Assessing How Consumers Interpret and Act on Results From At-Home COVID-19 Self-test Kits

Woloshin, Steven; Dewitt, Barry; Krishnamurti, Tamar; Fischhoff, Baruch

doi:10.1001/jamainternmed.2021.8075

Cited by 30 publications

(21 citation statements)

References 11 publications

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“…First, there is a significant need for educational campaigns to build lay user trust in the accuracy of at-home antigen tests and knowledge around when and how to use them, including how to act on test results [ 26 ]. Of the seven constructs that comprise acceptability, coherence and perceived effectiveness were most salient and determined whether participants ultimately felt it “was worth it” to test for COVID-19 daily.…”

Section: Discussionmentioning

confidence: 99%

A mixed methods study evaluating acceptability of a daily COVID-19 testing regimen with a mobile-app connected, at-home, rapid antigen test: Implications for current and future pandemics

et al. 2022

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Background Widespread use of at-home rapid COVID-19 antigen tests has been proposed as an important public health intervention to interrupt chains of transmission. Antigen tests may be preferred over PCR because they provide on-demand results for relatively low cost and can identify people when they are most likely to be infectious, particularly when used daily. Yet the extent to which a frequent antigen testing intervention will result in a positive public health impact for COVID-19 will depend on high acceptability and high adherence to such regimens. Methods We conducted a mixed-methods study assessing acceptability of and adherence to a daily at-home mobile-app connected rapid antigen testing regimen among employees of a US-based media company. Acceptability was assessed across seven domains of the Theoretical Framework of Acceptability. Results Among 31 study participants, acceptability of the daily testing intervention was generally high, with participants reporting high perceived effectiveness, intervention coherence, and self-efficacy; positive affective attitude; acceptable degree of burden and opportunity cost; and assessing the intervention as ethical. 71% reported a preference to test daily using an at-home antigen test than weekly employment-based PCR. Mean adherence to the 21-day testing regimen was 88% with 43% of participants achieving 100% adherence, 48% testing at least every other day, and 10% testing less than every other day. Conclusions Despite overall high acceptability and adherence, we identified three implementation challenges that must be addressed for frequent serial testing for COVID-19 to be implemented at scale and have a positive public health impact. First, users need guidance on how and when to adapt testing frequencies to different epidemiological conditions. Second, users and institutions need guidelines for how to safely store and share test results. Third, implementation of serial testing strategies must prioritize health equity and protect those most vulnerable to COVID-19.

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Section: Discussionmentioning

confidence: 99%

A mixed methods study evaluating acceptability of a daily COVID-19 testing regimen with a mobile-app connected, at-home, rapid antigen test: Implications for current and future pandemics

et al. 2022

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“…It can also be speculated that people who tested positive with a self-test and did not report it, were less compliant with the isolation requirement than those who were provider-tested. However, the results of the APB survey seem to indicate that people are well aware that they should isolate if the self-test is positive, as other research has also shown [27].…”

Section: Number Of Reported Positive Self-testsmentioning

confidence: 78%

Are SARS-CoV-2 self-tests used for their intended purpose? The experience in Belgium.

Lafort

Cornelissen

Cauteren

et al. 2022

Preprint

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Background Self-testing has been promoted as a means of increasing COVID-19 test coverage. In Belgium, self-testing was recommended as a complement to the formal, provider-administered indications, such as out of courtesy before meeting others and when feared to be infected. More than a year after the introduction of self-testing their place in the test strategy was evaluated. Methods We assessed trends in the number of self-tests sold, the number of positive self-tests reported, the proportion sold self-tests/total tests, and the proportion of all positive tests that were confirmed self-tests. To evaluate the reason why people use self-tests, we used the results of two online surveys among members of the general population: one among 27,397 people, held in April 2021, and one among 22,354 people, held in December 2021. Results The use of self-tests became substantial from end 2021 onwards. In the period mid-November 2021 – end-of-June 2022, the average proportion of reported sold self-tests to all COVID-19 tests was 37% and 14% of all positive tests were positive self-tests. In both surveys, the main reported reasons for using a self-test were having symptoms (34% of users in April 2021 and 31% in December 2021) and after a risk contact (27% in both April and December). Moreover, the number of self-tests sold, and the number of positive self-tests reported closely followed the same trend as the provider-administered tests in symptomatic people and high risk-contacts, which reinforces the hypothesis that they were mainly used for these two indications. Conclusions From end 2021 onwards, self-testing covered a significant part of COVID-19 testing in Belgium, which increased without doubt the testing coverage. However, the available data seem to indicate that self-testing was mostly used for indications outside of official recommendations. If and how this affected the control of the epidemic remains unknown.

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“…These results complement recent data on how consumers act on the results of at-home COVID-19 self-test kits. 14 …”

Section: Discussionmentioning

confidence: 99%

Adequacy of Serial Self-performed SARS-CoV-2 Rapid Antigen Detection Testing for Longitudinal Mass Screening in the Workplace

et al. 2022

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Key Points Question Can untrained persons correctly perform and interpret the results of SARS-CoV-2 rapid antigen detection tests (RADT), and can performance be optimized? Findings In this cross-sectional study of 278 participants self-performing SARS-CoV-2 RADT in an intended-use setting, the accuracy of RADT interpretation was poor when the manufacturer’s instructions were used. A modified quick reference guide was associated with significantly better user performance. Meaning These findings suggest that longitudinal mass RADT testing for SARS-CoV-2 could be accurately self-performed in an intended-use setting but there are potential interventions to optimize performance.

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Assessing How Consumers Interpret and Act on Results From At-Home COVID-19 Self-test Kits

Cited by 30 publications

References 11 publications

A mixed methods study evaluating acceptability of a daily COVID-19 testing regimen with a mobile-app connected, at-home, rapid antigen test: Implications for current and future pandemics

A mixed methods study evaluating acceptability of a daily COVID-19 testing regimen with a mobile-app connected, at-home, rapid antigen test: Implications for current and future pandemics

Are SARS-CoV-2 self-tests used for their intended purpose? The experience in Belgium.

Adequacy of Serial Self-performed SARS-CoV-2 Rapid Antigen Detection Testing for Longitudinal Mass Screening in the Workplace

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