Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Nov 1, 2021
Date Accepted: Jan 30, 2023
Date Submitted to PubMed: Jan 31, 2023
COVID-19 testing practices, preventive behaviors and factors associated with test positivity: Results from population-based statewide surveys in South Carolina, November 2020-June 2021
ABSTRACT
Background:
The COVID-19 pandemic has challenged public health efforts globally. Timely population-based surveillance is crucial to support public health programs and policies to limit the spread of COVID-19. In South Carolina (SC), the SC STRONG state-wide initiative was established to estimate population-level prevalence and immunity and characterize the transmission dynamics of the SARS-CoV-2 virus using community testing and online surveys.
Objective:
This paper aimed to leverage the survey data collected as part of the initiative to understand risk perceptions, testing practices and preventive behaviors, and identify risk factors for COVID-19 test positivity in SC over time.
Methods:
Probability proportionate to size cluster random sampling was used to select SC residents to participate in testing for COVID-19 infection and antibodies, and to complete an online survey. This paper focuses on data from the online surveys completed between November 2020 and June 2021. Descriptive statistics were performed to describe risk perceptions, attitudes and behaviors, and associated changes over time. Univariate and multivariate logistic regression models were used to identify factors associated with self-reported COVID-19 test positivity.
Results:
Among the 7,170 online survey respondents, 58.7% self-reported ever testing for COVID-19. The most commonly cited barriers to testing were inconvenient dates, time, location and discomfort. Overall, 18.7% of respondents reported a history of COVID-19 test positivity. Multivariate logistic regression results indicated that individuals who were 50 years and older, self-identified as Black/African American, obese, and employed as frontline health care workers and nursing home staff were more likely to self-report COVID-19 test positivity. By contrast, there was a decreased likelihood of test positivity among respondents who were concerned about the burden of COVID-19 in their community and about getting infected.
Conclusions:
Strategies to remove testing barriers should be implemented to improve access. Findings provide insights on statewide testing patterns, adoption of prevention behaviors and risk factors for infection and may inform public health strategies to curb transmission.
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.