When Usability Isn't Enough: Understanding Rural Challenges in Respiratory Virus Test Interpretation

Area of Science:

• Public Health
• Health Disparities
• Diagnostic Testing

Background:

• At-home diagnostic tests are crucial for managing respiratory illnesses like COVID-19 and influenza.
• Understanding usability and comprehension across diverse populations is essential for effective public health strategies.
• Geographic disparities may impact the interpretation and outcomes of at-home diagnostic testing.

Purpose of the Study:

• To evaluate the usability and comprehension of at-home COVID-19 and influenza diagnostic tests.
• To compare test interpretation and outcomes between rural and urban populations in Georgia.
• To identify disparities that can inform public health interventions for underserved communities.

Main Methods:

• 592 participants with respiratory symptoms were enrolled from rural Georgia and urban Atlanta.
• Structured usability assessments and RT-PCR confirmed diagnostic testing were performed.
• Demographic, clinical, and survey data were analyzed to compare rural and urban groups.

Main Results:

• Rural participants were older, with higher positivity rates for COVID-19 and Flu A in urban areas.
• Overall usability ratings exceeded 94% in both groups.
• Rural participants showed lower accuracy in identifying invalid test results and were more prone to procedural errors.

Conclusions:

• Geographic location significantly impacts diagnostic test comprehension, despite high usability.
• Gaps in recognizing invalid results among rural populations necessitate targeted educational strategies.
• Simplified instructions and tailored education are crucial for equitable test interpretation and public health response.