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Related Experiment Video

Updated: Jun 19, 2026

Remote Laboratory Management: Respiratory Virus Diagnostics

Remote Laboratory Management: Respiratory Virus Diagnostics

Published on: April 6, 2019

Diagnostic Testing Preferences in Rural and Vulnerable Populations During a Pandemic: Discrete Choice Experiment.

Eline van den Broek-Altenburg¹, Jamie Benson², Yvonne Jonk³

¹Department of Radiology, College of Medicine, University of Vermont, 89 Beaumont Avenue, Burlington, VT, 05405, United States, 1 8024956029.

JMIR Public Health and Surveillance

|October 21, 2025

Summary

COVID-19 testing access for vulnerable populations was challenging. Individual preferences, not just rurality, influence testing choices, highlighting the need for tailored health interventions.

Keywords:

access to care diagnostic testing discrete choice experiment individual and surveillance testing pandemic preferences rural populations

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Area of Science:

Public Health
Health Services Research
Behavioral Science

Background:

COVID-19 pandemic testing and treatment access was a challenge for vulnerable populations.
States implemented testing sporadically, creating uncertainty about access barriers for disadvantaged groups.
It remains unclear if barriers were systemic (e.g., rurality) or individual-driven.

Purpose of the Study:

To understand trade-offs in COVID-19 testing attributes among rural and vulnerable populations.
To explore how individual preferences for testing vary across different demographics.
To inform the RADx-UP consortium's research on COVID-19 testing patterns.

Main Methods:

Conducted 7 focus groups to identify barriers and strategies for COVID-19 testing.
Developed discrete choice experiments based on focus group findings.
Collected data from an online panel (n=780) oversampling rural populations, analyzed using conditional logit and latent class analysis.

Main Results:

Testing location attributes like wait time, travel time, cost, sample collection method, result turnaround, and discomfort significantly influenced choices.
Mail-order options and higher test accuracy were preferred.
Individual factors such as age, medical vulnerability, insurance, trust in government, and flu vaccination history were primary drivers of preference heterogeneity, more so than rurality.

Conclusions:

Social, behavioral, and policy factors significantly impact testing choices.
Rurality itself did not significantly affect testing preferences; rather, attitudes toward government and other beliefs were key.
Healthcare interventions must align with the underlying values of subpopulations to effectively reduce rural health disparities.