Abstract

Background: Blood services must consider innovative ways to encourage more Black people to donate blood to enhance the efficacy of treatment for conditions like Sickle Cell Disease. We evaluate how two innovative arts-based approaches (co-designed and locally produced films and media-targeted Marvel Studios’/NHSBT collaboration) can achieve this by generalising to a wider audience from their target audiences.

Study design and methods: Four co-designed short community films were produced: Comedy, Reciprocity, Donor-Recipient, and Sliding Doors. In Study 1 (N=44: Black people), these films were evaluated in the target community in which they were produced. In Study 2 (N=1,237: Black = 599, White = 638), the community and Marvel Black-Panther/NHSBT films were evaluated in a non-target general population sample. Evaluations were in terms of campaign behavioural efficacy (e.g., willingness to donate, encourage others to donate) and affect. These analyses were segmented by donor status, age, and gender. 

Results: Study 1 shows that the community groups rated the films very positively, with over 90% stating that they would be convinced to donate blood. Study 2 shows the results from the community films generalise to the general population, with the Black Panther film also rated positively in the general population. Three community films and the Black Panther film were rated equally positively. There were notable differences across generations and donor status. 

Discussion: The results highlight the power of arts-based approaches (both locally co-produced community films and franchise collaborations) in encouraging donors within their target audiences and, importantly, on the broader population as well.

Abstract

Background: The UK’s Infected Blood Inquiry (IBI) highlighted a major public health scandal, with at least 30,000 people infected and more than 3,000 deaths attributable to infected blood and blood products. This study investigates the impact of the IBI announcement on May 20, 2024, on public perceptions of blood supply risk, safety, and donation intentions in the UK compared to the USA.

Methods: A 2 (country: UK vs USA) x 2 (time: pre-, post-IBI announcement) between-within-subject study was conducted with 1,635 participants (888 UK, 747 USA). Pre-IBI data were collected from May 3-7, 2024, and post-IBI data from May 30-June 30, 2024. Key measures were perceived infection risk from transfusion, transfusion safety, willingness to donate and encourage others. The impact was assessed using differences-in-differences (DiD) and reliable-change-indices (RCI).

Results: UK participants showed a significant but small decrease in perceived safety compared to USA participants, with 1 in 30 UK individuals perceiving a significant reduction in perceived transfusion safety. Decreases in perceived safety were associated with significant decreases in willingness to donate and encouragement of others in the whole sample and in USA participants and significant decreases in willingness to encourage others in UK participants. Older people reported a greater reduction in safety, and non-donors were more likely to be put off donating and not ask others to donate as a result of their perception that safety had been reduced.

Conclusion: Overall, perceived safety decreased marginally in the UK general population. Future research should explore the long-term impacts of the IBI.

Abstract

Background and Objectives: Donor selection questions differentially impacting ethnic minorities can discourage donation directly or via negative word-of-mouth. We explore the differential impact of two blood safety questions relating to (i) sexual contacts linked to areas where human immunodeficiency virus (HIV) rates are high and (ii) travelling to areas where malaria is endemic. Epidemiological data are used to assess infection risk and the need for these questions.

Materials and Methods: We report two studies. Study 1 is a behavioural study on negative word-of-mouth and avoiding donation among ethnic minorities (n = 981 people from National Health Service Blood and Transplant (NHSBT) and the general population: 761 were current donors). Study 2 is an epidemiology study (utilizing NHSBT/UK Health Security Agency (UKHSA) surveillance data on HIV-positive donations across the UK blood services between1996 and 2019) to assess whether the sexual risk question contributes to reducing HIV risk and whether travel deferral was more prevalent among ethnic minorities (2015–2019). Studies 1 and 2 provide complementary evidence on the behavioural impact to support policy implications.

