Blood Donation:

Motivators and Barriers

Insights from Black or African American Donors 

and Non-Donors

March 2024
Blood Donation:

Motivators 

and Barriers

Insights from 

Black or African 

American Donors 

and Non-Donors

1

Understanding someone’s knowledge, attitudes, and perceptions about blood donation 

is critical to increasing and diversifying the blood supply in the United States. In 2023, the 

National Heart, Lung, and Blood Institute’s Blood Diseases & Disorders Education Program

conducted qualitative research on these topics. Initial conversations with blood donation 

subject matter experts (SMEs) identified Black or African American adults as an important 

audience for the focus of the research because of lower blood donation rates from this 

community. The SMEs suggested exploring the systemic and historical racism that has 

eroded trust in the medical system, including the racial segregation of blood donors and 

blood recipients. Additionally, common entry points for blood donations, such as college and 

workplace blood drives, have resulted in greater representation from white individuals and 

less representation from communities of color.

Twelve focus groups were conducted with 

Black or African American adults ages 

18 to 50 for a total of 67 participants. 

Participants were segmented based on 

age and blood donation experience. Those 

with previous blood donation experience 

are referred to as Donor Experimenters, 

and those without blood donation 

experience are referred to as Susceptible 

Non-Donors. All participants expressed an 

interest in donating blood in the future.

Susceptibility to donating blood was 

assessed using an adapted version of the 

Pierce Susceptibility Scale,1

 which uses a 

4-point Likert scale ranging from definitely 

yes, probably yes, and probably not, 

to definitely not. Those who responded 

definitely yes, probably yes, or probably not 

for at least one of the following questions 

were considered susceptible:

• Have you ever considered 

donating blood?

• Do you think that you will donate 

blood in the next year?

• If one of your best friends or family 

members were to donate blood, would you consider it?

Donation Experience

Participants

Younger (ages 18–30) Older (ages 31–50)

No. of Donor Experimenters 18 16

No. of Susceptible Non-Donors 16 17

Total Participants 34 33

African American Patient Population 

and Blood Transfusion

• Sickle cell disease affects more than 100,000 

people in the United States, mostly people of 

African ancestry or who identify as Black.

• Sickle cell disease patients may require blood 

transfusions throughout their lives to treat and 

prevent certain sickle cell disease complications.

• One in three African American blood donors are a 

match for people living with sickle cell disease.

• Black or African American blood donors are 

particularly important to patients with rare blood 

types who often need blood donated by someone 

with a similar race or ethnicity.

• Most blood types fall into one of the four major 

groups: A, B, AB, and O. However, some people 

have rare blood types, such as U-negative and 

Duffy-negative, that are unique to the African 

American community. For these patients, we 

need a more diverse blood supply.

1

 Pierce JP, Choi WS, Gilpin EA, Farkas AJ, Merritt RK. Validation of susceptibility as a predictor of which adolescents 

take up smoking in the United States. Health Psychol. 1996;15(5):355.
2

Methods

Based on key findings from initial conversations with blood health SMEs, the Blood Diseases 

& Disorders Education Program study explored blood donation experiences, motivators, and 

barriers among 67 Black or African American adults ages 18 to 50 who have different blood 

donation experiences. The study aimed to provide insights on how to re-engage past donors 

and motivate non-donors. Focus groups with four to six participants each were conducted 

virtually. The groups were moderated by African American facilitators experienced in leading 

discussions on health equity issues with the study population. 

Research Sample Participants were recruited based on the following eligibility criteria:

Race/Ethnicity Participants identified as Black or African American, or Black or 

African American and another race/ethnicity.

Age Participants were 18 to 50 years old.

Geographic 

Location

Participants identified themselves as living in an urban/suburban 

area. Participants living in rural areas were excluded because limited 

access to blood collection centers may be a more significant barrier 

than personal motivators.

Blood Donation 

Experience

Donor Experimenters: Participants must have donated only once in 

the past 5 years and were “susceptible” to donating blood again.

Susceptible Non-Donors: Participants had never donated blood 

before but were susceptible to donating blood in the future.

