Journal of

A B S T R A C T
Background and Objectives
Given the growing need for blood and blood products, coupled with an aging population and declining number of young donors, understanding the motivations of first-time young donors is essential. Self-Determination Theory distinguishes between different types of motivation, ranging from extrinsic to intrinsic. Research indicates that more intrinsic motivation is associated with the greater intention to donate, actual act of donation and the long-term retention. This study aimed to investigate motivation levels among first-time young blood donors (aged 18-34 years) in the country.
Materials and Methods
This secondary analysis was conducted on first-time young donors aged 18-34 years. Initial sampling was performed using a stratified cluster sampling method with a time-based clustering approach. Provinces served as strata, and working days (30 randomly selected working days from November to December 2024) served as the time clusters. Daily sampling of attendees was carried out using simple random sampling. Among 7187 donors initially enrolled, 573 (7.97%) were first-time young donors with the mean age of 28.79 years (SD=4.11). The samples were divided into three age groups: 18-24, 25-29, and 30-34 years. Due to missing data, multiple imputation was used to impute values for the motivation statements (24 statements). For statistical analysis, a linear mixed-effects regression model was applied using  STATA version 17.
Results
Of the 573 donors, 113 (19.72%), 169 ( 29.49%), and 291 (50.79%) were in the 18-24, 25-29, and 30-34 age groups, respectively. The model indicated that overall, and across all three age subgroups, all levels of motivation, except for amotivation which was considered the reference in the model, were associated with positive and significant regression coefficients (p ≤ 0.001) compared to amotivation. The most significant motivational factor overall was the intrinsic level of motivation (β = 2.99 [95% CI: 2.91-3.16]). This pattern was consistent across all age groups: 18-24 years (β = 3.10 [95% CI: 2.93-3.27]), 25-29 years (β = 3.01 [95% CI: 2.85-3.18]), and 30-34 years (β = 2.93 [95% CI: 2.81-3.06]).
Conclusions  
Within the framework of Self‑Determination Theory, this study found that motivation level 6 (internalized regulation) was the strongest determinant of blood donation motivation among first‑time young donors, consistently across all age subgroups. This suggests that these individuals view blood donation as part of their personal values and identity internalized and aligned with their sense of self- representing humanistic values, altruism, or internalized social responsibility, rather than external rewards, fear of judgment, or external pressure. This finding highlights the need to remove structural and cultural barriers and to strengthen targeted programs based on intrinsic motivation, so that the latent potential of young people actualizes into sustained participation.