Determinants of community members’ willingness to donate stool for faecal microbiota transplantation

Abstract

Universal stool banks rely on, but face difficulties recruiting, community volunteers to donate stool for faecal microbiota transplantation (FMT) to effectively treat recurrent Clostridioides difficile. This study sought to identify determinants of community members’ willingness to donate stool to guide donor recruitment. 397 Australian residents (52% male, 47% 21–30 years, 63% university educated) completed a survey to gauge willingness to donate stool, bowel habits, information needs, attitudes, barriers, and motives for donation. Most reported regular bowel movements (BMs; 90%), morning BMs (63%), BMs ≤5 minutes duration (67%), and some discomfort doing BMs in public restrooms (69%). Less than half were willing to donate stool in-centre (45% willing) or at home (48%). Important information needs identified by >80% were convenience and travel requirements associated with donation. Main barriers were logistics, capabilities to donate, disgust (e.g., donation process), and discomfort (e.g., privacy). The main motivator was altruism, with compensation secondary. Linear regression models identified less discomfort doing BMs in public restrooms (β = -0.15), understanding benefits to patients (β = 0.15), placing less importance on understanding the donation process (β = -0.13), and positive attitudes (β = 0.56) as determinants of willingness to donate in-centre. Understanding benefits to self (β = 0.11) and patients (β = 0.24), placing less importance on understanding the donation purpose (β = -0.19), and positive attitudes (β = 0.50) determined willingness to donate at home. Stool banks should consider donor’s bowel habits, comfort donating in-centre, and information needs early in recruitment; and implement flexible logistics for potential donors who face time constraints and limited access to stool banks.

A review of whole‐blood donors' willingness, motives, barriers and interventions related to donating another substance of human origin

“…Blood donation in the year prior was significantly, positively correlated with intention to donate stool 54 . Willingness to donate stool in‐centre was higher amongst those donating blood recently (year prior vs. not) 55 .…”

“…Blood donation in the year prior was significantly, positively correlated with intention to donate stool. 54 Willingness to donate stool incentre was higher amongst those donating blood recently (year prior vs. not). 55 However, willingness to donate stool at home and deliver it to the centre did not differ between these groups.…”

Faecal microbiota transplantation for recurrent C. difficile infections: challenges and improvement opportunities for clinical practice and healthcare systems

“…A web-based grey literature search (conducted June 2021) complemented the academic literature search to identify regulations and guidelines for FMT in the case of example countries. Twenty-five papers 17,19,23,25,26,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] An additional 10 publications, identified through targeted searches (e.g. for updates to regulation and guidance, details on specific health systems initiatives and areas where evidence is contested), were consulted on specific points raised in the literature.…”

“…31,32 Identifying and recruiting donors is a widescale challenge (Int1, 3, 7, expert workshops). 25,33,42,52 FMT programmes and/ or stool banks need to cultivate goodwill amongst individuals to encourage and retain donors, 45 while clearly communicating the voluntary nature of donation to prevent a sense of obligation. 45 Regulations related to donor eligibility can also present a ○ Gastroenterologists and ID specialists (Australia)…”

Psychological Adaptation to Transplanted Organ: A Hermeneutic Phenomenological Study

“…Therefore, the organ recipients express their concerns about the survival of the organ when knowing the donor and ensuring that he/she is young. Forsberg et al also suggested that although the participants do not know the donor, they think about the gender and age of the donor, and this would significantly affect the outcomes (26). In a study, the participants also stated that they were happy to have relationship with the donor's family and would like to know the donor, and that they wanted to know whether the donor was a woman or a man (27).…”