Abstract
Motivations for volunteering described by functional theory are loosely related to the types and duration of these activities. The motivating effects of individuals’ social- and role-based identities may need inclusion. Identity theories suggest that entering a specific service activity depends on whether the service benefits a social group with which a person identifies, while persisting in the work depends on rewards and legitimation gained from the role-identity of “volunteer.” Former cardiac patients’ motivations for engaging in peer-support volunteering were explored (n = 84). Respondents’ primary motive for starting this work was to reduce current patients’ anxieties, suggesting identification with cardiac patients in general. Respondents viewed their “volunteer” role-identity as deeply rewarding, promoting long-term involvement. Identification with the sponsoring organization (Mended Hearts) supplied additional benefits, supporting continued involvement. Social- and role-identities help to explain the start and persistence of this type of volunteer work and likely influence other volunteer activities.
In 2017, 30% of American adults volunteered for one or more organizations, contributing almost 7 billion hours of service, worth nearly $167 billion in estimated value (Corporation for National and Community Service, 2018). Volunteer work meets the needs of individuals and communities that are not addressed through private or government agencies. Thus, it adds to the well-being of community members, or, in some types of work such as fund raising, sustains the endeavors of existing service programs. But the reasons why individuals choose to volunteer their time and energy to aid strangers (or programs) without compensation are not fully understood. Understanding motives is necessary for effective recruitment and retention of experienced volunteers, reducing turnover and frequent training of new personnel.
Research shows that individuals’ motives for performing community service are loosely related to the type, amount, or duration of the work that they do. This is in part due to a persisting problem in the empirical literature: The specific volunteer activities that individuals are moved to perform are rarely considered (e.g., coaching teams, registering voters, clearing trails). Failing to distinguish differing motives for starting versus continuing volunteer work also weakens links between individuals’ goals and their service activities.
Identity theories may help to address these problems. These theories suggest that individuals enter into a specific service activity when it benefits a group with which they identify, and individuals continue this work when they embrace the role-identity of “volunteer” and gain rewards from role enactment. To explore these possibilities, volunteers’ decisions to begin and maintain a specific type of volunteer work are examined: providing peer support to persons who are undergoing a major life crisis.
Volunteers’ Motivations
. . . [V]olunteerism refers to freely chosen and deliberate helping activities that extend over time, are engaged in without expectation of reward or other compensation and often through formal organizations, and that are performed on behalf of causes or individuals who desire assistance. (Snyder & Omoto, 2008, p. 3)
Most researchers accept that volunteer work is motivated and draw on functional theory to explain persons’ decisions to begin, invest in, and continue it. Functional theory posits that individuals have purposes, aims, or goals (i.e., motives) that guide their decisions and actions, and volunteer work functions to fulfill those motives (Clary et al., 1998; Snyder & Omoto, 1992, 2008).
Investigators identify two to six volunteer motivations. The simplest scheme divides motives broadly into altruistic versus egocentric types (Davis et al., 2003; Haski-Leventhal, 2009), where altruistic motives refer to desires to help a community or specific group without expecting rewards, and egocentric reasons encompass goals based on self-interest (e.g., to gain marketable skills). Other schemes suggest three motives: altruistic, self-interest, and obligation, where obligation refers to expressing strongly held values (Musick & Wilson, 2008). Still others identify four “frameworks” individuals use to explain their volunteerism: a humanitarian framework (giving assistance to those for whom one feels compassion), a reciprocity framework (“giving back” or “paying it forward” to reimburse assistance previously received), a happiness framework (helping others for its intrinsic or extrinsic rewards), and a self-realization framework (helping others to achieve one’s own potential or grow as a person) (Wuthnow, 1995).
Most often, researchers adopt a six-motive scheme developed by functional theorists (Clary & Snyder, 1999; Snyder et al., 2000). In order of most to least frequently mentioned motives as assessed by the Volunteer Functions Inventory (VFI; Clary et al., 1998), these include expressing personal values (helping the needy), enhancing understanding (learning more about the world or one’s abilities), gaining self-enhancement (increasing self-esteem or personal growth), benefiting one’s career (acquiring job-related experiences, skills, or connections), strengthening social ties (meeting others’ expectations that one should volunteer), and addressing negative feelings or personal problems for self-protection (e.g., “Volunteering is a good escape from my own troubles”) (Clary & Snyder, 1999, p. 157).
The Loose Connections Between Motivations and Volunteer Involvements
Reviewers of the volunteer literature repeatedly assert that there must be a match between individuals’ motivations and an organization’s goals to attract workers and keep them satisfied and committed over time (Clary & Snyder, 1999; Haski-Leventhal, 2009; Musick & Wilson, 2008; Prouteau & Wolff, 2008; Snyder & Omoto, 2008; Studer & von Schnurbein, 2013; Wilson, 2012). Although studies support this assertion, for several reasons, matches are not tightly linked to starting, investing time, continuing, committing to, or being satisfied with one’s volunteer activities (Clary et al., 1994, 1998; Clary & Snyder, 1999; Davis et al., 2003; Finkelstein, 2008a; Manatschal & Freitag, 2014).
