scholarly journals Patterns of SARS-CoV-2 Testing Preferences in a National Cohort in the United States: Latent Class Analysis of a Discrete Choice Experiment (Preprint)

2021 ◽  
Author(s):  
Rebecca Zimba ◽  
Matthew L Romo ◽  
Sarah G Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
...  
Keyword(s):  
Choice Experiment ◽  
Latent Class ◽  
Diagnostic Testing ◽  
The United States ◽  
Turnaround Time ◽  
Test Type ◽  
Specimen Type ◽  
Opt Out ◽  
Additional Testing ◽  
Testing Uptake

BACKGROUND Inadequate screening and diagnostic testing in the United States throughout the first several months of the COVID-19 pandemic led to undetected cases transmitting disease in the community and an underestimation of cases. Though testing supply has increased, maintaining testing uptake remains a public health priority in the efforts to control community transmission considering the availability of vaccinations and threats from variants. OBJECTIVE This study aimed to identify patterns of preferences for SARS-CoV-2 screening and diagnostic testing prior to widespread vaccine availability and uptake. METHODS We conducted a discrete choice experiment (DCE) among participants in the national, prospective CHASING COVID (Communities, Households, and SARS-CoV-2 Epidemiology) Cohort Study from July 30 to September 8, 2020. The DCE elicited preferences for SARS-CoV-2 test type, specimen type, testing venue, and result turnaround time. We used latent class multinomial logit to identify distinct patterns of preferences related to testing as measured by attribute-level part-worth utilities and conducted a simulation based on the utility estimates to predict testing uptake if additional testing scenarios were offered. RESULTS Of the 5098 invited cohort participants, 4793 (94.0%) completed the DCE. Five distinct patterns of SARS-CoV-2 testing emerged. Noninvasive home testers (n=920, 19.2% of participants) were most influenced by specimen type and favored less invasive specimen collection methods, with saliva being most preferred; this group was the least likely to opt out of testing. Fast-track testers (n=1235, 25.8%) were most influenced by result turnaround time and favored immediate and same-day turnaround time. Among dual testers (n=889, 18.5%), test type was the most important attribute, and preference was given to both antibody and viral tests. Noninvasive dual testers (n=1578, 32.9%) were most strongly influenced by specimen type and test type, preferring saliva and cheek swab specimens and both antibody and viral tests. Among hesitant home testers (n=171, 3.6%), the venue was the most important attribute; notably, this group was the most likely to opt out of testing. In addition to variability in preferences for testing features, heterogeneity was observed in the distribution of certain demographic characteristics (age, race/ethnicity, education, and employment), history of SARS-CoV-2 testing, COVID-19 diagnosis, and concern about the pandemic. Simulation models predicted that testing uptake would increase from 81.6% (with a status quo scenario of polymerase chain reaction by nasal swab in a provider’s office and a turnaround time of several days) to 98.1% by offering additional scenarios using less invasive specimens, both viral and antibody tests from a single specimen, faster turnaround time, and at-home testing. CONCLUSIONS We identified substantial differences in preferences for SARS-CoV-2 testing and found that offering additional testing options would likely increase testing uptake in line with public health goals. Additional studies may be warranted to understand if preferences for testing have changed since the availability and widespread uptake of vaccines.

scholarly journals SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment (Preprint)

2020 ◽  
Author(s):  
Rebecca Zimba ◽  
Sarah Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
Chloe Mirzayi ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Turnaround Time ◽  
Urgent Care ◽  
Relative Importance ◽  
Test Type ◽  
Specimen Type ◽  
Testing Uptake ◽  
Community Transmission

BACKGROUND Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. OBJECTIVE This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. METHODS We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in >5 days. RESULTS Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. CONCLUSIONS Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

scholarly journals Patterns of SARS-CoV-2 testing preferences in a national cohort in the United States

2020 ◽  
Author(s):  
Matthew L. Romo ◽  
Rebecca Zimba ◽  
Sarah Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Turnaround Time ◽  
Specimen Type ◽  
Home Testing ◽  
Additional Testing ◽  
Testing Uptake ◽  
National Cohort ◽  
Antibody Tests

