Abstract
BackgroundInnovative 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.ObjectiveThe 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.MethodsBetween 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.ResultsWe 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.ConclusionsMost 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.
Highlights
MethodsThe first case of the novel coronavirus SARS-CoV-2 in the United States was identified on January 20, 2020 [1]
Most participants were willing to participate in a COVID-19 research study that involves laboratory testing; there was a strong preference for home specimen collection procedures over drive-through or clinic-based testing
To develop a better understanding of the exposure, disease, and recovery process associated with SARS-CoV-2 infection, infectious disease researchers have called for innovative testing approaches and a rapid scaleup in the number of persons tested [4]
Summary
MethodsThe first case of the novel coronavirus SARS-CoV-2 in the United States was identified on January 20, 2020 [1]. Self-specimen collection for testing has been successfully used in HIV and sexually transmitted infection (STI) research for well over a decade [5,6,7,8]. A review of 25 HIV testing studies found that across multiple specimen methods (finger prick, oral swabs), self-collection results had the same diagnostic accuracy as clinician-collected specimens, with no differences in the proportions of invalid results [9]. In one of our previous studies, 93% of participants were able to successfully complete multiple specimen collections, and 85% preferred self-collection of specimens at home to a standard office visit [11]. 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
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