Abstract
Objective
This study aimed to evaluate COVID-19 lateral flow testing (LFT) among asymptomatic university students.
Study design
This study was a mixed methods evaluation of LFT among University of Bristol students.
Methods
We conducted (1) an analysis of testing uptake and exploration of demographic variations in uptake using logistic regression; (2) an online student survey about views on university testing; and (3) qualitative interviews to explore participants’ experiences of testing and subsequent behaviour, analysed using a thematic approach.
Results
A total of 12,391 LFTs were conducted on 8025 of 36,054 (22.3%) students. Only one in 10 students had the recommended two tests. There were striking demographic disparities in uptake with those from ethnic minority groups having lower uptake (e.g. 3% of Chinese students were tested vs 30.7% of White students) and variations by level and year of study (ranging from 5.3% to 33.7%), place of residence (29.0%–35.6%) and faculty (15.2%–32.8%). Differences persisted in multivariable analyses. A total of 436 students completed the online survey, and 20 in-depth interviews were conducted. Barriers to engagement with testing included a lack of awareness, knowledge and understanding, and concerns about the accuracy and safety. Students understood the limitations of LFTs but requested further information about test accuracy. Tests were used to inform behavioural decisions, often in combination with other information, such as the potential for exposure to the virus and perceptions of vulnerability.
Conclusions
The low uptake of testing brings into question the role of mass LFT in university settings. Innovative strategies may be needed to increase LFT uptake among students.
This study aimed to evaluate COVID-19 lateral flow testing (LFT) among asymptomatic university students.
Study design
This study was a mixed methods evaluation of LFT among University of Bristol students.
Methods
We conducted (1) an analysis of testing uptake and exploration of demographic variations in uptake using logistic regression; (2) an online student survey about views on university testing; and (3) qualitative interviews to explore participants’ experiences of testing and subsequent behaviour, analysed using a thematic approach.
Results
A total of 12,391 LFTs were conducted on 8025 of 36,054 (22.3%) students. Only one in 10 students had the recommended two tests. There were striking demographic disparities in uptake with those from ethnic minority groups having lower uptake (e.g. 3% of Chinese students were tested vs 30.7% of White students) and variations by level and year of study (ranging from 5.3% to 33.7%), place of residence (29.0%–35.6%) and faculty (15.2%–32.8%). Differences persisted in multivariable analyses. A total of 436 students completed the online survey, and 20 in-depth interviews were conducted. Barriers to engagement with testing included a lack of awareness, knowledge and understanding, and concerns about the accuracy and safety. Students understood the limitations of LFTs but requested further information about test accuracy. Tests were used to inform behavioural decisions, often in combination with other information, such as the potential for exposure to the virus and perceptions of vulnerability.
Conclusions
The low uptake of testing brings into question the role of mass LFT in university settings. Innovative strategies may be needed to increase LFT uptake among students.
| Original language | English |
|---|---|
| Pages (from-to) | 54-62 |
| Number of pages | 9 |
| Journal | Public Health |
| Volume | 204 |
| DOIs | |
| Publication status | Published - 13 Jan 2022 |
Bibliographical note
Funding Information:This study is funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioral Science and Evaluation, a partnership between the UK Health Security Agency (UKHSA) and the University of Bristol. The views expressed are those of the author(s) and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care. The funders had no role in the design of the study, in collection, analysis, and interpretation of the data or in writing the article.
Funding Information:
C.E.F., SD., E.B.-P., H.W., and M.H. are supported by the NIHR Health Protection Research Unit in Behavioral Science and Evaluation. E.B.-P. is funded via the JUNIPER Consortium MRC grant MR/V038613/1 and MRC grant MC/PC/19067.
Publisher Copyright:
© 2022 The Royal Society for Public Health