Background: The coronavirus disease 2019 (COVID-19) epidemic affected blood collection in Guangzhou, China. Study Design and Methods: This paper includes three studies. The observational study reported the trends of blood collection during the epidemic in Guangzhou, China. The cross-sectional survey investigated factors influencing blood donation during the COVID-19 epidemic, and a self-administered questionnaire was given to 1584 street whole blood donors (SWBDs) who donated during the epidemic. The randomized controlled trial involved 19 491 SWBDs who donated in 2019 but did not donate during the epidemic. Trial participants were randomly assigned to two intervention groups: Group 1 completed Questionnaire 1, which contained precautionary measures in response to COVID-19 and other messages about blood donation during the epidemic; Group 2 completed Questionnaire 2, which did not include this information. A control group did not receive any questionnaire. Results: As measures were implemented, the number of blood donors increased accordingly. Both first-time and repeat SWBDs perceived the same level of blood need and donated blood because it would save lives. SWBDs who completed Questionnaire 1 expressed a greater intention to donate during the epidemic. Enabling blood donors to perceive a higher level of blood need and a lower level of COVID-19 infection risk related to blood donation mobilized experienced SWBDs to donate within 3 weeks. Intention-to-treat analyses and average-treatment-effect-on-the-treated estimations confirmed that Questionnaire 1 could motivate SWBDs to actually donate blood. Conclusion: Various measures could ease blood shortage during the COVID-19 epidemic. Administration of Questionnaire 1 could increase blood donations during the epidemic.

Background Recruiting of sufficient numbers of donors of blood products is vital worldwide. In this study we assessed the efficacy and cost-effectiveness of telephone calls and SMS reminders for re-recruitment of inactive blood donors. Methods This single-centre, non-blinded, parallel randomised controlled trial in Guangzhou, China included 11,880 inactive blood donors whose last donation was between January 1 and June 30, 2014. The donors were randomly assigned to one of two intervention groups (telephone call or short message service [SMS] communications) or to a control group without intervention. SMS messages with altruistic appeal were adopted in the SMS group; in addition to altruistic appeal, reasons for deferral of blood donation were also asked in the telephone group. All participants were followed up for 1 year. The primary outcome was re-donation rate, and rates in different groups were compared by intention-to-treat (ITT) analysis and estimation of the average treatment effect on the treated (ATT). Secondary outcomes were the self-reported deterrents. Other outcomes included the re-donation interval, and the incremental cost-effectiveness ratio (ICER) of telephone calls and SMS reminders on re-recruitment. Results ITT analysis revealed no significant differences in the re-donation rate among the three groups. ATT estimations indicated that among compliers, telephone calls significantly increased re-donation compared to both SMS reminders and no intervention. Donor return behaviour was positively associated with receiving reminders successfully, being male, older age, and previous donation history. The SMS reminder prompted donors to return sooner than no reminder within 6 months, and according to ICER calculations, SMS reminders were more cost-effective than telephone calls. Donors reported time constraints as the most main causes of self-deferral in the telephone group, and altruistic appeal had a positive effect on these donors. Conclusions Interventions to reactivate inactive blood donors can be effective, with telephone calls prompting more donors to return but at a greater cost than SMS messages. SMS reminder with altruistic appeal can urge donors to re-donate sooner within 6 months than no reminder. Trial registration NCT03366441 (Reactivation of Inactive Blood Donors). Retrospectively registered 4 December 2017.

Objective: To evaluate the development of blood transfusion services in Mainland China within the context of health-care system reform.Background: China launched a health-care reform program in 2009 to redistribute health-care resources, which are currently over-concentrated in well-developed cities. A geographically equitable blood transfusion service is key to achieving this goal.Methods: Based on the national survey of blood establishments in July 2015, total blood collection, whole-blood donations per 1000 population and the supply and demand relationship were analysed at the administrative region level. Areas at different developmental levels were compared in terms of total blood collection and human resources. Results:In 2014, Mainland China's 31 provinces showed wide variation, with total blood collection in blood facilities ranging from about 1000 units to over 600 000 units (each 200 mL), and the whole-blood donation rate per 1000 population, ranging from 1·48 to 17·09. 69% of the country's total collection, was concentrated in 29 provincial capitals, and 31% was in 311 non-capital cities. Of 97 personnel with doctorates, 74 worked in 32 provincial blood establishments, whereas the remaining 23 worked at the other 318 blood stations. In most provinces, per permanent resident donation was within 2-4 mL, and blood volume per inpatient was 10-35 mL regardless of the development of the transfusion service. Conclusion:In 2014, China had an imbalanced development and insufficient access to blood transfusion services. This service must be redeployed at the national level to facilitate health-care reform in China.

Objectives Prospect theory categorizes message framing according to whether it emphasizes a possible loss or a possible gain. Promotions of blood donation worldwide mainly focus on gain‐framed appeal. The objective of the current study is to examine the effects of message framing on recruiting Rh‐D‐negative blood donors (RDNBDs) in an emergency situation. Design Two randomized trials. Methods In Study 1, 813 group O and 500 group B RDNBDs were randomly assigned to three groups receiving three different recruitment text messages: (1) gain‐framed, (2) loss‐framed, and (3) information messages. In addition, 613 group A and 148 group AB RDNBDs were marked as (4) no message group. In Study 2, 758 RDNBDs were randomly provided one of two versions of materials focusing on either the possible survival (gain‐framed) or the death (loss‐framed) of a Rh‐D‐negative patient needed a blood transfusion. These participants then completed a questionnaire to examine the possible mechanisms underlying the observed effects. Results Compared to not receiving any message, significantly more RDNBDs re‐donated within 14 days after they received a loss‐framed message. Study 2 found that RDNBDs who read the loss‐framed material expressed more willingness to donate immediately than those who read the gain‐framed material. RDNBDs with high‐risk perception expressed a greater blood donation intention in the loss‐framed group. The loss‐framed message made participants perceive others' needs more strongly, which generated more empathy, and thus increased blood donation intention. Conclusions The results suggested that recruiting RDNBDs using a loss‐framed message is suitable under an emergency.

Whether the aging of rural population will affect the high-quality development of China’s agriculture is an important issue facing the construction of China’s characteristic modern agriculture. Using panel data from 30 provinces in China from 1999 to 2020, this paper used fixed effects models and mediation models for econometric regressions to explore the relationship between rural population aging and agricultural development, as well as the intermediate mechanisms involved. The study found that there was a positive relationship between rural population aging and agricultural labor productivity, and aging can stimulate agricultural development. Mechanism analysis revealed that rural population aging can promote the adjustment of the structure of agricultural factors, drive the deepening accumulation of capital and other factors, promote the modernization of agricultural production methods, and ultimately achieve an increase in agricultural labor productivity. Further examination showed that the positive relationship between rural population aging and agricultural productivity gradually weakened as the degree of rural population aging deepened. The study provides empirical evidence for sustainable agricultural development in the context of population aging.