First, people typically identify more than one motivation for volunteering. For example, Clary and Snyder (1999) found that roughly two thirds of their respondents selected two or more listed goals as important, with many choosing both altruistic and egocentric motives. Prouteau and Wolff (2008) similarly reported that almost 80% of their sample of volunteers cited multiple reasons for doing service work. Multiple reasons mean volunteer work is less closely linked to any one motive.
Second, individuals with different motivations pursue the same volunteer activity (Clary et al., 1998; Musick & Wilson, 2008; Snyder & Omoto, 1992), and the same volunteer activity is satisfying to individuals with very different motivations (Clary et al., 1996; Finkelstein, 2008b; Musick & Wilson, 2008). Motives and volunteer choices again are loosely coupled.
Third, the distinction between starting and continuing volunteer work is frequently disregarded (Musick & Wilson, 2008, p. 448). Many studies of volunteers do not distinguish between newcomers and those who have stayed over the long term (e.g., Manatschal & Freitag, 2014). Alternatively, researchers hold volunteers’ durations of service constant, missing motives possibly associated with differing durations (e.g., Principi et al., 2012). Given that individuals’ motives do change over time (Chacón et al., 2007; Lois, 2003; Wilson, 2012), the relationship between particular motives and volunteer activities will be relaxed.
Finally, the modest ability of functional motives to predict the initiation and continuation of volunteerism relates to a persisting problem in the literature: how the type of volunteer work is categorized. In large-sample studies, the kind of work that volunteers choose to perform is often not assessed at all (e.g., Manatschal & Freitag, 2014; Prouteau & Wolff, 2008). Similarly, in research on volunteers for a single organization, individuals’ motives are not examined with respect to the differing organizational jobs that they do (e.g., Finkelstein, 2008b; Finkelstein et al., 2005; Omoto & Snyder, 1995; Simon et al., 2000). In studies that do attend to types of activities, researchers devise ad hoc categories to classify what the service work entails—categories that are not comparable across studies or theoretically grounded. Musick and Wilson (2008; Wilson, 2000, 2012) have commented repeatedly on this problem: One problem is that the generic term “volunteering” embraces a vast array of quite disparate activities . . . The taxonomies of volunteering that are used to disaggregate volunteer work are folk categories (e.g., school-related, helping the elderly), and there is little reason to believe these categorizations are sociologically useful. (Wilson, 2000, pp. 233–234) We cannot separate our thinking about the motivation for volunteer work from our thinking about what that volunteer work entails. Serving as a docent in an art gallery is very different from acting as a “buddy” for AIDS patients . . . [I]f the work is different, people might have different reasons for doing it. (Musick & Wilson, 2008, p. 78)
In short, to better understand (and predict) the kinds of service work people will select and sustain, one should examine what motivates people to pursue a particular volunteer activity, rather than why they choose to volunteer in general or to engage in broadly classified kinds of activities. Consequently, this article focuses on a specific form of volunteer work, peer support-giving. Peer-support volunteers supply emotional, informational, and instrumental assistance to persons facing a major life stressor that the volunteers themselves have faced in the past self-conceptions (e.g., “I belong to this community.
It is important to note that the VFI (Clary et al., 1998) catalogs reasons that individuals frequently endorse when asked why they volunteer. Theoretically derived motivations are unexamined, despite other theory and research which suggests that identity processes can play a vital role in persons’ decisions to enter into and continue with service work (Mannino et al., 2011). Specifically, individuals’ social identities and role-identities may attract persons to particular types of volunteer work and sustain their involvement.
Social Identity and Role-Identity Motivations
Studies show that individuals are motivated to help others who are members of their in-group (Musick & Wilson, 2008, p. 60; Omoto & Packard, 2016; Omoto & Snyder, 2002; Simon et al., 2000; Thomas et al., 2017); for example, persons identified with the gay community often decide to assist those who have HIV/AIDS. Investigators have highlighted the importance of “solidarity” (Musick & Wilson, 2008), “psychological sense of community” (Omoto & Packard, 2016; Omoto & Snyder, 2002), or “collective identification” (Simon et al., 2000). These terms call up Tajfel’s (1978) concept of “social identity”: “. . . that part of an individual’s self-concept which derives from his knowledge of his membership of a social group (or groups) together with the value and emotional significance attached to that membership” (p. 58). A person may identify with a broad category or collectivity (e.g., “We are Latinos/Republicans/environmentalists”) or a specific organization (e.g., “We are members of AA/the Episcopal church/the teachers’ union”). Social identity theory and its corollary, self-categorization theory (Turner et al., 1987), help to explain why identifying with a disadvantaged or needy in-group can motivate giving service to that group, whether it is category-based and dispersed (e.g., pregnant teens) or organizational membership-based and interactive (e.g., Salvation Army). The same theoretical processes apply, regardless of the category- versus organizational-basis of a social identity.
