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At-home COVID-19 testing programs in schools are as effective as onsite testing for participation and adherence. This approach supports sustained screening and in-person learning, especially in disadvantaged communities.

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Area of Science:

  • Public Health
  • Epidemiology
  • School Health Programs

Background:

  • Equitable access to COVID-19 screening is crucial for reducing transmission and maintaining in-person learning in middle schools.
  • At-home rapid antigen testing offers potential advantages for school districts but its feasibility for sustained engagement is unknown.

Purpose of the Study:

  • To test the hypothesis that an at-home COVID-19 school testing program is noninferior to an onsite program regarding participation and adherence.
  • To evaluate the feasibility of initiating and sustaining engagement in at-home COVID-19 testing within middle school communities.

Main Methods:

  • A noninferiority trial was conducted across 3 middle schools from October 2021 to March 2022.
  • Two schools were randomized to onsite testing, and one school to at-home testing.
  • All students and staff were eligible to participate in the 21-week screening program.

Main Results:

  • At-home COVID-19 testing participation rates were noninferior to onsite testing over the 21-week trial.
  • Adherence to the weekly testing schedule was also noninferior in the at-home testing group.
  • Participants using at-home tests demonstrated more consistent testing during and before school breaks.

Conclusions:

  • At-home COVID-19 testing is a viable and effective alternative to onsite testing for school-based screening programs.
  • Implementing at-home testing should be considered a routine COVID-19 prevention strategy in schools nationwide.
  • Sufficient support is necessary to ensure consistent participation and adherence to at-home testing protocols.