Knowledge, Attitudes, and Behavior Related to COVID-19 Testing: A Rapid Scoping Review

Abstract

Testing programs for COVID-19 depend on the voluntary actions of members of the public for their success. Understanding people’s knowledge, attitudes, and behavior related to COVID-19 testing is, therefore, key to the design of effective testing programs worldwide. This paper reports on the findings of a rapid scoping review to map the extent, characteristics, and scope of social science research on COVID-19 testing and identifies key themes from the literature. Main findings include the discoveries that people are largely accepting of testing technologies and guidelines and that a sense of social solidarity is a key motivator of testing uptake. The main barriers to accessing and undertaking testing include uncertainty about eligibility and how to access tests, difficulty interpreting symptoms, logistical issues including transport to and from test sites and the discomfort of sample extraction, and concerns about the consequences of a positive result. The review found that existing research was limited in depth and scope. More research employing longitudinal and qualitative methods based in under-resourced settings and examining intersections between testing and experiences of social, political, and economic vulnerability is needed. Last, the findings of this review suggest that testing should be understood as a social process that is inseparable from processes of contact tracing and isolation and is embedded in people’s everyday routines, livelihoods and relationships.

Addressing COVID-19 Testing Inequities Among Underserved Populations in Massachusetts: A Rapid Qualitative Exploration of Health Center Staff, Partner, and Resident Perceptions

“…This qualitative study moves beyond individual perceptions of COVID-19 testing and underscores the substantial impact of upstream, structural disparities on the individual level experience of COVID-19, from infection to morbidity to mortality as well as on access to information and resources and uptake of preventive behaviors such as mask wearing and social distancing ( 19 , 34 ). While we found that stakeholders expressed barriers and facilitators to testing at each level of the Social Ecological Model—individual, interpersonal, organization, community, and societal—the solutions for addressing these influences depend on institutional and governmental changes ( 32 ).…”

“…The structural barriers identified, such as inadequate safety net policies for workers, immigration policies, and transportation, have lasting and multiplicative impacts at the individual level and may serve as launch points for next steps and future translational research. While prior studies have explored barriers and facilitators to COVID-19 testing among the general population or among one specific sub-population ( 18 , 19 , 36 , 37 ), our study drew on a diverse array of perspectives to understand barriers and facilitators specific to several underserved populations (e.g., individuals experiencing homelessness, immigrant populations, individuals living in multigenerational households). This data better informed how CHCs and community partners could apply targeted approaches most relevant to specific populations disproportionally impacted by COVID-19.…”

“…Prior studies have explored residents' perceived barriers to both coping with COVID-19 and COVID-19 testing. Barriers to testing identified include lack of access to testing, confusion about testing guidelines and eligibility, social stigma and concerns about the consequences of testing positive, cost of testing, logistics including transportation to testing sites, and fear and mistrust ( 18 , 19 ). In order to address these barriers, public health and healthcare institutions have partnered with community-based organizations (e.g., churches, schools) and community health centers to increase COVID-19 testing and COVID-19 communications in under-resourced communities ( 20 – 23 ).…”

Maternity services' responses to the COVID-19 pandemic: how Public Health England guidance was implemented in practice

“…The barriers identified in this research included patient choice and the unpredictable nature of maternity admissions. Elsewhere, the general population has commented on reasons for declining testing include that sample extraction is unpleasant, fear of the consequences of a positive result and test results taking too long [ 13 ], [ 14 ]. Our research found that only 27% of respondents’ hospitals test birth partners.…”

Introduction: Diagnostics, Medical Testing, and Value in Medical Anthropology

“…In fact, the ubiquity of testing in high-income countries afflicted by high case rates only makes the scarcity of testing systems in many low-and middle-income countries starker (Kelley et al 2020;Munharo et al 2020). Such testing disparities are also reflected in the distribution of social research into COVID-19 testing, with the vast majority of studies on the topic focusing on highincome countries in the Global North (Bevan et al 2021). Moreover, the fact that COVID-19 has brought the ethics and politics of medical testing to public attention does not mean medical testing was not already 'everywhere' before-only that, perhaps, it had less public visibility as a social, political, economic, and ethical 'problem'.…”