Social identity theory is a theory of inter-group relations, based on inter-group social comparisons, that explains the strategies that lower-status groups use to enhance their group’s social standing and their members’ self-esteem in relation to out-groups (Ellemers & Haslam, 2012). Group members are assumed to need a positive and distinctive social identity. Intergroup social comparisons highlight similarities among in-group members and differences between in-group and out-group members. When such comparisons place the in-group in an unfavorable light, the in-group will compete with the out-group for greater status or accentuate the in-group’s positive aspects instead (Ellemers & Haslam, 2012; Tajfel, 1978).
Self-categorization theory (Turner et al., 1987) extends social identity theory by focusing on intra-group perceptual and behavioral processes that follow from holding a social identity. It posits that when a social identity becomes salient, perceived similarities among in-group members and dissimilarities from out-group members become amplified. Perceived in-group similarity reinforces shared beliefs about both the in-group and the out-group and fosters in-group conformity, cohesion, and cooperation (Ellemers & Haslam, 2012; Turner et al., 1987).
It is a straightforward theoretical next step to suggest that shared beliefs and cohesion will promote mutual understanding and empathy among in-group members. These in turn should make in-group helping behaviors more probable (Batson et al., 1981; Omoto & Snyder, 2002; Simon et al., 2000). Research indeed shows that empathy predicts helping when those needing assistance are in-group members (e.g., Stürmer et al., 2005). Social identity and self-categorization processes thus imply that (a) individuals who have been through a specific life stressor can see themselves as members of that categorical in-group (e.g., former cancer patients, bereaved spouses) and (b) will be more likely to empathize with and be moved to offer assistance to members of their in-group.
Musick and Wilson (2008) supplied another factor that can generate collective identification among persons who have been victims of a life crisis or social injustice: receiving help from previous victims. For example, heart patients who are visited in the hospital by former heart patients may grasp that they belong to a broader collectivity of persons threatened by life-changing cardiac problems. Once recovered, patients may decide to reciprocate in-group assistance by supporting others presently struggling with cardiac illness—an act of solidarity (Musick & Wilson, 2008, p. 60; Omoto & Snyder, 2002). Note that this is consistent with Wuthnow’s (1995) “reciprocity framework” or motive.
Other identity-related processes are important. Studies consistently show that persistence in volunteer work depends on the emergence of a “volunteer” role-identity from giving service (Chacón et al., 2007; Charng et al., 1988; Finkelstein et al., 2005; Grube & Piliavin, 2000; Marta et al., 2014). Role-identity theories (Burke & Stets, 2009; McCall & Simmons, 1978; Stryker, 1980) presume that individuals typically define themselves as they are defined by other people in their social networks. These definitions include positions that they occupy in the social structure, for example, as spouses, parents, friends, architects/emergency technicians, swimmers, and so forth. Thus, after an individual has begun enacting a volunteer role, organizational staff, fellow volunteers, and service recipients recognize and categorize him or her as a volunteer, and that definition is typically accepted as an identity (“who I am”).
Drawing from McCall and Simmons (1978), once individuals have accepted a role as self-descriptive, they continue to perform it to elicit support for an idealized conception of themselves in that role. Because performances often fall short of their own and others’ expectations, individuals pursue role partners’ approval and legitimation, along with the intrinsic and extrinsic rewards gained from competent enactment (McCall & Simmons, 1978, pp. 75–76). In short, individuals’ motivations for continuing their service work—legitimation, social approval, and personal and material gratifications—are likely to be based, at least in part, on a personally embraced “volunteer” role-identity.
In sum, social identity-based self-conceptions (e.g., “I belong to this community of survivors”) and in-group-based motives (“We know what they’re going through, so we can be of help”) may explain entry into peer-support volunteerism, while role-identity-based motives (“People know me as a volunteer,” “Being a volunteer is a rewarding part of who I am”) are likely to sustain active involvement over time.
Do such motives play a part in starting and maintaining the specific task of supplying peer support to individuals facing a major adversity? Studies of the evolution in volunteers’ motives over time are uncommon, and even fewer examine both social and role-identities as sources of motivation for investing in the same service activity. The purpose of this study is to explore the reasons former heart patients (members of Mended Hearts) provide for giving support to current cardiac patients and their family members. Guiding expectations are that (a) volunteers’ collective identification with other heart patients and/or with Mended Hearts as an organization prompts the decision to begin this service work, and (b) accepting and performing the role-identity of “hospital visitor” sustains continuation of this work over time. How well functional motives apply to respondents’ reasons for starting or continuing this type of volunteerism is additionally assessed.
