REACT-2.3: Acceptability and Usability of In-home Self-testing for SARS-CoV-2

This COVID-19 study aims to evaluate the acceptability and usability of in-home self-testing for SARS-CoV-2 antibodies


Keywords: SARS-CoV-2; COVID-19; prevalence; PCR; virus; point-of-care diagnostics

Q&A with the REACT team: REACT researchers Dr Atchison and Prof Barclay host a public Q&A session on antibody testing.

Short of a vaccine, testing is the only way out of lockdown.

Prof ara darzi

Description of the Study:

  • Title: REACT-2: a study of SARS-CoV-2 antibody seroprevalence in the community in England.
    – Study 3: Acceptability and usability study of in-home self-testing for SARS-CoV-2 antibodies in a population-based sample.
  • Principal Investigators: Steven Riley, Christina Atchison, Deborah Ashby, Christl A. Donnelly, Wendy Barclay, Graham Cooke, Helen Ward, Ara Darzi and Paul Elliott.
  • Centers of Implementation: Imperial College London, Imperial College Healthcare NHS Trust and Ipsos MORI.
  • Study Population: A nationally representative sample (n=14,000) of the adult population (aged 18 years and over) in England who do NOT have a medical condition (or are taking medication) that might increase bleeding risk from self-delivered finger prick with a lancet.
  • Type of study: Cross-sectional study.
  • Design: LFIA kits are posted to each registered individual with instructions (and a link to an online video) for them to perform the test at home. On completion of the test, participants are asked to record their interpretation of the result as part of an online survey, with the option of uploading a photograph of the test result window. Further questions include information on sociodemographic characteristics and questions around the acceptability and usability of the kits.
  • Methods:
    – To determine how accurately participants interpret their test result, they look at the agreement between a participant’s self-reported test result compared with a clinician’s interpretation of the same result.
    – Acceptability is defined as consenting to and using the provided self-test in the participants’ homes. 

Objectives of the Study:

Principal Objective: To study the acceptability and usability of in-home self-testing for COVID-19.

More about this Study:

REACT-2 is a series of five sub-studies towards establishing the seroprevalence of antibodies to SARS-CoV-2 in England as an indicator of historical infection. The main study (study 5) uses the same design and sampling approach as REACT-1 using a self-administered lateral flow immunoassay (LFIA) test for IgG antibodies in repeated samples of 100,000 to 200,000 adults aged 18 years and above. To inform study 5, studies 1-4 evaluate performance characteristics of SARS-CoV-2 LFIAs (study 1) and different aspects of feasibility, usability and application of LFIAs for home-based testing in different populations (studies 2-4).

Conclusions: The REACT-2 results and statistics can be found on this page.

REACT: The REal-time Assessment of Community Transmission (REACT) programme is a series of epidemiological studies that are seeking to improve understanding of how the COVID-19 pandemic is progressing across England. To do this, the programme is carrying out two major pieces of work that are looking at the possibility of using home sampling and testing to track the infection. REACT-1 programme is monitoring coronavirus infection levels over time, while REACT-2 programme is assessing antibody finger-prick tests and using these to estimate how far the virus has spread.

Together REACT-1 and REACT-2 will improve our understanding of the transmission of the virus in the community to help guide policies on continued social distancing and other control measures.

Other studies of REACT:A study of SARS-CoV-2 virus prevalence in the community in England“, “Clinical and laboratory evaluation of SARS-CoV-2 lateral flow immunoassays“, “Public involvement and pilot testing to assess the feasibility of in-home self-testing for SARS-CoV-2 antibodies“, “Usability and validity of LFIA self-testing in key workers, including the assessment of dry blood spots for SARS-CoV-2 antibody detection and saliva for SARS-CoV-2 viral detection” and “National seroprevalence study of SARS-CoV-2 antibodies using a lateral flow immunoassay self-administered test”.

Imperial College London


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