ABSTRACT
Background: While nationwide SARS-CoV-2 testing in the United States shifted from facility- to home-based in 2021, less is known about testing behavior of older adults who live at home. We analyze characteristics of older adults who reported facility-based testing with those who tested only at home or at both locations. Method(s): Adults 70 years and older living at home with a landline in New York City were selected using random digit dialing and completed a COVID-19 survey from February 2022 - March 2022. We conducted descriptive statistics using survey weights and bi-variable and multivariable analyses. Result(s): Overall, 237 of a total of 294 (81%) participants had tested for SARS-CoV-2 in the prior year. Among those who tested, 81% had tested only at a facility, 4% only tested at home, and 15% tested at both locations (home and facility). White participants more often reported testing at both locations (27%) compared to Black (7%), Latinx (7%) or participants of another race (11%;p-value: 0.004). Those with college education or higher were less likely to rely solely on facilities for testing (75%) compared to those with less education (91%;p-value: 0.02) and 38% of those who reported currently working had tested both locations compared to only 12% of those who were not working (pvalue: 0.002). There were no differences in testing by age, sexual orientation, or self-reported mobility. A multivariable logistic regression model that compared those who only tested at a facility with those who tested at both locations or only at home found that when adjusting for working status, age group and education, compared to White participants, Black participants had a third (0.33) the odds of white participants of testing at home or at both locations (p-value: 0.026). Conclusion(s): In this sample of urban older adults, using a facility for SARS-CoV-2 testing was more frequently reported than testing at home, indicating the need to retain facility-based testing for this population. However, White participants, more educated participants and those who were working more frequently reported home-based testing compared to other groups suggesting that social constraints may limit access to home testing among the latter group of older adults.