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BMC Public Health
Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | COVID-19 | Research

Perceptions of COVID-19 self-testing and recommendations for implementation and scale-up among Black/African Americans: implications for the COVID-19 STEP project

Authors: Ucheoma Nwaozuru, Chisom Obiezu-Umeh, Hassim Diallo, Danielle Graham, Guy-Lucien Whembolua, Marie Janeeca Bourgeau, Tiarney D. Ritchwood, LaRon E. Nelson, Thembekile Shato, Allison Mathews, Rhoda Moise, Maranda C. Ward, Jocelyn Raude, Aima A. Ahonkhai, Diane J. Young, Donaldson F. Conserve

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

COVID-19 self-testing (ST) is an innovative strategy with the potential to increase the access and uptake of testing and ultimately to limit the spread of the virus. To maximize the uptake and reach of this promising strategy and inform intervention development and scale up, research is needed to understand the acceptability of and willingness to use this tool. This is vital to ensure that Black/African Americans are reached by the Biden-Harris Administration’s free national COVID-19 ST program. This study aimed to explore the acceptability and recommendations to promote and scale-up the uptake of COVID-19 ST among Black/African Americans.

Methods

We conducted a cross-sectional qualitative study using a semi-structured questionnaire to assess barriers and facilitators to the uptake of COVID-19 ST among a convenience sample of 28 self-identified Black/African Americans from schools, community centers, and faith-based institutions in Ohio and Maryland. Inductive content analysis was conducted to identify categories and subcategories related to acceptability and recommendations for implementing and scaling up COVID-19 ST in communities.

Results

Participants perceived COVID-19 self-testing as an acceptable tool that is beneficial to prevent transmission and address some of the barriers associated with health facility testing, such as transportation cost and human contact at the health facility. However, concerns were raised regarding the accurate use of the kits and costs. Recommendations for implementing and scaling up COVID-19 ST included engagement of community stakeholders to disseminate information about COVID-19 self-testing and creating culturally appropriate education tools to promote knowledge of and clear instructions about how to properly use COVID-19 ST kits. Based on these recommendations, the COVID-19 STEP (Self-Testing Education and Promotion) Project is being developed and will involve engaging community partners such as barbers, church leaders, and other community-based organizations to increase the uptake and use of free COVID-19 ST kits among Black/African Americans.

