Blood Donation Practices and Associated Factors among Adults in East Gojjam Zone, Northwest Ethiopia

Blood Donation Practices and Associated Factors among Adults in East Gojjam Zone, Northwest Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Blood Donation Practices and Associated Factors among Adults in East Gojjam Zone, Northwest Ethiopia Nigusie Gashaye Shita, Awoke Fetahi Woudneh, Metadel Azeze Mekonnen, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6599036/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Blood donation is a critical healthcare activity that saves millions of lives globally, yet access to timely donations remains a challenge in Ethiopia, particularly during emergencies. Identifying the socio-demographic, psychological, and contextual factors that influence blood donation is essential for developing strategies to improve donation rates and ensure a sustainable blood supply. This study investigates the factors influencing blood donation practices among adults in East Gojjam Zone, Ethiopia, over the past two years. Methods : A cross-sectional survey was conducted with 1,332 adults selected through multistage cluster sampling in East Gojjam Zone. Descriptive statistics were used to summarize donation behaviors, while Zero-Inflated Negative Binomial (ZINB) regression identified factors associated with donation frequency. Structural Equation Modeling (SEM) explored the relationships between donation behaviors and key predictors. Results : Among participants, 28.8% (95% CI: 26.4%-31.2%) had donated blood at least once, and 20.7% (95% CI: 18.5%-22.9%) had donated in the past two years. Frequent donation was positively associated with younger age, male gender, higher education, and employment in healthcare or education. Altruism, specifically the desire to help others, was the primary motivation for donation. Psychological barriers, including fear of needles, health concerns, and lack of awareness, were significant deterrents. ZINB regression revealed that psychological barriers negatively influenced donation frequency, while previous donation experience, awareness, and participation in campaigns were positive predictors. SEM analysis showed that donation intention had the strongest direct effect on donation behavior, with self-efficacy, positive attitudes, and social norms also contributing significantly. Conclusions : Donation rates were lower than expected, with few participants donating repeatedly. This study highlights the complex interaction of socio-demographic, psychological, and contextual factors influencing blood donation behavior. Interventions should address psychological barriers, enhance awareness, and foster altruism to increase donation rates. Public health campaigns should target vulnerable groups, including women, older adults, and individuals with lower educational attainment. Additionally, improving donation site accessibility, offering incentives, and leveraging social networks can help boost donations. Continuous evaluation and adaptation of strategies are essential to meet the growing demand for blood. Health sciences/Health care Health sciences/Medical research Health sciences/Risk factors Physical sciences/Mathematics and computing/Scientific data Physical sciences/Mathematics and computing/Statistics Blood donation socio-demographic factors psychological barriers donation intention Structural Equation Modeling public health interventions Ethiopia Introduction Blood donation is a critical healthcare practice that supports individuals suffering from blood loss due to trauma, surgery, pregnancy complications, or other medical conditions [1, 2]. However, blood donation rates in many low- and middle-income countries, including Ethiopia, have remained significantly lower than required to meet healthcare needs. According to the World Health Organization [3], high-income countries collect 40% of the world’s blood donations, despite representing only 16% of the global population. In contrast, sub-Saharan Africa, including Ethiopia, has continued to experience critical blood shortages, with Ethiopia collecting only 6.1% of the blood required to meet national needs [4]. The East Gojjam Zone, located in Northwest Ethiopia, has faced substantial challenges related to inadequate blood supply, compounded by factors such as maternal mortality, trauma, and surgical conditions [5-8]. In particular, maternal deaths due to postpartum hemorrhage remain a significant public health concern in Ethiopia and sub-Saharan Africa, where approximately 22 women die each hour from pregnancy-related complications, many of which could be mitigated by timely access to blood transfusions [9-12]. Consequently, ensuring a steady and sufficient supply of safe blood has been critical in saving lives, improving maternal health, and meeting the needs of patients in emergency situations. Despite several national and local efforts to promote voluntary blood donation, Ethiopia has continued to experience challenges in blood collection. The low blood donation rates in the country have been influenced by a range of factors, including misconceptions about the donation process, cultural beliefs, and logistical barriers [13-16]. Previous studies on blood donation in Ethiopia and other sub-Saharan African countries have predominantly focused on broader aspects like knowledge, attitudes, and socio-demographic factors affecting whether or not individuals choose to donate [14-17]. However, many of these studies have overlooked the frequency of donation among those who donate, which is a critical component in understanding blood donation behavior. This study aimed to address this gap by employing a Zero-Inflated model (ZIM) to examine the practice of blood donation in East Gojjam Zone. The Zero-Inflated model was deemed suitable for analyzing data where a significant number of individuals are non-donors (zeros) and a separate subset of individuals donate irregularly or regularly. This approach allowed for a clearer distinction between zero donors (those who never donate) and frequent or occasional donors, providing a comprehensive view of the factors influencing both the likelihood of donating and the frequency of donations among those who do engage in blood donation [18]. By exploring the socio-demographic, psychological, and structural factors that shaped the practice of blood donation, this study provided new insights into the barriers and facilitators of blood donation in East Gojjam. Understanding these factors was crucial for informing interventions aimed at increasing blood donation rates. Improved blood donation practices not only have the potential to save lives but also to strengthen the healthcare infrastructure in Ethiopia, ensuring a reliable supply of safe blood for those in need. The findings of this study contribute to public health initiatives and provide valuable recommendations for enhancing blood donation programs in the region. Methods Study Area and Population This community-based cross-sectional study was conducted in the East Gojjam Zone of the Amhara Region, Ethiopia, between April 23 and September 23, 2024. The zone, bordered by Oromia to the south, West Gojjam to the west, South Gondar to the north, and South Wollo to the east, is geographically diverse, with the Abay River forming natural boundaries. Three districts—Debre Markos, Amanuale, and Dejene—were randomly selected to ensure geographic and demographic representativeness. The study targeted adults aged 18–65 years who had resided in the selected districts for at least six months. Exclusion criteria included individuals with serious illness, hearing impairments, or known contraindications to blood donation (e.g., HIV, hepatitis). The sample size was calculated based on a 16.1% prevalence of blood donation[19], with a 95% confidence level and 3% margin of error. After adjusting for a design effect of 2 and a 16% non-response rate, the final sample size was 1,339 participants. Sampling Procedure A multistage sampling technique was employed. In the first stage, three districts were randomly selected from the East Gojjam Zone. In the second stage, four kebeles were selected from Debre Markos, and one kebele each from Amanuale and Dejene. In the third stage, households within each kebele were selected using systematic random sampling, with proportional allocation based on the population size. If multiple eligible individuals were present in a household, one participant was selected randomly using a lottery method. Data Collection Primary and secondary data were collected. Secondary data on the total number of households and the adult population in the selected areas were sourced from local administrative records. Primary data were collected via a structured questionnaire, which included socio-demographic, economic, and psychosocial characteristics, as well as knowledge, attitudes, behaviors, and practices related to blood donation. Prior to main data collection, a pre-test was conducted in a non-selected woreda involving 5% of the sample size to assess the clarity, consistency, and validity of the questionnaire. Revisions were made based on pilot study feedback, and the internal consistency of the tool was evaluated using Cronbach’s alpha, yielding a value greater than 0.7, indicating acceptable reliability [20]. Data were collected through face-to-face interviews conducted by trained enumerators. Participants requiring assistance with reading or writing were supported to ensure full participation. The survey instrument is provided as a supplementary document. Variables and Measurement The primary outcome was the frequency of blood donations over the past two years. Intention to donate blood was measured using three items on a 5-point Likert scale ranging from “completely unwilling” to “totally willing” [21]. Participants scoring 8 or higher were classified as having the intention to donate blood. Knowledge of blood donation was assessed through 10 items adapted from prior studies [21-23]. A score of at least five correct answers classified participants as knowledgeable. Behavioral constructs (attitudes, subjective norms, and self-efficacy) were measured on a 5-point Likert scale, with scores computed by summing positive items and subtracting negative ones. Additionally, a deterministic principal component analysis (PCA) approach was used, as recommended in similar studies [21, 24, 25]. To explore beliefs about blood donation, open-ended questions were included, addressing both behavioral and normative beliefs. Demographic, socio-economic, and psychological covariates were also collected. Ethical Considerations This study was conducted in accordance with the Declaration of Helsinki and the National Research Ethics Review Guideline of Ethiopia. Ethical approval was obtained from the Institutional Review Board (IRB) of Debre Markos University (Approval No: RTTD/844/10/2024) on June 4, 2024. Written informed consent was obtained from all participants after clearly explaining the study’s objectives, procedures, potential risks, and benefits. Participants were assured of their right to withdraw at any time without penalty. To ensure confidentiality, no personal identifiers were collected; all data were anonymized, securely stored, and accessible only to the research team. Statistical Analysis Descriptive statistics were first used to summarize the socio-demographic and blood donation-related characteristics of the participants. These included frequencies, percentages, means, and standard deviations. Bivariate regression analyses were conducted to identify potential factors influencing blood donation behaviors. Variables with a p-value ≤ 0.20 were considered for inclusion in the multivariate regression model. In the multivariate analysis, variables with p-values ≤ 0.10 were retained in the final model to control for confounding effects [26-28]. Statistical significance was defined as a p-value of less than 0.05, and all analyses were performed at a 95% confidence level. Given the high proportion of zero blood donation reports (over 78%) and the overdispersion in the data (where the variance exceeds the mean), a Zero-Inflated Negative Binomial (ZINB) regression model was employed to examine the factors associated with blood donation practices. The ZINB model has two components. The first component, the zero-inflation part, models the probability of an individual reporting zero donations. This component was estimated using a logit link function, which models the log odds of zero donations. The regression equation for this part is: Where represents the probability of zero donations for individual i, and , , are the explanatory variables (e.g., socio-demographic characteristics, knowledge, and attitudes). The α1, α2,…,αp are the parameters to be estimated. The second component of the ZINB model addresses the count data, modeling the frequency of donations for individuals who have made at least one donation. A Negative