A Youth-Led Community Recruitment Model to Increase Antigen-Matched Blood Availability for Sickle Cell Disease Patients in North Texas
Zachary J A Rouseau, Devaditya Ray, Anjan K Garg, Rohan K Jupelly, Harika Kancharla, Shreya R Jupelly, Adam J MilamAbstract
Background
Patients with sickle cell disease (SCD) often require chronic transfusion therapy, yet transfusion safety depends upon access to antigen-matched red blood cells. Partly due to Duffy and Kell antigen phenotype differences, patients with SCD are at an increased risk of alloimmunization and delayed hemolytic transfusion reactions. Although approximately 70% of Black donors are Duffy-negative, enabling antigen matching, they comprise only about 3.8% of the national blood donor pool. This disparity undermines transfusion outcomes for SCD patients.
Methods
Between 2021 and 2025, the North Texas Region of the American Red Cross (Figure 1) developed and implemented Blood for Change: a youth-led, community-centered donor recruitment initiative. Utilizing demographic mapping via the United States Census Bureau, we identified areas with high African American populations and low blood drive density, with a focus on Dallas and Tarrant counties. Recruitment strategies leveraged non-traditional pathways, including Red Cross Clubs, school athletic teams, Black fraternities and sororities (including university and graduate Divine Nine chapters), multicultural pre-health organizations, and faith-based institutions. In partnership with clinical and community health partners, we implemented a stepwise model: education, activation, and execution. Our teams introduced this model via presentations to students and potential blood donors. The activation step involved partner-designated Blood Program Leaders (BPLs) coordinating tabling and donor registration, serving as ongoing points of contact to streamline communication and sustain engagement through structured recognition. Utilizing the BPL’s, we established recurring blood donation sites in North Texas. A mixed-methods analysis using data from these regional blood drives and qualitative surveys was conducted to evaluate outcomes.
Results
According to the United States Census Bureau, 32% of residents across six represented donation sites (Table 1) identified as African American. Following implementation, 1,181 units of blood were collected over multiple donation events at seven sites, with 38.8% of donors identifying as African American compared to 3.8% of the national donor pool.
Conclusions
Youth-driven, community-based recruitment can measurably diversify blood donor demographics and increase access to antigen-matched blood for patients with SCD. This model provides a reproducible approach to reducing transfusion disparities.