more than a dozen unpublished ones, were collected by the Group, filed, and
listed in an annotated bibliography of some 100 articles. The list is available
on request from the Blood Donor Research Group. Material on donor motivation
is included, but the emphasis is on practical techniques resulting in increased
donation.

The Group plans to keep this bibliography current and to maintain a file
of all articles in this field which we have found likely to be of practical use
or major conceptual importance.

4. Follow-Up Study of Repeat Donors

One attraction of college campuses is that donors who begin blood dona-
tion at an early age can give many gallons of blood in the course of their
lives. If donation behavior can be initiated and reinforced while an indivi-
dual is in college, it has a greater chance of being expressed later when
that individual must fit donation in to a considerably more restricted time
schedule and expanded nexus of social commitments. Thus it is important to
know whether student donors become regular community donors when they pass

-12-
out into the world of work and familial responsibilities.

A sample of students who gave several pints as undergraduates in the
first year of the model campus program at the University of Illinois (1972-
73) is being contacted in a telephone survey and asked questions regarding
past and present donation behavior. The students are being traced through
Alumni Association records, where they exist, or through their parents. Of
the sample of approximately 100 students chosen for the research, 18 have
been contacted at this writing. Several are still in educational degree
programs .

Sixteen of the eighteen have given from one to 16 pints since under-
graduate graduation. Of the remaining two, one had made an appointment
to donate blood for the week following the telephone contact; she reported
that no blood agency draws at a location closer than 25 miles to her home.
The remaining ex-student has been ineligible to give blood as a consequence
of taking malaria pills, but will be eligible again this summer and plans
to re-commence donation.

This preliminary information suggests that student donors continue their
donation behavior after leaving college campuses. Nearly all reached so far
report, however, that the hours and locations of blood donation opportunities
are generally inconvenient and that they are giving less blood than they
would like to be giving.

This result reinforces the Group's conclusion that motivational problems
are less important than the general lack of convenient opportunities to give
blood. Every single donor reached so far has made efforts to give blood
since graduating from college. Motivation appears to remain high; it is
opportunity that is rate-determining.

The survey will continue until all 100 donors are reached or until all

-13-
ef forts to locate them have been exhausted.

5. A Model Blood Program for College Campuses

The model program which began in 1972 at the Urbana campus of the Uni-
versity of Illinois continues to operate and to experiment with different
approaches to providing students with opportunities to give blood. During
this year members of the Blood Donor Research Group worked with the students
of Volunteer Illini Projects to expand the program to involve five drawing
agencies and monthly blood donation days with multiple locations on campus
at which students could give blood. In addition, we encouraged students to
make donations throughout the month at the Champaign County Blood Bank, a
fixed-facility bank located near the campus.

The program collected a record 7878 units of blood, up from 5098 in
1974-75. (Prior to 1972, annual pint totals rarely exceeded 1000.)

A mass of detailed information on planning and executing an ambitious
program of this sort was assembled by members of the Group, including students
working with us over summer and Christmas vacations. The Bleeder's Digest:
A Reference Manual for Campus Blood Collection is the result. Its 138 pages
include check lists, narrative, sample publicity materials, annual planning
calendars, and other materials which we feel can help a campus group initiate
and execute an expanded blood program.

A flyer announcing the availability of this manual has been prepared.
Five hundred copies are being distributed in Illinois and elsewhere.

6. Campus Blood Programs in Illinois

Campus Blood Programs in Illinois, another document of the Group,
provides perhaps the most comprehensive data available on a class of blood

-14-

programs across any State or region. It covers some 71 blood programs on

146 campuses of postsecondary education in Illinois. These programs generated

approximately 25,000 pints in 1974-75.

Preliminary analysis of the data shows that in spite of increased interest
in college campuses as sources of blood, many are still underutilized. Rates
of blood donation vary by factors of five and ten for campuses of a given
size and type.

The data also support the widespread field impression that no one has
solved the problem of getting a successful blood program operating on a
commuter campus.

This document is being distributed to all blood drawing agencies in
Illinois. They will be able to compare their own campus programs against
others at campuses of the same type and size. Data include campus enrollment,
total pints drawn, number of drawing dates per year, average pints per day
collected, pints per thousand students per year collected, the number of
students living in university housing, whether the drawing agency is fixed-
facility or reaches the campus by mobile equipment, the type of campus
coordinating group, whether the campus is residential or commuter, and give
these for the four-year period, 1972-1976.