Binomial distribution was used with a log link function to account for overdispersion. The regression equation for this component is: In this equation, represents the expected count of donations for individual i, and , , are the explanatory variables, with representing the estimated coefficients. The overdispersion parameter is included to capture the extra variance in the data. Both ZINB regression and Structural Equation Modeling (SEM) were estimated using Maximum Likelihood Estimation (MLE). The performance of the ZINB model was evaluated using the Deviance test, which indicated a good fit to the data. For model comparison and selection, the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used, with lower values indicating better model fit and reduced risk of overfitting [29, 30]. In addition to ZINB regression, SEM was conducted to explore the complex relationships between behavioral factors (e.g., attitudes, knowledge, and self-efficacy) and blood donation practices. The SEM results showed a good fit to the data, suggesting that the model adequately represented the observed relationships. Model fit for SEM was assessed using metrics such as the Standardized Root Mean Square Residual (SRMR) and the Adjusted Goodness-of-Fit Index (AGFI), both of which supported the model's adequacy. Results Characteristics of study participants A total of 1,332 individuals met the inclusion criteria. Among them, 384 participants (28.8%) reported having donated blood at least once in their lifetime, with only 276 (20.7%) donating within the past two years. The majority of participants (948, 71.2%) had never donated blood, and frequent donors were uncommon. Among donors, 16.2% reported donating once, 7.2% twice, and 5.4% three or more times (Table 1). Table 1: Blood Donation History and Frequency among Participants Donations Past Years (Frequency, Percent) Last 2 Years (Frequency, percent) 0 948 (71.2%) 1056 (79.3%) 1 216 (16.2%) 156 (11.7%) 2 96 (7.2%) 84 (6.3%) 3 60 (4.5%) 24 (1.8%) 4 — 12 (0.9%) 15 12 (0.9%) — Total 1332 (100%) 1332 (100%) The mean age of donors was 33 (standard deviation (SD) = 8) years, significantly younger than non-donors, whose mean age was 38 (SD = 9) years. Gender differences were evident, with males constituting 62.5% of donors and 40.5% of non-donors. Conversely, females represented a higher proportion of non-donors (59.5%) compared to donors (37.5%). Educational attainment was positively associated with donation behavior: 96.9% of donors held a degree or higher, compared to 89.9% of non-donors. Additionally, a greater proportion of donors were employed as civil servants or health professionals (84.4% vs. 77.2%). Marital status also differed between groups; 60% of donors were married compared to 34.2% of non-donors. Most participants in both groups perceived blood donation positively, with 93.8% of donors and 97.5% of non-donors considering it a way to help others. Awareness of blood donation was high in both groups (96.9% among donors and 98.7% among non-donors). Notably, non-donors reported a slightly higher average monthly income (mean = 5,681 ETB, SD = 3,019) than donors (mean = 5,469 ETB, SD = 2,755). A high proportion of participants expressed future intentions to donate: 78.1% of donors and 73.4% of non-donors (Table 2). Table 2: Demographic Characteristics among Donors and Non-Donors Characteristic Category No (n=948) Yes (n=384) Age (Mean ± SD) - 38 ± 9 33 ± 8 Gender Male 384 (40.5%) 240 (62.5%) Female 564 (59.5%) 144 (37.5%) Education Level degree or above 852 (89.9%) 372 (96.9%) Others 96 (10.1%) 12 (3.1%) Job Status Health Professionals or civil servants 732 (77.2%) 324 (84.4%) Others 216 (22.8%) 60 (15.6%) Marital Status Married 324 (34.2%) 230 (60.0%) Others 624 (65.8%) 154(40.0%) Purpose of Donation Help those with blood loss 924 (97.5%) 360 (93.8%) Other 24 (2.5%) 24 (6.3%) Heard of Blood Donation No 12 (1.3%) 12 (3.1%) Yes 936 (98.7%) 372 (96.9%) Monthly Income (Mean ± SD) - 5681 ± 3019 5469 ± 2755 Intention No 252 (26.6%) 84 (21.9%) Yes 696 (73.4%) 300 (78.1%) Blood Donation Motivations and Barriers The most commonly cited motivation for donating blood was altruism. Specifically, 46.6% of donors and 43.1% of non-donors identified helping others as their primary motivator. Social responsibility was mentioned by 12.8% of donors and 3.7% of non-donors. Encouragement from family or friends influenced 6.3% of donors, while no non-donors cited this factor. Moreover, 34.4% of donors and 24.1% of non-donors reported a strong influence of family or friends on their donation decisions. Barriers to blood donation varied across groups. Lack of awareness was reported by 56% of donors and 35.5% of non-donors. Health and safety concerns were cited by 34.4% of donors and 35.4% of non-donors. Fear of needles (6.3% vs. 11.4%) and lack of trust in the donation process (12.5% vs. 7.6%) were also notable deterrents. Incentives played a significant role in motivating blood donation. More than half of the donors (53.4%) and 39.1% of non-donors reported being influenced by incentives. Religious teachings were a source of encouragement for 59.4% of donors and 40.5% of non-donors, while cultural influences affected 43.5% and 38.1%, respectively. A greater proportion of donors (72.1%) strongly agreed with the importance of blood donation compared to non-donors (55.6%). Ease of the donation process was also an influencing factor. More than half of donors (53.4%) strongly agreed that the process was easy, compared to only 21.4% of non-donors. Participation in blood donation campaigns was higher among donors (37.5%) than non-donors (12.7%), suggesting a positive association between campaign exposure and donation behavior (Table 3). Table 3: Blood Donation Practice with Blood Donation Motivations and Barriers Factor Category No (n=948) Yes (n=384) Motivation to donate blood To help those in need 409 (43.1%) 179 (46.6%) A sense of social responsibility 35 (3.7%) 49 (12.8%) Encouragement from family/friends 0 (0.0%) 24 (6.3%) To achieve personal satisfaction 24 (2.5%) 0 (0.0%) Other 108 (11.4%) 12 (3.1%) Influence of family/friends on donation decision Great impact 228 (24.1%) 132 (34.4%) Some effect 191 (20.1%) 109 (28.4%) No effect 241 (25.4%) 131 (34.1%) Lack of awareness preventing donation Yes 337 (35.5%) 215 (56.0%) No 372 (39.2%) 144 (37.5%) Not sure 215 (22.7%) 25 (6.5%) Reasons preventing donation Fear of needles/blood 108 (11.4%) 24 (6.3%) Safety/health concerns 336 (35.4%) 132 (34.4%) Lack of awareness about donation 108 (11.4%) 84 (21.9%) Lack of trust in the process 72 (7.6%) 48 (12.5%) Feeling unfit for health reasons 168 (17.7%) 12 (3.1%) Other 96 (10.1%) 60 (15.6%) Impact of incentives on likelihood to donate High likelihood 371 (39.1%) 205 (53.4%) Little impact 96 (10.1%) 48 (12.5%) No change 396 (41.8%) 48 (12.5%) Not sure 85 (9.0%) 83 (21.6%) Influence of religious teachings Positive 384 (40.5%) 228 (59.4%) Negative 156 (16.5%) 60 (15.6%) Not sure 408 (43.0%) 96 (25.0%) Influence of environmental culture Positive 361 (38.1%) 167 (43.5%) Negative 275 (29.0%) 133 (34.6%) Not sure 312 (32.9%) 84 (21.9%) Importance of blood donation Strongly disagree 120 (12.7%) 12 (3.1%) Disagree 60 (6.3%) 0 (0.0%) Neutral 48 (5.1%) 0 (0.0%) Agree 193 (20.4%) 95 (24.7%) Strongly agree 527 (55.6%) 277 (72.1%) Ease of blood donation process Strongly disagree 132 (13.9%) 12 (3.1%) Disagree 96 (10.1%) 24 (6.3%) Neutral 216 (22.8%) 0 (0.0%) Agree 301 (31.8%) 143 (37.2%) Strongly agree 203 (21.4%) 205 (53.4%) Ever organized a blood donation campaign? No 828 (87.3%) 240 (62.5%) Yes 120 (12.7%) 144 (37.5%) Factors Associated with Blood Donation Practices The Zero-Inflated Negative Binomial (ZINB) regression model provided the best fit for identifying factors associated with blood donation practices, as indicated by the lowest deviance, Akaike Information Criterion (AIC), and Bayesian Information Criterion (BIC) values (Table 4). Table 4: Model Comparison Summary Model Deviance AIC BIC Negative Binomial (NB) 741.28 769.11 783.91 Zero-Inflated Negative Binomial (ZINB) 715.10 752.75 777.40 Truncated Model 803.25 830.43 853.10 In the count component of the ZINB model, several factors were significantly associated with blood donation frequency (Table 5). Table 5: Zero inflated Negative binomial Regression Results for Blood Donation Practices Variable Count Model Zero Model Coefficient(B) IRR Standard Error (SE) p-value Coefficient AOR Standard Error (SE) p-value Intercept -0.672 0.511 0.238 0.005 1.659 5.254 0.423 0.000 Age -0.015 0.985 0.005 0.001 0.022 1.022 0.008 0.006 Gender (Male Vs. Female) 0.755 2.128 0.329 0.022 -0.98 0.375 0.315 0.002 Education (degree or above vs. others) 0.495 1.640 0.201 0.014 -0.675 0.509 0.313 0.031 Occupation (Healthcare or teachers vs. others) 0.894 2.445 0.321 0.005 -1.21 0.298 0.366 0.001 Marital Status (Married Vs. others) 0.612 1.844 0.268 0.023 -0.845 0.430 0.317 0.008 Knowledge of Blood Donation (Have vs. have not) 1.182 3.261 0.379 0.002 -0.759 0.468 0.432 0.079 Experience (Yes vs. No) 1.522 4.581 0.287 0.000 -0.21 0.811 0.335 0.528 Blood Donated by Family (Yes Vs. No) 0.802 2.230 0.329 0.015 -0.58 0.560 0.334 0.083 Family Needed Blood (Yes vs. No) 0.702 2.018 0.261 0.007 -0.845 0.430 0.328 0.01 Participation in Campaigns (Yes vs. No) 0.902 2.465 0.228 0.000 -0.582 0.559 0.311 0.062 Psychological Barriers (Yes vs. No) -0.972 0.378 0.315 0.002 0.932 2.540 0.396 0.019 Motivation (High vs. low) 1.163 3.200 0.418 0.005 -0.742 0.476 0.442 0.093 Incentive (Yes vs. No) 0.79 2.203 0.351 0.024 -1.012 0.363 0.423 0.017 Facilitators (Yes vs. No) 1.012 2.751 0.271 0.000 -0.555 0.574 0.312 0.075 Location (Debre Markos vs. others) 0.543 1.721 0.259 0.036 -0.254 0.776 0.31 0.414 Ln(alpha) 1.005693 2.734 0.1681357 0.000 alpha 2.733802 15.391 0.4596495 B= coefficients, Exp (β) =Exponent of Coefficient=Incidence Rate Ratio=IRR, AOR=Adjusted Odds Ratios Males (IRR = 2.13, p = 0.022), individuals with a degree or higher education (IRR = 1.64, p = 0.014), those working in healthcare or education (IRR = 2.45, p = 0.005), and married individuals (IRR = 1.84, p = 0.023) had higher donation rates. Other key factors included having knowledge about blood donation (IRR = 3.26, p = 0.002), prior donation experience (IRR = 4.58, p < 0.001), a family member who donated blood (IRR = 2.23, p = 0.015) or needed a transfusion (IRR = 2.02, p = 0.007), participation in campaigns (IRR = 2.47, p < 0.001), strong motivation (IRR = 3.20, p = 0.005), receiving incentives (IRR = 2.20, p = 0.024), and access to facilitators (IRR = 2.75, p < 0.001). In contrast, psychological barriers (IRR = 0.38, p = 0.002) and older age (IRR = 0.985, p = 0.001) were negatively associated with donation frequency. In the zero-inflation component, factors that increased the likelihood of never donating blood included older age (AOR = 1.02, p = 0.006) and psychological barriers (AOR = 2.54, p = 0.019). On the other hand, males (AOR = 0.38, p = 0.002), individuals with higher education (AOR = 0.51, p = 0.031), healthcare or education professionals (AOR = 0.30, p = 0.001), married individuals (AOR = 0.43, p = 0.008), those with a family member who needed blood (AOR = 0.43, p = 0.010), and those who receive incentives (AOR = 0.36, p = 0.017) were less likely to never donate blood. Path Analysis of Blood Donation Behavior Structural Equation Modeling (SEM) was conducted to explore the relationships among psychosocial and contextual factors influencing blood donation practice. Model fit statistics indicated a good fit between the proposed model and the observed data (Table 6). Table 6: Goodness-of-Fit Indices of the SEM Model Fit Index Value Root Mean Square Error of Approximation (RMSEA) 0.048 Standardized Root Mean Square Residual (SRMR) 0.033 Comparative Fit Index (CFI) 0.97 Tucker-Lewis Index (TLI) 0.96 Goodness-of-Fit Index (GFI) 0.94 Adjusted Goodness-of-Fit Index (AGFI) 0.91 Normed Fit Index (NFI) 0.95 The path analysis showed that Self-efficacy (β = 0.350) was the most significant positive predictor of blood donation practice, with individuals who felt more confident in their ability to donate being more likely to do so. Other key factors influencing donation behavior included positive attitudes toward blood donation (β = 0.290), previous donation experience (β = 0.280), and social influence (β = 0.260). Participation in blood donation campaigns (β = 0.220) and facilitators such as accessibility and motivation (β = 0.280) also positively affected donation behavior. Conversely, psychological barriers, including fear and concerns about anemia (β = -0.200), had a negative impact on donation practices. Incentive factors (β = 0.180) were also found to encourage blood donation, underscoring the role of both intrinsic and extrinsic motivators in promoting regular blood donation behavior. Lastly, intention (β = 0.62) was a strong predictor, suggesting that individuals who intended to donate were more likely to actually do