Methods
The Mended Hearts Organization
Mended Hearts, Inc. (MHI) is a national, non-profit, self-help organization, founded in 1951 to give peer support to heart patients and their families. Former cardiac patients visit current heart patients in the hospital to offer information, reassurance, and hope. Former caregivers to heart patients (typically spouses) also visit to provide support to family members during hospital visits.
For accreditation as a visitor, volunteers are required to complete 8 to 10 hrs of training and to be re-accredited annually. The Visiting Chair of each Mended Hearts chapter trains patient and caregiver visitors in hospital etiquette and support-giving strategies, using the national organization’s training materials. Only a subset of all Mended Hearts members serve as visitors. Other members and visitors attend monthly chapter meetings, open to all local cardiac patients and families, for informal support and up-to-date information about surgeries, medications, and recovery. This study focuses solely on hospital visitors.
Study Design
This institutional review board (IRB) and MHI-approved study had two phases. In the first stage, March to May 2010, a random sample of visitors received surveys assessing their degrees of involvement in this volunteer work and their physical and emotional well-being. In the second stage, May to July 2011, visitors who indicated in returned surveys that they were willing to participate in follow-up telephone interviews were called. The in-depth interviews explored two topic areas: (a) the kinds of support respondents received when ill and now give when visiting for Mended Hearts, and (b) their visiting experiences: why they decided to become a visitor, the benefits and costs of volunteering, whether they identify with heart patients/caregivers in general (social identity), and whether they identify as volunteer visitors (role-identity). The visiting experiences data are analyzed here.
Sampling
Stage 1 sample
The national office of MHI does not maintain a list of visitors. Because lists are kept by the Visiting Chairs of local chapters, surveys were sent to Visiting Chairs to distribute to their volunteers.
Seventy-five chapters were randomly drawn from a list of U.S. chapters with active visiting programs (n = 206), seven chapters with outstanding programs were added at the request of MHI, and two nearby chapters were included (n = 84). After five chapters were omitted because their programs had become inactive, 76 of the 79 Visiting Chairs were successfully contacted, all agreed to distribute surveys to their visitors in hardcopy or online format (depending on their usual communication mode with their volunteers), and 70 Chairs followed through. Hardcopies included a stamped, addressed return envelope. The 70 chapters comprised a total of 877 potential respondents, of whom 458 (52%) completed a survey, with one reminder delivered by Visiting Chairs 2 weeks after initial distribution. Response rates did not differ by mode of survey distribution. Although this response rate is good compared with most studies of organizational volunteers, the findings cannot be generalized to all volunteer visitors.
Stage 2 sample
Of the survey respondents, 49% agreed to participate in follow-up telephone interviews about their visiting experiences and were interviewed successfully (N = 226). Interviews averaged 45 min in duration.
Because the same themes repeatedly appeared in interviews, 84 transcripts were randomly drawn from the 226 for detailed coding and analysis. The composition of this subsample closely mirrored the Stage 1 survey and Stage 2 telephone samples (not shown).
Respondents’ characteristics
Of the 84 respondents, 61% were male, 94% were White, and 86% married. The average visitor was 71 (SD = 9). About 75% had some college education or more. The majority (88%) were patient visitors, which means that they were former cardiac patients. (The Mended Hearts rule is that only people who have undergone heart procedures may visit patients; former caregivers [12%] visit with family members only.) Participants had been visiting for their chapter an average of 8 years (SD = 6.5). Almost 60% were visited by a Mended Hearts volunteer when they or their family member were previously hospitalized.
Interviewers
A team of 10 graduate students conducted the telephone interviews. Because none had had heart problems or been peer supporters, they were “outsiders” to the topics of the interview. Although there are disadvantages to outsider status, outsiders have greater freedom than “insiders” to probe for clarification and elaboration of respondents’ views, much like students eager to learn from experts—a role most interviewees appreciate. Interviewers were trained regarding the pros and cons of outsider status and had practiced probing skills. Prior participant observation by the author at chapter, regional, and national meetings provided interviewers with (a) knowledge about the culture and structure of the Mended Hearts organization, (b) annotated lists of heart disease–related terms (e.g., CABG surgery, angina, stents, Warfarin), and (c) Mended Hearts–specific vocabulary (e.g., heart event, Path Pack, “the pillow”). Their qualitative training and grasp of organizational culture and terms facilitated good rapport and detailed interviews.
Coding and analysis
Transcripts were coded using The Ethnograph 6.0.1.0 (Qualis Research, 2008), following an abductive approach (Timmermans & Tavory, 2012). In abductive analysis, one alternates between deduction and induction. One begins deductively by coding instances in the data of key theoretical concepts (here, drawn from functional, social identity, and role-identity theories), while applying grounded theory analytical strategies (Glaser & Strauss, 1967). These strategies include comparing similarly coded excerpts; noting “surprises” (anomalies, exceptions, and unanticipated dimensions of coded concepts); and writing memos about comparisons, surprises, and fit between existing theory and the coded data. Surprises require revised explanations, revised concepts, and new coding—that is, inductive work—followed by another assessment of fit between revised explanations and the data.
