30

Because of the ever-increasing demand for donated blood, keeping active donors engaged and retaining them is a public health issue. In France, in the absence of payment for blood donation, loyal donors are committed donors who agree to make substantial efforts to maintain their donor status. Thus, this study aims to identify the factors of their engagement. First, using a model inspired by the theory of planned behavior and supplemented by the concept of altruism, we test the permanence of personal, social, moral, and altruistic motivations toward the intention of giving blood on a repeat basis, in the short, medium, and long term. This quantitative study shows that, in the short term, the intention to give blood again is explained by both social norms and the expected benefits of giving; in the medium and long term, only altruistic motivations explain the intention to give blood again. Then, through a qualitative study, we explore how altruistic motivations combine with other motivations for truly committed donors. We then show the importance of moral norms associated with education and altruism that committed donors internalize as a habit. The key roles of a sense of responsibility and identity as a donor support their engagement.