Summary

The REACT study, which stands for REal-time Assessment of Community Transmission, is a complex research programme looking at community transmission of SARS-COV-2, the virus that causes COVID-19.  One arm of the study, REACT-2, aims to better understand how many people have already had COVID-19 through home-based antibody testing. However, an important part of this includes confirming how accurate, easy to use and acceptable these self-testing antibody kits are before sending them to larger numbers of the general public. PERC are supporting this study by carrying out community involvement to gain early insight on people's thoughts about antibody testing in general, as well as their questions, concerns and suggestions to inform piloting of the self-testing kits in the community.

On Friday 1st May 2020, we held a community involvement zoom call (12–1pm), which was attended by 37 members of the public from across the UK. The majority were relatively experienced with public involvement in research, but for some this was their first time engaging with us in this way.

The agenda for the call included:

1. Context for the call and an introduction to the project team
2. A quick introduction to antibody testing and immunity
3. Our plans for the REACT studies and community involvement
4. Q&A and PreDiscussion Poll
5. Breakout room discussions (4 rooms; 9–10 members of the public per room) covering broad topics including (i) Understanding/Concerns/Acceptability (ii) Logistics (iii) Public material
6. Next Steps and Further Questions.
   
   

Key Insights

Overall the REACT study was well received, and at-home antibody testing was viewed to be appropriate. However, some felt an alternative approach to testing (beyond just at-home/self-testing) would be needed for certain groups who might struggle with the test due to perceived usability/accessibility challenges. Comments raised during the breakout room discussions have been themed and summarized in our Insight Report, which is available to download. Key messages are highlighted below.

• Overall support for the at-home antibody test with most feeling they would want to take part. 
  ➢ 97% (n=34) of respondents to our anonymous snap poll said they would be likely or very likely to take an at-home antibody test based on what they had heard during the call
  ➢ Participants also suggested they would be happy for the test to be available to their family members with some attendees also feeling that it would acceptable and desirable to test children with parental consent although this is something we would want to explore further with parent groups.

• Perceived usability challenges of the test may exclude certain members of the population.
  ➢ In general, the test was seen to present usability/accessibility challenges for those with physical or mental impairments, or those for whom English is not their first language.
  ➢ Several parts of the testing kit were viewed as being difficult to use or needing improvement. For example, people found the pipette difficult to use or did not understand where to deposit the blood on the cassette.
  
  
• Instruction video and booklet considered to be clear and well designed
  ➢ The sharing of testing instructions via a combination of video and instruction booklet was received positively, with both parts thought to be well designed.
  ➢ Some changes were suggested to improve their comprehensibility. For example, making the video shorter or in two parts and adding more detail to the booklet.
  ➢ Although call participants understood the REACT2 study is focused on the usability of the test (and that individual results could not be relied on as an indicator of immunity), there were still a number of comments regarding the accuracy of the results, including: (1) Concern around how people might interpret and feel about their test results and whether it would cause people to change their behaviour; and (2) Suggestions around how the accuracy of the test and purpose of study could be conveyed more clearly in the information booklet and what the limitations would mean for people’s perceptions of the test.
  
  
• Attendees identified several ways that the REACT2 study could be improved, including:
  ➢ Clear data sharing agreements
  ➢ Strong and consistent messaging and external/public communication about the study
  ➢ Recruitment that ensures representation from the BAME communities who might be most affected be SARS-COV-2 and/or the coronavirus outbreak in general
  
  

Next steps and study results

The REACT study is now underway. More information and updates on the latest findings can be found on the REACT study page. This includes our study findings on the usability and acceptability of coronavirus antibody testing, which was published on 12 August 2020. Click the following links to read the full peer-reviewed publication or an Infographic Summary (REACT-2: Usability and Acceptability Study). This long-read blog also gives more insight into what we learnt during our journey testing the usability of at-home antibody tests with members of the public.

We have established a Public Advisory Group comprised of eight public members who are continuing to guide and inform our research plans, study material and communication. You can also learn more about a related public involvement activity in which we invited parents/carers and young people to share their views on the acceptability of antibody testing on children.