Barriers to SARS-CoV-2 Testing among U.S. Employers in the COVID-19 Pandemic: A Qualitative Analysis Conducted January through April 2021

Abstract

During the first year of the COVID-19 pandemic, U.S. companies were seeking ways to support their employees to return to the workplace. Nonetheless, the development of strategies to support the access, use, and interpretation of SARS-CoV-2 testing was challenging. In the present study, we explore, from the perspective of owners and company leadership, the barriers to SARS-CoV-2 testing among U.S. companies. Key informant interviews with company representatives were conducted during January–April 2021 about SARS-CoV-2 testing. A pre-interview survey assessed respondent socio-demographic and organizational characteristics. Interview sessions were transcribed, coded, and analyzed using MaxQDA. A total of twenty interviews were completed with at least two interviews conducted in each major U.S. industry sector. Ninety percent of participants represented companies in business >10 years, comprising both small and large workforces. Using a grounded theory approach, six themes emerged: (1) access to and knowledge of SARS-CoV-2 tests; (2) strategies for symptomatic and asymptomatic testing of workers; (3) type/availability of personal protective equipment to mitigate coronavirus exposures; (4) return-to-work policies; (5) guidance and communication of SARS-CoV-2 Testing; and (6) use of contact tracing and SARS-CoV-2 vaccination. Various modifiable and non-modifiable challenges for SARS-CoV-2 testing among U.S. companies were identified and can inform work-related SARS-CoV-2 testing strategies.

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“…The Phase I qualitative study and thematic analysis for ETCH [18] described how employers were coping in general with the challenges presented by SARS-CoV-2 with a focus on testing. In our first analysis, we used grounded theory [37] to isolate key themes to capture this moment in time and isolate problems for further study in a larger scale quantitative survey.…”

“…The parent study [18] consisted of a mixed-methods sequential design to identify facilitators and barriers for SARS-CoV-2 testing among U.S. businesses. In phase one of the study, semi-structured interviews were completed with 20 individual employers to explore how diverse worksites were managing their response to COVID-19, with an emphasis on testing and screening measures.…”

“…Participants were instructed to leave their name blank when they logged onto the platform and to not transmit their video image to provide privacy and confidentiality in the study. Project team members followed a semi-structured interview script [18], with most interviews running under 30 min. The generated transcripts were reviewed by the team member conducting the interview, and transcription errors were corrected before forwarding to other team members for thematic coding.…”

“…Respondents were identified by occupations within NORA sectors (e.g., Healthcare, Retail, Mining, Education, Manufacturing). These 12 matrices and a template for further analyses were shared with the ETCH research team to complete the parent study [18].…”

“…The transcripts from these interviews have been analyzed twice. The first analysis [18] used thematic coding based on responses to the questions asked. As a co-author on that study, this paper's first author noted that the interview transcripts provided rich details about employer experiences with COVID-19 testing and their perceptions of products, processes, costs, and benefits.…”