Results
Becoming a Visitor
Social identification
The first guiding expectation, derived from social identity and self-categorization theories, was that respondents would identify with heart patients/caregivers in general or with the Mended Hearts organization itself, and this social identity would influence respondents’ decisions to become volunteer visitors.
Did respondents actually hold a categorical- or organizational-group social identity? Near the end of the interview (to avoid biasing responses to earlier questions about volunteering motives), participants were asked, “Do you think of yourself as part of a larger group of heart patients/caregivers, perhaps through your membership in Mended Hearts? In other words, do you identify with other heart patients/caregivers, in general?” The vast majority, 92% (n = 72), said that they did—as heart patients/caregivers (31%, n = 24), as Mended Hearts members (29%, n = 23), or both (33%, n = 26).
Oh yeah, I think you identify with anybody that’s had open heart surgery, you know. If you’ve been there and done that, then, yeah, you identify with them. (Eli, 78, patient visitor, Southwest chapter)
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Once you have that scar in the middle of your chest, we call that the zipper. So I’m a member of the zipper club. But, other than that, I’m a member of Mended Hearts, and therefore I belong to that, that whole group, which is about 22,000 [members] all over America. And, yeah, I’m, I’m a Mended Hearts member! (Wendell, 79, patient visitor, Southern chapter)
Did these categorical or organizational identities play a role in the decision to volunteer? Earlier, respondents had been asked, “Thinking back to when you first started visiting, what where your reasons for doing this?” and “Did any of your own experiences in the hospital affect your decision to become a volunteer visitor?” Contrary to expectations, social identification did not come up as a reason for volunteering, excepting three respondents. For example, Lindsay (49, patient visitor, Northeast chapter) said, “. . . it was just really wanting to try to be of help to other heart patients. That was really it.”
Respondents instead cited one or more of five reasons: they (a) desired to reassure patients and their families, (b) wished to “give back,” (c) were inspired by having been visited themselves, (d) were recruited to the work by other people, or (e) had time on their hands and/or the right skills.
Desiring to reassure patients and their families
The most frequent motive for becoming a visitor was the wish to assure patients and family members that patients would survive surgery and recover their health and well-being. A majority, 61% (n = 51), mentioned this motive.
Well, I just wanted to cheer people up and give them a sense of hope and confidence. (Daniel, 68, patient visitor, Mid-Atlantic chapter) . . . to encourage. To let the patient know that someone else has been where they are—a LOT of us. And that we’re just fine. You know, . . . we do what we did before [having surgery]. (Daria, 73, patient visitor, Western chapter)
The motive to reassure was grounded in respondents’ own experiential knowledge of what patients and family members typically think and feel while in the hospital: . . . it is a scary life-changing thing that usually happens so suddenly that you just don’t have time to think about it, and your life virtually falls apart in a heartbeat. I mean, it really does. And so that is exactly why we [my husband and I] decided to volunteer and be there as a support for patients and the families, and try to help them calm down . . . (Lydia, 59, caregiver visitor, Southern chapter) And the reason we do it, as I say, MY reason, is because . . . I know how it felt sitting there with my chest cut open and some guy telling me, “I had it [surgery] five years ago, and look at me [now].” I said, “Gee whiz, so there is hope.” (Simeon, 74, patient visitor, Northeast chapter)
Empathic understanding of patients’ and family members’ emotions and concerns prompted the desire to help. Respondents repeatedly generalized from their own experiences to others dealing with cardiac crises. Generalizing from oneself to a broader group of cardiac patients/family members indicates perceived similarity between oneself and that group—implicit identification with the broader category. When directly asked later, respondents immediately said that they did see themselves this way or as members of Mended Hearts (which formally represents the broader group). Despite few explicit references to in-group identification as an impetus to volunteering, it seemed implicitly there.
Wanting to give back
The second most frequent motive was a desire to “give back,” mentioned by 49% (n = 41). This phrase was probed further: Why give back? And to whom? The “why” was straightforward: gratitude. Respondents were grateful for their many blessings in life, the gift of survival, or the gift of unsolicited support from a visitor. Gratitude was most often for help provided by a Mended Hearts visitor during the recipient’s hospitalization: . . . when somebody takes the time to try and help you or to try to give you information out of their own life, to come to the hospital like a Mended Heart visitor did with me and my family, I thought that was really amazing . . . I just think giving something back . . . for me, I can say it was called for. (Franklin, 68, patient visitor, Southern chapter) And that’s why I got into it . . . somebody [a Mended Hearts visitor] did it for me, so I do it for somebody else. (Simeon, 74, patient visitor, Northeast chapter)
Note that the desire to give back reflects Wuthnow’s (1995) reciprocity framework.
