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Willingness to seek laboratory testing for SARS-CoV-2 with home, drive-through, and clinic-based specimen collection locations

Our take —

An online survey published as a preprint and thus not yet peer-reviewed, found that US adults expressed a high willingness to test for COVID-19 at home, at drive-through test sites, and at clinics if they developed illness symptoms, with a majority expressing preference for home-based testing. Additional evidence is needed to corroborate expressed testing preferences with actual testing uptake among symptomatic adults in the US.

Study design

Cross-Sectional

Study population and setting

The study included 1,435 adults 18 years and older in the United States who were recruited via social media advertisements between March 27 and April 1, 2020 and who completed an online survey measuring willingness to complete four different modalities of COVID-19 testing: home-based saliva, home-based swab, drive-through, and clinic-based. Testing willingness was compared across participant socio-demographic characteristics, levels of COVID-19 disease knowledge, and self-reported COVID-19 symptoms.

Summary of Main Findings

Respondents indicated the highest degree of willingness to test for COVID-19 with home-based testing, with 92% of participants endorsing (agreeing or strongly agreeing) willingness to test with home-based saliva tests and 88% with throat swabs. Fewer expressed interest in COVID-19 testing through drive-through (71%) and clinic-based (60%) specimen collection. All differences in mean willingness scores between modalities were statistically significant (p<0.001). Two-thirds (68%) expressed more willingness to test for COVID-19 if home-based testing were available. No differences in testing willingness or testing modality preferences were observed across socio-demographic categories, levels of COVID-19 knowledge, or self-reported COVID-19 symptoms.

Study Strengths

The study disaggregated results by different factors of interest (e.g., demographics, COVID-19 knowledge) and testing objectives (i.e., diagnosis or follow-up care).

Limitations

Given the survey’s online recruitment and implementation, individuals who willingly participated in the survey could be substantially different from non-participating individuals, suggesting the study is susceptible to selection bias. Study inclusion criteria were adjusted on the final day of survey recruitment to exclude non-Hispanic White individuals, resulting in 1,123 exclusions, indicating authors were concerned about a non-representative sample. Lastly, expressed testing preferences may not align with actual testing behavior if testing modalities were made widely available for symptomatic individuals.

Value added

This is among the first studies to describe and compare COVID-19 testing preferences and willingness to seek COVID-19 testing in a large online sample of US adults.