# Awareness and Use of Home-Based Respiratory Pathogen Testing Services in the Internet Era: Postpandemic Questionnaire Study

## TL;DR

This study explores how people in urban China are aware of and willing to use home-based respiratory testing services, finding that most see benefits but have concerns about privacy and accuracy.

## Contribution

The study introduces a novel analysis of adoption factors for home-based respiratory pathogen testing in a postpandemic digital health context.

## Key findings

- 54.7% of respondents were aware of home-based respiratory pathogen testing services.
- Higher education and living with family were significant predictors of adoption intention.
- Over 70% of respondents expressed willingness to adopt these services if available.

## Abstract

Home-based respiratory pathogen testing services (HRPTS), an emerging internet-based health care model, enable rapid pathogen identification within hours through digital platforms and eCommerce logistics. This decentralized approach overcomes conventional testing delays to accelerate diagnosis. However, public awareness, adoption, and influencing factors remain largely unknown.

In this study, we aimed to investigate digitally connected metropolitan residents' awareness and intention to adopt HRPTS and analyze factors influencing adoption intention.

This study used a structured questionnaire grounded in the technology acceptance model, which measured perceived usefulness, ease of use, risk, and behavioral intention. Questionnaire development involved focus group discussions to ensure content validity. Statistical analysis included descriptive statistics and multivariate linear regression, with scale reliability and validity confirmed by exploratory factor analysis. Using a convenience sampling strategy, 1850 volunteers completed questionnaires via Wenjuanxing. After data validation, 1756 surveys met the inclusion criteria (effective response rate: 94.92%) and were analyzed.

Among 1756 respondents, 54.7% (n=961) knew about HRPTS for respiratory diseases, and 15.3% (n=269) had previously used them. Perceived usefulness was high among respondents: fast pathogen identification (n=1092, 62.2%), early treatment (n=1136, 64.7%), time or cost savings (n=1119, 63.7%), and anxiety alleviation (n=1110, 63.2%). Regarding perceived ease of use, 55.9% (n=982) of the respondents cited robust logistics, 53.8% (n=945) cited online appointment convenience, and 54.2% (n=952) cited simple self-sampling. However, respondents expressed concerns regarding privacy (n=925, 52.7%), test accuracy questions (n=871, 49.6%), and insufficient regulations (n=948, 54.0%). Nevertheless, >70% of the respondents were willing to adopt HRPTS, if available. Multivariate regression showed that higher education (β=.598; P<.001), living with family (β=.271; P=.04), and absence of underlying chronic diseases (β=.321; P=.03) were significant predictors of adoption intention. Additionally, not having used HRPTS before (β=−1.203; P<.001) and less frequent health care–seeking behaviors were negatively associated with adoption intention.

HRPTS as an internet-based health care service holds value for early diagnosis, treatment, and health care optimization in urban China. However, significant concerns regarding test accuracy, data privacy, and regulatory accountability within this evolving digital health sector should be addressed to strengthen respiratory disease prevention in the postpandemic era.