Availability and Advice on Test Uptake During the COVID-19 Pandemic: a Vignette Study.

Availability and Advice on Test Uptake During the COVID-19 Pandemic: a Vignette Study on Lateral Flow Testing Policy in the Netherlands.

Lateral Flow Testing (LFT) use for COVID-19 related symptoms continues to rise, despite governmental advice to test at a test facility. In this study we investigate whether 1) adjusting the governmental testing advice will lead to a collective increase of people who test with COVID-19 symptoms and if this leads to a higher strategy sensitivity.

Study Overview

• Status: Completed
• Conditions: COVID-19
• Intervention / Treatment: Behavioral: Customised testing advice; Behavioral: LFT available; Behavioral: No LFT available; Behavioral: Regular testing advice

Detailed Description

In an online randomised multi-factorial survey (vignette study) participants are randomised to assess four scenario's. Between subject testing advise is randomised (IV1; 2 levels) and the availability of LFT (IV2; 2 levels). Within subject we asked participants to assess their most likely behaviour on day 1 of symptoms and day 3 of unchanged symptoms (IV3; 2 levels). Corona-related symptoms are randomly presented (IV4; 4 levels) and new incidences of symptoms are presented in additional vignettes describing new months (IV5; 4 levels).

Subjects are asked to immerse themselves in the scenario's before answering what their most likely behaviour would be: a) go to a test facility b) use a LFT c) wait and see or 4) no test. Participants who didn't choose the test facility on day 1 were presented with the same vignette on day 3 with unchanged symptoms, and were asked their most likely behaviour again.

After assessing the scenario's, participants fill in a questionnaire assessing demographics, behavioural determinants related to test behaviour, vaccine status, current symptoms and previous experience with Corona and testing.

The primary outcomes is defined as the average strategy sensitivity over time and therefore the chance of detecting a Covid-infection. Average strategy sensitivity is calculated by converting the choice of testing behaviour into the corresponding sensitivity score (PCR =1, LFT day 1 = .8, LFT day 3 = .7, wait and see and no test = 0), averaged over four scenario's.

Our primary hypothesis is:

1. Adjusting the governmental testing advice will lead to a higher strategy sensitivity.

   In follow-up analysis we will explore the following hypothesis:

2. Availability of LFT at home will lead to a higher strategy sensitivity.
3. The type of corona related symptoms (mild or severe) are predictive of the type of test used.
4. When confronted with a new incidence of corona-related symptoms over time, strategy sensitivity will decline.

• Study Type: Interventional
• Enrollment (Actual): 3270
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Netherlands
  • Utrecht
    • Bilthoven, Utrecht, Netherlands, 3720 BA
      • National Institute for Public Health and the Environment

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Participants were recruited from an online research panel representative for the Dutch population.

Inclusion Criteria:

• non

Exclusion Criteria:

• non

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Double

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Customised advice + LFT available at home; Respondents will see an altered testing advice in text and picture in which they are allowed to use LFT with corona related symptoms. Respondents will informed in writing that they don't currently have any LFT available at home.	Behavioral: Customised testing advice; Customised advice: With Corona related symptoms, get tested at a test facility. If this isn't possible, use a Lateral Flow test.; Behavioral: LFT available; LFT availability: Enough lateral flow tests available at home
Experimental: Customised advice + No LFT available at home; Respondents will see an altered testing advice in text and picture in which they are allowed to use LFT with corona related symptoms. Respondents will informed in writing that they don't currently have any LFT available at home.	Behavioral: Customised testing advice; Customised advice: With Corona related symptoms, get tested at a test facility. If this isn't possible, use a Lateral Flow test.; Behavioral: No LFT available; LFT availability: No lateral flow tests available at home
Experimental: Regular advice + LFT available at home; Respondents will see the regular testing advice in text and picture with the current governmental advice to visit a test facility with corona related symptoms. Respondents will informed in writing that they don't currently have any LFT available at home.	Behavioral: LFT available; LFT availability: Enough lateral flow tests available at home; Behavioral: Regular testing advice; Government guideline testing advice: "With Corona related symptoms, get tested at a test facility".
Active Comparator: Regular advice + No LFT available at home; Respondents will see the regular testing advice in text and picture with the current governmental advice to visit a test facility with corona related symptoms. Respondents will informed in writing that they don't currently have any LFT available at home.	Behavioral: No LFT available; LFT availability: No lateral flow tests available at home; Behavioral: Regular testing advice; Government guideline testing advice: "With Corona related symptoms, get tested at a test facility".

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average strategy sensitivity over time: day 1	The sensitivity of the test chosen was used to convert each answer: test facility on day 1 = 1, LFT on day 1= 0.8, Wait and see or No test = 0. Sensitivity scores were then averaged over the four scenario's.	average strategy sensitivity day 1
Maximum average strategy sensitivity over time	The sensitivity of the test chosen was used to convert each answer: test facility on day 1 or day 3 = 1, LFT on day 1= 0.8, LFT on day 3= 0.7, Wait and see or No test = 0. Sensitivity scores were then averaged over the four scenario's. The highest score of day 1 and day 3 was used to calculate the maximum sensitivity score.	maximum average strategy sensitivity day 1 and 3

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Willingness to test day 1	Willingness to test on day 1 (LFT & PCR =1, no test = 0), averaged over the four scenario's.	Day 1
Willingness to test - maximum	Willingness to test on day 1 and 3 (LFT & PCR =1, no test = 0), averaged over the four scenario's.	Day 1 and 3
Type of test chosen day 1	Percentage of testing behaviour (test facility, LFT, Wait and see, No test) on day 1, averaged over the four scenario's.	Day 1
Type of test chosen day 3	Percentage of testing behaviour (test facility, LFT, Wait and see, No test) on day 3, averaged over the four scenario's.	Day 3

Collaborators and Investigators

• Sponsor: National Institute for Public Health and the Environment (RIVM)
• Investigators: Study Chair: Marijn de Bruin, prof, RIVM

Publications and helpful links

Helpful Links

• Do members of the public think they should use lateral flow tests or PCR tests when they have COVID-19-like symptoms? The COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] study,

Study record dates

Study Major Dates

• Study Start (Actual): November 11, 2021
• Primary Completion (Actual): November 16, 2021
• Study Completion (Actual): November 16, 2021

Study Registration Dates

• First Submitted: January 24, 2022
• First Submitted That Met QC Criteria: January 28, 2022
• First Posted (Actual): January 31, 2022

Study Record Updates

• Last Update Posted (Actual): January 31, 2022
• Last Update Submitted That Met QC Criteria: January 28, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Keywords: Test intentions; Lateral Flow test uptake
• Additional Relevant MeSH Terms: Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Pneumonia, Viral; Pneumonia; Lung Diseases; COVID-19
• Other Study ID Numbers: G&M-537

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No