so (Table 7). Table 7: Path Coefficients for Blood Donation Behavior and Practice Construct Path to Practice β SE p-value Self-Efficacy 0.350 0.080 0.000 Attitudes Toward Blood Donation 0.290 0.090 0.001 Knowledge of Blood Donation 0.210 0.080 0.009 Social Influence (Norms, Family, Friends, and Community) 0.260 0.090 0.004 Previous Donation Experience 0.280 0.090 0.002 Participation in Campaigns 0.220 0.080 0.006 Barriers to Donation (Fear of Anemia & Psychological Barriers) -0.200 0.070 0.004 Incentive Factors 0.180 0.070 0.010 Facilitators (Accessibility & Motivation) 0.280 0.070 0.000 Intention 0.62 0.138 0.001 These findings highlight the importance of addressing both psychological barriers and external facilitators to increase blood donation frequency. Discussion In this study, 28.8% of individuals in East Gojjam Zone reported donating blood at least once, with 20.7% having donated within the past two years. Although this prevalence is slightly higher than the national pooled estimate of 25.82% reported in a systematic review and meta-analysis [16], it remains insufficient to meet the growing demand for safe blood. Regional variations across Ethiopia are notable, with lower rates observed in Gondar (15.53%) [31] and higher rates among hospital employees in Negele Arsi (39%) [32]. These discrepancies may reflect differences in health literacy, accessibility of donation services, and occupational exposure to health promotion activities. The low proportion of recent donations further underscores the ongoing challenge of maintaining a regular donor base. Therefore, targeted interventions—including public education campaigns, enhanced accessibility to donation services, and culturally sensitive community engagement strategies—are essential to improve both first-time and repeat voluntary blood donations. Several socio-demographic factors significantly influenced blood donation behavior in this study. Age was inversely associated with donation: each additional year corresponded to a 1.5% decline in donation frequency and a 2.2% increase in the odds of being a non-donor. This trend aligns with findings from Zimbabwe [33], although it contrasts with observations from Gondar [34], where middle-aged adults were more likely to donate. Such inconsistencies suggest that variations in health perceptions and exposure to donation campaigns may shape behavior differently across settings. Sex was another key determinant, with males demonstrating significantly higher rates of donation than females. Specifically, males exhibited 2.13 times greater expected donation counts and a 62.5% reduction in the odds of being non-donors. This is consistent with previous studies [35] and may reflect biological factors, such as menstruation-related eligibility issues among women, as well as social expectations that encourage public altruism more strongly among men. Educational attainment also emerged as a strong predictor. Participants with a degree or higher were more likely to donate and less likely to be non-donors compared to those with lower educational levels, suggesting that education enhances both awareness of blood donation's importance and responsiveness to public health messaging [36]. Occupational status further influenced donation patterns. Healthcare professionals and teachers exhibited 2.45 times higher expected donation counts and 70.2% lower odds of being non-donors compared to other occupations. These findings, consistent with prior research [37, 38], likely reflect greater exposure to health information and a heightened sense of civic duty. Nonetheless, persistent fears and misconceptions among these groups indicate the need for continued educational efforts [39]. Marital status was also significant: married individuals were 1.844 times more likely to donate blood and 57% less likely to be non-donors compared to their unmarried counterparts. Social support structures and a heightened sense of responsibility toward family and community members may partly explain this pattern, as reported in previous studies [38, 40]. Place of residence influenced donation rates as well. Participants residing in Debre Markos were 1.721 times more likely to donate compared to those from other areas, potentially due to more effective local blood donation campaigns and greater accessibility of donation services [23, 41]. Beyond socio-demographic characteristics, knowledge, previous donation experience, and family-related factors were critical determinants. Knowledge about blood donation was a key factor, with participants who had a better understanding of blood donation practices being more likely to donate. This reinforces the importance of educational interventions in raising awareness and dispelling myths about blood donation [17, 42, 43]. Prior donation experience was another significant factor, with previous donors being more likely to donate again. This finding supports the notion that familiarity with the process reduces fear and builds confidence in potential repeat donors [44]. Family influence also played a role; individuals with a family history of blood donation or those who had relatives who required transfusions were more likely to donate, underscoring the power of personal connections and lived experiences in motivating donation behavior [44, 45]. Psychosocial factors, particularly participation in blood donation campaigns, were associated with higher donation frequency and likelihood. Participants who engaged in campaigns were significantly more likely to donate, emphasizing the impact of organized public health initiatives and the success of widespread social campaigns like the Ice Bucket Challenge [46]. This suggests that promoting blood donation through campaigns and community engagement is a powerful tool for improving donation rates. On the other hand, psychological barriers, including fear of medical procedures and death anxiety, were found to negatively affect both current donation practices. Fearful individuals were less likely to donate, highlighting the need for targeted education and psychological support to address these barriers [47, 48]. Overcoming these fears is essential to ensure a steady, willing donor base. Positive motivation, driven by altruism, was another strong predictor of blood donation behavior. Highly motivated individuals were more likely to donate, particularly during times of crisis, such as the COVID-19 pandemic, which highlighted the importance of collective action in the face of public health emergencies [49, 50]. Additionally, external incentives—such as rewards or recognition—were shown to significantly increase donation rates. Participants who receive incentives were more likely to donate and less likely to be non-donors, suggesting that, when ethically implemented, incentives can enhance donation rates without diminishing the altruistic nature of the act [51]. Finally, facilitating factors, such as easy access to donation sites and robust social support networks, greatly enhanced both the frequency and likelihood of donation. Donation centers that are accessible and well-supported by local communities are crucial for ensuring that individuals have the opportunity to donate when they are willing [52]. This study provides valuable insights into blood donation behavior in East Gojjam Zone, but it has some limitations. The cross-sectional design restricts the ability to establish causal relationships, so longitudinal studies are needed to explore temporal dynamics. Additionally, self-reported data may introduce social desirability bias, which could be addressed by cross-referencing with data from donation centers. Lastly, since the study was conducted in a specific region, the findings may not be generalizable to other areas with different cultural, economic, or healthcare contexts. Expanding research across diverse regions could enhance understanding of regional variations in donation behavior. Conclusion and Recommendations This study provides valuable insights into the factors influencing blood donation behavior in the East Gojjam Zone. Despite 28.8% of participants having donated blood at least once and 20.7% in the past two years, these figures remain inadequate to meet the growing demand for safe blood supplies. Frequency of blood donation was positively associated with younger age, male gender, higher educational attainment, and employment in healthcare or education sectors. Psychosocial factors such as higher self-efficacy, knowledge, positive attitudes, strong intentions, social influence from family and community, prior donation experience, and participation in donation campaigns were found to be key drivers of increased donation frequency. In contrast, psychological barriers, including fear, misconceptions, and health-related concerns, were significant deterrents. Facilitators such as improved accessibility and motivational support also played a crucial role in encouraging higher donation frequency. To address these challenges, public health initiatives should focus on educational campaigns that address fears, misconceptions, and emphasize the altruistic value of blood donation. Targeted interventions for women, older adults, and individuals with lower education levels are necessary. Incentives, increased access through mobile units, extended service hours, and leveraging the influence of healthcare professionals and community leaders can further enhance participation. Continuous monitoring and evaluation are essential to ensure the responsiveness of blood donation programs to emerging needs and trends. Implementing these strategies can help improve blood donation frequency, ensuring a more sustainable and resilient blood supply in East Gojjam Zone and similar regions, thereby contributing to strengthened health system resilience. Declarations Ethical approval and consent to participate This study was conducted in accordance with the Declaration of Helsinki and the National Research Ethics Review Guideline of Ethiopia. Ethical approval was obtained from the Institutional Review Board (IRB) of Debre Markos University (Approval No: RTTD/844/10/2024) on June 4, 2024. Written informed consent was obtained from all participants after clearly explaining the study’s objectives, procedures, potential risks, and benefits. Participants were assured of their right to withdraw at any time without penalty. To ensure confidentiality, no personal identifiers were collected; all data were anonymized, securely stored, and accessible only to the research team. Consent for publication Not applicable. Funding This study was funded by the College of Natural and Computational Sciences, Debre Markos University. The funder had no role in the study design, data collection, analysis, interpretation of data, or manuscript preparation. Availability of data and materials The datasets used and analyzed during the study are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests. Authors' contributions N.G. conceived the study, designed the research, conducted data analysis, and drafted the manuscript. M.A., M.K., A.F., and M.G. contributed to the study’s conception, interpretation of results, and critical review of the manuscript. All authors have read and approved the final version of the manuscript for submission. Acknowledgements We sincerely thank the College of Natural and Computational Sciences, Debre Markos University, for their generous financial support of this research. Our heartfelt appreciation goes to the local administrations of Debre Markos, Dejen, and Amanuale towns for their essential cooperation and assistance throughout the data collection process. 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Collett, D., Modelling survival data in medical research . 2023: Chapman and Hall/CRC. Hosmer Jr, D.W., S. Lemeshow, and R.X. Sturdivant, Applied logistic regression . 2013: John Wiley & Sons. Akaike, H., A new look at the statistical model identification. IEEE transactions on automatic control, 1974. 19 (6): p. 716-723. Schwarz, G., Estimating the dimension of a model. The annals of statistics, 1978. 6 (2): p. 461-464. Kassie, A. and S. Birara, Retracted article: Practice of blood donation and associated factors among adults of Gondar City, Northwest Ethiopia: Bayesian analysis approach. Journal of Blood Medicine, 2020: p. 525-532. Nigussie Yirgu, A., et al., Blood donation and associated factors among employees working at Negele Arsi General Hospital and Medical College, Southeast Ethiopia: a cross-sectional study. Journal of Blood Medicine, 2021: p. 475-482. Chideme, C., D. Chikobvu, and T. Makoni, The Impact of Age Group in Hierarchical Forecasting of Monthly Blood Donations in Zimbabwe. Risk Management and Healthcare Policy, 2024: p. 311-328. Melku, M., et al., Knowledge, attitude, and practice of adult population towards blood donation in Gondar Town, Northwest Ethiopia: a community based cross‐sectional study. Journal of blood transfusion, 2016. 