Inspired by having been visited
The third most frequent reason for becoming a visitor was the inspiration gained from having been visited while ill. Thirty-six percent (n = 30) said the idea occurred to them when they were called on by a volunteer while hospitalized.
But I never heard of Mended Hearts until a fella walked in and said that, you know, he had had the surgery twelve years ago . . . And I just looked at him and said, “Wow.” You know, “Maybe I’m going to wake up tomorrow!” (laughs) . . . So it had a very, very good impression on me. You know, I felt better after he left, and I said, “Ahh, maybe I’ll do that someday.” (Susan, 65, patient visitor, Northeast chapter)
Mended Hearts visitors’ hope-instigating presence (alive and fully recovered) and their reassuring words triggered the idea of supporting others in the same way. Prior visitors essentially were respondents’ role models, motivating them to join the organization to take up this service work.
Recruited into the work
Some respondents (30%, n = 25) decided to become a visitor after having been guided to Mended Hearts by a knowledgeable individual or a Mended Hearts member.
. . . one of the nurses in the rehab, you know, thought that I would be a good volunteer because of my communication [abilities] and my interest in, you know, talking to patients who were doing a rehab program. So she herself picked me [out], and she said, “Aaron, would you be interested in doing it?” I said, “Sure.” (Aaron, 71, patient visitor, Central chapter)
These respondents did not self-select into volunteer work; they were socially selected by others who thought they might become capable visitors. As Musick and Wilson (2008, pp. 288–290) pointed out, most theory and research presumes that becoming a volunteer is self-initiated and volitional, yet roughly 30% of surveyed volunteers report that they started because someone had asked them to. The responses here reflect this pathway into service work.
Pragmatic reasons
A final set of reasons for becoming a visitor were pragmatic: having free time due to retirement or job loss, or having the right qualifications for visiting. One third of respondents (n = 26) mentioned one or both of these pragmatic motivations, citing the desire to do something useful with their free time most often.
. . . the President [of the local chapter] visited when I was doing my rehab stuff and talked to us about it [visiting], and I thought, . . . since I’m a retired person that this would be good, and also, as a pastor I’ve had many years’ experience of it anyway so I thought, well, this is something that I can do . . . (George, 75, patient visitor, Southern chapter)
Many studies show that retired individuals take up volunteering, or do more of it, with free time (van Ingen & Wilson, 2017).
Overall assessment of motives to begin volunteering
Contrary to theoretical expectations, social identification was not the stated impetus for becoming a visitor. Instead, respondents’ motivations were most often to provide reassurance to others going through the same crisis, to reciprocate the good fortune or help they had received, and/or to replicate the beneficial work of a Mended Hearts visitor. Still, an unstated motive was to aid others like themselves. It is plausible that respondents left their identification with similar peers unsaid because they took this for granted or assumed it was obvious.
Only one of the six functional motivations described by Clary and Snyder (1999; Clary et al., 1998) was cited by respondents as a reason for deciding to volunteer: expressing personal values. For example, Francisco (77, patient visitor, Central chapter) said, “. . . I just thought, ‘Well, maybe I can be of help to the next person’, which I think is what we should all do every day.” However, only 19% of participants (n = 16) attributed their decision to values.
Other functional motives were not mentioned. Respondents’ motives generally fell into two broad frameworks identified by Wuthnow (1995): a humanitarian framework (supplying assistance to people for whom the person feels sympathy) and a reciprocity framework (“giving back” to reimburse good fortune or help that was previously received).
Continuing the Volunteer Work
The role-identity of Mended Hearts visitor
The second guiding expectation, drawn from role-identity theory, was that respondents would see themselves as volunteer visitors and would continue to perform this role to retain the rewards reaped from satisfactory performance and other people’s legitimation.
Did respondents actually identify with their volunteer role? To avoid biasing responses, participants were asked toward the end of the interview, “Some people say that being a parent is ‘who they are’ or that their work ‘gives them an identity’. Do you see being a visitor this way? Is it part of who you are—an identity for you?” A large majority, 83% (n = 67) agreed it was—not their only identity, many added, but definitely one that defined them.
