Saving Lives with Pride: Development and Evaluation of Multimedia Resources to Engage Gay, Bisexual, and Queer Men in Canada As Stem Cell Donors
Authors: Hatkar Rupal , Sano Lauren , DeGurse Natalie , Kum Elena , Ho Michelle , Lu Bonnie , Park Brady , Koette Joel , Kandel Rana , Jagelaviciute Gabriele , Fingrut Warren 
Published: November 2021

Abstract
Background: Since 2009, gay, bisexual, and other men who have sex with men (gbMSM) have been eligible to register as stem cell donors in Canada and donate to patients in need. However, many gbMSM are unaware of their eligibility to be donors. Targeted recruitment of gbMSM could augment efforts to recruit donors from needed demographic groups and support a more inclusive donor registry. Here, we describe the development and evaluation of multimedia to engage gbMSM in Canada as stem cell donors.
Methods: Multimedia resources were developed by gbMSM in Canada, in collaboration with recruiters from Stem Cell Club (stemcellclub.ca) and were designed to highlight gbMSM eligibility and educate about the need for donors from diverse ancestries. Resources were reviewed for accuracy by transplantation experts and appeal by focus groups of gbMSM. The resources were published to stemcellclub.ca/savingliveswithpride/ and disseminated to members of the community of practice (CoP) in stem cell donor recruitment in Canada during an e-meeting. We evaluated stakeholder perspective on these multimedia and their impact 1) across social and traditional media; 2) on gbMSM eligible donors' knowledge and attitudes towards donation; and 3) on reducing barriers for gbMSM donation.
Results: Multimedia developed included: infographics emphasizing gbMSM eligibility regardless of recent sexual contact (Fig. A); @WhyWeSwab (twitter.com/whyweswab) story arcs featuring a stem cell donor and a stem cell recipient (Fig. B) from the LGBTQ2+ community; TikToks and other short videos (Fig. C), and testimonials (Fig. D) featuring gbMSM advocating for their communities to register as donors; and statements from Transplant Hematologists emphasizing that gbMSM donors will be treated sensitively and with respect (Fig. E).
33 CoP members from 6 provinces across Canada, and with a median of 2-years recruitment experience, participated in a survey post-publication. The majority felt the resources would engage gbMSM as donors (84%) and clarify gbMSM eligibility (87%); noted experiencing a lack of awareness from potential registrants on whether gbMSM were eligible to donate stem cells (69%); and felt that a national campaign to recruit gbMSM is needed (97%), would support a more inclusive registry (97%), and would augment recruitment of diverse donors (94%).
37 gbMSM eligible stem cell donors (84% gay men and 11% bisexual men; from 13 different ancestral groups; living in 5 provinces across Canada) completed surveys evaluating the impact of these multimedia on their knowledge and attitudes towards donation. After being shown these multimedia, mean scores on a 4 question knowledge test improved from 66% to 93% (p&lt;0.001, Fig. F); mean scores on the Simmons Ambivalence Scale significantly decreased from 38% to 24% (p&lt;0.001, Fig. G); and participants were more willing to register as donors (59% vs 84%, p=0.027) and less likely to believe there are significant barriers to donation for gbMSM (51% vs 11%, p=0.033). Qualitative analysis of feedback from focus groups with these participants identified examples of how the multimedia decreased barriers to donation impacting gbMSM (Fig. H).
Multimedia were included in a Pride Month (6/2021) Campaign in Canada, "Saving Lives With Pride", and were shared on social media by LGBTQ2+ groups including on campuses (e.g. SFU Out On Campus), in the community (e.g. Abbey of the Long Cedar Canoe, JQT Vancouver), and nationally (e.g. Canadian Queer Medical Students Association). They were also profiled and shared by major medical organizations (e.g. Canadian Blood Services blood.ca/en/stories/stem-cell-club-volunteers-aim-save-lives-pride-month-campaign) and by media across Canada including CityNews (ctvnews.ca/health/pride-month-tiktok-drive-encourages-stem-cell-donations-from-gay-bi-men-1.5475113) and CTV News (toronto.citynews.ca/video/2021/06/17/doctors-turn-to-queer-communities-for-stem-cell-donors), who also highlighted the resources and their message as one of the top stories in Canada on 6/18/21 (ctvnews.ca/mobile/5-things/5-things-to-know-for-friday-june-18-2021-1.5475813).
Conclusions: We developed an array of high-quality multimedia to support recruitment of gbMSM as potential stem cell donors and reduce barriers to donation. Our work is relevant to recruitment organizations worldwide seeking to develop more inclusive recruitment approaches.
Figure 1 Figure 1.

Disclosures
No relevant conflicts of interest to declare.