Vesnaver Elisabeth, Goldman Mindy, O'Brien Sheila, MacPherson Paul, Butler-Foster Terrie, Lapierre Don, Otis Joanne, Devine Dana V, Germain Marc, Rosser Andrew, MacDonagh Richard, Randall Taylor, Osbourne-Sorrell William, Clement-Thorne Broderic, Al-Bakri Taim Bilal, Rubini Kyle A, Hill Nolan E, Presseau Justin
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
Health Res Policy Syst. 2020 Nov 2;18(1):131. doi: 10.1186/s12961-020-00643-4.
Blood donation policy in Canada for gay, bisexual and other men who have had sex with men (gbMSM) has changed progressively in the last decade from indefinite deferral to 3-month deferral from last male-to-male sex. Driven by safety data and overseen by the national regulator, more inclusive policies continue to redress the disparity in donation for gbMSM. At the same time, the need for source plasma to prepare fractionated blood products is growing worldwide. The collection and processing of source plasma ensures greater safety compared to whole blood donation with respect to transfusion-transmitted infection. This greater safety offers an opportunity to evolve policies for gbMSM from time-based to behaviour-based deferral using revised eligibility criteria. However, changing policies does not in itself necessarily guarantee that gbMSM will donate or that staff in donor clinics are ready to support them to do so. In anticipation of a move to behaviour-based donation screening for gbMSM in Canada, we aim to assess the acceptability of and perceived barriers and enablers to source plasma donation using revised screening criteria for gbMSM among key stakeholders to inform policy implementation strategies.
This mixed-methods feasibility study will involve gbMSM and donor centre staff to understand modifiable barriers to implementing more inclusive eligibility criteria. Key informant interviews and surveys will be rooted in the Theoretical Domains Framework to identify modifiable factors associated with source plasma donation motives in gbMSM and training needs in donation centre staff. We will use an integrated knowledge translation approach involving a partnership between researchers, the national blood operator and gbMSM, situating knowledge users as key research team members to ensure their perspectives inform all aspects of the research.
Our integrated knowledge translation approach will provide a more comprehensive and collaborative understanding of blood operator and gbMSM needs while accelerating the implementation of study findings. Given the historical backdrop of the decades of exclusion of sexually active gbMSM from blood donation, this study has the potential not only to inform a process and policy for gbMSM to donate source plasma, a blood product, but also offers opportunities for new relationships between these knowledge users.
在过去十年中,加拿大针对男同性恋者、双性恋者以及其他与男性发生过性行为的男性(gbMSM)的献血政策逐渐从无限期延期献血转变为自上次男男性行为起推迟3个月献血。在安全数据的推动以及国家监管机构的监督下,更具包容性的政策继续纠正gbMSM在献血方面的差异。与此同时,全球对制备血液制品的原料血浆的需求不断增长。与全血捐献相比,原料血浆的采集和处理在输血传播感染方面能确保更高的安全性。这种更高的安全性为采用修订后的资格标准,将针对gbMSM的政策从基于时间的延期献血转变为基于行为的延期献血提供了契机。然而,政策的改变本身并不一定能保证gbMSM会献血,也不能保证献血诊所的工作人员准备好支持他们献血。预计加拿大将转向针对gbMSM的基于行为的献血筛查,我们旨在评估使用针对gbMSM的修订筛查标准进行原料血浆捐献的可接受性以及感知到的障碍和促进因素,以告知关键利益相关者政策实施策略。
这项混合方法可行性研究将涉及gbMSM和献血中心工作人员,以了解实施更具包容性的资格标准的可改变障碍。关键信息访谈和调查将基于理论领域框架,以确定与gbMSM原料血浆捐献动机相关的可改变因素以及献血中心工作人员的培训需求。我们将采用综合知识转化方法,包括研究人员、国家血液运营机构和gbMSM之间的合作关系,将知识使用者定位为关键研究团队成员,以确保他们的观点贯穿研究的各个方面。
我们的综合知识转化方法将在加速研究结果实施的同时,对血液运营机构和gbMSM的需求提供更全面和协作性的理解。鉴于过去几十年性活跃的gbMSM被排除在献血之外的历史背景,本研究不仅有可能为gbMSM捐献原料血浆(一种血液制品)的流程和政策提供信息,还为这些知识使用者之间建立新关系提供了机会。