Results: A high proportion of people from ethnic minorities were discouraged from donating and expressed negative word-of-mouth. This was mediated by perceived racial discrimination within the UK National Health Service. The number of donors with HIV who the sexual contact question could have deferred was low, with between 8% and 9.3% of people from ethnic minorities deferred on travel compared with 1.7% of White people.

Conclusion: Blood services need to consider ways to minimize negative word-of-mouth, remove questions that are no longer justified on evidence and provide justification for those that remain.

Abstract

Objectives: Understanding predictors of cooperative health protective behaviors (e.g., vaccination, social distancing) is critical for public health, especially during global crises that require collective action. This research examines two hypotheses in the context of the COVID-19 pandemic: (i) the situational strength hypothesis, which predicts that the impact of prosocial preferences on repeated low-cost cooperative actions (e.g., adherence to government guidelines) is moderated by the ambiguity of the situation (e.g., clarity of guidelines); and (ii) the vaccination-altruism hypothesis, predicting prosocial individuals are more likely to undertake high-cost cooperative actions (e.g., initial COVID-19 vaccination) due to motivations to protect others and achieve herd immunity.  

Methods: An eight-wave longitudinal panel survey conducted across the UK between March 2020 and July 2021, coinciding with varying phases of the COVID-19 pandemic. The survey collected data on adherence to government guidelines and vaccination behavior. Prosociality was assessed through past philanthropic behaviors (i.e., blood donation, volunteering etc.). Econometric techniques (i.e., generalised estimating equations, propensity score matching etc.) were used to analyze the data. 

Results: Individuals with a prosocial phenotype - those who engaged in health and non-health philanthropic behaviors - reported higher compliance with guidelines and were more likely to sustain cooperation when government rules were more ambiguous (i.e., weak situational strength). Prosocial individuals were also more likely to get vaccinated, driven by motivations to protect others and maintain herd-immunity. 

Conclusions: Prosociality plays a dynamic role in influencing both low- and high-cost cooperative health protective behaviors, offering insights for public health strategies in future crises. 

Abstract

By encouraging people from diverse ethnicities to join their donor panels, blood services can provide better treatments. Recruitment campaigns targeting ethnic minority donors can be either inclusive (promoting shared responsibility) or specific (linking recruitment to a health condition specific to that group, such as focusing on sickle-cell disease (SCD) to recruit Black people). One concern with specific campaigns is the potential for inadvertently fostering 'othering', a feeling of marginalisation and social exclusion. This study evaluates the relative efficacy of specific vs. inclusive campaigns to encourage Black people to donate blood in the UK. An online experiment (N=1,745: 718 Black, 1,027 Non-Black participants) employed a 2x2x2 between-subject design, varying (1) focus (non-specific; specific), (2) inclusivity (non-inclusive; inclusive), and (3) medium (context-free; contextualised). Specifically, participants were randomised to four different co-designed message frames: baseline, specific, inclusive, or mixed treatment message (that varied by context, a simple message or hypothetical social media advert). The baseline was a standard ‘Give blood. Save Lives’ slogan. The inclusive message focused on fostering diversity, the specific message on the link between SCD and the Black community, and the mixed message combined both elements. The key outcome variables were campaign response (i.e., willingness to donate), perceived othering (i.e., feelings of marginalisation and social exclusion), and affect (both positive and negative). The results show for the first time that ‘othering’ is a potential negative consequence of using specific messages. However, a key moderator of this relationship is awareness of the need for well-matched blood, which significantly decreased the negative effects of othering for both ethnic groups. These results have broader applicability in other areas of healthcare. The next steps involve understanding the most effective types of mixed messages and developing awareness campaigns about the need for well-matched blood.

