{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:03:05Z","timestamp":1790611385291,"version":"4.1.0"},"reference-count":60,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T00:00:00Z","timestamp":1357862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Efforts to expand the donor pool by recruiting younger donors have resulted in higher numbers of initial donations, but retention of young donors continues to be challenging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>Path analysis was used to examine the simultaneous relationships among syncopal reactions, donation anxiety, needle pain, donor satisfaction, and donation intention in predicting repeat donation. Participants included 421 first\u2010 and second\u2010time donors recruited for a study comparing the effects of predonation water loading with and without the use of applied muscle tension during donation (52% female, 60.8% first\u2010time donor, mean age 20.3 years). For this longitudinal follow\u2010up study, donor database records were accessed 2\u2009years after the index donation to assess repeat donation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results of a series of path analyses demonstrated the influential role of donor anxiety in shaping donor retention (final model \u03c7<jats:sup>2<\/jats:sup>\u2009=\u200935.75, root mean square error of approximation 0.03, comparative fit index 0.98, weighted root mean square residual 0.74). First, anxiety exerted a direct negative influence on donation intention, the proximal and sole direct predictor of repeat donation. Second, anxiety increased the likelihood of donor\u2010reported needle pain, adversely affecting donation satisfaction and, subsequently, donation intention. Finally, anxiety was associated with donor ratings of syncopal reactions through its impact on needle pain, which also contributed to decreased donation intention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These results provide novel evidence that donation anxiety plays a central role in shaping future donation behavior. Individual differences in anxiety must be considered when developing and testing strategies to enhance blood donor retention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.12069","type":"journal-article","created":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T11:28:40Z","timestamp":1357903720000},"page":"1992-2000","source":"Crossref","is-referenced-by-count":65,"title":["Donor anxiety, needle pain, and syncopal reactions combine to determine retention: a path analysis of two\u2010year donor return data"],"prefix":"10.1111","volume":"53","author":[{"given":"Christopher R.","family":"France","sequence":"first","affiliation":[{"name":"Ohio University  Athens Ohio"},{"name":"American Red Cross Blood Services Central Ohio Region  Columbus Ohio"},{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janis L.","family":"France","sequence":"additional","affiliation":[{"name":"Ohio University  Athens Ohio"},{"name":"American Red Cross Blood Services Central Ohio Region  Columbus Ohio"},{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Ellen","family":"Wissel","sequence":"additional","affiliation":[{"name":"Ohio University  Athens Ohio"},{"name":"American Red Cross Blood Services Central Ohio Region  Columbus Ohio"},{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blaine","family":"Ditto","sequence":"additional","affiliation":[{"name":"Ohio University  Athens Ohio"},{"name":"American Red Cross Blood Services Central Ohio Region  Columbus Ohio"},{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Dickert","sequence":"additional","affiliation":[{"name":"Ohio University  Athens Ohio"},{"name":"American Red Cross Blood Services Central Ohio Region  Columbus Ohio"},{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina K.","family":"Himawan","sequence":"additional","affiliation":[{"name":"Ohio University  Athens Ohio"},{"name":"American Red Cross Blood Services Central Ohio Region  Columbus Ohio"},{"name":"McGill University  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01517.x"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00388.x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2005.00593.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03666.x"},{"key":"e_1_2_8_6_1","unstructured":"WhitakerBL GreenJ KingMR LeibegLL MathewSM SchlumpfKS SchreiberGB.The 2007 national blood collection and utilization survey 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