Conclusion

Findings showed that most participants considered COVID-19 ST valuable for encouraging COVID-19 testing. However, cost and accuracy concerns may pose barriers. Future work should consider implementing interventions that leverage the benefits of COVID-19 ST and further assess the extent to which these identified facilitators and barriers may influence COVID-19 ST uptake.
Literature
1.
2.
Li L, Shim T, Zapanta PE. Optimization of COVID-19 testing accuracy with nasal anatomy education. Am J Otolaryngol. 2021;42(1):102777.PubMedCrossRef
3.
4.
Diesel J, Sterrett N, Dasgupta S, Kriss JL, Barry V, Esschert KV, et al. Covid-19 vaccination coverage among adults—United States, December 14, 2020–May 22, 2021. Morb Mortal Wkly Rep. 2021;70(25):922.CrossRef
5.
6.
Lee I, Wang C, Lin M, Kung C, Lan K, Lee C. Effective strategies to prevent coronavirus disease-2019 (COVID-19) outbreak in hospital. J Hosp Infect. 2020;105(1):102.PubMedPubMedCentralCrossRef
7.
Bevan I, Stage Baxter M, Stagg HR, Street A. Knowledge, attitudes, and behavior related to COVID-19 testing: a rapid scoping review. Diagnostics. 2021;11(9):1685.PubMedPubMedCentralCrossRef
8.
Evrin T, Szarpak L, Pruc M. Self-testing as a method of reducing COVID-19 infections. Disaster Emerg Med J. 2021;6:94–5.CrossRef
9.
Mina MJ, Parker R, Larremore DB. Rethinking Covid-19 test sensitivity—a strategy for containment. N Engl J Med. 2020;383(22):e120.PubMedCrossRef
10.
Nundy S, Patel KK. Self-service diagnosis of COVID-19—ready for prime time? In: JAMA health forum: 2020: American Medical Association; 2020;1(3):e200333. American Medical Association.
11.
12.
Jean S, Burnham CA, Chapin K, Garner OB, Pant Pai N, Turabelidze G, et al. At-home testing for infectious diseases: the laboratory where you live. Clin Chem. 2022;68(1):19–26.CrossRef
13.
Goggolidou P, Hodges-Mameletzis I, Purewal S, Karakoula A, Warr T. Self-testing as an invaluable tool in fighting the COVID-19 pandemic. J Prim Care Community Health. 2021;12:21501327211047782.PubMedPubMedCentralCrossRef
14.
Jaklevic MC. Surgeon fills COVID-19 testing gap in Philadelphia’s black neighborhoods. JAMA. 2021;325(1):14–6.PubMedCrossRef
15.
DeRoo SS, Torres RG, Ben-Maimon S, Jiggetts J, Fu LY. Attitudes about COVID-19 testing among black adults in the United States. Ethn Dis. 2021;31(4):519–26.CrossRef
16.
Abedi V, Olulana O, Avula V, Chaudhary D, Khan A, Shahjouei S, et al. Racial, economic, and health inequality and COVID-19 infection in the United States. J Racial Ethn Health Disparities. 2021;8(3):732–42.PubMedCrossRef
17.
Poteat T, Millett GA, Nelson LE, Beyrer C. Understanding COVID-19 risks and vulnerabilities among black communities in America: the lethal force of syndemics. Ann Epidemiol. 2020;47:1–3.PubMedPubMedCentralCrossRef
18.
19.
McFadden SM, Demeke J, Dada D, Wilton L, Wang M, Vlahov D, Nelson LE. Confidence and hesitancy during the early roll-out of COVID-19 vaccines among black, hispanic, and undocumented immigrant communities: A review. Journal of Urban Health. 2021;23:1–2.
20.
Verma R, Yabe T, Ukkusuri SV. Spatiotemporal contact density explains the disparity of COVID-19 spread in urban neighborhoods. Sci Rep. 2021;11(1):1–11.CrossRef
21.
Rogers TN, Rogers CR, VanSant-Webb E, Gu LY, Yan B, Qeadan F. Racial disparities in COVID-19 mortality among essential workers in the United States. World Med Health Policy. 2020;12(3):311–27.CrossRef
22.
Egede LE, Walker RJ. Structural racism, social risk factors, and Covid-19—a dangerous convergence for black Americans. N Engl J Med. 2020;383(12):e77.PubMedPubMedCentralCrossRef
23.
Kirksey L, Tucker DL, Taylor E Jr, Solaru KTW, Modlin CS Jr. Pandemic superimposed on epidemic: Covid-19 disparities in black Americans. J Natl Med Assoc. 2021;113(1):39–42.PubMed
24.
