Sentiments about COVID-19 testing among Black parents in the United States

Black-majority communities have been disproportionately affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, hospitalizations and deaths. As of September 2021, Black Americans had nearly three times the hospitalization rate and double the death rate due to coronavirus disease 2019 (COVID-19), as compared to White Americans.

An analysis led by Sarah Schaffer DeRoo, M.D., pediatrician at Children’s National Hospital, aimed to characterize knowledge, attitudes and beliefs about COVID-19 testing – a key tool for preventing COVID-19 transmission – among Black parents.

Semi-structured interviews were conducted and analyzed using a phenomenology approach with 26 self-identified Black parents after telemedicine visits with a children’s health center. Three central themes emerged regarding COVID-19 testing decision-making, including perceived COVID-19 disease susceptibility, barriers to testing and cues to action. Parents were keen to pursue testing to ensure the safety of themselves and their loved ones, especially if they perceived a high risk for COVID-19 infection, such as due to a known positive contact. However, barriers to testing for some parents included concerns about accuracy and safety of the tests, as well as possible stigma associated with a positive test result. Parents also shared their concern that a positive test result would not be met with an appropriate medical response due to structural racism in the health care system, making some reluctant to pursue testing.

“When considering the themes that emerged from these interviews, we were able to better understand Black Americans’ views of COVID-19 testing and motivations for accessing testing,” says Dr. Schaffer DeRoo. “Culturally responsive educational campaigns delivered by trusted community members should aim to improve understanding about disease transmission and testing.”

Framing testing as a means to ensure safety and acknowledging and addressing institutionalized racism that affects COVID-19 care may improve self-efficacy to obtain testing. “The health community should learn from these conversations with Black Americans so that disease prevention and mitigation strategies prioritize health equity,” says Dr. Schaffer DeRoo.