Promoting the return of lapsed blood donors: A seven-arm randomized controlled trial of the question–behavior effect.

Abstract

Objective: The aim of this study was to test key variations in the question-behavior effect against a control condition or an implementation intention condition on returning to give blood among lapsed donors (individuals who had not given blood in past two years).Design: At baseline, 7000 lapsed donors were randomized to one of six experimental or to a control condition. Participants in the experimental conditions were asked to complete a 6-item postal questionnaire assessing: intentions-only, interrogative intention, moral norm plus intention, anticipated regret plus intention, positive self-image plus intention, or implementation intentions. Objective measures of behavior were obtained 6 and 15 months later.Main Outcome Measure: The frequency of registrations to give blood over the next 6 and 15 months.Results: Intention-to-treat analysis of the frequency of registrations (GENMOD procedure, Poisson distribution) indicated main effects for condition (experimental versus control) at both 6 months,  2 (1) = 4.64, p < .05, and 15 months,  2 (1) = 5.88, p < .05. Positive self-image and implementation intention interventions outperformed the control condition at 6 months. At 15 months, standard intention, interrogative intention, and regret plus intention conditions each showed more frequent registrations compared to controls and were just as effective as implementation intention formation. Moderation analysis showed the moral norm and positive self-image conditions were significant for first-time (one previous donation) but not repeat (two or more previous donations) donors.Conclusions: The question-behavior effect can be used to reinvigorate blood donation among lapsed donors, and can be as effective as forming implementation intentions. extends previous work on the QBE in three key ways. First, we examine whether the impact of measuring intentions on subsequent behavior can be augmented by using the interrogative form or by measuring constructs in addition to intentions. Second, we compare the QBE not only to a standard nocontact control condition, but also in relation to an established behavior change intervention (i.e., implementation intentions; see (Gollwitzer & Sheeran, 2006) for a review). Third, we investigate the moderating effects of whether a questionnaire was returned or not and participants' age, sex, and donor status (first-time vs. repeat). The research focuses on a behavior of considerable importance for public health and on a sample of particular significance in this domain, namely, returning to give blood among lapsed blood donors. Augmenting the Question-Behavior EffectSeveral studies have tested the QBE in relation to blood donation, with mixed results. In the first study in this area, Godin et al. (2008) observed significantly more frequent attempts to give blood at both 6-and 12-month follow-ups among repeat blood donors who were asked to complete a Question -Behavior Effect Interventions 4 questionnaire based on an extended version of the theory of planned behavior (TPB; (Ajzen, 19...

The question-behaviour effect: A theoretical and methodological review and meta-analysis

“…Conner, Sandberg, Jackson, Godin, and Sheeran (in preparation) reported interrogative (compared to declarative) intention questions to increase objectively assessed attendance for cervical screening. In contrast, Godin, Germain, Conner, Delage, and Sheeran (2014) found both declarative and interrogative intention questions to significantly increase blood donation rates, compared to a no-question control condition at 15 months, with no significant difference between the two QBE conditions. Conner (in preparation) reported that interrogative self-prediction questions produced stronger impacts on self-reported physical activity compared to interrogative intentions, declarative intentions, declarative self-predictions or unrelated questions.…”

“…Testing the impact of adding anticipated regret questions to those tapping intentions (e.g., Godin et al, 2010Godin et al, , 2014 or those tapping components of the Theory of Planned Behaviour (Sandberg & Conner, 2009 has been the focus of a number of QBE studies. However, the reported effects have been mixed, with studies indicating that adding anticipated regret questions did (Sandberg & Conner, 2011) or did not (Godin et al, 2010;O'Carroll, Chambers, Brownlee, Libby, & Steele, 2015) increase the QBE.…”

The question–behavior effect: Genuine effect or spurious phenomenon? A systematic review of randomized controlled trials with meta-analyses.

“…The range of cognitive measures investigated to date has predominantly focused around constructs abstracted from the Theory of Planned Behavior as well as on anticipated regret. Other measures such as identity (van Dongen et al, 2012), self-image (Godin, Germain, Conner, Delage, & Sheeran, 2013a) and more emotion-related measures such as worry may deserve additional attention in future research. Effects may also differ due to features of the study population and the period of follow-up (Godin, et al, 2013a).…”

“Save lives” arguments might not be as effective as you think: A randomized field experiment on blood donation

“…Based on previous experience and similar studies [15], we expected the response rate to be as low as 10%; therefore, we needed to send out at least 500 letters for each condition in order to ensure we received replies from at least 50 people per group. Before proceeding to randomization, we examine the blood donation center's pool of lapsed donors: where several donors were registered at the same address, we sent them the standard version of the letter and excluded them from the analysis (n = 202) in order to prevent any uncontrolled social influence.…”