Best AL, Fletcher FE, Kadono M, Warren RC. Institutional distrust among African Americans and building trustworthiness in the COVID-19 response: implications for ethical public health practice. J Health Care Poor Underserved. 2021;32(1):90.PubMedPubMedCentralCrossRef
25.
26.
27.
Ciccone EJ, Conserve DF, Dave G, Hornik CP, Kuhn ML, Herling JL, et al. At-home testing to mitigate community transmission of SARS-CoV-2: protocol for a public health intervention with a nested prospective cohort study. BMC Public Health. 2021;21(1):1–15.CrossRef
28.
Petty NJ, Thomson OP, Stew G. Ready for a paradigm shift? Part 2: introducing qualitative research methodologies and methods. Man Ther. 2012;17(5):378–84.PubMedCrossRef
29.
Conserve DF, Mathews A, Choko AT, Nelson LE. Preparing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) self-testing implementation: lessons learned from HIV self-testing. Front Med. 2020;7:599521.CrossRef
30.
Bien-Gund C, Dugosh K, Acri T, Brady K, Thirumurthy H, Fishman J, et al. Factors associated with US public motivation to use and distribute COVID-19 self-tests. JAMA Netw Open. 2021;4(1):e2034001.PubMedPubMedCentralCrossRef
31.
Weller SC, Vickers B, Bernard HR, Blackburn AM, Borgatti S, Gravlee CC, et al. Open-ended interview questions and saturation. PLoS One. 2018;13(6):e0198606.PubMedPubMedCentralCrossRef
32.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.PubMedCrossRef
33.
Kyngäs H. Inductive content analysis. In: The application of content analysis in nursing science research. Cham: Springer; 2020. p. 13–21.CrossRef
34.
Fereday J, Muir-Cochrane E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int J Qual Methods. 2006;5(1):80–92.CrossRef
35.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.PubMedCrossRef
36.
Hall EW, Luisi N, Zlotorzynska M, Wilde G, Sullivan P, Sanchez T, et al. Willingness to use home collection methods to provide specimens for SARS-CoV-2/COVID-19 research: survey study. J Med Internet Res. 2020;22(9):e19471.PubMedPubMedCentralCrossRef
37.
Valentine-Graves M, Hall E, Guest JL, Adam E, Valencia R, Shinn K, et al. 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. PLoS One. 2020;15(8):e0236775.PubMedPubMedCentralCrossRef
38.
Brümmer LE, Katzenschlager S, Gaeddert M, Erdmann C, Schmitz S, Bota M, Grilli M, Larmann J, Weigand MA, Pollock NR, Macé A. Accuracy of novel antigen rapid diagnostics for SARS-CoV-2: A living systematic review and meta-analysis. PLoS medicine. 2021;18(8):e1003735.
39.
Echavarria M, Reyes NS, Rodriguez PE, Ypas M, Ricarte C, Rodriguez MP, et al. Self-collected saliva for SARS-CoV-2 detection: a prospective study in the emergency room. J Med Virol. 2021;93(5):3268–72.PubMedCrossRef
40.
Seitz T, Schindler S, Winkelmeyer P, Zach B, Wenisch C, Zoufaly A, et al. Evaluation of rapid antigen tests based on saliva for the detection of SARS-CoV-2. J Med Virol. 2021;93(7):4161–2.PubMedPubMedCentralCrossRef
41.
Njau B, Covin C, Lisasi E, Damian D, Mushi D, Boulle A, et al. A systematic review of qualitative evidence on factors enabling and deterring uptake of HIV self-testing in Africa. BMC Public Health. 2019;19(1):1–16.CrossRef
42.
Mathews A, Farley S, Conserve DF, Knight K, Le’ Marus A, Blumberg M, et al. “Meet people where they are”: a qualitative study of community barriers and facilitators to HIV testing and HIV self-testing among African Americans in urban and rural areas in North Carolina. BMC Public Health. 2020;20(1):1–10.CrossRef
43.
Steehler K, Siegler AJ. Bringing HIV self-testing to scale in the United States: a review of challenges, potential solutions, and future opportunities. J Clin Microbiol. 2019;57(11):e00257–19.PubMedPubMedCentralCrossRef
44.