Susceptibility to donating blood was assessed using an adapted 

version of the Pierce Susceptibility Scale, which uses a 4-point 

Likert scale ranging from definitely yes, probably yes, and probably 

not, to definitely not. Those who responded definitely yes, probably 

yes, or probably not for at least one of the following questions were 

considered susceptible:

• Have you ever considered donating blood?

• Do you think that you will donate blood in the next year?

• If one of your best friends or family members were to donate 

blood, would you consider it?
Blood Donation:

Motivators 

and Barriers

Insights from 

Black or African 

American Donors 

and Non-Donors

3

Key Insights

• Nearly all participants had been exposed to health information on social media, but most 

were not likely to trust that information. However, younger participants were more likely to 

seek health information, including information about blood donation, on social media 

(for example, YouTube, TikTok).

• Participants were most likely to have received 

information on blood donation from the 

American Red Cross and would use web 

search to obtain more. Younger participants 

recalled first receiving information about blood 

donation in high school and were more likely 

to currently receive information about blood 

donation from their college or university. 

• When participants were looking for 

information about blood donation, they cited 

resources such as the American Red Cross, 

Google, local clinics, and blood donation 

trucks in their local community.

• Most previous blood donors did not donate again because the process took place at an 

inconvenient time or location, but participants stated they would be motivated to donate 

if donating blood was made more convenient for them, for example, located in their 

neighborhoods at less traditional locations, such as malls, community centers, barbershops, 

and salons.

• Most of the older participants had little base knowledge about the blood donation process, 

and those older participants without any previous donation experience saw this as a major 

barrier to donating.

• The younger audience was more likely to outwardly recognize systemic barriers within the 

Black or African American community, such as mistrust of the medical system. The younger 

age group with blood donation experience was more likely to recognize word-of-mouth 

medical conspiracy theories shared by older generations.

• Most participants did not regularly think about blood donation but expressed motivation 

when encountering a personal reason for donating, such as to help a friend, family, or a 

community member in need.

• Participants wanted messaging and materials to address barriers. Specifically, they wanted 

resources to include the following:

− Pictures of people who looked like them donating blood

− Educational materials featuring Black or African American medical professionals 

debunking myths about blood donation

− Information about the impact of blood donation on people living with sickle cell disease 

because it is prevalent in Black or African American communities

− Facts and statistics about blood donation
4

Younger Participants (Ages 18–30) Older Participants (Ages 31–50)

Convenience

• Willing to spend up to 45 minutes 

donating blood, not including 

travel time

• Willing to spend up to an hour and 

a half donating blood, not including 

travel time

Knowledge

• More knowledgeable about the 

process of donating blood

• More knowledgeable about the 

eligibility criteria 

• Familiar with the different types 

of blood donation (for example, 

plasma donation)

• Less knowledgeable about the 

process of donating blood

• Knowledgeable about the eligibility 

criteria only if they were Donor 

Experimenters

• Less familiar with the different types 

of blood donation (only some Donor 

Experimenters were familiar)

Beliefs/Attitudes

• More trustful of the medical community 

but still somewhat hesitant

• Would use social media to look 

up health-related information

• Highly mistrustful of the medical 

community

• Would ask a doctor or do an internet 

search to look up health-related 

information
Blood Donation:

Motivators 

and Barriers

Insights from 

Black or African 

American Donors 

and Non-Donors

5

Where had participants received information about 

donating blood?

Most participants received information through blood donation events taking place at their 

school or at their job. 

“I think I first learned about it at elementary school [and] at my mom’s job. I’m pretty sure they would do 

an event where either the blood donation truck would come or as a company — she works for a corporate 

office — they would go and donate blood together, and I remember she would come home and talk about, 

oh, she donated blood today.” 

– Susceptible Non-Donor, Younger

Where would participants seek information about 

donating blood?

Most participants across age groups said that they would use Google or go to the American 

Red Cross website to seek additional information, including the following:

• Where they could donate

• Who was eligible to donate

• How to schedule an appointment

“American Red Cross. Sometimes you see them 

on billboards, like, ‘Save a life; give a donation,’ 

something like that.”

