Experiences with opt-in, at-home screening for SARS-CoV-2 at a primary school in Germany: an implementation study
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Abstract
Over the course of the pandemic, many countries have repeatedly closed schools and shifted schoolchildren to remote learning. However, evidence for negative mental and physiological health consequences of such measures for schoolchildren is increasing, highlighting the need for evidence-based recommendations on how to safely reopen schools. This study aims to assess implementation experiences, acceptability and feasibility of opt-in, at-home SARS-CoV-2 screening using rapid diagnostic tests (RDTs) to facilitate safe face-to-face teaching during a pandemic.
Methods
We present data from a prospective study implementing an RDT-based screening programme at a primary school in southwest Germany. In addition to quantitative data collected to assess screening diagnostic yield (number of participants, tests handed out to participants, positive RDT results reported), we conducted qualitative in-depth interviews with participating pupils, parents and school stakeholders to elicit implementation experiences and screening perceptions.
Results
The screening intervention was highly accepted and appreciated among participants; no screening-associated positive RDT was reported over the duration of the study. Self-testing at home before coming to school was feasible, but more positive consequences of screening participation (eg, easing of mask mandates) besides a personal feeling of safety would have been appreciated across respondent groups. Participants preferred home-based RDTs over some other measures, particularly mask mandates. Despite the RDTs being licensed as self-tests in Germany, additional training can help avoid mistakes, and ensuring intervention ownership and improving pre-implementation communication can facilitate buy-in.
Conclusions
Antigen-RDT-based SARS-CoV-2 screening programmes relying on self-testing at home are a feasible and acceptable supplement to the public health toolbox to facilitate a safe return to face-to-face teaching at schools.
Trial registration number
DRKS00024845.
Article activity feed
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SciScore for 10.1101/2021.09.13.21263486: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: All participants provided written informed consent separately for their participation in the screening and, if applicable, when they participated in the qualitative interview.
IRB: The ethical review board at the Medical Faculty, Heidelberg University, Germany approved this study (S-141/2021).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences …SciScore for 10.1101/2021.09.13.21263486: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: All participants provided written informed consent separately for their participation in the screening and, if applicable, when they participated in the qualitative interview.
IRB: The ethical review board at the Medical Faculty, Heidelberg University, Germany approved this study (S-141/2021).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, our study also has limitations. First, only parents and students who had decided to voluntarily participate in the overarching screening program could be recruited for interviews; critical voices therefore might be underrepresented in the data on parents and their children. Additionally, as RDTs for SARS-CoV-2 have been introduced in Germany on a large scale in recent months, generalizability of our results to other countries where RDTs were less present in the public discourse might be limited. RDT-based screening is an acceptable and easily scalable intervention to decrease risk of transmissions at schools and facilitate face-to-face teaching amidst a pandemic. Policymakers should ensure comprehensive capacity building for testing, fit-for-purpose training materials for all age levels and train-the-trainer programs to enable scale up of universal screening. Furthermore, consistent communication on regulations and readily available support networks (hotlines via phone or email) can reduce burden for school staff and families.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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