2016 (1): p. 7949862. Carver, A., et al., What motivates men to donate blood? A systematic review of the evidence. Vox sanguinis, 2018. 113 (3): p. 205-219. Zucoloto, M.L., et al., Comparison of the demographic and social profile of blood donors and nondonors in Brazil. Health & social care in the community, 2019. 27 (2): p. 330-336. Mohammadpour, M., A. Mohammadpour, and S. Najafi, Comparison of the effect of peer-led education and education by the healthcare personnel on awareness, attitude and performance of lettered people toward organ donation. Journal of Babol University of Medical Sciences, 2019. 21 (1): p. 306-313. Griffin, D., D. Grace, and A. O'Cass, Blood donation: comparing individual characteristics, attitudes, and feelings of donors and nondonors. Health marketing quarterly, 2014. 31 (3): p. 197-212. Costaguta, G.A., A. Romero, and A.C. Costaguta, Influence of Information Access on Organ Donation: A Questionnaire-Based Cross-Sectional Study. medRxiv, 2024: p. 2024.07. 08.24310086. Korkut, B., Evaluation of Blood Donation Awareness Level: A Cross-Sectional Study. Cureus, 2023. 15 (10). Shrivastava, S., P. Shrivastava, and A. Joshi, Strengthening blood donation practices in low-and middle-income nations. Cukurova Medical Journal, 2024. 49 (4): p. 1122-1125. Devi, V.K., et al., Assessment of knowledge, attitude, and practice of blood donation among paramedical students of a medical college in Chennai, Tamil Nadu. Iraqi Journal of Hematology, 2024. 13 (1): p. 71-78. Yolanda, D., Korelasi Pengetahuan dan Minat Donor Darah pada Remaja di MA Hidayatullah Martapura. Jurnal Kesehatan Indonesia, 2024. 14 (03): p. 180-183. Roberts, L., J.P. Rose, and E.A. Vogel, Experiencing is believing: prior experience moderates the impact of self-based and socially-based cues in the context of blood donation. Journal of Behavioral Medicine, 2017. 40 : p. 998-1010. Ciaușescu, A., et al., Blood, it runs in the family: Intergenerational transmission of blood-donor behaviour. Davison, T.E., Understanding, predicting and influencing blood donation: an introduction to the special issue on donor behaviour . 2021, Wiley Online Library. p. 128-131. Saqlain, N., et al., Association of blood donation related fears with donors’ characteristics and their impact on future donation. International Journal of Research in Medical Sciences, 2023. 11 (10): p. 3636. Chen, L., et al., How anxiety relates to blood donation intention of non-donors: The roles of moral disengagement and mindfulness. The Journal of Social Psychology, 2024. 164 (1): p. 43-58. Quee, F.A., et al., Blood donor motivators during the COVID‐19 pandemic. Journal of Philanthropy and Marketing, 2022. 27 (3): p. e1757. Amoloza, E.M., Listening to the Hearts of Today’s Heroes: Exploring Donors’ Motivations and Feedback on UPOU Blood Donation Drive. International Journal of Research and Innovation in Social Science, 2024. 8 (12): p. 2897-2911. Lacetera, N., M. Macis, and R. Slonim, Rewarding altruism? a natural field experiment . 2011, National Bureau of Economic Research. Sadler, A., et al., Incentives for blood donation: a discrete choice experiment to analyze extrinsic motivation. Transfusion medicine and hemotherapy, 2018. 45 (2): p. 116-124. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6599036","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":549225786,"identity":"8e2b54db-8c8b-45ef-9477-065c0bd99b97","order_by":0,"name":"Nigusie Gashaye Shita","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1ElEQVRIiWNgGAWjYDACZhBhwCBnf7wBxLAgXosxw5kDIIYE8ZYlNtxIANFEaDFnZ78m+aPAhrFx5vOrG34USDDwt3cn4NVi2cxTJs1jkMbMLJ1TdrMH6DCJM2c34NVicJgnTRpIsrFJ56Td4AFqMZDIJaxF8ofBfx4eyTNpN/8Qp4X9mASPwQEJCQn2Y7eJtYXZmscg2cCAJ4fttoyBBA9hv5w//vDmjz929RvYjz+7+eaPjRx/ey9+LQwMPAYoDB4CykGA/QE6YxSMglEwCkYBKgAAob5CVtat/M0AAAAASUVORK5CYII=","orcid":"","institution":"Debre Markos University","correspondingAuthor":true,"prefix":"","firstName":"Nigusie","middleName":"Gashaye","lastName":"Shita","suffix":""},{"id":549225787,"identity":"eced6a3a-834f-4153-a146-6e07b6d62b6a","order_by":1,"name":"Awoke Fetahi Woudneh","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Awoke","middleName":"Fetahi","lastName":"Woudneh","suffix":""},{"id":549225788,"identity":"399dca8b-8720-4150-b590-4b69234f1a06","order_by":2,"name":"Metadel Azeze Mekonnen","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Metadel","middleName":"Azeze","lastName":"Mekonnen","suffix":""},{"id":549225789,"identity":"fb0728d8-e6c8-4939-a446-74a2955b54b8","order_by":3,"name":"Mihretie Gedfew","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Mihretie","middleName":"","lastName":"Gedfew","suffix":""},{"id":549225790,"identity":"d128f756-6b81-4d32-a0d8-a3662ccb56bb","order_by":4,"name":"Misganaw Mekonnen Nigussie","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Misganaw","middleName":"Mekonnen","lastName":"Nigussie","suffix":""},{"id":549225791,"identity":"2facb8fe-9979-4669-858f-753d66ee09dd","order_by":5,"name":"Fetene Getnet Gebeyehu","email":"","orcid":"","institution":"Debre Markos University","correspondingAuthor":false,"prefix":"","firstName":"Fetene","middleName":"Getnet","lastName":"Gebeyehu","suffix":""}],"badges":[],"createdAt":"2025-05-06 05:08:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6599036/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6599036/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":100548403,"identity":"8fb23c04-633c-42d8-b496-af5bf7608775","added_by":"auto","created_at":"2026-01-19 08:18:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1048274,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6599036/v1/1365be2e-54dc-40c1-acc6-762e2b06cf51.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Blood Donation Practices and Associated Factors among Adults in East Gojjam Zone, Northwest Ethiopia","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBlood donation is a critical healthcare practice that supports individuals suffering from blood loss due to trauma, surgery, pregnancy complications, or other medical conditions\u0026nbsp;[1, 2].\u0026nbsp;However, blood donation rates in many low- and middle-income countries, including Ethiopia, have remained significantly lower than required to meet healthcare needs. According to the World Health Organization\u0026nbsp;[3], high-income countries collect 40% of the world\u0026rsquo;s blood donations, despite representing only 16% of the global population. In contrast, sub-Saharan Africa, including Ethiopia, has continued to experience critical blood shortages, with Ethiopia collecting only 6.1% of the blood required to meet national needs\u0026nbsp;[4].\u003c/p\u003e\n\u003cp\u003eThe East Gojjam Zone, located in Northwest Ethiopia, has faced substantial challenges related to inadequate blood supply, compounded by factors such as maternal mortality, trauma, and surgical conditions [5-8]. In particular, maternal deaths due to postpartum hemorrhage remain a significant public health concern in Ethiopia and sub-Saharan Africa, where approximately 22 women die each hour from pregnancy-related complications, many of which could be mitigated by timely access to blood transfusions [9-12]. Consequently, ensuring a steady and sufficient supply of safe blood has been critical in saving lives, improving maternal health, and meeting the needs of patients in emergency situations.\u003c/p\u003e\n\u003cp\u003eDespite several national and local efforts to promote voluntary blood donation, Ethiopia has continued to experience challenges in blood collection. The low blood donation rates in the country have been influenced by a range of factors, including misconceptions about the donation process, cultural beliefs, and logistical barriers [13-16]. Previous studies on blood donation in Ethiopia and other sub-Saharan African countries have predominantly focused on broader aspects like knowledge, attitudes, and socio-demographic factors affecting whether or not individuals choose to donate [14-17]. However, many of these studies have overlooked the frequency of donation among those who donate, which is a critical component in understanding blood donation behavior.\u003c/p\u003e\n\u003cp\u003eThis study aimed to address this gap by employing a Zero-Inflated model (ZIM) to examine the practice of blood donation in East Gojjam Zone. The Zero-Inflated model was deemed suitable for analyzing data where a significant number of individuals are non-donors (zeros) and a separate subset of individuals donate irregularly or regularly. This approach allowed for a clearer distinction between zero donors (those who never donate) and frequent or occasional donors, providing a comprehensive view of the factors influencing both the likelihood of donating and the frequency of donations among those who do engage in blood donation [18].\u003c/p\u003e\n\u003cp\u003eBy exploring the socio-demographic, psychological, and structural factors that shaped the practice of blood donation, this study provided new insights into the barriers and facilitators of blood donation in East Gojjam. Understanding these factors was crucial for informing interventions aimed at increasing blood donation rates. Improved blood donation practices not only have the potential to save lives but also to strengthen the healthcare infrastructure in Ethiopia, ensuring a reliable supply of safe blood for those in need. The findings of this study contribute to public health initiatives and provide valuable recommendations for enhancing blood donation programs in the region.\u003c/p\u003e"},{"header":"Methods","content":"\u003ch2\u003eStudy Area and Population\u003c/h2\u003e\n\u003cp\u003eThis community-based cross-sectional study was conducted in the East Gojjam Zone of the Amhara Region, Ethiopia, between April 23 and September 23, 2024. The zone, bordered by Oromia to the south, West Gojjam to the west, South Gondar to the north, and South Wollo to the east, is geographically diverse, with the Abay River forming natural boundaries. Three districts\u0026mdash;Debre Markos, Amanuale, and Dejene\u0026mdash;were randomly selected to ensure geographic and demographic representativeness. The study targeted adults aged 18\u0026ndash;65 years who had resided in the selected districts for at least six months. Exclusion criteria included individuals with serious illness, hearing impairments, or known contraindications to blood donation (e.g., HIV, hepatitis). The sample size was calculated based on a 16.1% prevalence of blood donation[19], with a 95% confidence level and 3% margin of error. After adjusting for a design effect of 2 and a 16% non-response rate, the final sample size was 1,339 participants.\u003c/p\u003e\n\u003ch2\u003eSampling Procedure\u003c/h2\u003e\n\u003cp\u003eA multistage sampling technique was employed. In the first stage, three districts were randomly selected from the East Gojjam Zone. In the second stage, four kebeles were selected from Debre Markos, and one kebele each from Amanuale and Dejene. In the third stage, households within each kebele were selected using systematic random sampling, with proportional allocation based on the population size. If multiple eligible individuals were present in a household, one participant was selected randomly using a lottery method.\u003c/p\u003e\n\u003ch2\u003eData Collection\u003c/h2\u003e\n\u003cp\u003ePrimary and secondary data were collected. Secondary data on the total number of households and the adult population in the selected areas were sourced from local administrative records. Primary data were collected via a structured questionnaire, which included socio-demographic, economic, and psychosocial characteristics, as well as knowledge, attitudes, behaviors, and practices related to blood donation.\u003c/p\u003e\n\u003cp\u003ePrior to main data collection, a pre-test was conducted in a non-selected woreda involving 5% of the sample size to assess the clarity, consistency, and validity of the questionnaire. Revisions were made based on pilot study feedback, and the internal consistency of the tool was evaluated using Cronbach\u0026rsquo;s alpha, yielding a value greater than 0.7, indicating acceptable reliability [20]. Data were collected through face-to-face interviews conducted by trained enumerators. Participants requiring assistance with reading or writing were supported to ensure full participation. The survey instrument is provided as a \u003cstrong\u003esupplementary document.\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003eVariables and Measurement\u003c/h2\u003e\n\u003cp\u003eThe primary outcome was the \u003cstrong\u003efrequency of blood donations\u003c/strong\u003e over the past two years. \u003cstrong\u003eIntention to donate blood\u003c/strong\u003e was measured using three items on a 5-point Likert scale ranging from \u0026ldquo;completely unwilling\u0026rdquo; to \u0026ldquo;totally willing\u0026rdquo; [21]. Participants scoring 8 or higher were classified as having the intention to donate blood.