ABSTRACTIn order to understand preferences about SARS-CoV-2 testing, we conducted a discrete choice experiment among 4793 participants in the Communities, Households, and SARS-CoV-2 Epidemiology (CHASING COVID) Cohort Study from July 30-September 8, 2020. We used latent class analysis to identify distinct patterns of preferences related to testing and conducted a simulation to predict testing uptake if additional testing scenarios were offered. Five distinct patterns of SARS-CoV-2 testing emerged. “Comprehensive testers” (18.9%) ranked specimen type as most important and favored less invasive specimen types, with saliva most preferred, and also ranked venue and result turnaround time as highly important, with preferences for home testing and fast result turnaround time. “Fast track testers” (26.0%) ranked result turnaround time as most important and favored immediate and same day turnaround time. “Dual testers” (18.5%) ranked test type as most important and preferred both antibody and viral tests. “Non-invasive dual testers” (33.0%) ranked specimen type and test type as similarly most important, preferring cheek swab specimen type and both antibody and viral tests. “Home testers” (3.6%) ranked venue as most important and favored home-based testing. By offering less invasive (saliva specimen type), dual testing (both viral and antibody tests), and at home testing scenarios in addition to standard testing scenarios, simulation models predicted that testing uptake would increase from 81.7% to 98.1%. We identified substantial differences in preferences for SARS-CoV-2 testing and found that offering additional testing options, which consider this heterogeneity, would likely increase testing uptake.SIGNIFICANCEDuring the COVID-19 pandemic, diagnostic testing has allowed for early detection of cases and implementation of measures to reduce community transmission of SARS-CoV-2 infection. Understanding individuals’ preferences about testing and the service models that deliver tests are relevant in efforts to increase and sustain uptake of SARS-CoV-2 testing, which, despite vaccine availability, will be required for the foreseeable future. We identified substantial differences in preferences for SARS-CoV-2 testing in a discrete choice experiment among a large national cohort of adults in the US. Offering additional testing options that account for or anticipate this heterogeneity in preferences (e.g., both viral and antibody tests, at home testing), would likely increase testing uptake.ClassificationBiological Sciences (major); Psychological and Cognitive Sciences (minor)

scholarly journals SARS-CoV-2 Testing Service Preferences of Adults in the United States: Discrete Choice Experiment

10.2196/25546 ◽  
2020 ◽  
Vol 6 (4) ◽  
pp. e25546 ◽  
Author(s):  
Rebecca Zimba ◽  
Sarah Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
Chloe Mirzayi ◽  
...  
Keyword(s):  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Turnaround Time ◽  
Urgent Care ◽  
Relative Importance ◽  
Test Type ◽  
Specimen Type ◽  
Testing Uptake ◽  
Community Transmission

Background Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. Objective This study aims to determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. Methods We used a discrete choice experiment to assess preferences for SARS-CoV-2 test type, specimen type, testing venue, and results turnaround time. Participants (n=4793) from the US national longitudinal Communities, Households and SARS-CoV-2 Epidemiology (CHASING) COVID Cohort Study completed our online survey from July 30 to September 8, 2020. We estimated the relative importance of testing method attributes and part-worth utilities of attribute levels, and simulated the uptake of an optimized testing scenario relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal swab in a provider’s office or urgent care clinic with results in >5 days. Results Test result turnaround time had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). In simulations, immediate or same-day test results, both PCR and serology, or oral specimens substantially increased testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same-day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. Conclusions Testing strategies that offer both PCR and serology with noninvasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

scholarly journals Testing, Testing: What SARS-CoV-2 testing services do adults in the United States actually want?

2020 ◽  
Author(s):  
Rebecca Zimba ◽  
Sarah Kulkarni ◽  
Amanda Berry ◽  
William You ◽  
Chloe Mirzayi ◽  
...  
Keyword(s):  
Cohort Study ◽  
The United States ◽  
Turnaround Time ◽  
Urgent Care ◽  
Relative Importance ◽  
Test Results ◽  
Care Clinic ◽  
Specimen Type ◽  
Testing Uptake ◽  
Community Transmission

Importance: Ascertaining preferences for SARS-CoV-2 testing and incorporating findings into the design and implementation of strategies for delivering testing services may enhance testing uptake and engagement, a prerequisite to reducing onward transmission. Objective: To determine important drivers of decisions to obtain a SARS-CoV-2 test in the context of increasing community transmission. Design: A discrete choice experiment (DCE) was used to assess the relative importance of type of SARS-CoV-2 test, specimen type, testing venue, and results turnaround time. Uptake of an optimized testing scenario was simulated relative to the current typical testing scenario of polymerase chain reaction (PCR) via nasopharyngeal (NP) swab in a provider office or urgent care clinic with results in >5 days. Setting:​ Online survey, embedded in an existing cohort study, conducted during July 30 - September 8, 2020. Participants: ​Participants (n=4,793) were enrolled in the CHASING COVID Cohort Study, a national longitudinal cohort of adults >18 years residing in the 50 US states, Washington, DC, Puerto Rico, or Guam. Main Outcome(s) and Measure(s): Relative importance of SARS-CoV-2 testing method attributes, utilities of specific attribute levels, and probability of choosing a testing scenario based on preferences estimated from the DCE, the current typical testing option, or choosing not to test. Results: ​Turnaround time for test results had the highest relative importance (30.4%), followed by test type (28.3%), specimen type (26.2%), and venue (15.0%). Participants preferred fast results on both past and current infection and using a noninvasive specimen, preferably collected at home. Simulations suggested that providing immediate or same day test results, providing both PCR and serology, or collecting oral specimens would substantially increase testing uptake over the current typical testing option. Simulated uptake of a hypothetical testing scenario of PCR and serology via a saliva sample at a pharmacy with same day results was 97.7%, compared to 0.6% for the current typical testing scenario, with 1.8% opting for no test. Conclusions and Relevance: ​Testing strategies that offer both PCR and serology with non-invasive methods and rapid turnaround time would likely have the most uptake and engagement among residents in communities with increasing community transmission of SARS-CoV-2.