– Donor Experimenter, Older

The younger audience was more likely to seek 

health information on social media, including 

TikTok and YouTube.

“I’d go on TikTok or probably YouTube if I was really 

interested. I would go on YouTube and find a physician 

YouTuber, someone that’s obviously a professional in their 

field and breaks down the process.” 

– Susceptible Non-Donor, Younger

“I would go to YouTube, because I like watching vlogs and 

stuff like that, because you’re actually seeing a real physical 

person go in there. Reading an article, I’m not a fan; just 

show me how it’s going to go, and then I’m good with it.” 

– Donor Experimenter, Younger
6

What knowledge did participants have about 

blood donation?

Most older participants had little knowledge regarding specific eligibility criteria and mostly 

made educated guesses. Those with basic knowledge were aware of eligibility factors related to 

the following:

• Weight

• Illicit drug use

• Sexual behavior, including men who 

have sex with men

• Certain conditions or viruses, such 

as HIV and hepatitis C

“Not having any communicable diseases, 

no HIV; nothing that can be transferred to 

another person [through] blood.”

– Donor Experimenter, Older

“I think one thing that may come up now is people that have various sexual orientations and have 

had sexual contact with others of the same gender, they may wonder if they could give blood.” 

– Donor Experimenter, Older

Most younger participants had more knowledge than older participants regarding specific blood 

donation eligibility criteria. Those with basic knowledge were aware of eligibility factors related 

to the following:

• The donation process, including signing up, staying hydrated, and completing screenings

• Medical history/conditions, such as anemia or pregnancy

• Certain health-related behaviors, such as heavy use of tobacco and alcohol

• Recent travel to specific countries outside of the United States

“From what I remember, you fill out an application, which asks you questions about your medical history and 

things that could influence the blood, and then you wait, and then you take — you go to someone that tests 

your blood, and that’s where you would find out if you have, like, low iron or if you can meet the requirements to 

donate, and then if you meet [the requirements], then you can sit in the chair, and they’ll take your blood.” 

– Susceptible Non-Donor, Younger

“I think also you can’t be pregnant, and you have to weigh a certain amount. In general, you have to be considered 

healthy, like no sexually transmitted diseases, like HIV and stuff.” 

– Susceptible Non-Donor, Younger

“I know you’ve got to be a certain weight limit. It’s over 150, I think. That’s one thing I know for sure. It’s either 

100 or 150; if you’re under that, you don’t qualify.” 

– Donor Experimenter, Younger
Blood Donation:

Motivators 

and Barriers

Insights from 

Black or African 

American Donors 

and Non-Donors

7

What questions did participants have about 

donating blood?

Many participants in the older groups provided insights on what they already knew and what 

more they wanted to learn, including the following:

• Whether there would be a medical screening process before donating

• How long it took to donate blood

• What their blood would be used for (for example, research, a single life-saving transfusion, 

multiple transfusions)

• Whether there were any personal health risks associated with donating blood

“My question is, what are the health risks for donating blood? Like, my biggest concern is cross-contamination. 

What are the measures that are taken to make sure that you’re not affected by someone that came in before you 

to give blood?”

– Susceptible Non-Donor, Older 

The younger participants did not have questions about the process of donating blood. Both 

the Susceptible Non-Donors and Donor Experimenters shared a basic understanding about 

the blood donation process; however, much of this was inferential, based on their general 

understanding of needing to be healthy and to go through the screening process.

“There’s probably a questionnaire to begin with, just to see if you’re eligible. Also, if you pass all the preliminaries, 

they’ll schedule you for an appointment. I’m sure you arrive, they probably take your vitals, maybe. I’m guessing! 

They take your vitals, and then they draw your blood. I don’t know after — I would assume they probably test it 

just to make sure it can be used, but that would be my guess.” 

