Perceptions of COVID-19 self-testing and recommendations for implementation and scale-up among Black/African Americans: implications for the COVID-19 STEP project


Ucheoma Nwaozuru, Department of Implementation Science, Wake Forest School of Medicine, 475 Vine Street, Winston-Salem, NC, 27101, USA.
Chisom Obiezu-Umeh, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, Saint Louis, MO, 63104, USA.
Hassim Diallo, School of Public Health, University of Maryland, College Park, MD, 20742, USA.
Danielle Graham, Department of Africana Studies, University of Cincinnati, 2815 Commons Way, Cincinnati, OH, 45221-0370, USA.
Guy-Lucien Whembolua, Department of Africana Studies, University of Cincinnati, 2815 Commons Way, Cincinnati, OH, 45221-0370, USA.
Marie Janeeca Bourgeau, Department of Psychology, Queens College, City University of New York, 65-30 Kissena Blvd, Queens, New York, NY, 11567, USA.
Tiarney D. Ritchwood, Department of Family Medicine and Community Health, Duke University School of Medicine, 2200 W Main St, Durham, NC, 27705, USA.
LaRon E. Nelson, School of Nursing, Yale University, 400 West Campus Drive, Orange, CT, 06477, USA.
Thembekile Shato, Washington University in Saint Louis, Brown School, 1 Brookings Drive, Saint Louis, MO, 63130, USA.
Allison Mathews, Gilead COMPASS Faith Coordinating Center, School of Divinity, Wake Forest University, 2596 Reynolda Rd., Suite 215C, Winston-Salem, NC, 27106, USA.
Rhoda Moise, Rhoda Moise, LLC, 127 Church Road, Elkins Park, PA, 19027, USA.
Maranda C. Ward, School of Medicine and Health Science, The George Washington University, 2600 Virginia Ave, NW, Washington, DC, 20036, USA.
Jocelyn Raude, EHESP School of Public Health, Avenue du Pr Leon Bernard, F-35000, Rennes, France.
Aima A. Ahonkhai, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, USA.
Diane J. Young, Prince George's County Health Department, Family Health Services, Largo, MD, 20774, USA.
Donaldson F. Conserve, The George Washington University, Milken Institute School of Public Health, 950 New Hampshire Ave, NW, Washington, DC, 20052, USA.

Document Type

Journal Article

Publication Date



BMC public health








Barriers; Black/African Americans; COVID-19 self-testing; Facilitators


BACKGROUND: COVID-19 self-testing (ST) is an innovative strategy with the potential to increase the access and uptake of testing and ultimately to limit the spread of the virus. To maximize the uptake and reach of this promising strategy and inform intervention development and scale up, research is needed to understand the acceptability of and willingness to use this tool. This is vital to ensure that Black/African Americans are reached by the Biden-Harris Administration's free national COVID-19 ST program. This study aimed to explore the acceptability and recommendations to promote and scale-up the uptake of COVID-19 ST among Black/African Americans. METHODS: We conducted a cross-sectional qualitative study using a semi-structured questionnaire to assess barriers and facilitators to the uptake of COVID-19 ST among a convenience sample of 28 self-identified Black/African Americans from schools, community centers, and faith-based institutions in Ohio and Maryland. Inductive content analysis was conducted to identify categories and subcategories related to acceptability and recommendations for implementing and scaling up COVID-19 ST in communities. RESULTS: Participants perceived COVID-19 self-testing as an acceptable tool that is beneficial to prevent transmission and address some of the barriers associated with health facility testing, such as transportation cost and human contact at the health facility. However, concerns were raised regarding the accurate use of the kits and costs. Recommendations for implementing and scaling up COVID-19 ST included engagement of community stakeholders to disseminate information about COVID-19 self-testing and creating culturally appropriate education tools to promote knowledge of and clear instructions about how to properly use COVID-19 ST kits. Based on these recommendations, the COVID-19 STEP (Self-Testing Education and Promotion) Project is being developed and will involve engaging community partners such as barbers, church leaders, and other community-based organizations to increase the uptake and use of free COVID-19 ST kits among Black/African Americans. CONCLUSION: Findings showed that most participants considered COVID-19 ST valuable for encouraging COVID-19 testing. However, cost and accuracy concerns may pose barriers. Future work should consider implementing interventions that leverage the benefits of COVID-19 ST and further assess the extent to which these identified facilitators and barriers may influence COVID-19 ST uptake.


Prevention and Community Health