Would I Lie to You? Falsification of Lateral Flow Tests in England During the Covid-19 Pandemic

Abstract During the COVID-19 pandemic, lateral flow tests (LFTs) were used in England to regulate access to work, education, social activities, and travel. However, falsification of home LFT results was a concern. This study estimated the prevalence of LFT falsification behaviours (FBs) in a representative sample of adults living in England (n=1577) who have previously taken an at-home LFT using direct questioning (DQ) and an indirect questioning technique, the extended crosswise model (ECWM). The prevalence of FBs using DQ was significantly lower than ECWM estimates (reporting a negative result without conducting a test: 5.7% DQ vs 18.4% ECWM; reporting a positive test as negative 4.6% DQ vs 11.0% ECWM; producing a fake positive test 1.7% DQ vs 6.4% ECWM). Moral norms, subjective norms, anticipated regret, perception of risk to self, and trust in government predicted some FBs. Home LFT testing is subject to prevalent FBs. Data about compliance with behavioural regulations derived from conventional DQ methods can considerably affect the quality of the evidence available to policymakers and public health experts in their decision making. Indirect questioning techniques can help provide more realistic and higher quality data to government and public health agencies.