– Susceptible Non-Donor, Younger 

“If you want to donate, you walk in, they’ll give you whatever questionnaire or they’ll ask you whatever questions they 

ask, and I believe if you pass the questionnaire, and then they take you to the back, you just donate. Like everyone 

else said, you sit, wait, get a little — get some crackers and some juice — and they send you on your way.” 

– Donor Experimenter, Younger
8

What questions did participants have about the 

eligibility criteria? 

Older participants were not fully aware of the current eligibility criteria. They raised questions 

about the medical screening process, the minimum age requirement, how often people can 

donate, and whether having a tattoo would disqualify them.

“If you have tattoos, can you give blood?”

– Donor Experimenter, Older

Many participants in the younger groups asked questions about how eligibility criteria fit 

into the process, including the age requirements; whether a certain medical history, such as 

sickle cell disease, would disqualify them; and whether having tattoos would disqualify them. 

Participants also questioned whether there were any potential health risks to donating.

“I was also going to ask — people who have sickle cell trait and things like that, can they give blood? 

Is that a hindrance? That’s just something that popped into my head. I’m not necessarily sure.” 

– Donor Experimenter, Younger

What did participants know about the different types 

of blood donation?

Older Susceptible Non-Donors had little knowledge about the different types of blood donation 

(for example, whole blood, power red, platelets, plasma). However, older Donor Experimenters 

were aware of the different types of blood donation.

“For one thing, I didn’t know that there were different types of 

blood donations.” 

– Susceptible Non-Donor, Older

“You can donate red blood cells and you can donate plasma.”

– Donor Experimenter, Older

Younger Donor Experimenters knew about plasma 

donations because they were aware of the financial 

incentives offered. They had more knowledge 

regarding plasma donation than any other subgroup.

“ ... people donate plasma, and some donate red blood cells and white blood cells.”

– Susceptible Non-Donor, Younger

“I know there’s plasma donations. I never know if that’s different than just like blood donations, but 

I know in college and afterwards, they were like, ‘Oh, you can make money giving plasma.’”

– Donor Experimenter, Younger

“How often are you allowed to donate blood?”

– Susceptible Non-Donor, Older
Blood Donation:

Motivators 

and Barriers

Insights from 

Black or African 

American Donors 

and Non-Donors

9

What were the perceived barriers to blood donation?

Participants highlighted a range of barriers that would deter them from donating blood. These 

barriers varied by the amount of donation experience they reported having.

Donor Experimenters

Most Donor Experimenters said that they donated 

only because it was convenient (for example, it was 

easy to attend a blood drive at work or at school).

“Same thing, once a year, when the blood center comes 

to my job. Once a year, they come and do it.” 

– Donor Experimenter, Older

“I liked that it was convenient. I didn’t have to go to a blood 

donation center or something; I could just do it quick.” 

– Donor Experimenter, Younger

Some stated that they were concerned about the 

experience level of the staff taking the blood and were 

worried about being pricked incorrectly or multiple 

times. Some also said that they were afraid of needles.

“Yeah, for me, it was — I guess I had a friend in college that had a bad experience, where he says maybe they hit 

a muscle instead of a vein, and his whole arm got bruised and he had to go to the hospital. I wasn’t there. I didn’t 

see it, but the way he was telling it, it always stuck with me.” 

– Donor Experimenter, Younger

Some younger Susceptible Non-Donors, younger Donor Experimenters, and older Donor 

Experimenters said that they were willing to spend no more than an hour and a half for the 

entire blood donation process. Most participants said that the locations were inconvenient and 

that they were too busy to spend multiple hours donating blood.

Conversely, some older Susceptible Non-Donors said that they would be willing to spend 

multiple hours donating blood. 

“Just opportunity, like, finding the time to research where I can go to donate that blood and having the time off 

work to just do it in my free time. It was convenient because it was in the same location of where I go to work, so 

that’s why I did it that first time, but I’m not opposed to doing it more times.” 

– Donor Experimenter, Older

“I’d say it wasn’t as accessible. For me, the first time I did it, I was at school. There was a van parked maybe 50 

yards from our front door, so I just walked outside and did it. That just made it really easy. I was already at school. 

