Mobile Intervention for Increasing COVID-19 Testing in K-12 Schools Serving Disadvantaged Communities: Randomized...

Area of Science:

• Public Health
• Health Informatics
• Epidemiology

Background:

• Schools faced challenges monitoring and preventing COVID-19 cases during the pandemic.
• Limited scalable infrastructure, including IT systems, hindered widespread diagnostic testing and resource connection for students and families.
• Few schools could implement effective COVID-19 mitigation strategies due to infrastructure gaps.

Purpose of the Study:

• To test a novel health information technology approach, SCALE-UP Counts, for COVID-19 testing in school settings.
• To evaluate the effectiveness of automated, bidirectional text messages in alerting parents to testing options and guidance.
• To assess the impact of this intervention on testing rates and missed school days.

Main Methods:

• A Sequential Multiple Assignment Randomized Trial (SMART) design was employed.
• Parents received either intensive, automated, bidirectional text messaging or usual care (unidirectional text messaging).
• Free at-home COVID-19 test kits were provided; primary outcomes were testing proportion and missed school days, measured via self-report questionnaires.

Main Results:

• The SCALE-UP Counts intervention significantly increased self-reported COVID-19 testing compared to the control group (22.8% vs. 13.5%).
• The intervention demonstrated a 64% relative increase in testing rates (RR=1.64, 95% CI 1.31-2.02; P<.001).
• No significant difference in missed school days was observed between the intervention and control arms (P=.06).

Conclusions:

• The SCALE-UP Counts intervention successfully utilized a scalable health information technology approach to facilitate COVID-19 testing in school communities.
• This method proved effective in providing automated testing information and access to free test kits, benefiting diverse student populations.
• Similar health IT strategies can enhance testing access, reduce burden, and deliver tailored health information for various public health concerns in schools.