Social context is key to COVID testing success

Edinburgh experts who completed a comprehensive review of COVID-related research carried out by social scientists found it to be limited in depth and scope.

Finding out what people know about testing—and how this influences attitudes and behaviors—is vital if programs are to be effective worldwide, researchers say.

A team from the University's School of Social and Political Science and Usher Institute reviewed 47 studies from around the world to reach their conclusions.

The review showed that people are largely accepting of COVID-19 testing technologies and are principally motivated to use them by a sense of social solidarity and care for others.

Significant barriers to people undertaking testing include their uncertainty about eligibility, how to access tests and difficulty interpreting symptoms, researchers found.

Logistical issues—including transport to and from test sites—discomfort of sample extraction and concerns about the consequences of a positive result were other key concerns.

The review findings suggest that testing should be understood as a social process and not just as a medical procedure, researchers say.

Practical challenges

Outcomes are inseparable from the practical challenges associated with contact tracing and self-isolation and are influenced by people's everyday routines, livelihoods and relationships.

Researchers have urged greater understanding of how people's social, political, and economic vulnerability can impact on participation.

More research that monitors people's long-term engagement with testing programs—rather than isolated studies—would be beneficial, the team says.

Greater use of qualitative research, including patient interviews and focus groups, would also help build a clearer understanding of programs' effectiveness.

More research

Researchers add that more research is needed in Low and Middle Income Countries where testing infrastructure was already under-resourced before the pandemic.

The study was carried out by members of the University of Edinburgh's flagship TestEd research program and was funded by the Medical Research Council and the European Research Council.

The findings have been published by DiaDev—a partnership between the University of Edinburgh, Kings College London, Kings Health Partners, and Public Health Foundation India.

Dr. Alice Street, of the University's School of Social and Political Science, said: "Testing programs depend on voluntary responses if they are to be successful. Understanding people's thought processes is therefore key to the design of effective testing worldwide."