An excerpt from this report is given as Table III.

7 . Evaluative Measures of Performance in Blood Collection: Blood
I'rogram Effectiveness and Efficiency

The evaluation work originally conceived was to involve assessment of

programs at new sites. We found substantial barriers to the development of

new programs on college campuses and simultaneously identified much more

-15-

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College of DuPage

Southern Illinois
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Loyola University

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- NO BLOOD

PROGRAM

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12344

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12608

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14478

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Western Illinois 15458 2529 164
University

Northwestern University 15764 1180 75

Southern Illinois 19009 2514 132
University - Carbondale

Illinois State University 19450 1490 77

10 253 55 M

18 66 20 M
14 180 33 M

213 42

M

University of Illinois, Chi

Northern Illinois
University

20244

623

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0

F

24812

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University of Illinois
Urbana-Champai gn

Chicago City Colleges

35117 5098 145 21 243 26 M,F
59291 650 11 16 41 0 M

Table III

Campus Blood Programs in Illinois -- Campuses with 10,000+ Students

-16-
promising areas in which to have impact on donation rate and timing. There-
fore, no evaluation program has been conducted of the sort envisioned.

However, a methodology was been worked out by Professor Roistacher
and his assistant, Jo Day. They will describe this work in a paper to be
completed this summer, presently scheduled to be presented at a conference
next fall.

8. Consulting

Several campuses interested in expanding their blood programs learned
of the activities of the Blood Donor Research Group through personal contact
and Group members' attendance at professional meetings. We made site visits
to several campuses. Working papers and recruitment materials developed in
the pilot program at Urbana were shared.

We found that complicated relationships between campus programs and
drawing agencies and rivalries between drawing agencies presented formidable
obstacles to rapid implementation of expanded blood programs. In addition,
the two most promising campuses both lay outside Illinois.

We believe that our consultations have had some impact but that its
translation into program change and donation increases will not be visible
for some time. We are confident that our materials will prove useful, but
had not expected the problems of annual planning and institutional lethargy
into which we ran. Campuses remain exciting for their potential as sources
both of blood in the present and of blood donors who will give blood for the
rest of their lives. But it will be slower to build programs than we thought,

We expect consultation to be a larger part of our activities in the
future, now that our presence is known and our materials have been dissemina-
ted widely. We will be available to help churches and campus groups adapt
our materials to their particular situations.

-17-

9. Documents

Documents prepared and in preparation by the Blood Donor Research Group
during the period of IRMP funding are listed in Table IV. Emphasis was put
on producing those items that will have a direct impact on the collection of
blood. Reports of a research nature were begun as data became available and
generally have reached completion later than manuals.

The Bleeder's Digest: A Reference Manual for Campus Blood Collection
is an illustrated how-to-do-it manual for expanding or initiating a campus
blood program featuring frequent opportunities to give blood and donor educa-
tion as well as more traditional approaches. We printed 275 copies. A year
from now the manual will be up-dated from comments received from the field.

Your Congregation and Blood Donation: A Manual had attracted considerable
interest in draft form. Therefore we printed 5225 copies. Printing was done
on newsprint which brought the cost of this 48-page manual down to lOtf each
and kept the weight down which will minimize mailing costs. At this writing
we have made arrangements for distribution of about half our stock; we expect
to exhaust this printing by September, 1976.

To our knowledge, this manual describes a unique approach to the use
of church congregations: the donor group itself takes responsibility for
scheduling donations, on a year-around basis, as well as for recruiting
donors and adding to the donor base.

Help Avert A Holiday Season Blood Shortage is the third of the action-
oriented manuals we prepared this year. It has been printed in small numbers
and will be announced to potential users. We will assess demand and deter-
mine final printing quantities as that demand becomes clearer.

The remaining titles in Table IV are self-explanatory. Four separate
surveys by the Group provide the data on which most are based.

