| Abstract|| |
BACKGROUND AND OBJECTIVES: The study examines the young donors' intention toward blood donation using much validated theory of planned behavior (TPB). Personality construct is added into the TPB model to measure its predictive power. To get additional insights, the researchers analyzed the moderating effect of the demographic variables.
MATERIALS AND METHODS: A total of 960 prospective college students responses were collected by adopting snowball and convenience sampling techniques. Structured equation modeling was used to analyze the data and to evaluate the structural relationship between the constructs.
RESULTS: The study revealed that the model supports student's intention and personality constructs partially influence students' intention to donate blood. Further, gender also partially moderates the structural relationship among the constructs on which female involvement is found to be significant.
CONCLUSIONS: The study turns out to be significant by addition of personality construct in the model which further enhanced its predictive power to determine young donor's blood donating intention in Indian context.
Keywords: Blood donors, gender, personality, structural equation model, theory of planned behavior, young adults
|How to cite this URL:|
Saha S, Soodan V. Does gender moderate young adults' intention to donate blood? A planned behaviour and big five personality trait perspective. Asian J Transfus Sci [Epub ahead of print] [cited 2023 Jan 28]. Available from: https://www.ajts.org/preprintarticle.asp?id=363207
| Introduction|| |
Modern day medical science has made huge inroads in changing human lives. But the challenge of meeting chronic blood shortage is still a dominant problem in the healthcare sector. To overcome the persistent threat of blood shortage, voluntary blood donation is the only substance for safe and adequate supply of blood., Currently, most of the world's population lives in Asia, of which 1.3 billion belongs to India which holds world's second largest population. As per estimates, India requires more than 10 million units of blood and its components under the health-care system. The overall requirement of blood in India is attributed to malnourished kids, pregnant women, road accidents and thalassemia patients. There is a need of suitable framework to encourage young adults participation and ensuring safe blood transfusion system to protect people from transmissible diseases. Earlier, the research on blood donation was succinctly studied to understand the blood donors attitude, behavior belief, knowledge, values, ethics, etc., They are from the developed nations,,, and their mined variables were widely used in a developing country context.,,, However, there is a dearth of literature on personality of donors and its impact on blood donation. Hence, illuminated by the preceding revelations, this study attempts to design and promote voluntary blood donation intention using theory of planned behavior (TPB) model with a support of personality traits of young population in the Indian context.
Theoretical background and hypothesis development
TPB is a well-accepted model in the research community to predict the intention of human/consumer behavior. Using TPB into this study, the research hypothesize and explicate the causal relationship among attitudes, beliefs, intentions, and perceived behavior control., The theory stresses on relationships among the variables. It can be said that positive attitude leads to develop strong subjective norms (SN) that further develop a higher degree of perceived behavioral control which will make the strong intention to carry out a given behavior., Based on previous researches, TPB is found to be very useful in envisaging the intention of a transversely different culture, specifically in the blood donation perspective.
TPB is open for alteration to increase the predictive power by adding the path of already prevailing variable (i.e., factors of TPB). TPB is based on assumption that suggests prediction of behavioural intention through assessment of variables such as attitude, subjective norms and perceived behavioural control. On suggestions of previous researches,, the study made an attempt to add personality variables into the TPB model to enhance predictive efficacy of TPB in knowing the intention of blood donors toward blood donation [Figure 1] and across other domains.
Various personality traits from the literature have their importance in developing strong intention to give blood. The purpose to include big-five personality traits in the model is to explore the relationship between the personalities of youths with their intention to donate blood. By participating in blood donation activity, inherent extravert donors fulfill their desire of being social since they are considered as energetic, talkative, and enthusiastic. Moreover, many authors have reported that the high rate of extraversion leads to higher levels of self-efficacy. Subsequently, individual emotional steadiness is depicted as neuroticism. Neurotic people have a propensity to get irritated usually on any negative happening. It is therefore believed that college students during the process of blood donation could easily get irritated with the pandemonium conditions of blood banks during transfusion. Therefore, it is explicable that any negative belief can reduce intention to donate blood.