Since then, that kind of accessibility isn’t really as common.” 

– Donor Experimenter, Younger
10

Susceptible Non-Donors

Susceptible Non-Donors reported significantly more barriers to donating than other groups. 

Particularly, the younger participants were more likely than older participants to say that blood 

donation was not a priority and that they did not have the time.

“I would say the accessibility, like how far you would have to travel to be able to donate. Now, you have to basically 

plan out your day and how to travel and things of that nature, so if it was more accessible or if there were more 

trucks around in these neighborhoods that we live in, then I would — I probably would have already did it already.” 

– Susceptible Non-Donor, Younger

“I would say time. I don’t make that much money, so in my free time, I’m trying to make more money, so the 

thought of helping others doesn’t really come a lot to me, because I feel like I’m just trying to survive out here.” 

– Susceptible Non-Donor, Younger

Most participants were concerned about the cleanliness and sterility of the environment. 

Furthermore, most participants who did not have donation experience needed more 

information about the donation process to feel comfortable giving blood.

“I just wonder how it might affect my body. I just feel like something’s being taken away from me if I were to 

donate blood. Even though I know that blood is — there’s a constant supply of blood in our bodies, I just — 

maybe if I was more — if they had educational sessions about blood donation, that might help me, but for some 

reason I just feel like something’s being depleted from me.” 

– Susceptible Non-Donor, Older

“I feel like you can risk infection. Of course, everything is sterile, I feel like, but due to any nurse with like 

malpractice, or they forgot to do this or that, or something touched this or that, you can become seriously 

[infected] with something.” 

– Susceptible Non-Donor, Younger
Blood Donation:

Motivators 

and Barriers

Insights from 

Black or African 

American Donors 

and Non-Donors

11

Susceptible Non-Donors and Donor Experimenters

Both Susceptible Non-Donors and Donor Experimenters said that needles and inconvenient 

locations were barriers.

Many older and younger participants described a fear of needles as a reason they may not 

want to donate.

“The pain. Not everybody experiences pain with blood 

donation, giving blood, or anything like that, but some 

people are more sensitive, so they have a phobia or a 

fear of being stuck with a needle regardless of how big 

or small that needle is.” 

– Donor Experimenter, Older 

“I hate needles. I mean, when I go to the doctor, even 

the little tubes that they have to do when they have to 

draw my blood for testing. I just hate it, so in my head, 

I’m like, I know they have to draw way more, and it’s not 

something that I have to do, so it’s just going to be hard 

for me to do it.” 

– Susceptible Non-Donor, Younger

Many participants said that blood donation sites 

were not easily available for them and were 

rarely located in their communities.

“For me, personally, I work Monday through Friday. I feel like that’s the times when doctors’ offices 

are open, 9 to 5, literally, so I would have to take time off of work to do it, so that may be a thing.” 

– Susceptible Non-Donor, Younger

For nearly all participants, blood donation is not top of mind for them and is not a regular topic 

of conversation among peers or with providers.

“It’s just like not in my face, basically. It doesn’t really ever cross my mind. To be honest, now, when you’re in 

school or college or in a work environment that’s involved with the Red Cross, you hear about that stuff more 

often, but that doesn’t really cross my mind, to be honest.” 

– Donor Experimenter, Younger 
12

What barriers are unique for the Black or African 

American community?

Older participants said that fear and mistrust may prevent the Black or African American 

community from donating blood, including the following:

• Mistrust of the medical community/blood collection organizers

• Historical abuses in communities of color (for example, being used as research 

subjects without permission)

“Yeah, it doesn’t make a lot of sense for us, as Black women, to want to contribute to a medical 

system that does not treat us fairly.” 

– Susceptible Non-Donor, Older

“I feel like a lot of us Black people don’t trust [those in power]. We think we’re going to get in there 

and they might be experimenting on us, or ... they might be putting something into our bodies, so 

we don’t trust the ... type of facilities.”