18-

Table IV.
Documents

The Bleeder's Digest: A Reference Manual for Campus Blood Collection

Your Congregation and Blood Donation -- A Manual

Help Avert a Holiday Season Blood Shortage -- A Manual

In preparation

Campus Blood Programs in Illinois

Suitability of College Campuses for Blood Collection

Measuring Efficiency and Effectiveness in Campus Blood Programs

A Three-Year Study of Blood Donor Characteristics and Motivations on a
College Campus

A Fol low-Up Study of Repeat College Donors Who Have Graduates

An Annotated Bibliography of Blood Donor Recruitment Literature

A Hospital Survey of Blood Donor Programs in Illinois

Sample Publicity Aids for Campus Blood Programs

Use of Direct Mail and Campus Mail in Communicating with Blood Donors on
College Campuses

Projected

Effect of Pledge Cards for Vacation Donation on Response to Campus Bloodmobiles
Immediately Prior to and Following the Vacation Periods

A Survey of Alpha Phi Omega Campus Blood Programs in the United States

Relationships Among Donor Recruitment Practices, Replacement Fees, Replacement
Rates, and Processing Fees in Illinois

-19-

10. Dissemination

The completion of the three action-oriented documents described above
initiates the broad dissemination phase of the project. Their distribution
has been described in part above. In addition, we will be distributing
materials through the 400 campus chapters of the national service fraternity,
Alpha Phi Omega. We hope to make these materials available through the
Council of Community Blood Centers, the American Association of Blood Banks,
the American National Red Cross and the American Blood Commission Task Force
on Donor Recruitment.

Fifty nine packages of materials adequate to start pledge card projects
for vacation period donations from college students were sent to the Red
Cross's national office for distribution to the individual blood centers
throughout the country. The document Help Avert a Holiday Season Blood
Shortage is now available as well.

A brochure describing the Blood Donor Research Group is being mass
mailed to campuses. We hope it will generate contacts from campuses ripe
for program improvements or for program initiation where no continuing
blood effort exists now.

The documents in preparation are predominantly of a research rather
than an action nature and will be presented at professional meetings and
submitted to journals, as appropriate and as resources allow.

-20-

Regionalization

This project provided several thousand additional pints of blood in our
region from the model campus program and provided over 5000 pledges to
blood agencies throughout Illinois which will be of use to them over the
difficult summer months and were already of help last Christmas. The pledge
card project seems to have improved inter-agency cooperation. The Red Cross
Regional Programs were especially cooperative in distributing and collecting
cards at their campus drawings, even though the major benefit of the program
will accrue to the Chicago area banks which rely more on donor call-in, as
opposed to the Red Cross's emphasis -- especially downstate -- on mobiles.
In Chicago, the Red Cross and the other blood agencies are cooperating in a
distribution scheme for the Chicago pledge cards. The magnitude of the pro-
ject this year cannot help but convince all Illinois banks that all benefit
from cooperative efforts of this sort: although one may watch its donors
disperse for the summer to other regions, it finds pledge cards arriving
from other agencies who similarly are both losing and gaining donors.

The church-based effort appears to offer great potential throughout the
State. Whether the agency involved is a fixed-facility bank or one which
relies on mobile drawings, the approach we have developed and tested should
reduce agency expense and increase the quantity and improve the timing of
its pints. The cost reductions will be passed back to patients, especially
heavy blood users and the elderly, in areas where replacement fees are still
used. Elsewhere the program should allow slower rates of increase or even
decreases in processing charges for blood.

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Project Continuation

The Group expects substantially increased demand for its consulting
services consequent to the dissemination of manuals and reports currently
underway. Further, we think it important to maintain an applied research
group to offer practical assistance to any agency or donor group and
to continue to collect and distribute research results which promise to
be of practical use in the field.

We have submitted a proposal to the National Heart and Lung Institute
for funds to continue work in progress, expanding it to include national
scope. The pledge card and church projects are examples of approaches
which we believe to have potential for major impact at the national level.

In the meantime we are approaching several organizations with which
we have worked for small amounts of money to hold the group together and
to allow completion of several projects.

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Recommendations and Comments

We began this project convinced that college campuses have enormous
underutilized potential to produce blood and to produce blood donors who
will support their community's needs for blood for the rest of their lives.
We remain convinced that these are accurate assessments. However, our initial
concept was to work directly with student groups and to effect program
changes through them. Our experience at the Urbana campus predisposed us to
this approach.