Abstract

Even though reporting mistakes could substantially improve work processes and productivity within organisations, employees often hesitate to do so. This paper studies the role of fear (of being fired) and futility (i.e. reports being inconsequential) in explaining such employee silence. Drawing on a principal-agent framework with career concerns, we formalise mistakes as noisy signals of both agent quality and the work environment and show that optimal reporting decisions are affected by fear and futility considerations. We then use a novel experiment to exogenously manipulate the degree of fear and futility and test our theoretical predictions. In a 2x2 between-subject design, we vary the anonymity of reporting and the likelihood of organisational response. Results show that reducing fear and futility are complementary actions. Tackling both significantly increases reporting by about 20pp. This improvement in communication is accompanied by better organisational income, highlighting the value of improved reporting structures for firms and employees. 

Abstract

In the modern world, individuals are increasingly faced with decisions about how to allocate their time between tasks that vary in their degree of urgency and importance. This research investigates the mere urgency effect (Zhu et al., 2018), a novel finding showing that individuals are more likely to pursue unimportant tasks when they are characterised by spurious time-pressure. We conduct four experiments to replicate this effect and examine if it remains robust to changes in experimental design to rule out possible confounds that might explain choice. With a combined sample size of (N=2,003), our results show that although the mere urgency effect significantly attenuates after controlling for confounds, it remains robust, providing further compelling evidence for its existence. Moreover, we find strong evidence for the attention-based psychological account as an explanation behind the effect. Subjects in our experiments have an overwhelming tendency to pursue things that are made urgent, irrespective of whether it makes financial sense for them to do so, and this is mediated by relative attentional focus on temporal versus pecuniary elements in the decision-environment.

Abstract

Substantial literature shows the importance of choice bracketing to contexts that involve interdependent decisions. However, little is known about bracketing within the context of time allocation. This is surprising given the relevance of bracketing to a wide-class of time allocation problems and that such decisions are collectively amongst the most important choices an individual ever makes. In this research, we set out to answer two questions. Does narrow bracketing in time allocation exist? And if so, how robust is it? We develop a simple theoretical framework that, under certain conditions, predicts a separation between broad and narrow bracketing behaviour. We operationalise this framework in an experimental design. Across three studies, our results find surprisingly high levels of narrow bracketing and that it remains remarkably persistent. We unpick the underlying motivations for bracketing in our set-up, finding that payoff considerations are not the only factor underlying choice behaviour. Moreover, we find that comprehension, attention, cognitive ability, and certain demographics significantly correlate with suboptimal time-use.

Abstract

Utilising a novel experimental paradigm developed in previous research, we conduct an experiment to test the effect that inducing two forms of scarcity have on narrow bracketing behaviour. More specifically, we experimentally manipulate the time at which particular tasks are available (urgency) and the extent to which subjects are short of time (busyness). In our framework, these manipulations are expected to increase the propensity of suboptimal time allocation behaviour as urgency and busyness result in an increased focus on narrow choices and disregard for the broader picture. Contrasting these hypotheses, our experimental results show negligible support for urgency and busyness increasing suboptimal time allocation. Analysis of ex-post questionnaire responses suggests that, while the experimental manipulations objectively affected urgency and busyness, the subjects, on average, did not perceive them as such. After dichotomising these measures, in lieu of treatment manipulations, we observe a significant correlation between high perceived urgency and busyness on narrow bracketing behaviour. These results demonstrate the importance of shifting perceptions and offer some interesting implications for future research.

Abstract

This research investigates the asymmetric effect of expectations on subjective well-being in a developing countries context. The theoretical literature posits that expectations can affect utility through two channels. The first is directly in the presence of anticipatory emotions, and the second is indirectly through deviations from realisations and prior expectations. We investigate these effects by exploiting four waves of the National Income Dynamic Study, South Africa’s largest household panel survey dataset. A strong asymmetry is observed in the way expectations as anticipatory emotions affect well-being. However, while positive deviations from prior expectations have a significantly positive impact on well-being, no significant effect is observed for losses, which is in contradiction to both the theoretical and empirical literature. With cognisance of the South African context, key differences across income and racial groups are also investigated.

MSC dissertation (supervisor: Professor Abigail Barr)