If you build it, will they come? Social, economic, and psychological determinants of COVID-19 testing decisions

Abstract

Background The efficacy of testing and tracing programs to reduce COVID-19 transmission hinges not only on widespread access to testing, but also on the public’s willingness to participate in them. To the extent that testing intentions are patterned by social determinants of health, this constitutes an understudied mechanism of disparities in COVID-19 morbidity and mortality. Design Using data from a representative household probability sample, the Person to Person Health Interview Study (n = 935), sociodemographic, economic, and psychological determinants of testing considerations were evaluated across six domains: treatment affordability, ability to work if positive, hospital effectiveness, symptom severity, proximity to infected, and risk of transmitting to others. Results Findings demonstrated significant differences in testing motivations across race/ethnicity, education level, socioeconomic status, and worry about self and loved ones. Notably, Black (p<0.01) and Latino (p<0.05) respondents and those experiencing financial strain (p<0.001) were disproportionately likely to indicate that resource factors would influence their decision to get tested. Desire to reduce transmission and concern about proximity to the infected were reported among those who expressed COVID-19 worries (p<0.001). Conclusion Public health efforts to combat the COVID-19 pandemic must address social, economic, and psychological factors that enable and constrain individual behavior. Increasing access to preventative interventions and technologies, including vaccines, is unlikely to markedly reduce morbidity and mortality without effective messaging and economic support to improve uptake in vulnerable populations.

Intolerance of uncertainty predicts fear of healthcare settings but not desire for testing during the novel coronavirus pandemic

“…Instead, the significant predictors of desire for testing included perceiving the virus as dangerous to one’s own personal health (Fig. 2 A), which had the largest effect size (Table 3 ), and is consistent with other research [ 19 ]. Fear of leaving the home, perceived access to testing, and reporting having symptoms that could be due to COVID-19, were also significant predictors (Fig.…”

“…From a public health standpoint, testing is critical for identifying locations where a virus is more widespread, and for contact tracing, to slow transmission. It has also been proposed as a way to balance public health and economic concerns (e.g., as a way to participate in large social gatherings or other activities) [ 19 ]. However, relatively few studies have examined what factors influence people’s willingness to be tested for COVID-19 [ 19 – 21 ].…”

“…It has also been proposed as a way to balance public health and economic concerns (e.g., as a way to participate in large social gatherings or other activities) [ 19 ]. However, relatively few studies have examined what factors influence people’s willingness to be tested for COVID-19 [ 19 – 21 ]. They include demographic factors, such as race and ethnicity, socioeconomic status, and education, as well as concern about the virus, the desire to avoid infecting others, and the perceived costs of getting tested, such as having to quarantine and miss work if the test is positive [ 19 ].…”

“…However, relatively few studies have examined what factors influence people’s willingness to be tested for COVID-19 [ 19 – 21 ]. They include demographic factors, such as race and ethnicity, socioeconomic status, and education, as well as concern about the virus, the desire to avoid infecting others, and the perceived costs of getting tested, such as having to quarantine and miss work if the test is positive [ 19 ]. A main goal of our study was to extend this research by examining whether IU is also related to the desire or willingness to get tested.…”

How Did Federal Aid to States and Localities Affect Testing and Vaccine Delivery?

“…Historic experiences in the African-American and Hispanic communities with the US healthcare system have led to high levels of distrust in the government, the medical profession, and vaccines (Alsan and Wanamaker, 2018;Balasuriya et al, 2021). Perry et al (2021) find that Black and Hispanic individuals are also more concerned with resource constraints when deciding to take a COVID-19 test. 3 However, there is some evidence that interventions can mitigate vaccine hesitancy and increase take-up by delivering information through individuals of similar socioeconomic backgrounds to the target population and by establishing state outreach efforts and clinics in hesitant communities (Alsan and Eichmeyer, 2021;Gonzales, et al, 2021).…”