We have gained considerable respect for the Red Cross and non-Red Cross
personnel who deal with college campuses. They face an awesome task each
year as new students with little previous experience assume positions in
campus contact organizations. They are understandably reluctant to upset
working relationships and techniques that have allowed repeatable, if some-
times modest, results on campuses.

We took seriously the reservations expressed by these agency personnel
when exposed to the pledge card project. We believe we have satisfied all
participants that much more is gained than is risked in approaching students
for vacation pledges.

In general, we learned that the only way to up-grade campus programs,
where they already exist -- and in Illinois, that is the case on most cam-
puses -- is to involve students and their blood agencies simultaneously
and to present program changes that both groups can find rewarding.

The greatest problem with campus programs is the lack of continuity
from one year to the next. It may not be possible to build programs as
ambitious as that at the Urbana campus as widely as we originally believed.
However, the pledge card project is much more manageable in a setting of
high volunteer turnover and promises to deliver a benefit at least as great

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as expanded term-time donations. Moreover, once a mechanism is established
for sorting and distributing pledge cards, they can be collected from groups
other than college students. We have sent semi-annual letters to our univer-
sity faculty and staff for several years, explaining that vacation periods
are always difficult times for blood agencies. Those who will be in town
and are eligible to give respond. The agency is profuse in its gratitude
for these slips from individuals who are expecting to be called and who
respond at once and with grace when called. Similar projects could be
initiated in other settings, among any group of employees.

Our emphasis on church congregations this year grew directly out of
our frustrations with agency inertia and lack of student continuity. We
reasoned that campus ministries might offer excellent sources of continuity
for campus blood programs. Instantly it occurred to us that church congre-
gations are, in general, ideally suited to blood donation programs.

We realized that there was nothing new about that insight. But we
felt that we had once again identified an element in society that is under-
utilized by blood agencies. Many churches participate in blood assurance
programs in large cities, or lend their facility to mobile drawing agencies
in smaller communities. But why not involve them more actively in the pro-
cess of scheduling donations? We do not think that America will ever have
a timely and adequate blood donation response from its populace unless we
stop viewing donor recruitment and donation scheduling as technical problems
to be solved by doctors and blood agency personnel.

We think enormous progress can be made if blood agencies will begin to
share their responsibilities with donor group representatives -- like our
church program coordinators. People need only to be told three basic facts
about blood to begin to respond to the problems of supply, safety, and cost
which plague American blood agencies:

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° every donor should be told that he can give five or six pints a
year if he wishes (our church program includes a pledge card that
explains this and then asks the donor to tell us how many pints he
would like to give. Most donors indicate multiple donation; the
average exceeds three pints per year.)

° donors and group representatives must understand that blood is
normally assigned a three-week shelf-life. This explains why it
is important to pace donations evenly around the calendar. Too
many group assurance plans encourage massive donation all at one
time, build up adequate credits, and then present the agency with
a population reluctant to respond during periods of blood shortage
because it perceives itself as having satisfied its obligation

0 only if citizens take an interest in their community's blood

supply can they be assured that blood will be available when theii
loved ones need it. There is no substitute for human blood; and
when it is needed, it is often needed immediately. Furthermore,
if one area is experiencing a shortage, chances are great that
other areas are similarly situated and unable to help.

We have found that church congregations include individuals who respond
very positively to the responsibility for recruiting donors and seeing th; t
those donors are called as frequently as they have indicated is their wis! .
Blood agencies are delighted to work with groups which do not limit their
cooperation to an initial generation of a list of potential donors.

There is enormous untapped potential for citizen involvement in the
recruitment and scheduling of blood donations. Blood donation can become
a major community service for a substantial number of individuals, both
donors and donation coordinators. It need not be presented as a "duty"
or an act of "assurance" to protect one's family.

It appears to us that the American people have a great desire to act
in altruistic fashion, contributing to their community's welfare. Blood
donation is one of the few acts available to a wide range of the population
which enjoys consistently high and positive associations.

If blood agencies will share their problems and their responsibilities
for providing blood with responsible individual non-professionals, they will
find their burdens considerable lightened.