A new perspective on the incentive-blood donation relationship: partnership, congruency, and affirmation of competence.

BACKGROUND: The Motivation Crowding-out Theory suggests that incentives undermine intrinsic motivation and thus blood donation behavior. While there is strong evidence showing the negative relationship between monetary incentives and blood donation, findings on the effect of nonmonetary incentives are mixed. Set in a voluntary, nonremunerated environment, this study explores aspects of the nonmonetary incentiveblood donation relationship not captured by the crowding-out hypothesis. STUDY DESIGN AND METHODS: In-depth interviews were conducted to explore donors' attitudes toward nonmonetary incentives currently used or considered by the Australian Red Cross Blood Service (Blood Service). Transcripts were analyzed using an inductive, thematic approach. RESULTS: Of the nonmonetary incentives examined (i.e., health screening tests, branded tokens, paid time off work, recognition of key milestones, and postdonation refreshments), none were found to crowd out intrinsic motivation, although not all were viewed favorably. Donors who viewed branded tokens negatively considered the cost implications for the Blood Service, while donors who responded positively considered the public benefit of tokens in raising the profile of the Blood Service. Other nonmonetary incentivespaid time off work, postdonation refreshments, and health screening testswere viewed positively because donors perceived them to be congruent to the effort expended in donating blood. Finally, donors expressed a preference for private over public recognition when acknowledging significant contributions. CONCLUSION: When operating in a voluntary, nonremunerated environment, blood services should view donors as supply partners rather than customers, only consider nonmonetary incentives that are congruent with the act of donation, and provide private rather than public recognition of key milestones.