Respondents were asked earlier, “What makes visiting worthwhile for you?” and “Are there aspects of visiting that you don’t enjoy or that make it a problem for you?” Respondents overwhelmingly mentioned the rewards received from helping patients and families, 83% (n = 67)
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: . . . I feel like I’ve done something. I help ’em and I give them some encouragement. And they feel better when I walk out. When I walk out of the hospital . . . I’ve accomplished something . . . I feel good about it. (Burt, 74, patient visitor, Central chapter) . . . no matter how many patients I might visit, whether it be 1 or 10 or 20, . . . it gives me an inner satisfaction that I think and feel that I have helped someone get through this. (Lennie, 81, patient visitor, Central chapter)
Many participants (42%, n = 34) spontaneously offered examples of direct positive feedback received from patients, family members, and hospital staff—evidence of identity legitimation: . . . part of it is when the family is also there, and they just are effusive at the end of my visit and appreciative and tell me how much they appreciate me coming in, even though the patient, I mean the patient is appreciative, you can just tell, . . . but sometimes the family just gushes all over, you know . . . I think that that’s good feedback. (Yolanda, 74, patient visitor, Northeast chapter) . . . they’ve done articles about us [Mended Hearts] . . . in the hospital newspaper—we get employees stopping us, I mean, [even] maintenance people, people from the cafeteria, who say, “Thank you for all you do for the hospital.” You know, so that’s nice, too, to know that everybody thinks we make a difference. (Lydia, 59, caregiver visitor, Southern chapter)
Respondents mentioned other gratifications from visiting, but rarely: meeting people (n = 14), giving back (n = 7), and growing as a person (n = 2). In general, respondents cited intrinsic rewards (“I feel good about it”), extrinsic ones (“Thank you for all you do”), and approving feedback from others which validated their role-identities.
Overall assessment of motives to continue volunteering
Consistent with theoretical expectations, respondents identified as volunteer visitors, cited rewards gained from performing the identity, and received explicit legitimation from others. Reinforcement theory tells us that positive rewards for behavior lead to repeated behavior. It is not surprising, then, that respondents have engaged in this volunteer work an average of 8 years. Wuthnow’s (1995) broad “happiness framework” (helping others for its rewards) also fits this set of findings. In contrast, functional theory motivations (e.g., expressing values, personal growth) were rarely mentioned.
Importantly, respondents’ initial motives for taking up visiting were not supplanted but supplemented by the rewards acquired from role-identity enactment. When asked whether their reasons for visiting had changed over time, a majority (76.5%, n = 62) said no. The rewards and legitimation from visits simply supplied more reasons for continuing their service (see also Omoto & Snyder, 2002; Schusterschitz et al., 2014).
Continuing the work: An unanticipated finding
Given considerable research on organizational determinants of volunteers’ satisfaction and retention (Studer & von Schnurbein, 2013), it seemed likely that Mended Hearts membership at the chapter or national level might offer rewards beyond those obtained from the visitor role. Participants were asked, “Beyond the visiting experience, what other sorts of things do you gain from belonging to Mended Hearts in general—if anything?”
The most frequently cited benefit was social in nature; 88.5% (n = 71) mentioned one or more of three social bonuses: gaining friends or a social life (47.5%, n = 38), camaraderie with other members (31%, n = 25), and a sense of family (10%, n = 8).
. . . Mended Hearts is an opportunity to meet with other people who have had experiences similar to mine. And we develop a camaraderie, if you will. We have developed some close friends within the organization. (Lars, 75, patient visitor, Northeast chapter) The nice thing about Mended Hearts [is] when we have our monthly [chapter] meetings . . . it’s just kind of an extended family of people who’ve gone through what you’ve gone through. (Franklin, 68, patient visitor, Southern chapter)
Respondents also cited information or education they gained from chapter meetings (36%, n = 29) and the social support received from other chapter members (22.5%, n = 18).
I think that the monthly meetings, of my local chapter anyway, they try to bring in professionals to speak for a half hour or so on . . . latest findings in the open heart surgery world or in the medications. So it’s, the information that’s passed is very, very good. I find that important. (Vinnie, 72, patient visitor, Northeast chapter) We’re a support group among ourselves. So I think that’s a nice, nice feature. (Howie, 65, patient visitor, Western chapter)
These social, educational, and supportive benefits of organizational membership echo common findings in the volunteer retention literature (e.g., Merrilees et al., 2020; Milbourn et al., 2019) as well as the “happiness framework” described by Wuthnow (1995). These rewards likely contributed to the longevity of respondents’ volunteer involvement, as one patient visitor observed (Noah, 58, Mid-Atlantic chapter): “. . . socialization with the other Mended Hearts people is an important part of what brings you back.” The unexpected aspect of this finding was that these organizational benefits reflected two of the six functional motives suggested by Clary and Snyder (1999): strengthening (new) social ties and obtaining understanding/knowledge. These motives were not cited as reasons for becoming a volunteer as functional theory proposes; rather, organizational belonging produced a new circle of friends and greater knowledge about cardiac issues, rewarding experiences which likely strengthened volunteers’ identification with the organization itself and their ongoing investment in the work (see Gray & Stevenson, 2020; Prouteau & Wolff, 2008).
