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In-Home COVID-19 Testing for Children With Medical Complexity: Feasibility and Association With School Attendance and
Ryan J Coller1, Michelle M Kelly1, Kristina Devi Howell1
1Ryan J. Coller, Michelle M. Kelly, Kristina Devi Howell, Gemma Warner, Sabrina M. Butteris, Mary L. Ehlenbach, Joseph A. McBride, Madeline Kieren, and Gregory P. DeMuri are with the Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison. Nicole Werner is with the Department of Industrial and Systems Engineering, University of Wisconsin-Madison. Barbara Katz is with Family Voices of Wisconsin, Madison. Shawn Koval is with the Health Kids Collaborative, UW Health, Madison, WI.
Insights
In-home rapid antigen COVID-19 testing was feasible for children with medical complexity. This approach successfully identified cases and improved school safety perceptions.
Area of Science:
- Pediatric Health
- Infectious Disease Surveillance
- Public Health Interventions
Background:
- Children with medical complexity face unique challenges in maintaining educational continuity.
- Reliable COVID-19 testing is crucial for safe in-person schooling for vulnerable populations.
- The REstarting Safe Education and Testing (RESET) program aimed to address these needs.
Purpose of the Study:
- To evaluate the feasibility of in-home rapid antigen COVID-19 testing for children with medical complexity.
- To assess the effectiveness of this testing strategy in identifying SARS-CoV-2 infections.
- To explore the impact of testing protocols on school safety perceptions.
Main Methods:
- The RESET program involved parents/guardians administering BinaxNOW rapid antigen tests twice weekly for three months.
- Participants transitioned to symptom- and exposure-based testing or continued surveillance.
- Feasibility was measured by the percentage of expected tests completed.
Main Results:
- In-home testing demonstrated high feasibility, with 92.5% of expected tests conducted.
- Symptomatic testing effectively identified seven out of nine COVID-19 cases.
- Participants who opted for symptom-based testing reported higher school safety perceptions.
Conclusions:
- In-home rapid antigen COVID-19 testing is a feasible strategy for children with medical complexity.
- This approach aids in identifying infections and can enhance perceptions of school safety.
- The RESET program provides a model for safe educational participation for vulnerable children.
Abstract:
The REstarting Safe Education and Testing program for children with medical complexity was implemented in May 2021 at the University of Wisconsin to evaluate the feasibility of in-home rapid antigen COVID-19 testing among neurocognitively affected children. Parents or guardians administered BinaxNOW rapid antigen self-tests twice weekly for three months and changed to symptom and exposure testing or continued surveillance. In-home testing was feasible: nearly all (92.5%) expected tests were conducted. Symptomatic testing identified seven of nine COVID-19 cases. School safety perceptions were higher among those opting for symptom testing. Clinical Trials.gov identifier: NCT04895085. (Am J Public Health. 2022;112(S9):S878-S882. https://doi.org/10.2105/AJPH.2022.306971).
