Action Research to develop a model for exclusive voluntary non-remunerated blood donation in a former colony: The case of Trinidad and Tobago
Bibliographic record
Abstract
ABSTRACT \nBackground: International transfusion bodies recommend blood collection from exclusively voluntary non-remunerated donors for safety, adequacy and equal access. This goal has been achieved in some former British colonies in the Pan American Health Organization Region of the Americas such as America and Canada. Trinidad and Tobago is one former British colony whose national blood transfusion service remains heavily reliant on family replacement (> 80%) and remunerated (18%) donors despite its high development index and social capital. An attempt to switch to voluntary non-remunerated blood donation was curtailed by an abrupt fall in donations that disrupted clinical services. \nMethod: Action Research was used to examine historical and social determinants, describe the current situation, implement change in a closed setting, monitor outcomes and produce a model for achieving exclusive voluntary non-remunerated blood donation in Trinidad and Tobago. \nFindings: Policy determined in the colonial period and path dependency after independence prevented uptake of voluntary non-remunerated blood donation in Trinidad and Tobago. Family replacement donation with its attendant deficiencies developed insidiously and became institutionalized over decades. Failure to develop a social interface between the transfusion service and the community with its blood donors allowed fear and mistrust to undermine the introduction of voluntary non-remunerated blood donation. A university-led programme of research, education and collaboration generated a pool of mostly young (49% 18-25 years old), female (56%) and repeat (58%) voluntary non-remunerated donors who were less likely to be deferred (8%) or test positive for transfusion transmissible infections (1.1%) than the existing pool of family replacement donors (p < 0.05 for all domains). This programme has been accepted by decision-makers as the model for achieving exclusive voluntary non-remunerated blood donation nationally. \nConclusion: Action research was used to overcome historical and social barriers to voluntary non-remunerated blood donation in a former colony.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.008 | 0.010 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".