Willingness to Seek Diagnostic Testing for SARS-CoV-2 With Home, Drive-through, and Clinic-Based Specimen Collection Locations

Abstract

Background SARS-CoV-2 virus testing for persons with COVID-19 symptoms, and contact tracing for those testing positive, will be critical to successful epidemic control. Willingness of persons experiencing symptoms to seek testing may determine the success of this strategy. Methods A cross-sectional online survey in the United States measured willingness to seek testing if feeling ill under different specimen collection scenarios: home-based saliva, home-based swab, drive-through facility swab, and clinic-based swab. Instructions clarified that home-collected specimens would be mailed to a laboratory for testing. We presented similar willingness questions regarding testing during follow-up care. Results Of 1435 participants, comprising a broad range of sociodemographic groups, 92% were willing to test with a home saliva specimen, 88% with home swab, 71% with drive-through swab, and 60% with clinic-collected swab. Moreover, 68% indicated they would be more likely to get tested if there was a home testing option. There were no significant differences in willingness items across sociodemographic variables or for those currently experiencing COVID-19 symptoms. Results were nearly identical for willingness to receive testing for follow-up COVID-19 care. Conclusions We observed a hierarchy of willingness to test for SARS-CoV-2, ordered by the degree of contact required. Home specimen collection options could result in up to one-third more symptomatic persons seeking testing, facilitating contact tracing and optimal clinical care. Remote specimen collection options may ease supply chain challenges and decrease the likelihood of nosocomial transmission. As home specimen collection options receive regulatory approval, they should be scaled rapidly by health systems.

At-home self-collection of saliva, oropharyngeal swabs and dried blood spots for SARS-CoV-2 diagnosis and serology: Post-collection acceptability of specimen collection process and patient confidence in specimens

“…[18] Further, respondents in the same online study reported high willingness to use home-collection kits to receive COVID-19-related testing for their clinical care (92% reported willingness to use self-collection of saliva and 88% reported willingness to selfcollect a throat swab for clinical care). [12] Willingness to use saliva collection and throat swabs for clinical care in that study did not differ by age groups, race/ethnicity, COVID-19 stigma score, COVID-19 knowledge score, or COVID-19 symptomatology. The consistency in the hypothetical willingness to use these methods for research or clinical care, and the acceptability of their use after using the kits, is notable.…”

“…The United States is in dire need of options to increase screening for SARS-CoV-2 infection and immune experience, and survey data suggest that people might be more willing to collect specimens at home for research and clinical purposes than to travel into labs or clinics to provide specimens. [12,18] At-home self-collection offers possibilities to reduce the exposure of people in need of screening to others by not requiring travel to test; to reduce the need for PPE for invasive screening tests; to offer options for screening of populations without symptoms who might be unwilling to travel to a clinic for testing. Next steps in this development process include modification to kit instructions and assembly, addition of instructions for shipping, development of video instructions (emphasizing areas of lack of clarity or participant concern), and reassessment of kit usability and performance with another group of participants observed by a telehealth clinician in an intended use environment (e.g., home collection).…”

“…There are a number of barriers to expanding testing [9]. Since the beginning of the epidemic, barriers have included supply chain constraints for rigid swabs [10], shortages of personal protective equipment needed for healthcare workers collecting invasive specimens [11], limited transport media for swab-based specimens, and limited laboratory reagents for testing specimens [6].Further, there is limited willingness of people to travel into a laboratory or clinic to be tested for SARS-CoV-2 infection [12].Responding to these challenges calls for the development of alternative specimen collection processes that produce high-quality specimens, are acceptable to a broad segment of the population for screening purposes (i.e., not only for diagnostic testing of those suspected of having COVID-19), and minimize the need for personal protective equipment (PPE) for collection.…”

Evaluation of a novel community-based COVID-19 ‘Test-to-Care’ model for low-income populations

“…Furthermore, although all participants and their close contacts were provided information regarding free COVID-19 testing sites, further data is needed to assess the uptake of testing among household contacts. Moreover, interventions to expand low-barrier, community-based COVID-19 testing including self-test kits, mobile testing, or providing direct support to access existing services [6,40] coupled with surveillance systems to monitor and ensure testing uptake among all household and other close non-household contacts, are needed [9,11,12,17].…”

Willingness of Nigerian residents to disclose COVID-19 symptoms and take COVID-19 test

“…2 Having highlighted the importance of self-surveillance and testing, success of these strategies will however be dependent on people's willingness to disclose COVID-19 symptoms and willingness to take the COVID-19 test which are also dependent on several factors such as people's perception of COVID-19 and their acceptability of COVID-19 testing. 3 Fear of the unknown about COVID-19 is another factor that can determine the success of the strategies. With progress of the coronavirus pandemic in Nigeria, false and misleading claims in the media have continued to spread more than the disease itself.…”