Umbilical cord blood is a key source of hematopoietic stem cells for patients who face life-threatening diseases and need transplants from unrelated donors. However, only a very small share of parents opts for donating the cord blood upon the birth of their children. Why are donation rates so low and what can be done to increase them? How can conceptual and methodological perspectives from the social sciences provide helpful insights?
We implement a natural field experiment in collaboration with an OB-GYN clinic. We are interested, in particular, in the effect of providing information about an activity that might not be known by most expectant parents, and in the effect of the timing at which information, as well as the request of interest to donate, is provided to these prospective parents. For example, if someone is asked early in the pregnancy, the temporal distance from the actual event might lead to both cognitive and emotional distance, such that individuals might not fully appreciate the value of their choice. Conversely, issues such as self-control may be relevant; at a certain point during the pregnancy, parents may agree on donating the cord blood upon delivery, but they might change their mind or simply overlook this issue as delivery comes close. In a condition of informational and emotional overload, the salience of this issue may also play a relevant role.
Hundreds of pregnant women visiting the clinic will be randomly assigned to the following experimental conditions: (1) the provision of information about the importance of donating cord blood; (2) the possibility for the subjects to express the (non-binding) will to donate upon delivery; and (3) reminders about the subjects’ reported intention to donate or not. Treatment groups (1) and (2) will be split in two, and subjects in each half will be treated at one of two stages of the pregnancy. The main outcome of interest is the decision on how to use the cord blood upon delivery (including the self-storage decision). We will also have access to hospital data, which will include demographics, basic health information about the subjects, and information about their pregnancy. In addition to the hospital data, information on the subjects will be obtained from a questionnaire administered at baseline, i.e., at the subjects’ first visit in their pregnancy. The main goal of the baseline survey is to obtain socio-economic information about the subjects which is not available in hospital records, such as education, occupation, and family structure. The survey will also contain items aimed at eliciting risk preferences.
The proposed study will contribute to the literature on the motivations for altruistic behavior, by providing evidence on a specific activity that has been seldom considered in the social sciences, and by devising new mechanisms to increase donations. Some of the mechanisms that we propose build on the research on the power of “soft commitments” as well as on the effect of reminders and “multiple asking”. A particular feature of this setting is that the analyzed decision includes, in addition to the non-use, both an altruistic option (donate to a public bank) and a “selfish” option (self-storage), unlike other comparable contexts such as blood or organ donations where this three-way choice set is not present. The findings will inform the scholarly debate but also be of primary relevance for organizations engaged in enhancing donations (in particular, public cord blood bank that are growing in several countries), and for policymakers.