Discussion and Conclusion
This study explored individuals’ identities as sources of motivation for starting and continuing peer-support volunteerism. Unexpectedly, few respondents cited social identification with heart patients/family caregivers in general or with the Mended Hearts organization as a reason for beginning this activity. Instead, they most often described a desire to reassure anxious cardiac patients and families that recovery was possible, a wish to reciprocate the gift of previously received support, and inspiration from having been helped by a volunteer role model. Nevertheless, when later asked directly whether they identified with heart patients/family caregivers in general or with Mended Hearts members as a group, the vast majority readily agreed that they did. The fact that respondents had chosen to help cardiac patients and families (not ill patients in general) and their extrapolations from their own experiences to others in similar distressing circumstances suggests that social identification did play a part in deciding to enter this work.
This inference must remain tentative due to the wording of the social identity questions, which, following theory, did not differentiate between categorical- and organizational-group memberships. Had these types of social identity been distinguished and probed with respect to starting and continuing volunteer work, a more elaborate theoretical process might have emerged: Respondents likely first perceived that they had become members of a broad category of similar others, that is, heart patients/caregivers in general. Similarity allowed them to imaginatively take the role of categorical in-group members and empathically anticipate those members’ distress, prompting a desire to help. To do so, they joined an organization devoted to supporting their in-group. By joining and training for support-giving, respondents not only acquired the role-identity of volunteer but obtained an organization-based social identity too—Mended Hearts member. Each acquired identity (one role-based, one organization-based) supplied rewards sustaining volunteers’ involvement. Future research should disentangle categorical-group from organizational-group identities and examine this elaborated sequence. Although these social identities predict the amount and duration of individuals’ volunteerism (Gray & Stevenson, 2020; Omoto & Packard, 2016; Simon et al., 2000; Thomas et al., 2017), they have yet to be theorized or shown to motivate the decision to volunteer. A first step in this direction has been made here.
There was good evidence that accepting and performing the role-identity of “hospital visitor” helped to sustain continuation of this work over time. Consistent with role-identity theory, respondents definitely saw the role of visitor as part of “who I am,” viewed enactments as immensely rewarding, and received legitimating feedback from others. Rewards and legitimation likely sustained continued work, given the 8-year mean duration of respondents’ service. Importantly, despite many studies documenting a positive relationship between holding a volunteer role-identity and long-term service (Chacón et al., 2007; Charng et al., 1988; Finkelstein, 2008a; Finkelstein et al., 2005; Grube & Piliavin, 2000; Marta et al., 2014), investigators uniformly have overlooked the intrinsic and extrinsic rewards from identity performance that should explain that relationship (McCall & Simmons, 1978). Taken together with the observation that Mended Hearts membership yielded additional bonuses (new friendships, informal support, education about heart disease), these results suggest that long-term volunteerism might be more fully explained by assessing both role-identity and organizational-identity rewards, rather than rewards from one or the other identity source alone, which has been the predominant approach to date.
It was clear that functional motivations (Clary et al., 1998) were very rarely cited by Mended Hearts volunteers as reasons for starting or persisting in this service work. Wuthnow’s (1995) broad motivational rationales seemed more applicable: Respondents employed humanitarian and reciprocity frameworks when explaining their decisions to start visiting and a happiness framework for their enduring involvements. Like Wuthnow’s broad frameworks, functional motivations tap generalized reasons for becoming or remaining a volunteer (“I feel it is important to help others,” “My friends volunteer”); identity-related motives draw people into starting and maintaining a specific endeavor. This is probably why, when directly compared, stronger associations are observed between volunteers’ identities and time investments than between their functional motivations and investments (Finkelstein, 2008a; Finkelstein et al., 2005).
The study’s limitations must be kept in mind. First, this is one type of volunteer activity with very specific targets of assistance (e.g., adults rather than children, stigma-free rather than stigmatized recipients). Motives for starting and maintaining peer-support work may differ by the target of service. Second, because Mended Hearts recruits volunteers from previously helped patients/families, “giving back” was perhaps cited more frequently than it might in other studies; different recruitment strategies attract persons with different motives (Studer & von Schnurbein, 2013). Third, stated motives make one’s decisions and behaviors both meaningful and socially acceptable to oneself and others (Musick & Wilson, 2008). Whether a motive precedes a volunteer act or the act precedes a (statement of) motive cannot be determined with cross-sectional data. Longitudinal studies examining functional, social identity, and role-identity motives together will be needed. Finally, evidence that respondents took up visiting because they identified with a broader category of similar others was indirect. Future work should disentangle categorical-group from organizational-group identities to better understand social identity motives for starting versus continuing volunteerism.
Despite these limitations, exploring aspects of identity that prompt individuals to begin and sustain a specific service activity seems fruitful. Crucially, because social- and role-identity theories are generalizable to a wide range of group memberships and social roles, they may apply to the initiation and duration of many other volunteer activities beyond peer support–giving. Incorporating both types of identity-based motives in future studies may pinpoint new ways to recruit and retain persons who willingly supply needed community services.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The author received funds from the Department of Sociology, Indiana University, for conducting this research.
