Willingness to Use Home Collection Methods to Provide Specimens for SARS-CoV-2/COVID-19 Research: Survey Study

Abstract

Background Innovative laboratory testing approaches for SARS-CoV-2 infection and immune response are needed to conduct research to establish estimates of prevalence and incidence. Self-specimen collection methods have been successfully used in HIV and sexually transmitted infection research and can provide a feasible opportunity to scale up SARS-CoV-2 testing for research purposes. Objective The aim of this study was to assess the willingness of adults to use different specimen collection modalities for themselves and children as part of a COVID-19 research study. Methods Between March 27 and April 1, 2020, we recruited 1435 adults aged 18 years or older though social media advertisements. Participants completed a survey that included 5-point Likert scale items stating how willing they were to use the following specimen collection testing modalities as part of a research study: home collection of a saliva sample, home collection of a throat swab, home finger-prick blood collection, drive-through site throat swab, clinic throat swab, and clinic blood collection. Additionally, participants indicated how the availability of home-based collection methods would impact their willingness to participate compared to drive-through and clinic-based specimen collection. We used Kruskal-Wallis tests and Spearman rank correlations to assess if willingness to use each testing modality differed by demographic variables and characteristics of interest. We compared the overall willingness to use each testing modality and estimated effect sizes with Cohen d. Results We analyzed responses from 1435 participants with a median age of 40.0 (SD=18.2) years and over half of which were female (761/1435, 53.0%). Most participants agreed or strongly agreed that they would be willing to use specimens self-collected at home to participate in research, including willingness to collect a saliva sample (1259/1435, 87.7%) or a throat swab (1191/1435, 83.1%). Willingness to collect a throat swab sample was lower in both a drive-through setting (64%) and clinic setting (53%). Overall, 69.0% (990/1435) of participants said they would be more likely to participate in a research study if they could provide a saliva sample or throat swab at home compared to going to a drive-through site; only 4.4% (63/1435) of participants said they would be less likely to participate using self-collected samples. For each specimen collection modality, willingness to collect specimens from children for research was lower than willingness to use on oneself, but the ranked order of modalities was similar. Conclusions Most participants were willing to participate in a COVID-19 research study that involves laboratory testing; however, there was a strong preference for home specimen collection procedures over drive-through or clinic-based testing. To increase participation and minimize bias, epidemiologic research studies of SARS-CoV-2 infection and immune response should consider home specimen collection methods.

Performance of at-home self-collected saliva and nasal-oropharyngeal swabs in the surveillance of COVID-19

“…Nevertheless, biological specimen collection is an important logistic challenge to provide massive testing [ 1–3 ]. The possibility to use self-collected samples for COVID-19 testing offers several advantages, especially to minimize the risk of exposing health-care workers to the virus, since self-collection does not require direct involvement of trained personnel in the sample collection [ 4 , 5 ]. Recently, publications have been shown a similar sensitivity between saliva samples and nasal swabs collected by health-care workers and those collected by a patient for COVID-19 molecular diagnosis, thus providing an important background for the choice of this strategy for surveillance of COVID-19 [ 6–8 ].…”

“…In a pandemic scenario, at-home self-collection of samples plays a key role in the surveillance and control of the infection by allowing the patient with clinical suspicion of COVID19 to have access to proper healthcare and quick isolation of the confirmed cases [ 4 , 5 ]. Recently published studies show that 80–85% of individuals infected with SARS-CoV-2 have few or no symptoms, while 15–20% develop more severe disease, often associated with advanced age or other co-morbidities [ 15 ].…”

Performance of At-Home Self-Collected Saliva and Nasal-Oropharyngeal Swabs in the Surveillance of COVID-19

“…Nevertheless, biological specimen collection is an important logistic challenge to provide massive testing (1)(2)(3). The possibility to use self-collected samples for COVID- 19 testing offers several advantages, especially to minimize the risk of exposing healthcare workers to the virus, since self-collection does not require direct involvement of trained personnel in the sample collection (4,5). Recently publications have been showed a similar sensitivity between saliva samples and nasal swabs collected by healthworkers and those collected by a patient for COVID-19 molecular diagnosis, thus providing an important background for the choice of this strategy for surveillance of COVID-19 (6)(7)(8).…”

Evolution of Specimen Self-Collection in the COVID-19 Era: Implications for Population Health Management of Infectious Disease

“…A survey of more than 1400 adults representing a broad range of sociodemographic groups found a strong preference for research studies that allowed home-based self-collection. 40 Most respondents reported that they would be willing to provide saliva (88%) or throat swab (83%) specimens for research studies if they could be self-collected at home, while fewer would be willing to provide throat swab specimens at drive-through (64%) or clinical (53%) settings. Overall, 69% of respondents reported being more inclined to participate in a study if they were able to collect the specimen at home.…”