BACKGROUND:

As bone marrow transplantation becomes one of the preferred treatments for life-threatening diseases of the blood, increasing numbers of patients must seek compatible marrow from unrelated donors. The low probability of finding a good patient-donor marrow match means that between one- to two-thirds of ill patients never locate a donor with perfectly compatible marrow. Furthermore, once volunteers are identified as a preliminary match for a patient, 30 to 40 percent are either unwilling or medically unable to actually donate marrow. Thus, volunteer attrition contributes significantly to the problems already inherent in finding a suitable donor candidate.

DESIGN NARRATIVE:

The study examined the relationship of volunteer characteristics and donor center factors to volunteer psychological outcomes during two critical stages in the blood testing process and to donor center rates of volunteer cooperation at these stages.

Longitudinal and cross-sectional survey data were gathered from a total of over 2,900 potential marrow donors who were at one of two critical decision points in the process leading to donation (DR-blood-typing, CT-blood-typing), and from personnel at the 100 NMDP donor centers. These data allowed the investigators to (a) describe the distribution and interrelationships between donor center structural characteristics and the strategies centers utilize for volunteer recruitment and retention, (b) determine which donor center factors (both structural and tactical) and volunteer background characteristics best predict positive volunteer-specific psychological outcomes at later typing stages, and examine and revise models of individual volunteer-specific outcomes and aggregate across-center retention rates.