Structural Equation Modeling of Factors Associated with Repeat Blood Donation
Keywords:
Repeated blood donation, Structural Equation Model, Brahmavihara, Sangahavatthu, Cognitive PsychologyAbstract
Thailand faces a growing blood shortage due to population aging, while donor numbers remain insufficient. This study examined factors associated with repeat blood donation using structural equation modeling (SEM) and validated the proposed model against empirical data. The model integrated Individual Difference Theory, the Theory of Planned Behavior, Kohlberg's Theory of Moral Development, and Buddhist principles to explain commitment to repeat blood donation among Thai donors. The model comprised five latent constructs: perception through blood donation media, motivation, repeat donation experience, attitude toward repeat donation, and commitment to repeat donation, the outcome construct measured by cumulative donation frequency and donation regularity.
This quantitative study recruited blood donors aged ≥18 years at the National Blood Centre, Thai Red Cross Society, Bangkok, who had donated whole blood at least twice, with the most recent donation within one year, using purposive sampling. Data were collected from September to November 2025 using a validated 52-item six-point Likert questionnaire (IOC = 0.57–1.00; CVI = 0.93–0.99; Cronbach's alpha = 0.703–0.954; CITC = 0.410–0.959). Analyses included descriptive statistics, Pearson's correlation, confirmatory factor analysis, and SEM.
The model showed good fit ( /df = 1.83, CFI = 0.980, GFI = 0.975, AGFI = 0.937, SRMR = 0.040, RMSEA = 0.044, LSR = 1.961, standardized residual slope ≈ 1.0) and explained 40.2% of the variance in commitment (R² = 0.402). Among 426 participants, attitude partially mediated the effects of media-related perception, motivation, and donation experience on commitment. Media-related perception showed the strongest direct effect, whereas motivation showed the greatest total effect.
The findings support interventions emphasizing media-related awareness, donor motivation, and positive donation experiences to strengthen attitudes and commitment to repeat blood donation.
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