scholarly journals Exploring Social Desirability Bias in Perceptions of Dog Adoption: All’s Well that Ends Well? Or Does the Method of Adoption Matter?

Animals ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. 154 ◽  
Author(s):  
Courtney Bir ◽  
Nicole Olynk Widmar ◽  
Candace Croney
Keyword(s):  
Social Desirability ◽  
Choice Experiment ◽  
Latent Class ◽  
Latent Class Model ◽  
The United States ◽  
Social Desirability Bias ◽  
Random Parameters ◽  
Class Model ◽  
Random Parameters Logit ◽  
Nationally Representative

Dogs are a popular companion animal in the United States; however, dog acquisition is often a contentious subject. Adoption is often cited as an ethical and popular method of acquisition but interpretation of the term ‘adoption’ may vary. In a nationally representative survey of the U.S., 767 respondents were asked questions regarding their opinions of dog acquisition and adoption. Within the sample, 45% had a dog; of those, 40% had adopted a dog, and 47% visited a veterinarian once a year. A best-worst choice experiment, where respondents were asked to choose the most ethical and least ethical method of acquiring a dog from a statistically determined set of choices, was used to elicit respondents’ preferences for the most ethical method of dog adoption. A random parameters logit and a latent class model were used to estimate relative rankings of dog adoption methods. In the random parameters logit model, the largest preference share was for adoption from a municipal animal shelter (56%) and the smallest preference share was for adoption from a pet store (3%). Dog acquisition was further evaluated by creating an index of social desirability bias using how important respondents believed certain dog characteristics were compared to how important respondents believed others would rate/rank the same dog characteristics. The highest incidences of social desirability bias occurred for the dog characteristics of appearance and breed.

scholarly journals SARS-CoV-2 and Variant Diagnostic Testing Approaches in the United States

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2492
Author(s):  
Emmanuel Thomas ◽  
Stephanie Delabat ◽  
Yamina L. Carattini ◽  
David M. Andrews
Keyword(s):  
United States ◽  
Rapid Development ◽  
Diagnostic Testing ◽  
The United States ◽  
Antibody Responses ◽  
Standard Laboratory ◽  
Additional Testing ◽  
Diagnostic Approaches ◽  
Pertinent Information ◽  
The U.S

Purpose of Review Given the rapid development of diagnostic approaches to test for and diagnose infection with SARS-CoV-2 and its associated variants including Omicron (B.1.1.529), many options are available to diagnose infection. Multiple established diagnostic companies are now providing testing platforms whereas initially, testing was being performed with simple PCR-based tests using standard laboratory reagents. Recent Findings Additional testing platforms continue to be developed, including those to detect specific variants, but challenges with testing, including obtaining testing reagents and other related supplies, are frequently encountered. With time, the testing supply chain has improved, and more established companies are providing materials to support these testing efforts. In the United States (U.S.), the need for rapid assay development and subsequent approval through the attainment of emergency use authorization (EUA) has superseded the traditional arduous diagnostic testing approval workflow mandated by the FDA. Through these efforts, the U.S. has been able to continue to significantly increase its testing capabilities to address this pandemic; however, challenges still remain due to the diversity of the performance characteristics of tests being utilized and newly discovered viral variants. Summary This review provides an overview of the current diagnostic testing landscape, with pertinent information related to SARS-CoV-2 virology, variants and antibody responses that are available to diagnose infection in the U.S.

scholarly journals Using Market Segmentation Analysis to Identify Consumer Preferences for Fresh Peach Attributes