To complement the personality variables, a person having agreeable nature is often helpful, altruistic, trusted, and forthright. People having characteristics (i.e. agreeableness) are likely to expedite or having concern toward cooperative behavior,, i.e. blood donation in a group. Therefore, this study assumes that predictive power of the model can be increased by adding this construct to gauge the intention of blood donors. Furthermore, many authors depicted that people with high conscientious belief are responsible, dependable, organized, and self-disciplined,, in order to accomplish their goals and cooperative. Similarly, in blood donation, young donors will donate blood because they view it as one of their prime responsibility toward the society.
A growing body of research also validates that high openness is characterized as creative, ready for new experiments in life., Comparatively, people who have an open nature would understand the importance of blood donation well and its posteffect on health, while others would not, until they willingly experiment this with blood donation. Therefore, the study attempts to link this with the intention toward blood donation.
Personality has been perceived as individual belief and differences that influence how people respond to a particular situation.,, Thus, according to personality theorists, it can be said that young adults who would likely donate blood are different from those who do not donate blood. Therefore, inclusion of personality traits into the TPB model has proven its applicability in behavioral studies by adding its explanatory power in various other domains.,,
Moderating role of gender
Gender is considered as a vital component to determine intentions. In order to address the irregularities in literature on role of gender in blood donation, this study tries to corroborate whether intention to donate blood differs by gender. Study results on demographic characteristics reveal that both genders (males and females) are important for behavioral studies and show a significant difference in their blood donation intentions.,, Thus, the importance of gender confers that gender comprising both males and females should provide an opportunity to express altruistic values and their voluntary participation in blood donation activity.
| Materials and Methods|| |
A cross-sectional research was conducted from March to May 2018. Responses were collected through self-administered questionnaire distributed at four different higher education institutes (i.e., institutes of national importance) in India. The study employed snowball and convenience sampling approach which is proved as a reliable measure for such studies. The data were collected from young participants falling in the age group of 18–30 years. The purpose of selecting young adults was based on their level of decree and ability to give consent on giving their blood for a good cause. The questionnaire comprised close-ended questions for testing the TPB as well as personality constructs. To test the personality traits of blood donors, International Personality Item Pool (IPIP) developed by Goldberg was selected,, and modified accordingly to gauge blood donor's personality. On analysis part, researcher reversed the final scores of scale items superscript with “R” on questionnaire [Table 1] to make the scale items consistent in the current research. The scale items of the questionnaire and their source of adoption are given in [Table 1], whereas [Table 2] reflects the demographics of the study. Moreover, pilot testing was conducted on ten percent of the sample size of the questionnaire with the recommendation of modification in the questionnaire. Suggestions given by the 98 respondents from a pilot study were incorporated to purify the questionnaire before its final submission for data collection. Subsequently, 1130 potential respondents were approached to fill the questionnaire after briefly explaining the topic and purpose of the survey. Total 960 correctly filled questionnaires were included for data analysis after eliminating extreme outliers and missing data. Although 320 responses on 32 items had met the condition for data analysis, a larger sample size was taken to strengthen the detection of differences across gender. On the basis of factors discussed in introduction section, the study hypothesizes the following:
- H1: Attitude would influence college students' intention to donate blood
- H2: SN would influence college students' intention to donate blood
- H3: Perceived behavioral control would influence college students' intention to donate blood
- H4: Extroversion would influence college students' intention to donate blood
- H5: Neuroticism would influence college students' intention to donate blood.
- H6: Agreeableness would influence college students' intention to donate blood
- H7: Conscientious would influence college students' intention to donate blood
- H8: Openness would influence college students' intention to donate blood.
