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

Study Overview
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Brief Summary
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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.

Detailed Description
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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: Adjusting the governmental testing advice will lead to a higher strategy sensitivity. In follow-up analysis we will explore the following hypothesis: Availability of LFT at home will lead to a higher strategy sensitivity. The type of corona related symptoms (mild or severe) are predictive of the type of test used. When confronted with a new incidence of corona-related symptoms over time, strategy sensitivity will decline.

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

Conditions
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COVID-19

Intervention / Treatment
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* Behavioral: Customised testing advice
* Behavioral: Regular testing advice
* Behavioral: LFT available
* Behavioral: No LFT available


Participation Criteria
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Eligibility Criteria
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Participants were recruited from an online research panel representative for the Dutch population. Inclusion Criteria: non Exclusion Criteria: non

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model 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).
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Customised advice + LFT available at home<br>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<br>* Customised advice: With Corona related symptoms, get tested at a test facility. If this isn't possible, use a Lateral Flow test.<br>Behavioral: LFT available<br>* LFT availability: Enough lateral flow tests available at home<br>|
| Experimental: Customised advice + No LFT available at home<br>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<br>* Customised advice: With Corona related symptoms, get tested at a test facility. If this isn't possible, use a Lateral Flow test.<br>Behavioral: No LFT available<br>* LFT availability: No lateral flow tests available at home<br>|
| Experimental: Regular advice + LFT available at home<br>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: Regular testing advice<br>* Government guideline testing advice: With Corona related symptoms, get tested at a test facility.<br>Behavioral: LFT available<br>* LFT availability: Enough lateral flow tests available at home<br>|
| Active Comparator: Regular advice + No LFT available at home<br>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: Regular testing advice<br>* Government guideline testing advice: With Corona related symptoms, get tested at a test facility.<br>Behavioral: No LFT available<br>* LFT availability: No lateral flow tests available at home<br>|

What is the study measuring?
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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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Test intentions, Lateral Flow test uptake