HortScience ◽  
2018 ◽  
Vol 53 (11) ◽  
pp. 1664-1668 ◽  
Author(s):  
Ruchen Zhou ◽  
Chengyan Yue ◽  
Shuoli Zhao ◽  
R. Karina Gallardo ◽  
Vicki McCracken ◽  
...  
Keyword(s):  
Market Segmentation ◽  
Choice Experiment ◽  
Online Survey ◽  
Latent Class ◽  
Consumer Preferences ◽  
The United States ◽  
Peach Fruit ◽  
Segmentation Analysis ◽  
Heterogeneous Preference ◽  
Latent Class Logit

Consumer preferences for attributes of fresh peach fruit in the United States are largely unknown on a national basis. We used a choice experiment to explore market segmentation based on consumer heterogeneous preference for fruit attributes including external color, blemish, firmness, sweetness, flavor, and price. We collected the data using an online survey with 800 U.S. consumers. Using a latent class logit model, we identified three segments of consumers differing by different sets of preferred quality attributes: experience attribute-oriented consumers, who valued fruit quality (48.8% of the sample); search attribute-oriented consumers, who valued fruit appearance (33.7% of the sample); and balanced consumers, who considered search attributes and experience attributes but who valued each in a balanced way (17.5% of the sample). Each group demonstrated differentiated demographics and purchasing habits. The results have important marketing implications for peach breeders and suppliers.

scholarly journals Exploring Decisional Conflict With Measures of Numeracy and Optimism in a Stated Preference Survey

2021 ◽  
Vol 6 (2) ◽  
pp. 238146832110586
Author(s):  
Jessie Sutphin ◽  
Rachael L. DiSantostefano ◽  
Colton Leach ◽  
Brett Hauber ◽  
Carol Mansfield
Keyword(s):  
Latent Class ◽  
Stated Preference ◽  
Decisional Conflict ◽  
The United States ◽  
P Value ◽  
Health Care Decisions ◽  
Membership Probability ◽  
Opting Out ◽  
Opt Out ◽  
Choice Tasks

Objectives Low optimism and low numeracy are associated with difficulty or lack of participation in making treatment-related health care decisions. We investigated whether low optimism and low self-reported numeracy scores could help uncover evidence of decisional conflict in a discrete-choice experiment (DCE). Methods Preferences for a treatment to delay type 1 diabetes were elicited using a DCE among 1501 parents in the United States. Respondents chose between two hypothetical treatments or they could choose no treatment (opt out) in a series of choice questions. The survey included a measure of optimism and a measure of subjective numeracy. We used latent class analyses where membership probability was predicted by optimism and numeracy scores. Results Respondents with lower optimism scores had a higher probability of membership in a class with disordered preferences ( P value for optimism coefficient = 0.032). Those with lower self-reported numeracy scores were more likely to be in a class with a strong preference for opting out and disordered preferences ( P = 0.000) or a class with a preference for opting out and avoiding serious treatment-related risks ( P = 0.015). Conclusions If respondents with lower optimism and numeracy scores are more likely to choose to opt out or have disordered preferences in a DCE, it may indicate that they have difficulty completing choice tasks.

scholarly journals Publics’ preferences for sharing health data: a discrete choice experiment (Preprint)

2021 ◽  
Author(s):  
Jennifer Johansson ◽  
Heidi Beate Bentzen ◽  
Nisha Shah3 ◽  
Eik Haraldsdóttir4 ◽  
Guðbjörg Andrea Jónsdóttir ◽  
...  
Keyword(s):  
Health Information ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Latent Class ◽  
Technological Development ◽  
Digital Health ◽  
Health Data ◽  
Governance Mechanism ◽  
Opt Out

BACKGROUND The digital technological development in the last 20 years has led to a significant growth in collecting, using and sharing health data digitally. In order to maintain public trust in the digital society and for acceptable policy making in the future, it is important to investigate peoples’ preferences for sharing digital health data. OBJECTIVE The aim of this study was to elicit the publics’ preferences in different Northern-European countries (the UK, Norway, Iceland and Sweden) for sharing health information in different contexts. METHODS A discrete choice experiment was answered by 1,967 individuals. Respondents completed several ‘choice tasks’ which asked if data sharing in the described hypothetical situation was acceptable to them. Latent class logistic regression models were used to determine attribute level estimates and the heterogeneity in preferences. We calculated the relative importance of the attributes and the predicted acceptability for different contexts where data is shared from the estimates. RESULTS All attributes influenced the participants’ willingness to share health information. The most important attribute was whether the respondents will be informed about their data being shared. The possibility to opt-out from sharing data was preferred over the opportunity to consent (opt-in). CONCLUSIONS Participants from different countries have different preferences for sharing their health data regarding the value of a review process and the reason for the new use. Offering respondents information about the use of their data and the possibility to opt-out is the most preferred governance mechanism.

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