Until recently, sexually active gay, bisexual and men who have sex with men (gbMSM) have been excluded from contributing their blood plasma, one of Canada’s vital health resources, since 1983. Policies are incrementally shifting toward greater inclusivity with Health Canada recently approving, and Canadian Blood Services (CBS) implementing, new screening criteria at two donation centres (London, ON and Calgary, AB). The new criteria allow gbMSM to donate source plasma if they have been in a mutually exclusive relationship with their partner for at least three months. After being excluded from the blood system for so long, many gbMSM will be new donors unfamiliar with the donation experience and will need support to make engaging/re-engaging with the system as positive an experience as it can. Following mixed-methods identification of barriers and enablers to plasma donation in gbMSM in London and Calgary informed by the Theoretical Domains Framework (TDF), we aimed to co-develop behavioural theory-informed interventions to support gbMSM in donating plasma.
In collaboration with local gbMSM advisors from the two cities, we first identified feasible modes of delivery for intervention. Next, we used the Behaviour Change Techniques Taxonomy version 1 (BCTTv1) and the UCL Theories and Techniques Tool to map TDF-linked barriers and enablers to fit-for-purpose strategies to address plasma donation barriers and enablers. We then collaborated with community members using development groups to co-develop and operationalize BCTs across identified modes of delivery.
A website and a short video were identified as feasible modes of delivery. The overall focus of the website was to provide information from a safe and credible source independent from CBS. We mapped 13 TDF domains to 15 BCTs. For example, some gbMSM are not aware of their eligibility (TDF domain: Knowledge). This was addressed by providing a clear description of the current gbMSM criteria as well as where to find other criteria (BCT: Instruction on how to perform behaviour). The focus of the video was to visually represent new gbMSM donors and convey what they can expect. We mapped 7 TDF domains to 11 BCTs. For example, some gbMSM were concerned that they would be tolerated but not welcomed into donor clinics by staff (TDF domain: Beliefs about Consequences). This was addressed by showing real staff interacting positively with gbMSM in clinic (BCT: Information about social consequences).
By using a community-engaged research approach, along with behavioural theory, we co-developed multimodal interventions to support a community that has long been excluded from contributing a much-needed health resource. This work will continue to help support gbMSM as Canadian policy further evolves towards greater inclusivity.Amelia Palumbo slides