Barriers to and strategies to address COVID-19 testing hesitancy: a rapid scoping review

Mark Embrett, S. Meaghan Sim, Hilary A.T. Caldwell, Leah Boulos, Ziwa Yu, Gina Agarwal, Rhiannon Cooper, Allyson J.Gallant Aj, Iwona A. Bielska, Jawad Chishtie, Kathryn Stone, Janet Curran, Andrea Tricco

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Background: Testing is a foundational component of any COVID-19 management strategy; however, emerging evidence suggests that barriers and hesitancy to COVID-19 testing may affect uptake or participation and often these are multiple and intersecting factors that may vary across population groups. To this end, Health Canada’s COVID-19 Testing and Screening Expert Advisory Panel commissioned this rapid review in January 2021 to explore the available evidence in this area. The aim of this rapid review was to identify barriers to COVID-19 testing and strategies used to mitigate these barriers. Methods: Searches (completed January 8, 2021) were conducted in MEDLINE, Scopus, medRxiv/bioRxiv, Cochrane and online grey literature sources to identify publications that described barriers and strategies related to COVID-19 testing. Results: From 1294 academic and 97 grey literature search results, 31 academic and 31 grey literature sources were included. Data were extracted from the relevant papers. The most cited barriers were cost of testing; low health literacy; low trust in the healthcare system; availability and accessibility of testing sites; and stigma and consequences of testing positive. Strategies to mitigate barriers to COVID-19 testing included: free testing; promoting awareness of importance to testing; presenting various testing options and types of testing centres (i.e., drive-thru, walk-up, home testing); providing transportation to testing centres; and offering support for self-isolation (e.g., salary support or housing). Conclusion: Various barriers to COVID-19 testing and strategies for mitigating these barriers were identified. Further research to test the efficacy of these strategies is needed to better support testing for COVID-19 by addressing testing hesitancy as part of the broader COVID-19 public health response.

Original languageEnglish
Article number750
JournalBMC Public Health
Issue number1
StatePublished - Dec 2022
Externally publishedYes


  • Coronavirus
  • Covid-19
  • Equity
  • Health policy
  • Scoping review
  • Social determinants of health
  • Testing
  • Testing hesitancy


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