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BackgroundThe Internet enables an unprecedented opportunity to access a broad range of self-tests (e.g. testing for HIV, cancer, hepatitis B/C), which can be conducted by lay consumers without the help of a health professional. However, there is only little knowledge about the determinants of the use of self-tests. Thus, the aims of this study were (1) to experimentally investigate the impact of situational and application-related characteristics on the intention to use a self-test (ST), compared to being tested by a health professional at home (HPH) or at a doctor’s office (HPD), (2) to examine the applicability of social-cognitive health behaviour theories on self-testing, and (3) to explore the advantages of integrating technological affinity into social-cognitive health behaviour models to predict self-testing.MethodsIn a factorial survey, 1248 vignettes were rated by 208 students. The core concepts of social-cognitive health behaviour theories, technological affinity, and different situational and application-related characteristics were investigated.ResultsIntention to ST was only predicted by the medical expertise of the tested person, while HPH and HPD were also associated with the application purpose of the test and the presence of an emotionally supporting person. Perceived severity and outcome-expectancy significantly predicted intention to self-test. Technological enthusiastic people had a higher intention to use a self-test.ConclusionsIntention to ST, HPH and HPD were predicted by different situational and application-related characteristics. Social-cognitive health behaviour theories can be applied to predict self-testing and do not need to be extended by technological affinity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2394-x) contains supplementary material, which is available to authorized users.

IntroductionA broad range of self-tests (testing for e.g. HIV, cancer, hepatitis B/C) have become available and can be conducted by lay consumers without the help of a health professional. The aims of this study were to (a) investigate the prevalence of self-testing, (b) identify the most frequently used self-tests, and (c) explore the associations between socio-demographic, health-related and individual factors with self-testing.MethodsA face-to-face plus paper-pencil cross-sectional survey was conducted. The sample consisted of 2.527 respondents who were representative of the German population in terms of the age, sex, and residence. Basic descriptive statistics and univariate logistic regression analyses were performed.Results8.5% of the participants reported having used one or more self-tests in the past, totalling 363 self-tests, with a mean of 1.7 (min. = 1, max. = 6). The three self-tests most frequently indicated were for detecting diabetes, bowel cancer, and allergies. Self-testers were older (Nagelkerke R2 = .006, p < .01), had a higher BMI (Nagelkerke R2 = .013, p < .001) and displayed more physical and mental fatigue (Nagelkerke R2 = .031, p < .001) than non-testers. Self-testers also reported higher global life satisfaction values (Nagelkerke R2 = .008, p < .01) and a higher educational level (Nagelkerke R2 = .015, p < .01).ConclusionsSelf-testing is fairly prevalent in Germany Given the current shortage of physicians in Germany, especially in rural areas, and recent studies on the use of self-medication, the topic of self-testing has a great practical and socio-political relevance. Future studies should investigate further predictors of self-testing (e.g. contextual, situational and individual factors) as well as the emotional consequences of testing as a layperson without the attendance of a health professional.

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