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge of blood donation\u003c/strong\u003e was assessed through 10 items adapted from prior studies\u0026nbsp;[21-23]. A score of at least five correct answers classified participants as knowledgeable. \u003cstrong\u003eBehavioral constructs\u003c/strong\u003e (attitudes, subjective norms, and self-efficacy) were measured on a 5-point Likert scale, with scores computed by summing positive items and subtracting negative ones. Additionally, a deterministic principal component analysis (PCA) approach was used, as recommended in similar studies [21, 24, 25].\u003c/p\u003e\n\u003cp\u003eTo explore beliefs about blood donation, open-ended questions were included, addressing both behavioral and normative beliefs. Demographic, socio-economic, and psychological covariates were also collected.\u003c/p\u003e\n\u003ch2\u003eEthical Considerations\u003c/h2\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki and the National Research Ethics Review Guideline of Ethiopia. Ethical approval was obtained from the Institutional Review Board (IRB) of Debre Markos University (Approval No: RTTD/844/10/2024) on June 4, 2024. Written informed consent was obtained from all participants after clearly explaining the study\u0026rsquo;s objectives, procedures, potential risks, and benefits. Participants were assured of their right to withdraw at any time without penalty. To ensure confidentiality, no personal identifiers were collected; all data were anonymized, securely stored, and accessible only to the research team.\u003c/p\u003e\n\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\n\u003cp\u003eDescriptive statistics were first used to summarize the socio-demographic and blood donation-related characteristics of the participants. These included frequencies, percentages, means, and standard deviations.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBivariate regression analyses were conducted to identify potential factors influencing blood donation behaviors. Variables with a p-value \u0026le; 0.20 were considered for inclusion in the multivariate regression model. In the multivariate analysis, variables with p-values \u0026le; 0.10 were retained in the final model to control for confounding effects [26-28]. Statistical significance was defined as a p-value of less than 0.05, and all analyses were performed at a 95% confidence level.\u003c/p\u003e\n\u003cp\u003eGiven the high proportion of zero blood donation reports (over 78%) and the overdispersion in the data (where the variance exceeds the mean), a Zero-Inflated Negative Binomial (ZINB) regression model was employed to examine the factors associated with blood donation practices.\u003c/p\u003e\n\u003cp\u003eThe ZINB model has two components. The first component, the zero-inflation part, models the probability of an individual reporting zero donations. This component was estimated using a logit link function, which models the log odds of zero donations. The regression equation for this part is:\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"611\" height=\"39\" 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\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003eWhere\u0026nbsp;\u003cimg width=\"15\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u0026nbsp;represents the probability of zero donations for individual i, and\u0026nbsp;\u003cimg width=\"17\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e,\u003cimg width=\"21\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e,\u003cimg width=\"38\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u0026nbsp;are the explanatory variables (e.g., socio-demographic characteristics, knowledge, and attitudes). The \u0026alpha;1, \u0026alpha;2,\u0026hellip;,\u0026alpha;p are the parameters to be estimated.\u003c/p\u003e\n\u003cp\u003eThe second component of the ZINB model addresses the count data, modeling the frequency of donations for individuals who have made at least one donation. A Negative Binomial distribution was used with a log link function to account for overdispersion. The regression equation for this component is:\u003c/p\u003e\n\u003cp\u003e\u003cimg width=\"577\" height=\"23\" 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\" alt=\"image\"\u003e\u003c/p\u003e\n\u003cp\u003eIn this equation,\u0026nbsp;\u003cimg width=\"14\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u0026nbsp;represents the expected count of donations for individual i, and\u0026nbsp;\u003cimg width=\"17\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e,\u003cimg width=\"21\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e,\u003cimg width=\"40\" height=\"21\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u0026nbsp;are the explanatory variables, with\u0026nbsp;\u003cimg width=\"105\" height=\"23\" src=\"data:image/png;base64,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\" alt=\"image\"\u003e\u0026nbsp;representing the estimated coefficients. The overdispersion parameter is included to capture the extra variance in the data.\u003c/p\u003e\n\u003cp\u003eBoth ZINB regression and Structural Equation Modeling (SEM) were estimated using Maximum Likelihood Estimation (MLE). The performance of the ZINB model was evaluated using the Deviance test, which indicated a good fit to the data. For model comparison and selection, the Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used, with lower values indicating better model fit and reduced risk of overfitting [29, 30].\u003c/p\u003e\n\u003cp\u003eIn addition to ZINB regression, SEM was conducted to explore the complex relationships between behavioral factors (e.g., attitudes, knowledge, and self-efficacy) and blood donation practices. The SEM results showed a good fit to the data, suggesting that the model adequately represented the observed relationships. Model fit for SEM was assessed using metrics such as the Standardized Root Mean Square Residual (SRMR) and the Adjusted Goodness-of-Fit Index (AGFI), both of which supported the model\u0026apos;s adequacy.\u003c/p\u003e"},{"header":"Results","content":"\u003ch2\u003eCharacteristics of study participants\u003c/h2\u003e\n\u003cp\u003eA total of 1,332 individuals met the inclusion criteria. Among them, 384 participants (28.8%) reported having donated blood at least once in their lifetime, with only 276 (20.7%) donating within the past two years. The majority of participants (948, 71.2%) had never donated blood, and frequent donors were uncommon. Among donors, 16.2% reported donating once, 7.2% twice, and 5.4% three or more times (Table 1).\u003c/p\u003e\n\u003cp\u003eTable 1: Blood Donation History and Frequency among Participants\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDonations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePast Years (Frequency, Percent)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLast 2 Years (Frequency, percent)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e948 (71.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1056 (79.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e216 (16.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e156 (11.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96 (7.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60 (4.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (0.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026mdash;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1332 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1332 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe mean age of donors was 33 (standard deviation (SD) = 8) years, significantly younger than non-donors, whose mean age was 38 (SD = 9) years. Gender differences were evident, with males constituting 62.5% of donors and 40.5% of non-donors. Conversely, females represented a higher proportion of non-donors (59.5%) compared to donors (37.5%). Educational attainment was positively associated with donation behavior: 96.9% of donors held a degree or higher, compared to 89.9% of non-donors. Additionally, a greater proportion of donors were employed as civil servants or health professionals (84.4% vs. 77.2%).\u003c/p\u003e\n\u003cp\u003eMarital status also differed between groups; 60% of donors were married compared to 34.2% of non-donors. Most participants in both groups perceived blood donation positively, with 93.8% of donors and 97.5% of non-donors considering it a way to help others. Awareness of blood donation was high in both groups (96.9% among donors and 98.7% among non-donors). Notably, non-donors reported a slightly higher average monthly income (mean = 5,681 ETB, SD = 3,019) than donors (mean = 5,469 ETB, SD = 2,755). A high proportion of participants expressed future intentions to donate: 78.1% of donors and 73.4% of non-donors (Table 2).\u003c/p\u003e\n\u003cp\u003eTable 2: Demographic Characteristics among Donors and Non-Donors\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCharacteristic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo (n=948)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes (n=384)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge (Mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38 \u0026plusmn; 9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33 \u0026plusmn; 8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e384 (40.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e240 (62.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e564 (59.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e144 (37.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEducation Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003edegree or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e852 (89.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e372 (96.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96 (10.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (3.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eJob Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHealth Professionals or civil servants\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e732 (77.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e324 (84.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e216 (22.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60 (15.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e324 (34.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e230 (60.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e624 (65.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e154(40.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePurpose of Donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHelp those with blood loss\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e924 (97.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e360 (93.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (2.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHeard of Blood Donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (3.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e936 (98.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e372 (96.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMonthly Income (Mean \u0026plusmn; SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5681 \u0026plusmn; 3019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5469 \u0026plusmn; 2755\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eIntention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e252 (26.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84 (21.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e696 (73.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e300 (78.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2\u003eBlood Donation Motivations and Barriers\u003c/h2\u003e\n\u003cp\u003eThe most commonly cited motivation for donating blood was altruism. Specifically, 46.6% of donors and 43.1% of non-donors identified helping others as their primary motivator. Social responsibility was mentioned by 12.8% of donors and 3.7% of non-donors. Encouragement from family or friends influenced 6.3% of donors, while no non-donors cited this factor. Moreover, 34.4% of donors and 24.1% of non-donors reported a strong influence of family or friends on their donation decisions.\u003c/p\u003e\n\u003cp\u003eBarriers to blood donation varied across groups. Lack of awareness was reported by 56% of donors and 35.5% of non-donors. Health and safety concerns were cited by 34.4% of donors and 35.4% of non-donors. Fear of needles (6.3% vs. 11.4%) and lack of trust in the donation process (12.5% vs. 7.6%) were also notable deterrents.\u003c/p\u003e\n\u003cp\u003eIncentives played a significant role in motivating blood donation. More than half of the donors (53.4%) and 39.1% of non-donors reported being influenced by incentives. Religious teachings were a source of encouragement for 59.4% of donors and 40.5% of non-donors, while cultural influences affected 43.5% and 38.1%, respectively. A greater proportion of donors (72.1%) strongly agreed with the importance of blood donation compared to non-donors (55.6%).