TY - JOUR
T1 - Implementation of School-Based COVID-19 Testing Programs in Underserved Populations
AU - Haroz, Emily E.
AU - Kalb, Luther G.
AU - Newland, Jason G.
AU - Goldman, Jennifer L.
AU - Mast, Dana Keener
AU - Ko, Linda
AU - Grass, Ryan
AU - Shah, Parth
AU - Walsh, Tyler
AU - Schuster, Jennifer E.
N1 - Funding Information:
FUNDING: Funded in part by the Rapid Acceleration of Diagnostics (RADx) Underserved Populations (RADx-UP) (U24 MD016258; National Institutes of Health Agreement Numbers 1 OT2 HD107543-01, 1 OT2 HD107544-01, 1 OT2 HD107553-01, 1 OT2 HD107555-01, 1 OT2 HD107556-01, 1 OT2 HD107557-01, 1 OT2 HD107558-01, 1 OT2 HD107559-01); the Trial Innovation Network, which is an innovative collaboration addressing critical roadblocks in clinical research and accelerating the translation of novel interventions into life-saving therapies; and the National Institute of Child Health and Human Development contract (HHSN275201000003I) for the Pediatric Trials Network (principal investigator, Daniel Benjamin). The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the National Institutes of Health. Funded by the National Institutes of Health (NIH).
Funding Information:
CONFLICT OF INTEREST DISCLOSURES: Dr Haroz reports funding from the National Institutes of Health (NIH), National Institute of Mental Health (NIMH) (K01MH116335). Dr Newland reports funding from the Agency for Healthcare Research and Quality, National Institutes of Health, and a research grant from Merck. Dr Goldman reports funding from the National Institutes of Health. Dr Schuster reports funding from the National Institutes of Health and Merck. The other authors have no financial relationships relevant to this article to disclose.
Publisher Copyright:
Copyright © 2022 by the American Academy of Pediatrics
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Evidence suggests that coronavirus disease 2019 (COVID-19) testing in schools can add a layer of protection to reduce the spread of Severe Acute Respiratory Syndrome Coronavirus 2 and facilitate a safer return to in-person learning. Despite this evidence, implementation of testing in school settings has been challenging initially because of a lack of funding and limited availability of testing, but, as the pandemic has progressed and more funding and resources have been devoted to testing, other implementation challenges have arisen. We describe key implementation barriers and strategies that have been operationalized across 5 projects working to help schools with predominantly underserved populations who have faced significant COVID-19–related health disparities. We leveraged a key framework from the implementation science field to identify the challenges and used a matching tool to align implementation strategies to these challenges. Our findings suggest that the biggest obstacles to COVID-19 testing were the perceived relative advantages versus burden of COVID-19 testing, limited engagement with the target beneficiaries (eg, families, students, staff), and innovation complexity. Common strategies to overcome these challenges included identifying and preparing testing champions, altering incentive and allowance structures, assessing for readiness, and identifying barriers and facilitators. We aim to augment existing implementation guidance for schools by describing common barriers and recommended solutions from the implementation science field. Our results indicate a clear need to provide implementation support to schools to facilitate COVID-19 testing as an added layered mitigation strategy.
AB - Evidence suggests that coronavirus disease 2019 (COVID-19) testing in schools can add a layer of protection to reduce the spread of Severe Acute Respiratory Syndrome Coronavirus 2 and facilitate a safer return to in-person learning. Despite this evidence, implementation of testing in school settings has been challenging initially because of a lack of funding and limited availability of testing, but, as the pandemic has progressed and more funding and resources have been devoted to testing, other implementation challenges have arisen. We describe key implementation barriers and strategies that have been operationalized across 5 projects working to help schools with predominantly underserved populations who have faced significant COVID-19–related health disparities. We leveraged a key framework from the implementation science field to identify the challenges and used a matching tool to align implementation strategies to these challenges. Our findings suggest that the biggest obstacles to COVID-19 testing were the perceived relative advantages versus burden of COVID-19 testing, limited engagement with the target beneficiaries (eg, families, students, staff), and innovation complexity. Common strategies to overcome these challenges included identifying and preparing testing champions, altering incentive and allowance structures, assessing for readiness, and identifying barriers and facilitators. We aim to augment existing implementation guidance for schools by describing common barriers and recommended solutions from the implementation science field. Our results indicate a clear need to provide implementation support to schools to facilitate COVID-19 testing as an added layered mitigation strategy.
UR - http://www.scopus.com/inward/record.url?scp=85123969288&partnerID=8YFLogxK
U2 - 10.1542/peds.2021-054268G
DO - 10.1542/peds.2021-054268G
M3 - Article
C2 - 34737173
AN - SCOPUS:85123969288
SN - 0031-4005
VL - 149
JO - Pediatrics
JF - Pediatrics
M1 - e2021054268G
ER -