Finally, the theoretical model [Figure 1] was tested with SPSS and AMOS Version 22, IBM, Armonk, N.Y., USA. The model of structured equation modeling was followed by measurement model (reliability and validity), and a structural model used for testing the hypothesis and checking the model fitness., Finally, the moderating effect of demographic was measured in AMOS on scale items related to intention factor.
| Results|| |
To test the measurement model, exploratory factor analysis (EFA) was performed with principal component analysis using varimax rotation for all 32 items, namely, attitude, subjective norm, perceived behavior, intention, and on all the construct of personality. The IPIP in the study was used to establish content validity. But not to develop the instrument. The Sampling adequacy was assessed through KMO and Bartlett's test of sphericity. Analysis found KMO = 0.84 and Chi Square value for Bartlett's test =7716.193, thereby fulfilling the criteria of recommended values. These values further suggest the appropriateness of sample for factor analysis. The 32 scale items emerged in nine factors in the EFA, explaining a total variance of 79.87%. Following the analytical criteria in [Table 3], the factor structure revealed that all items were appropriately loaded on their designated factors.
The findings of confirmatory factor analysis resulted in a nine-factor model with 32 items to reflect best fit. The normed Chi-square (χ2/df = 2.401), Root Mean Square Error of Approximation (RMSEA) (0.066), and Comparative Fit Index (CFI) (0.92) were all within the acceptable range. In addition, analysis revealed that Cronbach's alpha (α) scores range between 0.80 to 0.93 which is in accordance to the acceptable threshold limit of 0.7 and higher. Convergent validity and discriminant validity was established through composite reliability (CR), factor loadings and average variance extracted (AVE). Analysis found CR ranging between 0.81to 0.93, factor loading from 0.70 to 0.91 and AVE ranged between 0.59 to 0.78 thus satisfying the recommended criterion., [Table 3] reflects the convergent validity and reliability. Furthermore, the details of descriptive statistics and discriminant validity are shown in [Table 4].
Structural model fitness
Structural model followed the acceptance criteria as values satisfy the threshold limits, where χ2 = 1308.906, χ2 /df = 2.883, goodness of fit index = 0.88. Tucker Lewis Index = 0.89, CFI = 0.90, Incremental Fit Index = 0.892, RMSEA = 0.07. Since these values fulfil the goodness of fit criteria, this indicates that the structural model is more stable in SEM analysis.
Hypothesis testing revealed that variables: Subjective Norms (SN) (β = 0.405, P < 0.05), Perceived Behavioural Control (PBC) (β = 0.108, P < 0.05), Attitude (β = 0.176, P < 0.05) were significantly associated with behavioral intentions. Hence H1, H2, and H3 were supported. Among the TPB variables, SN were found to be the strongest determinant of donating blood followed by attitude toward blood donation. Moreover, from personality construct, agreeableness (H6: β = 0.204, P < 0.05), conscientiousness (H7: β = 0.098, P < 0.05), and openness (H8: β = 0.143, P < 0.05) had a positive impact on the intention of blood donation. However, extroversion (H4: β = 0.027, P > 0.05) and neuroticism (H5: β = 0.032, P > 0.05) were insignificant, thus rejecting the hypothesis H4 and H5. Therefore, from all five traits of personality which were added to TPB model, agreeableness, openness, and conscientiousness were found significant.
Multigroup moderator analysis
To measure the moderating effect “gender,” a pairwise parameter comparison matrix (through AMOS) was examined to see the comparison of path coefficients across models. For multigroup moderation, the demographic was categorized into two groups, namely male (n = 756) and female (n = 204). As per the recommendation,, researchers compared the χ2, df between the unconstrained and constrained model. [Table 5] shows the significant value of χ2/df, also display a Z-score, where the critical value of the path will be considered significant when the value will be be lower than -1.96 or higher than 1.96. with P = 0.05. Results depict significant difference between male and female respondents' response towards blood donation.
