TABLE 3.

Test‐related factors as barriers to diagnostic testing and their associated psychosocial consequences, according to community health workers and Promotor/as

Barriers	Sub‐categories	Sample quotations	Psychosocial consequences
Cost of test	1. Affordability	Often, when they do the blood test, they charge $75 or $50 and [people] don't have [the money] … if you are active with COVID‐19, what is going to happen next? Who is going to carry the bill? A lot of [people] in my area do not have medical insurance. So it seems l.	Worry Fear Confusion Doubt Frustration Despair Perceived discrimination Sense of unfairness
		What they have heard is horror stories that the testing is very expensive … they rather not get tested and just wait and see if they have symptoms.
Test characteristics	1. Accuracy	It is costing people a lot of money, with unreliable results. They know that the accuracy of the test is not good, so they do not trust in those things … people are scared and frantic …. they are paying just to find out and then it is not even 100 percent [accurate].
	2. Variations in test administration	I do not think it is that accurate, because … if you did it [tested] yourself, you do not know if everyone does it [that way]. You wonder if you did it correctly because you are not someone who knows or has practiced doing those types of [self‐administered nasal swab] tests.
Testing Information	1. Confusion between diagnostic and antibody testing	they rather not ge It seems like there is a disparity in [testing] price and confusion in terms of what test [to take] … [people] have a lot of questions because one [test] is through the nasal cavities and another is with a blood sample … [people] do not know which test to get done.
		Someone that I knew took a test … they did blood work and then they did the swab … she did say, “Well, with the blood, I came out negative, so I am good” … I did not understand what she meant by that.
		One of the employees ended up being positive with COVID … he was so scared because his wife was pregnant … he ended up going to get tested somewhere else but with the nasal [swab] … it ended up saying that he was negative.
	2. Poor understanding or rumours about the testing procedure	I heard that it is dangerous to have the test go down so far into your nose and it may choke you … they say they hurt you, that they make you bleed … I am afraid of doing the test myself.
		[People say] that [testing] is painful … I had a client who claimed it was as if they were touching the brain.
	3. Not knowing where to test	The information they are lacking is where to go … several people have called me because they do not know where to go get tested.
	4. Not knowing when to test	There is a lot that we need to know… when is it a right time to check? What to do?
	5. Testing requirements (e.g., documentation)	A big question is whether or not they will accept their Matricula, whether or not they will accept the identification … if they have an identification or if it is expired … [many] find out later that they are not qualified … people think that legal documents are required prior to testing and that people need a doctor's prescription to get tested.
Testing logistics	1. Scarcity of tests	There are not enough tests … many times [people] do not get tested because by the time their turn comes, they are turned away and told there are no more tests available, even though they are getting up very early to get tested.
		A lot of testing sites are booked … it is a big problem because you go to the website and it is constantly booked and you cannot book a week in advance.
	2. Not convenient (e.g., long wait; competing demands; safety protocols)	I have to work, and I do not have the time to go stand in line, so I am not going to get tested.
		I had an experience with an individual who came to the local clinic … upon arrival, a staff member told her she had to get in her car, because she couldn't be outside there because she was putting others at risk … she replied, “Miss, look, I do not have a car, I took the bus” … the staff member told her, “Then, I am terribly sorry, but I can't test you.”

Other people to know. It is like.