At-home testing to mitigate community transmission of SARS-CoV-2: protocol for a public health intervention with a nested prospective cohort study

BMC Public Health

Giselle Corbie-Smith¹  Jessica L. Herling²  Marlena L. Kuhn²  Michelle Song²  Alan Richmond³  Warren A. Kibbe⁴  Aaron Jones⁴  Allison E. Aiello⁵  Michael Cohen-Wolkowiez⁶  Christoph P. Hornik⁶  Donaldson F. Conserve⁷  Christopher W. Woods⁸  Gaurav Dave⁹  Emily J. Ciccone^1,10  Shani Alston^1,11  Samuel Broderick^1,11  Lindsay Singler^1,11  Lisa M. Wruck^1,11  Michael D. Schmidt^1,12 

[1] Center for Health Equity Research, Department of Social Medicine, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA;Center for Health Equity Research, Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA;Community-Campus Partnerships for Health, Raleigh, NC, USA;Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA;Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA;Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA;Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA;Departments of Medicine and Pathology, Duke University School of Medicine, Durham, NC, USA;Division of General Medicine and Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill, NC, USA;Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC, USA;Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA;Office of Technology, DataRobot, Inc, Boston, MA, USA;

关键词: COVID-19 pandemic;    SARS-CoV-2 antigen testing;    Public health initiative;    Community engagement;    Health behavior;    Health equity;    Non-pharmaceutical interventions;   

DOI  :  10.1186/s12889-021-12007-w

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to evolve as a global health crisis. Although highly effective vaccines have been developed, non-pharmaceutical interventions remain critical to controlling disease transmission. One such intervention—rapid, at-home antigen self-testing—can ease the burden associated with facility-based testing programs and improve testing access in high-risk communities. However, its impact on SARS-CoV-2 community transmission has yet to be definitively evaluated, and the socio-behavioral aspects of testing in underserved populations remain unknown.MethodsAs part of the Rapid Acceleration of Diagnostics–Underserved Populations (RADx-UP) program funded by the National Institutes of Health, we are implementing a public health intervention titled “Say Yes! COVID Test” (SYCT) involving at-home self-testing using a SARS-CoV-2 rapid antigen assay in North Carolina (Greenville, Pitt County) and Tennessee (Chattanooga City, Hamilton County). The intervention is supported by a multifaceted communication and community engagement strategy to ensure widespread awareness and uptake, particularly in marginalized communities. Participants receive test kits either through online orders or via local community distribution partners. To assess the impact of this intervention on SARS-CoV-2 transmission, we will conduct a non-randomized, ecological study using community-level outcomes. Specifically, we will evaluate trends in SARS-CoV-2 cases and hospitalizations, SARS-CoV-2 viral load in wastewater, and population mobility in each community before, during, and after the SYCT intervention. Individuals who choose to participate in SYCT will also have the option to enroll in an embedded prospective cohort substudy gathering participant-level data to evaluate behavioral determinants of at-home self-testing and socio-behavioral mechanisms of SARS-CoV-2 community transmission.DiscussionThis is the first large-scale, public health intervention implementing rapid, at-home SARS-CoV-2 self-testing in the United States. The program consists of a novel combination of an at-home testing program, a broad communications and community engagement strategy, an ecological study to assess impact, and a research substudy of the behavioral aspects of testing. The findings from the SYCT project will provide insights into innovative methods to mitigate viral transmission, advance the science of public health communications and community engagement, and evaluate emerging, novel assessments of community transmission of disease.

【 授权许可】

CC BY