What does this research mean for the field?

Comprehensive self-efficacy fully mediates the positive relationship between altruistic factors and voluntary non-remunerated blood donation behavior, indicating that altruistic motivation translates into action through an individual's perceived knowledge, confidence, and trust. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To explore how altruistic factors relate to voluntary blood donation and assess whether self-efficacy mediates this relationship.

April 14, 2026Open Access

Investigating the mediating role of comprehensive self-efficacy in the relationship between altruistic factors and voluntary non-remunerated blood donation behavior

XHXiaogai HanBeijing Red Cross Blood Center SZShicheng ZhangChinese Academy of Medical Sciences & Peking Union Medical College XZXinhao ZhangCzech Academy of Sciences, Institute of Biotechnology

Key Points

To explore how altruistic factors relate to voluntary blood donation and assess whether self-efficacy mediates this relationship.
Conducted a cross-sectional survey in Zhengzhou and Xinxiang, Henan Province, China.
Recruited 9,622 residents aged 18–60 through stratified random sampling.
Utilized questionnaires to gather data on altruistic factors, self-efficacy, and blood donation history.
Employed multinomial logistic regression and bootstrap mediation analysis for data analysis.
Altruistic factors showed a significant positive association with donation behavior with odds ratios ranging from 1.673 to 2.592.
Comprehensive self-efficacy was identified as a strong independent predictor of donation behavior.
Mediation analysis indicated that self-efficacy fully mediates the relationship between altruistic factors and donation behavior.

Abstract

Objective To investigate the relationship between altruistic factors and voluntary non-remunerated blood donation behavior, and to examine the potential mediating role of comprehensive self-efficacy in this relationship. Methods A cross-sectional survey was conducted from June 2023 to April 2024 in Zhengzhou and Xinxiang, Henan Province, China. Using stratified random sampling, 9,622 residents aged 18–60 years were recruited. Data were collected via questionnaires assessing sociodemographic characteristics, altruistic factors (score range: 0–3), comprehensive self-efficacy regarding blood donation (a composite score of knowledge, situational confidence, policy awareness, and service evaluation), and self-reported blood donation history. Blood donation behavior was categorized for analysis as non-donor versus donor (≥1 donation). Multinomial logistic regression and bootstrap mediation analysis were employed. Results Altruistic factors showed a significant positive association with donation behavior, exhibiting a clear dose–response relationship (ORs ranged from 1.673 to 2.592, all p 0.001). Comprehensive self-efficacy was a strong independent predictor of donation ( p 0.001). Crucially, mediation analysis revealed a statistical pattern consistent with full mediation: the association between altruistic factors and donation behavior was significantly mediated by comprehensive self-efficacy (indirect effect: 0.335, 95% CI 0.301, 0.372), with no significant direct effect detected. Owing to the cross-sectional nature of this study, this finding only describes the statistical association between variables, and cannot confirm a definitive causal mediating pathway. Significant demographic disparities were also observed. Conclusion Altruistic motivation provides the foundational impetus for blood donation, but its translation into action is channeled through an individual’s perceived comprehensive self-efficacy. This suggests that promotion strategies should evolve from solely emphasizing altruism towards integrated efforts that systematically build public knowledge, confidence, and trust in the donation process. Integrated strategies that enhance both altruistic motivation and comprehensive self-efficacy are essential for improving donor recruitment and retention.

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