Sociodemographic characteristics of SARS-CoV-2 serosurveillance studies with diverse recruitment strategies, Canada, 2020 to 2023

Publication date: Dec 30, 2024

Background. Serological testing was a key component of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) surveillance. Social distancing interventions, resource limitations, and the need for timely data led to serosurveillance studies using a range of recruitment strategies, which likely influenced study representativeness. Characterizing representativeness in surveillance is crucial to identify gaps in sampling coverage and to assess health inequities. Methods. We retrospectively analyzed three pre-existing longitudinal cohorts, two convenience samples using residual blood, and one de novo probabilistic survey conducted in Canada between April 2020 – November 2023. We calculated study specimen counts by age, sex, urbanicity, race/ethnicity, and neighborhood deprivation quintiles. We derived a ‘representation ratio’ as a simple metric to assess generalizability to a target population and various sociodemographic strata. Results. The six studies included 1,321,675 specimens. When stratifying by age group and sex, 65% of racialized minority subgroups were moderately underrepresented (representation ratio < 0.75). Representation was generally higher for older Canadians, urban neighborhoods, and neighborhoods with low material deprivation. Rural representation was highest in a study that used outpatient laboratory blood specimens. Racialized minority representation was highest in a de novo probabilistic survey cohort. Conclusion. While no study had adequate representation of all subgroups, less traditional recruitment strategies were more representative of some population dimensions. Understanding demographic representativeness and barriers to recruitment are important considerations when designing population health surveillance studies.

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Concepts Keywords
August Blood
Canada Canadian
December Canpath
Healthcare Ccahs
Pathogens12040551 Clsa
Cohort
Doi
Https
Medrxiv
Population
Preprint
Representation
Representativeness
Specimens
Version

Semantics

Type Source Name
disease MESH health inequities
disease IDO blood
disease MESH COVID 19
disease IDO history
disease MESH uncertainty
disease MESH living alone
drug DRUGBANK Abacavir
drug DRUGBANK Gold
disease IDO assay
disease IDO country
disease MESH privacy
drug DRUGBANK Etoperidone

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