Children's National Hospital, Division of General and Community Pediatrics, Washington, DC.
Children's National Hospital, Center for Translational Research, Washington, DC.
Ethn Dis. 2021 Oct 21;31(4):519-526. doi: 10.18865/ed.31.4.519. eCollection 2021 Fall.
Black Americans are disproportionately affected by coronavirus disease 2019 (COVID-19) hospitalizations and deaths. Decreasing health disparities requires widespread uptake of COVID-19 testing, but attitudes about COVID-19 testing among Black Americans have not been studied. We aimed to characterize knowledge, attitudes, and beliefs about COVID-19 testing 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. Interviews were recorded and transcribed; 65% were double coded with a resultant free-marginal interrater kappa score of 86.8%.
Most participants were women, spent time inside the homes of friends or family members, and almost half knew someone diagnosed with COVID-19. Three central themes emerged regarding COVID-19 testing decision making, including: 1) perceived COVID-19 disease susceptibility; 2) barriers to testing, with subthemes including trust in test accuracy and safety, perceived stigma of a positive test result, and impact of racism on self-efficacy; and 3) cues to action.
When considering these themes as constructs of the Health Belief Model, we are better able to understand Black Americans' views of COVID-19 testing and motivations for accessing testing. Culturally responsive educational campaigns delivered by trusted community members should aim to improve understanding about disease transmission and types of tests available. Importantly, framing testing as a means to ensure safety may improve self-efficacy to obtain testing. Lastly, the health community should learn from these conversations with Black Americans so that disease prevention and mitigation strategies prioritize health equity.
非裔美国人因 2019 冠状病毒病（COVID-19）住院和死亡而受到不成比例的影响。减少健康差距需要广泛采用 COVID-19 检测，但尚未研究非裔美国人对 COVID-19 检测的态度。我们旨在描述黑人社群中对 COVID-19 检测的知识、态度和信念。
在儿童健康中心的远程医疗访问后，对 26 名自认为是黑人的父母进行了半结构式访谈，并采用现象学方法进行了分析。访谈进行了录音和转录；65%的访谈进行了双编码，最终的自由边际评分kappa 值为 86.8%。
大多数参与者是女性，在朋友或家庭成员的家中度过时间，近一半的人认识被诊断患有 COVID-19 的人。COVID-19 检测决策有三个核心主题，包括：1）感知 COVID-19 疾病易感性；2）检测障碍，包括对检测准确性和安全性的信任、对阳性检测结果的感知耻辱感、以及种族主义对自我效能的影响；3）行动线索。
当将这些主题视为健康信念模型的结构时，我们能够更好地理解非裔美国人对 COVID-19 检测的看法以及获取检测的动机。由值得信赖的社区成员提供的文化响应性教育运动应旨在提高对疾病传播和可用检测类型的理解。重要的是，将检测视为确保安全的一种手段可能会提高获得检测的自我效能。最后，医疗界应该从与非裔美国人的这些对话中吸取教训，以便疾病预防和缓解策略优先考虑公平。