|Table 5: Results of multiple group moderator analysis on the basis of gender|
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The results of the invariance testing on structural relationships suggest that three structural hypotheses are supported and five hypotheses are not supported. Hypotheses H4, H6, and H7 suggest that gender moderates the influence of extroversion (β = 0.077; P < 0.05), agreeableness (β = 0.26; P < 0.05), and conscientiousness (β = 0.21; P < 0.05) on intention to donate blood, as significant effect was observed only in case of female blood donors (P < 0.05). In case of hypotheses H1, H2, H3, H5, and H8, critical Z-score value was found to be insignificant (Z > 1.96); thus, gender moderation was found to be insignificant in building of intention to donate blood with their attitude, SN, PBC, neuroticism, and openness to experience.
| Discussion|| |
In theoretical model [e.g. [Figure 2]], two factors, namely SN and perceived behavioral control of TPB model along with three constructs from personality model, i.e., agreeableness (H6: β = 0.204, P < 0.05), conscientiousness (H7: β = 0.098, P < 0.05), and openness (H8: β = 0.143, P < 0.05), appeared to be a strong influential factor to the blood donation intention. Changes in cultural belief (social norm) in India signify the importance of positive attitude along with a strong perceived behavior of young college students toward blood donation. The study findings are consistent with the research, where the proposed model validates the donors intents on giving blood donation. Moreover, result support for agreeableness (H6) was surprising. In other words, people having strong socially valued traits and proactive social motives usually have an agreeable nature since they donate blood voluntary with perseverance of helping others and these attributes are strongly found among young donors. Surprisingly, result also show the positive association among conscientiousness (H7) and college students' intention to donate blood because conscientious nature of college students is generally perceived as self-motivated, cooperative, and task oriented;, furthermore, it was observed that both males and females have cooperative behavior in creating a strong intent for donating blood. In case of openness (H8), it has been found that those donating blood for the first time has a curiosity for this new experience and see it as important cause to serve the society. Therefore, higher the openness among these young donors, more the chances for having intention to donate blood., In contrast, the study results observed that extroversion (H4) and neuroticism (H5) personality traits are not linked with students intention as extrovert people are more social talkative and assertive; and they find themselves more person oriented. It has also been reported that association between extraversion trait of an individual and his/her involvement in any activity is affected by various factors like: health status and inclination towards seeking attention from others. It has also been reported that association between extraversion and participation in any activities is affected by various factors, like health status and their socially active nature. Therefore, there is no significant relationship between extroversion and intention. Moreover, it is perceived that a neurotic person may feel frustrated by seeing the pandemonium condition of blood bank or donation camps that decrease the intention to donate blood. However, in this study, no such difference has been observed; it shows that college students are satisfied with the condition of blood bank/donation camp. The findings of the study contradict other findings. Finally, on getting additional insights, a multigroup moderation analysis was performed to measure the effect of gender on structured relationship. Gender partially supports the hypothesis and only female students found significant with extroversion (β = 0.077; P < 0.05), agreeableness (β = 0.26; P < 0.05), and conscientiousness (β = 0.21; P < 0.05) upon intention to donate blood. Such result elaborates that women's contribute very marginal in blood donation activity, as compared to their intention, which is strong to donate blood. These significant changes increase women's participation in each sector and uplift the status of women which was dominated earlier by the males in Indian societies.
The findings suggested that college students (both males and females) have a strong intention to donate blood (i.e. mean = 3.57/5). Therefore, serious efforts by the policy makers for improving the safe donation can encourage more youngsters to participate in blood donation activity.
| Conclusions|| |
It has also been reported that association between extraversion trait of an individual and his/her involvement in any activity is affected by various factors like: health status and inclination towards seeking attention from others. Results further revealed that young adults are proactive in blood donation activity, though a significant difference was found in female participation in donating blood as compared to their male counterpart. The findings of this study can be used by policy makers or nongovernment organizations to encourage women participation for blood donation in big numbers. As a woman is known for epitome of care giving and selfless love, she can save lives of many by donating blood. Therefore, consciousness and responsiveness of women are essential in blood donation to boost gender equality in saving precious lives.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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Source of Support: None, Conflict of Interest: None
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]