\u003c/p\u003e\n\u003cp\u003eEase of the donation process was also an influencing factor. More than half of donors (53.4%) strongly agreed that the process was easy, compared to only 21.4% of non-donors. Participation in blood donation campaigns was higher among donors (37.5%) than non-donors (12.7%), suggesting a positive association between campaign exposure and donation behavior (Table 3).\u003c/p\u003e\n\u003cp\u003eTable 3: Blood Donation Practice with Blood Donation Motivations and Barriers\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFactor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCategory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo (n=948)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes (n=384)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eMotivation to donate blood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo help those in need\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e409 (43.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e179 (46.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eA sense of social responsibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35 (3.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e49 (12.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEncouragement from family/friends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo achieve personal satisfaction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (2.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (3.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eInfluence of family/friends on donation decision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGreat impact\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e228 (24.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e132 (34.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSome effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e191 (20.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e109 (28.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo effect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e241 (25.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e131 (34.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eLack of awareness preventing donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e337 (35.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e215 (56.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e372 (39.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e144 (37.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e215 (22.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25 (6.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eReasons preventing donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFear of needles/blood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSafety/health concerns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e336 (35.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e132 (34.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLack of awareness about donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108 (11.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84 (21.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLack of trust in the process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e72 (7.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFeeling unfit for health reasons\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e168 (17.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (3.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96 (10.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60 (15.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eImpact of incentives on likelihood to donate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigh likelihood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e371 (39.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e205 (53.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLittle impact\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96 (10.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo change\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e396 (41.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48 (12.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e85 (9.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e83 (21.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eInfluence of religious teachings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e384 (40.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e228 (59.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e156 (16.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60 (15.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e408 (43.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96 (25.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eInfluence of environmental culture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e361 (38.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e167 (43.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e275 (29.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e133 (34.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNot sure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e312 (32.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e84 (21.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eImportance of blood donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStrongly disagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e120 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (3.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDisagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e60 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNeutral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e48 (5.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAgree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e193 (20.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95 (24.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStrongly agree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e527 (55.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e277 (72.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eEase of blood donation process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStrongly disagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e132 (13.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (3.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDisagree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96 (10.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24 (6.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNeutral\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e216 (22.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0 (0.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAgree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e301 (31.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e143 (37.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStrongly agree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e203 (21.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e205 (53.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEver organized a blood donation campaign?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e828 (87.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e240 (62.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e120 (12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e144 (37.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ch2\u003eFactors Associated with Blood Donation Practices\u003c/h2\u003e\n\u003cp\u003eThe Zero-Inflated Negative Binomial (ZINB) regression model provided the best fit for identifying factors associated with blood donation practices, as indicated by the lowest deviance, Akaike Information Criterion (AIC), and Bayesian Information Criterion (BIC) values (Table 4).\u003c/p\u003e\n\u003cp\u003eTable 4: Model Comparison Summary\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDeviance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNegative Binomial (NB)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e741.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e769.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e783.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eZero-Inflated Negative Binomial (ZINB)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e715.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e752.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e777.40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTruncated Model\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e803.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e830.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e853.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIn the count component of the ZINB model, several factors were significantly associated with blood donation frequency (Table 5).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5: \u0026nbsp;Zero inflated Negative binomial Regression Results for Blood Donation Practices\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"579\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 136px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 230px;\"\u003e\n \u003cp\u003eCount Model\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" style=\"width: 212px;\"\u003e\n \u003cp\u003eZero Model\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003eCoefficient(B)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003eIRR\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003eStandard Error (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003eCoefficient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003eAOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003eStandard Error (SE)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eIntercept\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e-0.672\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e1.659\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e5.254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.423\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e-0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.985\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e1.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eGender (Male Vs. Female)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.755\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.375\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eEducation (degree or above \u0026nbsp;vs. others)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.640\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.675\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.509\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.313\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.031\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eOccupation (Healthcare or teachers vs. others)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.894\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.445\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.321\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.298\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.366\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eMarital Status (Married Vs. others)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.612\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.844\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.268\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.845\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.317\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eKnowledge of Blood Donation (Have vs. have not)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e3.