Daily COVID-19 Self-Testing with a Lateral Flow Antigen Test (CoV-SCAN): an Acceptability Study

Name: Alicia H. Li
School: Vagelos College of Physicians and Surgeons, Class of 2024, Varmus Global Scholar 2021
Mentor: Kathrine Meyers, DrPH, MS, MPP
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Rapid antigen tests have an important role to play in controlling the pandemic because they can be performed frequently, are inexpensive to produce, and do not require special processing equipment, allowing testers to quickly isolate if needed. This mixed-methods implementation science study seeks to understand how acceptable participants find the use of CoV-SCAN, a COVID-19 rapid lateral flow antigen testing technology and associated mobile app, through the lens of Sekhon’s Theoretical Framework of Acceptability (TFA). The TFA defines acceptability as consisting of seven domains: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. 31 employees of a media company were provided with CoV-SCAN tests and instructions to test daily for 21 days. After the testing period, participants completed a survey designed to measure CoV-SCAN acceptability along the TFA domains. A subset of participants (N=15) engaged in semi-structured in-depth interviews to discuss their experiences using CoV-SCAN. Transcripts were coded using a thematic framework analysis informed by the TFA. Preliminary results suggest that most participants not only generally find daily CoV-SCAN testing acceptable across all of Sekhon’s domains, but also (71%) prefer it to either weekly PCR testing or ad hoc testing; this provides support for CoV-SCAN’s implementability as a public health tool. However, in spite of strong acceptability, adherence to testing was unexpectedly varied. Qualitative interview data suggest that context, including public health context, personal context, and study context may account for this discrepancy. This new “domain” may prove to be a useful addition to future acceptability studies.