key: cord-0822133-961h5r54 authors: Jones, Jeb; Sullivan, Patrick S; Sanchez, Travis H; Guest, Jodie L; Hall, Eric W; Luisi, Nicole; Zlotorzynska, Maria; Wilde, Gretchen; Bradley, Heather; Siegler, Aaron J title: Similarities and Differences in COVID-19 Awareness, Concern, and Symptoms by Race and Ethnicity in the United States: Cross-Sectional Survey date: 2020-07-10 journal: J Med Internet Res DOI: 10.2196/20001 sha: 9248f2c53248adf49508e63f6fb880ba380c6719 doc_id: 822133 cord_uid: 961h5r54 BACKGROUND: Existing health disparities based on race and ethnicity in the United States are contributing to disparities in morbidity and mortality during the coronavirus disease (COVID-19) pandemic. We conducted an online survey of American adults to assess similarities and differences by race and ethnicity with respect to COVID-19 symptoms, estimates of the extent of the pandemic, knowledge of control measures, and stigma. OBJECTIVE: The aim of this study was to describe similarities and differences in COVID-19 symptoms, knowledge, and beliefs by race and ethnicity among adults in the United States. METHODS: We conducted a cross-sectional survey from March 27, 2020 through April 1, 2020. Participants were recruited on social media platforms and completed the survey on a secure web-based survey platform. We used chi-square tests to compare characteristics related to COVID-19 by race and ethnicity. Statistical tests were corrected using the Holm Bonferroni correction to account for multiple comparisons. RESULTS: A total of 1435 participants completed the survey; 52 (3.6%) were Asian, 158 (11.0%) were non-Hispanic Black, 548 (38.2%) were Hispanic, 587 (40.9%) were non-Hispanic White, and 90 (6.3%) identified as other or multiple races. Only one symptom (sore throat) was found to be different based on race and ethnicity (P=.003); this symptom was less frequently reported by Asian (3/52, 5.8%), non-Hispanic Black (9/158, 5.7%), and other/multiple race (8/90, 8.9%) participants compared to those who were Hispanic (99/548, 18.1%) or non-Hispanic White (95/587, 16.2%). Non-Hispanic White and Asian participants were more likely to estimate that the number of current cases was at least 100,000 (P=.004) and were more likely to answer all 14 COVID-19 knowledge scale questions correctly (Asian participants, 13/52, 25.0%; non-Hispanic White participants, 180/587, 30.7%) compared to Hispanic (108/548, 19.7%) and non-Hispanic Black (25/158, 15.8%) participants. CONCLUSIONS: We observed differences with respect to knowledge of appropriate methods to prevent infection by the novel coronavirus that causes COVID-19. Deficits in knowledge of proper control methods may further exacerbate existing race/ethnicity disparities. Additional research is needed to identify trusted sources of information in Hispanic and non-Hispanic Black communities and create effective messaging to disseminate correct COVID-19 prevention and treatment information. Please select True or False for each option. Wear a face mask Is the following statement true or false? Consistently wearing a face mask is highly effective in protecting you from getting infected with the new coronavirus. For the purpose of this question, "highly effective" is defined as reducing your risk of getting infected by >95% and a"face mask" is a common medical mask. Survey. Ann Intern Med. 2020; [Epub ahead of print 20 March 2020]. doi: https://doi.org/10.7326/M20-0912 How many people in the US do you think will die from the new coronavirus by the end of 2020? The next questions are about testing for COVID-19 by using a saliva sample or throat swab. Your results would be returned to you electronically and privately. • What is a home saliva sample? A home saliva sample would involve you spitting in a tube and sending it to a certified laboratory. • What is a home throat swab? A home throat swab would involve you using a throat swab and sending it into a certified laboratory. • What is a drive-through site? A drive-through site for throat swab would involve your traveling to a drive-through facility in your car to have a healthcare worker collect the swab. • What is a laboratory throat swab? A laboratory throat swab would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect the swab. I would be willing to go to a drivethrough site for throat swab test as part of a research study. I would be willing to go to a clinic for a lab-collected throat swab test as part of a research study. The next questions are about testing for COVID-19 by using a saliva sample or throat swab. Your results would be returned to you electronically and privately. • What is a home saliva sample? A home saliva sample would involve you spitting in a tube and sending it to a certified laboratory. • What is a home throat swab? A home throat swab would involve you using a throat swab and sending it into a certified laboratory. • What is a drive-through site? A drive-through site for throat swab would involve your traveling to a drive-through facility in your car to have a healthcare worker collect the swab. • What is a laboratory throat swab? A laboratory throat swab would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect the swab. The next questions are about testing for COVID-19 by using a saliva sample or throat swab. Your results would be returned to you electronically and privately. • What is a home saliva sample? A home saliva sample would involve you spitting in a tube and sending it to a certified laboratory. • What is a home throat swab? A home throat swab would involve you using a throat swab and sending it into a certified laboratory. • What is a drive-through site? A drive-through site for throat swab would involve your traveling to a drive-through facility in your car to have a healthcare worker collect the swab. • What is a laboratory throat swab? A laboratory throat swab would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect