BACKGROUND: Blacks have significantly lower blood donation rates than whites. Many views, experiences, and behaviors associated with blood donation are unique to black culture. Evidence suggests that culturally tailored health promotion programs help with increasing black blood donation. To be effective, tailored interventions should be based on valid and reliable measures. The Transtheoretical Model's (TTM) Processes of Change (POC) construct provides an assessment of participants' covert and overt activities and experiences in blood donation. This study describes development and validation of POC for increasing blood donation tailored to blacks. STUDY DESIGN AND METHODS: Cross-sectional measure development with online survey dissemination was used in 566 blacks in the Northeastern United States. Factor analytic structural modeling procedures were used to examine validity of the POC measure. Blood donation POC were examined in participants representing a range of blood donation history and intentions (nondonors, sometimes donors, regular donors) based on an established algorithm. RESULTS: Confirmatory analyses replicated the theoretically expected structure of POC scales which is a 10-factor, fully correlated best-fit model. Expected POC patterns by Stages of Change based on theoretical and empirical predictions were confirmed. The range of effect sizes for 10 POC were η2 = 0.04 to 0.25, indicating that TTM POC are strong strategies in blood donation decision making for blacks and can be applied to interventions to increase blood donation for a minority population. CONCLUSION: POC measure was internally and externally valid in a sample of blacks. Interventions can utilize the POC measure to guide stage-matched interventions to encourage use of relevant experiential and behavioral strategies to increase blood donation.
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