Trust and distrust: Identifying recruitment targets for ethnic minority blood donors

Eamonn Ferguson*, Erin Dawe-Lane, Zaynah Khan, Claire Reynolds, Katy Davison, Dawn Edge, Susan R. Brailsford

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: We explore the role of trust, distrust, and the prevailing socio-political context to better understand why people from ethnic minority communities are less likely to be blood donors compared to people from White communities. Recruiting more ethnic minority donors will enhance representativeness, reduce inequality, and help meet the clinical need to increase the proportion of blood with Ro Kell antigen to treat Sickle Cell Disease (SCD). Study design and methods: A 2 (donor-status: current donor; non-donors) by 4 (ethnicity: People from Asian, Black, Mixed and White ethnic backgrounds) quasi-experiment (N = 981) was conducted to examine perceptions of trust/distrust and their influence on willingness to donate blood, within the socio-political context of the Windrush scandal and Brexit. Results: We identified five domains of trust (‘National Health Service [NHS] and staff,’ ‘NHS Blood and Transplant,’ ‘outgroups,’ ‘individuals’ and ‘politics’), and a single domain of conditional distrust domain. Trust across all the domains was lower, and ‘conditional distrust’ higher for ethnic minorities. Trust in ‘individuals’ and ‘NHSBT’ predicted willingness to donate in non-donors from ethnic minorities and White non-donors, respectively. Concerns about the Windrush scandal were related to lower political trust. Viewing Brexit as ‘positive for the UK’ was related to lower trust across domains and reduced willingness to donate in White non-donors through its influence on reduced trust in NHSBT. Conclusion: Distinct domains of trust and distrust are identified, and targeting ‘trust in others’ through conditional cooperation is recommended as a strategy to increase donor numbers from ethnic minority communities.

Original languageEnglish
JournalTransfusion Medicine
Publication statusAccepted/In press - 2022
Externally publishedYes

Bibliographical note

Funding Information:
This work was funded by a grant from NHSBT Trust Fund (TF082) to the first author. The views expressed here are those of the authors solely and do not reflect the funding organisation or any of the organisations and groups involved in this research. Funding information

Publisher Copyright:
© 2022 The Authors. Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society.


  • blood donation
  • ethnicity
  • recruitment
  • trust


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