The annual increase in unrelated SCTs from 3237 in 1997 to 12 822 in 20101 would not have been possible without the growth of the worldwide unrelated donor registries from 4.8 to 18.5 million donors in the same period. However, many patients are still unable to find an HLA-matched donor. This holds true especially for patients from ethnic groups with limited representation and/or a high genetic diversity.2 Therefore, registries may focus on the recruitment of individuals from specific ethnic groups.3, 4
Ongoing donor recruitment efforts are also necessary due to attrition based upon donor age and availability. Young individuals are a specific target of recruitment efforts as they are preferred by transplant physicians for donation. In addition, they will remain on the registry for many years.5
However, it is not sufficient to add young donors from under-represented ethnicities to the registry as nature and quality of the recruitment process, for example the perception of recruiters being informative, have implications for long-term donor retention, willingness to donate when asked, and psychosocial donor outcomes.6, 7, 8
Therefore, with continued growth of unrelated SCT, skilled and trained recruiters have a key role in the overall availability and commitment of registered donors. To date, there have been no collective efforts to develop guidelines regarding recruiter qualifications and training.
The World Marrow Donor Association standard 3.029, 10 states: ‘The recruitment of donors must be performed under the direction of individuals who are experienced in recruitment of donors and in management activities including education, consenting, counseling, confidentiality, and medical screening. These individuals must be appropriately qualified and provided with timely and relevant training. The training and experience of these individuals must be documented.’
It is the goal of this document to further support this standard and to provide recommendations regarding qualifications and training of recruiters.
Donor recruitment approaches differ considerably between donor registries. While some registries, for example, focus their recruitment efforts on routine blood donors, others engage the general public. The following definitions consider these differences by generalizing the recruitment process:
A recruiter is actively involved in the donor recruitment process and communicates directly with potential new registrants regarding the recruitment and their role as potential donor. Recruiters may be employees or volunteers of donor registries or centers. Recruiters are responsible for
educating potential registrants
verifying registrant medical eligibility
obtaining and storing informed consent and registrant identification data
maintaining authenticity, integrity and confidentiality of registrant data
collecting and storing samples for HLA typing.
A supervisor manages the work of recruiters. Supervisors are responsible for
controlling the recruitment processes
decisions on specific recruitment activities
ensuring recruiters are compliant with recruitment processes
training and education of recruiters.
Supervisors may also be involved in
strategic donor registry/center decisions on recruitment
definition and development of recruitment policies and processes.
These definitions will not necessarily match exactly with recruitment processes and/or organizational structures of all donor registries/centers. It may therefore happen that individuals are both recruiters and supervisors.
As stem cell donor recruitment is a unique activity, newly hired recruiters and supervisors often have no specific experience regarding their new tasks. Therefore, it is important to define criteria that provide a framework for candidate assessment.
An overview of relevant criteria is found in Table 1. Tables 1 and 2 consider current practices of various donor registries/centers and were compiled after discussions within the Quality Assurance Working Group of the World Marrow Donor Association. In some countries, stricter requirements regarding formal qualifications may be defined by law.
Table 1 shows a strong focus on ‘soft’ skills. Excellent communication and organizational skills are highly essential for recruiters and their supervisors.
There are fewer requirements for volunteer recruiters as this group also includes individuals who may support only a single recruitment drive. It has to be noticed that a volunteer is not considered a volunteer recruiter if the task does not include direct communication with potential registrants regarding the recruitment and/or the role as donor.
Due to the high specificity and relevance of the stem cell donor recruitment process, new recruiters and supervisors require an intense training including both theoretical and practical elements. Table 2 shows recommended training topics. The training period at the beginning of employment will normally require several months. We recommend a mix of more formal teaching elements and supervised on-the-job training. With this developed knowledge and experience, the new recruiter will increasingly take on responsibility. An example of a training program for new recruiters is given in the Supplementary Information.
After completion of training at the beginning of employment, we recommend periodic training that includes reviews of the initial training and new material as required by, for example, changes in regulations or processes. The topics and scope of training, along with the names of participants, should be documented as required by World Marrow Donor Association Standard 3.02.
The training of volunteer recruiters who will support only one specific recruitment drive under supervision of an employed recruiter will normally consist of one or two training sessions. If the task of a volunteer recruiter is defined before the training session(s), she/he needs not to be trained with respect to other topics even if they are included in Table 2.
In conclusion, we developed recommendations for the qualification and training of stem cell donor recruiters. Our recommendations are aimed to be of general relevance, irrespective of specific recruitment processes. We believe these qualifications and core training topics are vital to the competency of a recruiter to properly educate the public about stem cell donation and the role as stem cell donor, thus contributing to a high long-term donor availability.
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The authors declare no conflict of interest.
Supplementary Information accompanies the paper on Bone Marrow Transplantation website
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Schmidt, A., Amer, B., Halet, M. et al. Qualifications and training of adult stem cell donor recruiters: recommendations by the World Marrow Donor Association. Bone Marrow Transplant 48, 148–150 (2013). https://doi.org/10.1038/bmt.2012.98
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