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Abstract
Objective To assess the impact of describing an antibody-positive test result using the terms Immunity and Passport or Certificate, alone or in combination, on perceived risk of becoming infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and protective behaviours.
Design 2×3 experimental design.
Setting Online.
Participants 1204 adults from a UK research panel.
Intervention Participants were randomised to receive one of six descriptions of an antibody test and results showing SARS-CoV-2 antibodies, differing in the terms describing the type of test (Immunity vs Antibody) and the test result (Passport vs Certificate vs Test).
Main outcome measures Primary outcome: proportion of participants perceiving no risk of infection with SARS-CoV-2 given an antibody-positive test result. Other outcomes include: intended changes to frequency of hand washing and physical distancing.
Results When using the term Immunity (vs Antibody), 19.1% of participants (95% CI 16.1% to 22.5%) (vs 9.8% (95% CI 7.5% to 12.4%)) perceived no risk of catching coronavirus given an antibody-positive test result (adjusted OR (AOR): 2.91 (95% CI 1.52 to 5.55)). Using the terms Passport or Certificate—as opposed to Test—had no significant effect (AOR: 1.24 (95% CI 0.62 to 2.48) and AOR: 0.96 (95% CI 0.47 to 1.99) respectively). There was no significant interaction between the effects of the test and result terminology. Across groups, perceiving no risk of infection was associated with an intention to wash hands less frequently (AOR: 2.32 (95% CI 1.25 to 4.28)); there was no significant association with intended avoidance of physical contact (AOR: 1.37 (95% CI 0.93 to 2.03)).
Conclusions Using the term Immunity (vs Antibody) to describe antibody tests for SARS-CoV-2 increases the proportion of people believing that an antibody-positive result means they have no risk of catching coronavirus in the future, a perception that may be associated with less frequent hand washing.
Trial registration number Open Science Framework: https://osf.io/tjwz8/files/
- public health
- public health
- immunology
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Footnotes
Twitter @Jo_WallerKCL
Contributors The study was conceptualised by TM, JW and GJR. ALM completed the data collection. JW and HWWP analysed the data. All authors contributed to, and approved, the final manuscript.
Funding Data collection for this study was funded by a block UK government grant to the Behavioural Insights Team. JW is funded by a career development fellowship from Cancer Research UK (Ref C7492/A17219). GJR is funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with Public Health England (PHE), in collaboration with the University of East Anglia.
Disclaimer The views expressed in this paper are those of the authors and not necessarily those of UK government, Cancer Research UK, NIHR or Public Health England.
Competing interests HWWP declares consultancy fees from Babylon Health.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval Ethical approval for this study was granted by the King’s College London Research Ethics Committee (reference: MRA-19/20-18685).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request. Anonymised data will be made available upon reasonable request.