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.379\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.759\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.468\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eExperience (Yes vs. No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.522\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e4.581\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.811\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.335\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.528\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eBlood Donated by Family (Yes Vs. No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.802\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.329\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.560\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eFamily Needed Blood (Yes vs. No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.702\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.261\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.845\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.430\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.328\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eParticipation in Campaigns (Yes vs. No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.902\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.465\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.228\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.582\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.559\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003ePsychological Barriers (Yes vs. No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e-0.972\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e0.378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e0.932\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e2.540\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.019\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eMotivation (High vs. low)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e3.200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.418\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.742\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.476\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eIncentive (Yes vs. No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-1.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.363\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.423\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eFacilitators (Yes vs. No)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.751\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.271\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.574\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.312\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.075\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eLocation (Debre Markos vs. others)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e0.543\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e1.721\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.259\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.036\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e-0.254\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e0.776\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e0.414\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003eLn(alpha)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e1.005693\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e2.734\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.1681357\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 136px;\"\u003e\n \u003cp\u003ealpha\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\"\u003e\n \u003cp\u003e2.733802\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\"\u003e\n \u003cp\u003e15.391\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 59px;\"\u003e\n \u003cp\u003e0.4596495\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 46px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 52px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 35px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eB= coefficients, Exp (\u0026beta;) =Exponent of Coefficient=Incidence Rate Ratio=IRR, AOR=Adjusted Odds Ratios\u003c/p\u003e\n\u003cp\u003eMales (IRR = 2.13, p = 0.022), individuals with a degree or higher education (IRR = 1.64, p = 0.014), those working in healthcare or education (IRR = 2.45, p = 0.005), and married individuals (IRR = 1.84, p = 0.023) had higher donation rates. Other key factors included having knowledge about blood donation (IRR = 3.26, p = 0.002), prior donation experience (IRR = 4.58, p \u0026lt; 0.001), a family member who donated blood (IRR = 2.23, p = 0.015) or needed a transfusion (IRR = 2.02, p = 0.007), participation in campaigns (IRR = 2.47, p \u0026lt; 0.001), strong motivation (IRR = 3.20, p = 0.005), receiving incentives (IRR = 2.20, p = 0.024), and access to facilitators (IRR = 2.75, p \u0026lt; 0.001). In contrast, psychological barriers (IRR = 0.38, p = 0.002) and older age (IRR = 0.985, p = 0.001) were negatively associated with donation frequency.\u003c/p\u003e\n\u003cp\u003eIn the zero-inflation component, factors that increased the likelihood of never donating blood included older age (AOR = 1.02, p = 0.006) and psychological barriers (AOR = 2.54, p = 0.019). On the other hand, males (AOR = 0.38, p = 0.002), individuals with higher education (AOR = 0.51, p = 0.031), healthcare or education professionals (AOR = 0.30, p = 0.001), married individuals (AOR = 0.43, p = 0.008), those with a family member who needed blood (AOR = 0.43, p = 0.010), and those who receive incentives (AOR = 0.36, p = 0.017) were less likely to never donate blood.\u003c/p\u003e\n\u003ch2\u003ePath Analysis of Blood Donation Behavior\u003c/h2\u003e\n\u003cp\u003eStructural Equation Modeling (SEM) was conducted to explore the relationships among psychosocial and contextual factors influencing blood donation practice. Model fit statistics indicated a good fit between the proposed model and the observed data (Table 6).\u003c/p\u003e\n\u003cp\u003eTable 6: Goodness-of-Fit Indices of the SEM Model\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eFit Index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003eValue\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eRoot Mean Square Error of Approximation (RMSEA)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.048\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eStandardized Root Mean Square Residual (SRMR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.033\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eComparative Fit Index (CFI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eTucker-Lewis Index (TLI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eGoodness-of-Fit Index (GFI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eAdjusted Goodness-of-Fit Index (AGFI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.91\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 295px;\"\u003e\n \u003cp\u003eNormed Fit Index (NFI)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThe path analysis showed that Self-efficacy (\u0026beta; = 0.350) was the most significant positive predictor of blood donation practice, with individuals who felt more confident in their ability to donate being more likely to do so. Other key factors influencing donation behavior included positive attitudes toward blood donation (\u0026beta; = 0.290), previous donation experience (\u0026beta; = 0.280), and social influence (\u0026beta; = 0.260). Participation in blood donation campaigns (\u0026beta; = 0.220) and facilitators such as accessibility and motivation (\u0026beta; = 0.280) also positively affected donation behavior. Conversely, psychological barriers, including fear and concerns about anemia (\u0026beta; = -0.200), had a negative impact on donation practices. Incentive factors (\u0026beta; = 0.180) were also found to encourage blood donation, underscoring the role of both intrinsic and extrinsic motivators in promoting regular blood donation behavior. Lastly, intention (\u0026beta; = 0.62) was a strong predictor, suggesting that individuals who intended to donate were more likely to actually do so (Table 7).\u003c/p\u003e\n\u003cp\u003eTable 7: Path Coefficients for Blood Donation Behavior and Practice\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"475\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 313px;\"\u003e\n \u003cp\u003eConstruct\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 162px;\"\u003e\n \u003cp\u003ePath to Practice\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026beta;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003eSE\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eSelf-Efficacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.350\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eAttitudes Toward Blood Donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.290\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eKnowledge of Blood Donation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.210\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eSocial Influence (Norms, Family, Friends, and Community)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.260\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003ePrevious Donation Experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.090\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eParticipation in Campaigns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eBarriers to Donation (Fear of Anemia \u0026amp; Psychological Barriers)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e-0.200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eIncentive Factors\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eFacilitators (Accessibility \u0026amp; Motivation)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 54px;\"\u003e\n \u003cp\u003e0.280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 48px;\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 60px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 313px;\"\u003e\n \u003cp\u003eIntention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e0.138\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eThese findings highlight the importance of addressing both psychological barriers and external facilitators to increase blood donation frequency.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn this study, 28.8% of individuals in East Gojjam Zone reported donating blood at least once, with 20.7% having donated within the past two years. Although this prevalence is slightly higher than the national pooled estimate of 25.82% reported in a systematic review and meta-analysis [16], it remains insufficient to meet the growing demand for safe blood. Regional variations across Ethiopia are notable, with lower rates observed in Gondar (15.53%) [31] and higher rates among hospital employees in Negele Arsi (39%) [32]. These discrepancies may reflect differences in health literacy, accessibility of donation services, and occupational exposure to health promotion activities. The low proportion of recent donations further underscores the ongoing challenge of maintaining a regular donor base. Therefore, targeted interventions—including public education campaigns, enhanced accessibility to donation services, and culturally sensitive community engagement strategies—are essential to improve both first-time and repeat voluntary blood donations.\u003c/p\u003e\n\u003cp\u003eSeveral socio-demographic factors significantly influenced blood donation behavior in this study. Age was inversely associated with donation: each additional year corresponded to a 1.5% decline in donation frequency and a 2.2% increase in the odds of being a non-donor. This trend aligns with findings from Zimbabwe [33], although it contrasts with observations from Gondar\u0026nbsp;[34], where middle-aged adults were more likely to donate. Such inconsistencies suggest that variations in health perceptions and exposure to donation campaigns may shape behavior differently across settings.\u003c/p\u003e\n\u003cp\u003eSex was another key determinant, with males demonstrating significantly higher rates of donation than females. Specifically, males exhibited 2.13 times greater expected donation counts and a 62.5% reduction in the odds of being non-donors. This is consistent with previous studies [35] and may reflect biological factors, such as menstruation-related eligibility issues among women, as well as social expectations that encourage public altruism more strongly among men.\u003c/p\u003e\n\u003cp\u003eEducational attainment also emerged as a strong predictor. Participants with a degree or higher were more likely to donate and less likely to be non-donors compared to those with lower educational levels, suggesting that education enhances both awareness of blood donation's importance and responsiveness to public health messaging [36].\u003c/p\u003e\n\u003cp\u003eOccupational status further influenced donation patterns. Healthcare professionals and teachers exhibited 2.45 times higher expected donation counts and 70.2% lower odds of being non-donors compared to other occupations. These findings, consistent with prior research [37, 38], likely reflect greater exposure to health information and a heightened sense of civic duty. Nonetheless, persistent fears and misconceptions among these groups indicate the need for continued educational efforts [39].\u003c/p\u003e\n\u003cp\u003eMarital status was also significant: married individuals were 1.844 times more likely to donate blood and 57% less likely to be non-donors compared to their unmarried counterparts. Social support structures and a heightened sense of responsibility toward family and community members may partly explain this pattern, as reported in previous studies [38, 40].