– Susceptible Non-Donor, Older

A few participants said that there was a lack of knowledge about the entire process of blood 

donation and that people did not know what to expect or focused on the potential negative 

outcomes of donating (for example, bruising, nausea, vomiting).

“I think there is a disconnect [regarding] trusting exactly where the blood is going, who’s going to benefit from it. 

I think the who, what, where, and why has to be answered. Just like when you give charitable donations and then 

you hear years later that the money doesn’t go where it was intended.” 

– Donor Experimenter, Older
Blood Donation:

Motivators 

and Barriers

Insights from 

Black or African 

American Donors 

and Non-Donors

13

Older participants had ideas about where it might be convenient to hold blood drives in Black 

or African American communities.

“Hey, where a lot of [us] spend our 

time — at the shopping mall. I think 

if there was a blood donation center 

or drive at the shopping mall.” 

– Donor Experimenter, Older

“Barbershop.” 

– Donor Experimenter, Older

Younger participants in both groups shared that distrust and misconceptions are specific 

barriers for the Black or African American communities, especially among the older generations.

“I also kind of think it’s sometimes a conspiracy, like they’re going to use your blood for some other 

reasons. I know my dad can be like, ‘Oh, I’m not doing this testing because they’re going to put it in this 

and set me up.’ It’s just things like that, but I don’t know if that’s an older generation thing, but I know my 

dad can be like that. I think it’s interesting.” 

– Donor Experimenter, Younger

“I don’t know how they put that syphilis up in the Black people, and then that’s why Blacks — 

I think that’s why some Black people don’t like taking shots. I don’t take shots because I don’t 

know what they’re going to be putting up in me, but stuff like that.” 

– Donor Experimenter, Younger

“I’ve had it happen probably two different times over the 

years that I’ve gone, and I can’t find anywhere that’s close 

by that has an appointment that works with my personal 

and work schedule, and I’m shut down. That’s why I haven’t 

donated, just because I can’t find a time that works.” 

– Susceptible Non-Donor, Older
14

What would motivate participants to donate blood?

Some participants shared that convenience would influence them to donate more often. Also, 

they would be more inclined if they had someone to go with them. Almost all participants said 

that they would want to be compensated.

Convenience:

• Some said they would donate if they passed a 

donation site and it was convenient for them, 

such as at a church, mall, recreation center, 

community center, or barbershop.

• Many said that they would drive 30 minutes each 

way to donate blood if there was an incentive 

(for example, money, food).

• Many said they would donate if a friend, partner, 

or spouse went with them.

“I liked that it was convenient. I didn’t have to go to a blood 

donation center or something; I could just do it quickly.” 

– Donor Experimenter, Younger

“I think in the community that you’re serving is probably the best way, because 

... you’re kind of giving people the option to do it right away, like, putting them 

on the spot, like, ‘Hey, we’re having a blood drive at this time.’” 

– Donor Experimenter, Older

“I’ll be open to it but I also feel like, because it’s not something I’ve done before, I would 

feel more comfortable coming with a family member, just coming with someone.” 

– Susceptible Non-Donor, Older

Compensation: Nearly all participants said that compensation would motivate them to 

donate blood.

“I think that monetary thing will get them in the 

door, too — get ‘us’ in the door. I’m not going 

to say ‘them’ — get ‘us’ in the door, because 

we’ll [Black people] show up for that.” 

– Susceptible Non-Donor, Older

Helping others: Many participants reported that helping someone in need, whether it be a 

family member, a friend, or a stranger, would motivate them to donate blood.

“I don’t know how to put it into words... so 

to speak, but it’s an intrinsic benefit. It’s 

an internal ‘make you feel good that you 

gave back’ type of thing.” 

– Donor Experimenter, Older

“It doesn’t just have to be financial. It could 

be free food or something.” 

– Donor Experimenter, Younger

“I would say, yeah, the opportunity if I was going 

to be able to save someone’s life, you feel like 

that’s a no-brainer. You’ve got to say yes to that.” 

– Susceptible Non-Donor, Younger
March 2024

To learn more about blood donation, 

visit nhlbi.nih.gov/blood