Don’t tell Nicola Lacetera economists are only good at crunching numbers.
The University of Toronto Mississauga associate professor has spent a decade delving into a topic not typically associated with his particular area of expertise: organ donation.
Specifically, Dr. Lacetera, who is also chief scientist with the Behavioural Economics in Action at Rotman Centre, is part of a team of academics from across disciplines exploring what makes people want to donate vital organs, blood and body tissues, such as plasma and bone marrow.
The end goal is beyond mere scholarly interest. “We want to help in devising strategies, by applying economics and behavioural sciences, to enhance the supply of blood, plasma and organs, which often lags behind demand,” he says in an e-mail. The demand “is likely to increase in the future with the development of new medical technologies and with an aging population.”
His newest research, published in the Nature journal, is focused on life-saving cord blood, drawn from the umbilical cords of newborn babies. Rich in stem cells, cord blood is used to treat a host of life-threatening diseases, such as leukemia and lymphoma. Researchers are also experimenting with stem cell use to treat spinal cord injury, cerebral palsy, diabetes, heart disease, stroke and Parkinson’s disease.
Yet, to date, most cord blood ends up as medical waste, says Dr. Lacetera.
In Italy, where the two-year study was conducted, the rate of cord blood donation to a public blood bank by the parents of newborns is about 1 per cent, according to the research team. In the United States, the rate is below 5 per cent. Canadian rates are also low and the first national public cord blood bank opened in Ottawa in just 2013.
(Private bank donations for a fee are more widely embraced by parents, but that model was not included as part of this study).
In a controlled experiment, researchers borrowed tools from social and behavioural science to see if they could boost donations to a public bank.
The results are encouraging. A two-year study of expectant mothers in Milan resulted in double the number of cord blood units collected. The jump in donation rates came as parents-to-be were given the information necessary to fully understand the cord blood donation process, then strategically “nudged” along the way to ensure they follow through with their commitment.
Nudging is a technique used to create a low-key, non-coercive intervention that makes it easier for people to take positive actions they support, but may find hard to do. In this case, for instance, the strategic prompting resulted in more parents filling out the necessary donation paperwork, and other tasks, to ensure the cord blood collection at the baby’s birth.
The study found that mothers who received the most nudges had the highest donation rate: Out of 850 expectant mothers, 57 cord blood donations were made when nudging was used, compared to 18 to 20 without the intervention.
Dr. Lacetera believes the donation rates would have been even higher had researchers been able to effectively address institutional challenges associated with blood collection, such as a lack of staff at the hospital to perform the medical procedure and inflexible operating hours at the blood bank.
Still, he says, “We more than doubled the number of cord blood units that were collected. We learned a lot and we did a little bit of good, too, so that feels nice.”
The study was co-authored by Daniela Grieco of Bocconi University in Milan, Mario Macis of Johns Hopkins University in Baltimore and Daniela Di Martino, an ob-gyn at Ospedale Buzzi in Milan.
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