the swab. Compared to testing in a drive-through facility, would the availability of a home test kit to take a sample from your own mouth (spit or throat swab) for COVID-19 make you:* • Drive-through facility: A drive-through site would involve your traveling to a drive-through facility in your car to have a healthcare worker collect a sample from your mouth. • Sample from your own mouth: A sample from your mouth would involve you spitting in a tube or using a throat swab. About the same likelihood to participate in a research study Less likely to participate in a research study Compared to testing in a laboratory or clinic, would the availability of a home test kit to take a sample from your own mouth (spit or throat swab) for COVID-19 make you:* • Laboratory or clinic: A laboratory test would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect a sample from your mouth. • Sample from your own mouth: A sample from your mouth would involve you spitting in a tube or using a throat swab. About the same likelihood to participate in a research study Less likely to participate in a research study Compared to testing in a drive-through facility, would the availability of a home test kit to take a sample from your own mouth (spit or throat swab) for COVID-19 make you:* • Drive-through facility: A drive-through site would involve your traveling to a drive-through facility in your car to have a healthcare worker collect a sample from your mouth. • Sample from your own mouth: A sample from your mouth would involve you spitting in a tube or using a throat swab. More likely to seek COVID19 testing if you are feeling ill About the same likelihood to seek COVID19 testing if you are feeling ill Less likely to seek COVID19 testing if you are feeling ill Compared to testing in a laboratory or clinic, would the availability of a home test kit to take a sample from your own mouth (spit or throat swab) for COVID-19 make you:* • Laboratory or clinic: A laboratory test would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect a sample from your mouth. • Sample from your own mouth: A sample from your mouth would involve you spitting in a tube or using a throat swab. More likely to seek COVID19 testing if you are feeling ill About the same likelihood to seek COVID19 testing if you are feeling ill Less likely to seek COVID19 testing if you are feeling ill The next questions are about testing for COVID-19 antibodies by using a blood test. Your results would be returned to you electronically and privately.* • What is a home blood test?: A home blood test would involve using an automated finger prick device, collecting a blood sample on a specimen card, and mailing in a prepaid mailer to a certified laboratory. • What is a laboratory blood test?: A laboratory blood test would involve your traveling to a laboratory facility in a clinic or a private lab to have a blood draw similar to a usual doctor's visit. Agree Agree Undecided Disagree Strongly Disagree I would be willing to use a home blood test as part of a research study. I would be willing to go to a clinic for a lab-collected blood test as part of a research study. About the same likelihood to participate in a research study Less likely to participate in a research study Page logic: This page will show when question "Do you have children under age 18 in your household?" is "Yes". The next questions are about testing YOUR CHILD for COVID-19 by using a saliva sample or a throat swab. Your results would be returned to you electronically and privately. • What is a home saliva sample?: A home saliva sample would involve your child spitting in a tube and sending it to a certified laboratory. • What is a home throat swab?: A home throat swab would involve you using a throat swab and sending it into a certified laboratory. • What is a drive-through site?: A drive-through site for throat swab would involve your traveling to a drive-through facility in your car to have a healthcare worker collect the swab. • What is a laboratory throat swab?: A laboratory throat swab would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect the swab. Page logic: This page will show when question "Do you have children under age 18 in your household?" is "Yes". The next questions are about testing YOUR CHILD for COVID-19 by using a saliva sample or a throat swab. Your results would be returned to you electronically and privately. • What is a home saliva sample?: A home saliva sample would involve your child spitting in a tube and sending it to a certified laboratory. • What is a home throat swab?: A home throat swab would involve you using a throat swab and sending it into a certified laboratory. • What is a drive-through site?: A drive-through site for throat swab would involve your traveling to a drive-through facility in your car to have a healthcare worker collect the swab. • What is a laboratory throat swab?: A laboratory throat swab would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect the swab. Page logic: This page will show when question "Do you have children under age 18 in your household?" is "Yes". The next questions are about testing YOUR CHILD for COVID-19 by using a saliva sample or a throat swab. Your results would be returned to you electronically and privately. • What is a home saliva sample?: A home saliva sample would involve your child spitting in a tube and sending it to a certified laboratory. • What is a home throat swab?: A home throat swab would involve you using a throat swab and sending it into a certified laboratory. • What is a drive-through site?: A drive-through site for throat swab would involve your traveling to a drive-through facility in your car to have a healthcare worker collect the swab. • What is a laboratory throat swab?: A laboratory throat swab would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect the swab. I would be willing to apply a home throat