JMIR Publications

ABSTRACT

Background:

Mass asymptomatic testing for COVID-19 was piloted for the first time in the UK in Liverpool in November 2020. There is limited evidence on uptake of mass testing and previously where surge testing has been deployed, uptake has been low.

Objective:

There was an urgent need to rapidly evaluate acceptance of asymptomatic testing, specifically identifying barriers and motivators to taking part.

Methods:

As part of the wider evaluation, we conducted a rapid thematic analysis of local community narratives on social media to provide insights from people unlikely to engage in testing or other standard evaluation techniques, such as surveys or interviews. Three publicly available data sources were identified; the comments section of a local online newspaper, the city council Facebook page and Twitter. Data were collected between 2 and 8 November 2020, to cover the period between announcement of mass testing in Liverpool and the first week of testing. Overall 1096 comments were sampled; 219 newspaper comments, 472 Facebook comments and 405 Tweets. Data were analysed using an inductive thematic approach.

Results:

Key barriers were accessibility, including site access and concerns over queuing. Queues were also highlighted as a concern due to risk of transmission. Consequences of testing, including an increase in cases leading to further restrictions and financial impact of the requirement to self-isolation were also identified as barriers. In addition, a lack of trust in authorities and the test (including test accuracy and purpose of testing) was identified. Lack of trust was particularly apparent in those with a strong sense of collective identity with the city of Liverpool, which led to a feeling of marginalisation and feeling like test subjects. However, this sense of identity with Liverpool had a dual role and also acted a motivator to engage in testing and encourage others to do so; for this group being part of a pilot was seen as a positive experience and an opportunity to demonstrate the city could successfully manage the virus.

Conclusions:

Our analysis highlights the importance of promoting honest and open communication to encourage and harness existing community identities to enhance the legitimacy of asymptomatic testing as a policy. In addition, adequate and accessible financial support needs to be in place prior to the implementation of community asymptomatic testing to mitigate any concerns surrounding financial hardship. Rapid thematic analysis of social media is a pragmatic method to gather insights from communities around acceptability of public health interventions, such as mass testing or vaccination uptake.