Symbolic Incentives Can Affect the Frequency of Blood and Plasma Donations: Evidence From 12 Years of Donors' Behavior

We investigate how donors respond to symbolic incentives, specifically medals, tied to donation intensity and duration. To this aim, we employ panel data encompassing the entire population of blood and plasma donors affiliated with the primary donor association (AVIS) in Tuscany, Italy, covering the period from 2008 to 2019. The structure of the award scheme adopted by AVIS enables us to examine the impact of two distinct characteristics of the symbolic incentives: the assignment as either private or public and the criterion of assignment based exclusively on the number of donations (donation-only) or, under less demanding donation requirements, also on the years of membership (donation-and-membership). After controlling for time-constant unobservable individual traits that may influence the level and the evolution of performance over a donor's career, we find that (i) these symbolic awards do not affect behavior before their obtainment, (ii) receiving an award through the donation-and-membership criterion leads to a subsequent increase in donation frequency, and (iii) receiving an award through the donation-only criterion, regardless of whether it is announced publicly or privately, does not boost donors' performance. These findings suggest that symbolic awards are effective when bestowed upon less accomplished donors by making their attainment not solely contingent on performance but also on membership, and are related to community identification and self-image concerns rather than status-seeking behavior.