Catania J, Dolcini M, Dowhower D, Harper G, Teixeria N, Dolcini-Catania L. Dissemination of at home HIV testing to high-risk urban African American youth: barriers and solutions. In: Boston: American Public Health Association Annual Meeting: 2013; 2013.
45.
Snowden LR, Graaf G. COVID-19, social determinants past, present, and future, and African Americans’ health. J Racial Ethn Health Disparities. 2021;8(1):12–20.PubMedCrossRef
46.
Peek ME, Simons RA, Parker WF, Ansell DA, Rogers SO, Edmonds BT. COVID-19 among African Americans: an action plan for mitigating disparities. Am J Public Health. 2021;111(2):286–92.PubMedPubMedCentralCrossRef
47.
48.
Evans W, Harrington C, Patchen L, Andrews V, Gaminian A, Ellis L, et al. Design of a novel digital intervention to promote healthy weight management among postpartum African American women. Contemp Clin Trials Commun. 2019;16:100460.PubMedPubMedCentralCrossRef
49.
Henry Akintobi T, Jacobs T, Sabbs D, Holden K, Braithwaite R, Johnson LN, et al. Community engagement of African Americans in the era of COVID-19: considerations, challenges, implications, and recommendations for public health. Prev Chronic Dis. 2020;17:E83.PubMedPubMedCentralCrossRef
50.
Wehrhahn MC, Robson J, Brown S, Bursle E, Byrne S, New D, et al. Self-collection: an appropriate alternative during the SARS-CoV-2 pandemic. J Clin Virol. 2020;128:104417.PubMedPubMedCentralCrossRef
51.
Altamirano J, Govindarajan P, Blomkalns AL, Kushner LE, Stevens BA, Pinsky BA, et al. Assessment of sensitivity and specificity of patient-collected lower nasal specimens for severe acute respiratory syndrome coronavirus 2 testing. JAMA Netw Open. 2020;3(6):e2012005.PubMedPubMedCentralCrossRef
52.
Fu LY, Haimowitz R, Thompson D. Community members trusted by African American parents for vaccine advice. Hum Vaccin Immunother. 2019;15(7-8):1715–22.PubMedPubMedCentralCrossRef
53.
Weekes CV. African Americans and health literacy: a systematic review. ABNF J. 2012;23(4):76–80.PubMed
54.
Muvuka B, Combs RM, Ayangeakaa SD, Ali NM, Wendel ML, Jackson T. Health literacy in African-American communities: barriers and strategies. Health Lit Res Pract. 2020;4(3):e138–43.PubMedPubMedCentral
55.
Baker JL, Brawner B, Cederbaum JA, White S, Davis ZM, Brawner W, et al. Barbershops as venues to assess and intervene in HIV/STI risk among young, heterosexual African American men. Am J Mens Health. 2012;6(5):368–82.PubMedCrossRef
56.
Berkley-Patton J, Thompson CB, Moore E, Hawes S, Simon S, Goggin K, et al. An HIV testing intervention in African American churches: pilot study findings. Ann Behav Med. 2016;50(3):480–5.PubMedCrossRef
57.
Wilson TE, Gousse Y, Joseph MA, Browne RC, Camilien B, McFarlane D, et al. HIV prevention for black heterosexual men: the barbershop talk with brothers cluster randomized trial. Am J Public Health. 2019;109(8):1131–7.PubMedPubMedCentralCrossRef
58.
Pillay Y. The role of the black church, the barbershop/beauty salon, and digital communication to support African American persons living with HIV/AIDS. J Creat Ment Health. 2011;6(4):340–50.CrossRef
59.
Wolfe R, Harknett K, Schneider D. Inequalities at work and the toll of COVID-19. Health Affairs Health Policy Brief. 2021;4.
Metadata
Title
Perceptions of COVID-19 self-testing and recommendations for implementation and scale-up among Black/African Americans: implications for the COVID-19 STEP project
Authors
Ucheoma Nwaozuru
Chisom Obiezu-Umeh
Hassim Diallo
Danielle Graham
Guy-Lucien Whembolua
Marie Janeeca Bourgeau
Tiarney D. Ritchwood
LaRon E. Nelson
Thembekile Shato
Allison Mathews
Rhoda Moise
Maranda C. Ward
Jocelyn Raude
Aima A. Ahonkhai
Diane J. Young
Donaldson F. Conserve
Publication date
01-12-2022
Publisher
BioMed Central
Keywords
COVID-19
COVID-19
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-13619-6

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