SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment

  1. Rebecca Zimba
  2. Sarah Kulkarni
  3. Amanda Berry
  4. William You
  5. Chloe Mirzayi
  6. Drew Westmoreland
  7. Angela Parcesepe
  8. Levi Waldron
  9. Madhura Rane
  10. Shivani Kochhar
  11. McKaylee Robertson
  12. Andrew Maroko
  13. Christian Grov
  14. Denis Nash

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Abstract

Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission.

Objective

This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission.

Methods

We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in >5 days.

Results

Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test.

Conclusions

Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

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  1. ScreenIT

    SciScore for 10.1101/2020.09.15.20195180: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical review: The study was approved by the Institutional Review Board at the City University of New York Graduate School of Public Health.
    RandomizationThe combinations presented and the order of their presentation to each participant were randomized to reduce bias (see eMethods 1 in the Supplement).
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations of the study include the omission of other attributes which may influence testing preferences, such as frequency of testing, cost, facility wait times or distance. In addition, the majority of our participants had already completed at-home self-collection of a dried blood spot specimen for our study. Though the venue attribute had the lowest relative importance, this prior experience may have influenced their preferences for venue in the DCE. To the extent that it is possible to align public health strategies to deliver testing services with the preferences of those being targeted for testing, greater uptake and engagement may be achieved. Additional research is needed to increase SARS-CoV-2 testing uptake in ways that are aligned with the public health goals of the pandemic response, including preferences for engaging in public health interventions following a positive test, such as isolation and contact tracing.3

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.2196/25546
  3. Version published to 10.2196/preprints.25546
  4. Version published to 10.1101/2020.09.15.20195180v1 on medRxiv