Empowerment model construction and empirical study of community-based recruitment of platelet donors

To address the structural mismatch between high clinical demand and limited public participation in platelet donation recruitment in megacities, this study constructed a three-dimensional community empowerment model-organizational empowerment, cognitive empowerment, and service empowerment-based on social capital theory, community governance theory, and planned behavior theory. A cross-sectional questionnaire survey was then conducted to examine statistical associations between key factors and attitudes toward platelet donation via machine collection, as well as blood donation intention, thereby providing empirical evidence for subsequent community recruitment strategy design.

A multi-stage stratified sampling approach was used to select nine administrative districts and 32 communities in Chongqing according to population size and community type. Permanent residents aged ≥18 years who had lived in the community for at least 6 months were recruited. Of 2,200 distributed questionnaires, 2,004 valid responses were returned (valid response rate: 91.0%). Data were cleaned and analyzed using Excel, SPSS 26.0, and AMOS 26.0. The full sample was used to describe demographic and sociological characteristics, awareness deficits, and recruitment preferences; respondents with prior blood donation history were used to describe blood donation behavior; and 1,964 complete cases were included in confirmatory factor analysis (CFA) and structural equation modeling (SEM). The measurement and structural models were evaluated using Cronbach's α, KMO and Bartlett's test of sphericity, CFA, average variance extracted (AVE), composite reliability (CR), discriminant validity testing, Pearson correlation analysis, and SEM.

Among respondents, 9.80% reported prior blood donation, and 59.18% of these donors had donated only once in the past year, suggesting limited sustained participation. Misconceptions remained common: 38.47% believed blood donation could harm health, and 31.34% of potential donors identified lengthy procedures as the primary participation barrier. Short science-popularization videos (penetration rate: 79.49%), government-enterprise collaborative recruitment programs (penetration rate: 68.21%), and leadership by Party members and officials in blood donation activities (penetration rate: 71.71%) showed high acceptance. CFA indicated standardized factor loadings of 0.65-0.85; AVE values were > 0.50 and CR values were > 0.70. Model fit was good [CMIN/DF = 1.583 (1-3), RMSEA = 0.017 < 0.05, and NFI, TLI, and CFI all > 0.90]. SEM results showed that institutional trust, fixed donor loyalty, community philanthropic culture, blood usage transparency, and social support norms were all significantly and positively associated with attitudes toward platelet donation via machine collection and blood donation intention.

The community empowerment model developed in this study helps explain variation in residents' attitudes toward platelet donation via machine collection and blood donation intention from the perspectives of institutional trust, community philanthropic culture, blood usage transparency, and service accessibility. Given the cross-sectional study design, the findings indicate correlations rather than causal effects and do not demonstrate direct improvements in recruitment efficiency attributable to specific recruitment measures. Future studies should incorporate longitudinal follow-up, intervention trials, and cost-effectiveness evaluation to further verify the model's validity and generalizability in real-world community recruitment practice.