Int J Health Econ Manag. https://doi.org/10.1007/s10754-019-09269-8 RESEARCH ARTICLE Motivation structures of blood donation: a means-end chain approach Yeong Sheng Tey 1,2 · Poppy Arsil 3 · Mark Brindal 4 · Sook Kuan Lee 2 · Chi Teen Teoh 2 Received: 30 April 2018 / Accepted: 21 June 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract Understanding blood donation behaviours is pivotal to recruiting and retaining blood donors. Despite rich literature, this is the first study investigating the content and structure of motiva- tions that underlie blood donation using a means-end chain approach. Based on soft laddering interviews with 227 respondents (31 first-time blood donors and 196 repeat blood donors) in the Klang Valley of Malaysia, we identified that their blood donation was primarily driven by the attribute ‘help people’, the consequences ‘increase blood supply’ (as perceived by first-time blood donors) and ‘indirect downstream reciprocity’ (as perceived by repeat blood donors) associated with the attribute and the belief that the consequences can lead to the fulfilment of the value ‘humanitarianism’. Understanding of such hierarchical links between motivators is crucial in developing self-relevant communications. The resultant outcomes are likely to be more effective than the traditional approaches in behavioural change. Keywords Blood donation · Motivation · Means-end chain · Communication JEL Classification I10 · I31 Introduction There is growing concern about the sufficiency of blood in saving lives of many patients. This is resulted from the increasing need for blood transfusion that associated with accidents and injuries, diagnostic and treatment options, and new medical regimens and procedures. Many countries depend on voluntary non-remunerated donation to maintain blood bank. B Yeong Sheng Tey tyeong.sheng@gmail.com 1 Institute of Agricultural and Food Policy Studies, Universiti Putra Malaysia (UPM), 43400 UPM Serdang, Selangor, Malaysia 2 Putra Business School, 43400 UPM Serdang, Selangor, Malaysia 3 Department of Agricultural Technology, Jenderal Soedirman University, Purwokerto 53123, Central Java, Indonesia 4 School of Agriculture, Food and Wine, The University of Adelaide, Urrbrae, SA 5064, Australia 123