Eligible blood donors’ decisions about donating stool for fecal microbiota transplantation: Does ambivalence play a role?

Abstract

Background Blood collection agencies (BCAs) are expanding core business by inviting blood donors to donate stool for fecal microbiota transplantation (FMT). However, whether blood donors also want to donate stool is unclear since, despite its benefits, stool donation is viewed by many as unpleasant. This study examined the prevalence, contributors to, and role of these mixed feelings (ambivalence) in stool donation intentions. Study Design and Methods This cross‐sectional study surveyed Australian residents aged 18 years or more who believed themselves eligible to donate blood and met broad criteria for prescreening as a stool donor (eg, healthy, not taking medication). Survey questions assessed attitude, norms, self‐efficacy, motives, disgust, ambivalence, and intentions to donate stool. Results A total of 382 eligible blood donors aged not more than 50 years (mean, 28.71 years; 48% female, 62% “healthy” body mass index) participated. Six percent indicated no ambivalence about donating stool. In regression, significant determinants of ambivalence were less awareness of FMT, lower self‐efficacy, motivated by ensuring that stool is available for loved ones, and more disgust about stool donation. Higher ambivalence contributed to decreased donation intention. Self‐efficacy and disgust differentiated participants with moderate ambivalence, a group likely responsive to intervention, from those with low or high ambivalence. Conclusion Ambivalence about donating stool was common among eligible blood donors. BCAs should raise awareness about stool donation and FMT before requesting donation. BCAs may increase cost savings and donor retention by giving clear guidance about donation requirements and implementing processes that build confidence. Early screening of potential donors for ambivalence and disgust will enable BCAs to provide decision support.

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

“…University human research ethics committee approval was obtained prior to study commencement. Data from a sub-group of these participants that examines a different set of variables regarding the role of ambivalence in eligible blood donors' decisions to donate stool has been published elsewhere [30].…”

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 . However, willingness to donate stool at home and deliver it to the centre did not differ between these groups 55 .…”

“…Willingness to donate stool in‐centre 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 55 . Significantly more blood (59%) versus non‐blood (48%) donors reported high willingness to donate stool, and two‐thirds of those highly willing blood donors had donated blood ≤10 times 57 …”

“…55 However, willingness to donate stool at home and deliver it to the centre did not differ between these groups. 55 Significantly more blood (59%) versus non-blood (48%) donors reported high willingness to donate stool, and two-thirds of those highly willing blood donors had donated blood ≤10 times. 57 Behaviour A third of newly enrolled stool donors were blood donors.…”

“Why don't you want my poop?” Willing stool donor's experiences of being ineligible to donate intestinal microbiota

“…2,3 Blood donors are ideal candidates as "healthy" donors who are more likely to meet stringent stool donor screening criteria (20%-30%) compared to the general community (<10%). 4 Despite willingness for donation among blood donors and the community, 5,6 recruitment of stool donors is still challenging due to the strict screening criteria, the donation process, and high attrition between screening stages.…”