Optimisation of Instructions for the Use of COVID-19 Self-Test Kits in Abuja, Nigeria: Enhancing Usability with References from Malawi and Zimbabwe

Abstract

Background: Self-test kits have emerged as promising tools for enhancing testing accessibility and convenience. We optimised the instructions for the use of self-test kits for Corona Virus Disease (COVID-19) testing in Nigeria, drawing from adaptations made by Malawi and Zimbabwe to ensure accurate self-testing outcomes and promote effective self-testing practices. Methods: We conducted a qualitative study employing the health literacy framework, a cognitive interview of three rounds of iterations among participants selected purposively across primary health care, patent medicine stores, and community pharmacy settings. We observed while they performed COVID-19 self-testing using modified Instruction For Use (IFU). A structured guide, which outlined the process of testing in the IFU, was used to guide the optimization process. Qualitative data were analysed using a thematic approach and proportions. Results: Twelve participants were recruited over three rounds of iterative cognitive interviews. Seventy-five percent were females, and over half had a primary and secondary education. Overall, all participants (100%) recorded usability in conducting the steps in the testing process, with a few records of misinterpretation of the images, symbols, and instructions in the IFU among participants during the self-testing process. However, all the participants interpreted their test results correctly after the first round of IFU revision. Conclusion: Despite cultural differences, the adapted optimised IFUs required only minor modifications in Nigeria to support accurate self-testing. Our results show the value of rapid evaluation of manufacturer’s IFUs using cognitive interviewing.