\u003c/p\u003e\n\u003cp\u003ePlace of residence influenced donation rates as well. Participants residing in Debre Markos were 1.721 times more likely to donate compared to those from other areas, potentially due to more effective local blood donation campaigns and greater accessibility of donation services [23, 41].\u003c/p\u003e\n\u003cp\u003eBeyond socio-demographic characteristics, knowledge, previous donation experience, and family-related factors were critical determinants. Knowledge about blood donation was a key factor, with participants who had a better understanding of blood donation practices being more likely to donate. This reinforces the importance of educational interventions in raising awareness and dispelling myths about blood donation [17, 42, 43]. Prior donation experience was another significant factor, with previous donors being more likely to donate again. This finding supports the notion that familiarity with the process reduces fear and builds confidence in potential repeat donors [44]. Family influence also played a role; individuals with a family history of blood donation or those who had relatives who required transfusions were more likely to donate, underscoring the power of personal connections and lived experiences in motivating donation behavior [44, 45].\u003c/p\u003e\n\u003cp\u003ePsychosocial factors, particularly participation in blood donation campaigns, were associated with higher donation frequency and likelihood. Participants who engaged in campaigns were significantly more likely to donate, emphasizing the impact of organized public health initiatives and the success of widespread social campaigns like the Ice Bucket Challenge [46]. This suggests that promoting blood donation through campaigns and community engagement is a powerful tool for improving donation rates.\u003c/p\u003e\n\u003cp\u003eOn the other hand, psychological barriers, including fear of medical procedures and death anxiety, were found to negatively affect both current donation practices. Fearful individuals were less likely to donate, highlighting the need for targeted education and psychological support to address these barriers [47, 48]. Overcoming these fears is essential to ensure a steady, willing donor base.\u003c/p\u003e\n\u003cp\u003ePositive motivation, driven by altruism, was another strong predictor of blood donation behavior. Highly motivated individuals were more likely to donate, particularly during times of crisis, such as the COVID-19 pandemic, which highlighted the importance of collective action in the face of public health emergencies [49, 50]. Additionally, external incentives—such as rewards or recognition—were shown to significantly increase donation rates. Participants who receive incentives were more likely to donate and less likely to be non-donors, suggesting that, when ethically implemented, incentives can enhance donation rates without diminishing the altruistic nature of the act [51].\u003c/p\u003e\n\u003cp\u003eFinally, facilitating factors, such as easy access to donation sites and robust social support networks, greatly enhanced both the frequency and likelihood of donation. Donation centers that are accessible and well-supported by local communities are crucial for ensuring that individuals have the opportunity to donate when they are willing [52].\u003c/p\u003e\n\u003cp\u003eThis study provides valuable insights into blood donation behavior in East Gojjam Zone, but it has some limitations. The cross-sectional design restricts the ability to establish causal relationships, so longitudinal studies are needed to explore temporal dynamics. Additionally, self-reported data may introduce social desirability bias, which could be addressed by cross-referencing with data from donation centers. Lastly, since the study was conducted in a specific region, the findings may not be generalizable to other areas with different cultural, economic, or healthcare contexts. Expanding research across diverse regions could enhance understanding of regional variations in donation behavior.\u003c/p\u003e"},{"header":"Conclusion and Recommendations","content":"\u003cp\u003eThis study provides valuable insights into the factors influencing blood donation behavior in the East Gojjam Zone. Despite 28.8% of participants having donated blood at least once and 20.7% in the past two years, these figures remain inadequate to meet the growing demand for safe blood supplies. Frequency of blood donation was positively associated with younger age, male gender, higher educational attainment, and employment in healthcare or education sectors.\u003c/p\u003e\n\u003cp\u003ePsychosocial factors such as higher self-efficacy, knowledge, positive attitudes, strong intentions, social influence from family and community, prior donation experience, and participation in donation campaigns were found to be key drivers of increased donation frequency. In contrast, psychological barriers, including fear, misconceptions, and health-related concerns, were significant deterrents. Facilitators such as improved accessibility and motivational support also played a crucial role in encouraging higher donation frequency.\u003c/p\u003e\n\u003cp\u003eTo address these challenges, public health initiatives should focus on educational campaigns that address fears, misconceptions, and emphasize the altruistic value of blood donation. Targeted interventions for women, older adults, and individuals with lower education levels are necessary. Incentives, increased access through mobile units, extended service hours, and leveraging the influence of healthcare professionals and community leaders can further enhance participation. Continuous monitoring and evaluation are essential to ensure the responsiveness of blood donation programs to emerging needs and trends.\u003c/p\u003e\n\u003cp\u003eImplementing these strategies can help improve blood donation frequency, ensuring a more sustainable and resilient blood supply in East Gojjam Zone and similar regions, thereby contributing to strengthened health system resilience.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eEthical approval and consent to participate\u003c/h2\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki and the National Research Ethics Review Guideline of Ethiopia. Ethical approval was obtained from the Institutional Review Board (IRB) of Debre Markos University (Approval No: RTTD/844/10/2024) on June 4, 2024. Written informed consent was obtained from all participants after clearly explaining the study\u0026rsquo;s objectives, procedures, potential risks, and benefits. Participants were assured of their right to withdraw at any time without penalty. To ensure confidentiality, no personal identifiers were collected; all data were anonymized, securely stored, and accessible only to the research team.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was funded by the College of Natural and Computational Sciences, Debre Markos University. The funder had no role in the study design, data collection, analysis, interpretation of data, or manuscript preparation.\u003c/p\u003e\n\u003ch2\u003eAvailability of data and materials\u003c/h2\u003e\n\u003cp\u003eThe datasets used and analyzed during the study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch2\u003eAuthors\u0026apos; contributions\u003c/h2\u003e\n\u003cp\u003eN.G. conceived the study, designed the research, conducted data analysis, and drafted the manuscript. M.A., M.K., A.F., and M.G. contributed to the study\u0026rsquo;s conception, interpretation of results, and critical review of the manuscript. All authors have read and approved the final version of the manuscript for submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank the College of Natural and Computational Sciences, Debre Markos University, for their generous financial support of this research. Our heartfelt appreciation goes to the local administrations of Debre Markos, Dejen, and Amanuale towns for their essential cooperation and assistance throughout the data collection process.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGetie, A., et al., \u003cem\u003eBlood Donation Practice and Associated Factors in Ethiopia: A Systematic Review and Meta-analysis.\u003c/em\u003e BioMed research international, 2020. \u003cstrong\u003e2020\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eArage, G., S. Ibrahim, and E. 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Macis, and R. Slonim, \u003cem\u003eRewarding altruism? a natural field experiment\u003c/em\u003e. 2011, National Bureau of Economic Research.\u003c/li\u003e\n\u003cli\u003eSadler, A., et al., \u003cem\u003eIncentives for blood donation: a discrete choice experiment to analyze extrinsic motivation.\u003c/em\u003e Transfusion medicine and hemotherapy, 2018. \u003cstrong\u003e45\u003c/strong\u003e(2): p. 116-124.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Blood donation, socio-demographic factors, psychological barriers, donation intention, Structural Equation Modeling, public health interventions, Ethiopia","lastPublishedDoi":"10.21203/rs.3.rs-6599036/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6599036/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Blood donation is a critical healthcare activity that saves millions of lives globally, yet access to timely donations remains a challenge in Ethiopia, particularly during emergencies. Identifying the socio-demographic, psychological, and contextual factors that influence blood donation is essential for developing strategies to improve donation rates and ensure a sustainable blood supply. This study investigates the factors influencing blood donation practices among adults in East Gojjam Zone, Ethiopia, over the past two years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A cross-sectional survey was conducted with 1,332 adults selected through multistage cluster sampling in East Gojjam Zone. Descriptive statistics were used to summarize donation behaviors, while Zero-Inflated Negative Binomial (ZINB) regression identified factors associated with donation frequency. Structural Equation Modeling (SEM) explored the relationships between donation behaviors and key predictors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Among participants, 28.8% (95% CI: 26.4%-31.2%) had donated blood at least once, and 20.7% (95% CI: 18.5%-22.9%) had donated in the past two years. Frequent donation was positively associated with younger age, male gender, higher education, and employment in healthcare or education. Altruism, specifically the desire to help others, was the primary motivation for donation. Psychological barriers, including fear of needles, health concerns, and lack of awareness, were significant deterrents. ZINB regression revealed that psychological barriers negatively influenced donation frequency, while previous donation experience, awareness, and participation in campaigns were positive predictors. SEM analysis showed that donation intention had the strongest direct effect on donation behavior, with self-efficacy, positive attitudes, and social norms also contributing significantly.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: Donation rates were lower than expected, with few participants donating repeatedly. This study highlights the complex interaction of socio-demographic, psychological, and contextual factors influencing blood donation behavior. Interventions should address psychological barriers, enhance awareness, and foster altruism to increase donation rates. Public health campaigns should target vulnerable groups, including women, older adults, and individuals with lower educational attainment. Additionally, improving donation site accessibility, offering incentives, and leveraging social networks can help boost donations. Continuous evaluation and adaptation of strategies are essential to meet the growing demand for blood.\u003c/p\u003e","manuscriptTitle":"Blood Donation Practices and Associated Factors among Adults in East Gojjam Zone, Northwest Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-31 08:36:55","doi":"10.21203/rs.3.rs-6599036/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ebc88e01-02a5-454f-917a-cd0d16bb4e47","owner":[],"postedDate":"December 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":58442483,"name":"Health sciences/Health care"},{"id":58442484,"name":"Health sciences/Medical research"},{"id":58442485,"name":"Health sciences/Risk factors"},{"id":58442486,"name":"Physical sciences/Mathematics and computing/Scientific data"},{"id":58442487,"name":"Physical sciences/Mathematics and computing/Statistics"}],"tags":[],"updatedAt":"2026-01-17T10:54:20+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-31 08:36:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6599036","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6599036","identity":"rs-6599036","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}