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Evaluating Knowledge, Attitudes, Beliefs, and Behavior of Muslim Migrants Regarding Blood Donation

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Date

2025

Authors

Asad, Zunirah

Supervisor

Holroyd, Eleanor
Mearns, Gael

Item type

Thesis

Degree name

Doctor of Philosophy

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Publisher

Auckland University of Technology

Abstract

Background: Blood donation is an essential life-saving intervention that promotes a proactive approach to life-threatening situations, regardless of the human setting. However, discrepancies exist in various populations' understanding of blood donation that can adversely impact their donation practices. Among Muslim migrant populations, these aspects are further highlighted by their unique cultural and religious beliefs, attitudes, and behaviors that add further complexities to decision-making regarding blood donation. This research aimed to explore the knowledge, attitudes, beliefs, and behaviors of Muslim migrants in New Zealand regarding blood donation. Additionally, it sought to identify critical information that should be included to an existing questionnaire that assesses these aspects for Muslim migrants. Method: This research employed an exploratory-sequential mixed-method approach using the Theory of Planned Behavior (TPB) as a framing lens. In the first phase, focus groups were conducted with purposively sampled Muslim migrant participants recruited from community centres, mosques, and healthcare facilities. Focus groups included a total of 31 first-generation Muslim migrants aged 18 to 66 who had lived in Auckland, New Zealand, for at least three years. The groups included both older (50-66 years) and younger (18-49 years) participants, representing backgrounds from Pakistan and India. A thematic analysis of this data revealed seven key themes. In the second phase, a relevant pre-existing questionnaire was identified through the literature, with the themes identified in Phase I informing the development of an additional open-ended questionnaire. Both questionnaires underwent expert validation to ensure their clarity, relevance, and appropriateness for Muslim migrants. Results: Phase I identified seven key themes from the thematic analysis of the focus groups: 1. The importance of knowledge for blood donation; 2. Islamic expectations and priorities regarding blood donation; 3. Weighing up risks and benefits related to blood donation, 4. Gendered, familial, cultural, and social dynamics influencing blood donation; 5. Perceived role of blood banks: 6. Acculturation and country of origin influence blood donation behaviors; and 7. Health promotion recommendations for blood donation approaches. Phase II: The themes from Phase I informed the adaptation of Polonsky’s survey, “Understanding Barriers and Enablers to Blood Donation Amongst Sub-Saharan African Migrants and Refugees”, which formed Part A of the questionnaire, together with a discrete set of 10 questions formulated to constitute a distinct section, denominated Part B of the questionnaire, to address these specific domains. Both Part A and Part B of the questionnaire underwent expert validity testing and calculation of the content validity index (CVI). The questionnaire's content validity index (CVI) was 1.0 for clarity, relevance, and appropriateness, indicating strong content validity. The overall S-CVI/Ave also scored 1.0, suggesting that the instrument is robust and well-validated for Muslim migrants. This process resulted in the development of a culturally relevant questionnaire to better understand the barriers and enablers of blood donation, ultimately contributing to improved blood donation strategies. The results highlighted the importance of blood donation and knowledge about eligibility and procedures. Islamic teachings that support saving lives were acknowledged, but concerns over blood contamination and lifestyle differences led many to prefer donating only to other Muslims. Cultural norms also significantly influenced women's participation, with many requiring male family members' approval to donate blood. Despite challenges in understanding New Zealand's blood donation protocols, participants expressed trust in the safety of the system. Notably, younger participants, having integrated more into New Zealand society, showed a higher likelihood of donating blood compared to their elders. Conclusion: The study’s findings reveal novel insights into the gendered, cultural, and familial dynamics influencing blood donation among Muslim migrants in New Zealand, emphasizing the importance of involving families and encouraging women in blood donation initiatives. The study highlights how Muslim migrants’ integration issues specific to New Zealand further complicate these challenges. The findings underscore the need for tailored, culturally appropriate blood donation strategies and policies that address barriers and actively engage families and community leaders, fostering a more inclusive blood donation environment for Muslim migrants. Future studies should focus on enhancing the psychometric validation of the current research instrument and adopting a co-design approach involving Muslim blood recipients and community stakeholders to ensure culturally sensitive and effective interventions.

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http://hdl.handle.net/10292/18986

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