Donation initiators: Shifting the focus from outcome to first-time engagement - An interview study.

BACKGROUND: A stable whole-blood supply is vital to healthcare and relies on the successful recruitment and retention of donors, with first-time donors playing a key role in replacing those who lapse over time. The initial donation attempt is emotionally and cognitively significant, and deferral at this stage can lead to disappointment and disengagement. Language that foineligibility rather than intent may reinforce negative self-perceptions and reduce the likelihood of future donation. OBJECTIVE: This study aimed to explore the subjective experiences of deferral among first-time donation candidates and to identify a term that accurately reflects their intent to donate. METHODS: Twenty individuals temporarily deferred during their first whole-blood donation attempt participated in semi-structured interviews. A constructivist-phenomenological approach guided data collection and analysis, focusing on participants' motivations, identity perceptions, and preferences for appropriate terminology. Suggested terms were evaluated through qualitative content analysis based on four criteria: donation status and context, avoidance of donor labeling, positive and inclusive language, and bilingual feasibility. RESULTS: Fifteen out of 20 participants did not see themselves as blood donors due to the absence of a completed donation. They proposed 25 terms, grouped into 17 categories. "Donation Initiators" emerged as the preferred label, positively acknowledging the intent without implying failure and framing deferral as part of the donation journey. CONCLUSION: Introducing the term "Donation Initiators" offers a low-threshold, linguistically inclusive alternative that may improve communication, reduce negative emotional reactions to deferral, and support donor engagement. Future research should investigate its impact on donor identity and retention.