swab test to my child as part of follow-up care. I would be willing to take my child to a drive-through site for throat swab test as part of follow-up care. I would be willing to take my child to a clinic for a lab-collected throat swab test as part of follow-up care. Page logic: This page will show when question "Do you have children under age 18 in your household?" is "Yes". Compared to testing your child in a drive-through facility, would the availability of a home test kit to take a sample from your child's mouth (spit or throat swab) for COVID-19 make you:* The following definitions were displayed to respondents in a pop-up box if clicked for more information. • Drive-through facility: A drive-through site would involve your traveling to a drive-through facility in your car to have a healthcare worker collect a sample from your child's mouth. • Sample from your child's mouth: A sample from your child's mouth would involve your child spitting in a tube or using a throat swab. More likely to have your child participate in a research study About the same likelihood to have your child participate in a research study Less likely to have your child participate in a research study Compared to testing your child in a laboratory or clinic, would the availability of a home test kit to take a sample from your child's mouth (spit or throat swab) for COVID-19 make you:* • Laboratory or clinic: A laboratory test would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect a sample from your child's mouth. • Sample from your child's mouth: A sample from your child's mouth would involve your child spitting in a tube or using a throat swab. More likely to have your child participate in a research study About the same likelihood to have your child participate in a research study Less likely to have your child participate in a research study Page logic: This page will show when question "Do you have children under age 18 in your household?" is "Yes". Compared to testing your child in a drive-through facility, would the availability of a home test kit to take a sample from your child's mouth (spit or throat swab) for COVID-19 make you:* • Drive-through facility: A drive-through site would involve your traveling to a drive-through facility in your car to have a healthcare worker collect a sample from your child's mouth. • Sample from your child's mouth: A sample from your child's mouth would involve your child spitting in a tube or using a throat swab. More likely to have your child get COVID19 testing if they are feeling ill About the same likelihood to have your child get COVID19 testing if they are feeling ill Less likely to have your child get COVID19 testing if they are feeling ill Compared to testing your child in a laboratory or clinic, would the availability of a home test kit to take a sample from your child's mouth (spit or throat swab) for COVID-19 make you:* The following definitions were displayed to respondents in a pop-up box if clicked for more information. • Laboratory or clinic: A laboratory test would involve your traveling to a laboratory facility in a clinic or private laboratory to have a healthcare worker collect a sample from your child's mouth. • Sample from your child's mouth: A sample from your child's mouth would involve your child spitting in a tube or using a throat swab. More likely to have your child get COVID19 testing if they are feeling ill The next questions are about testing YOUR CHILD for COVID-19 antibodies by using a blood test. Your results would be returned to you electronically and privately. * • What is a home blood test?: A home blood test would involve using an automated finger prick device, collecting a blood sample on a specimen card, and mailing in a prepaid mailer to a certified laboratory. • What is a laboratory blood test?: A laboratory blood test would involve your traveling to a laboratory facility in a clinic or a private lab to have a blood draw similar to a usual doctor's visit. Agree Agree Undecided Disagree Strongly Disagree I would be willing to apply a home blood test to my child as part of a research study. I would be willing to take my child to a clinic for a lab-collected blood test as part of a research study. Thank you for all of the information you have provided so far. We have just a few last questions. Our research group is also enrolling for another study about COVID-19. That study is offering a $50 token of appreciation for eligible participants to complete a home specimen collection kit for COVID-19 and a behavioral survey. The study will test the willingness and acceptability to complete and send at-home specimens, and gather input to improve home specimen kit collection instructions. Are you interested in learning more about this study?* Question logic: This question will show when question "Are you interested in learning more about this study?" is "Yes". Thank you for your interest. Please provide an email address so we can reach out to you with more information about the specimen collection study. Note: Gender identity question was moved from Part 1 Demographics to Part 2 Demographics on the final day of data collection as part of amendment to increase minority representation in the sample. What is your current gender identity?* Transgender female/Trans woman Transgender male/Trans man Genderqueer Other (please specify): What is the highest level in school that you completed? College, post graduate, or professional school Some college, Associate's Degree and/or Technical School High school or GED your household income last year from all sources before taxes? (monthly/yearly) $0 to $417 (monthly) / $0 to $ $418 to $833 (monthly) / $5,000 to $9 $2,501 to $3,333 (monthly) / $30 $6,251 or more (monthly) / $75,000 or more (yearly) Don't know For more information about Coronavirus and how to protect yourself, please visit https://www.cdc.gov/coronavirus/2019-ncov/index.html.