A qualitative process analysis of daily contact testing as an alternative to self-isolation following close contact with a confirmed carrier of SARS-CoV-2.

Covid-19 Lateral flow device Process evaluation Qualitative Testing

Journal

BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562

Informations de publication

Date de publication:
18 07 2022
Historique:
received: 13 12 2021
accepted: 12 07 2022
entrez: 19 7 2022
pubmed: 20 7 2022
medline: 22 7 2022
Statut: epublish

Résumé

In July 2021, a randomised controlled trial was conducted to compare the effect on SARS-CoV-2 transmission of seven days of Daily Contact Testing (DCT) using Lateral Flow Test (LFT) and two Polymerase Chain Reaction (PCR) tests as an alternative to 10 days of standard self-isolation with one PCR, following close contact with a SARS-CoV-2 carrier. In this qualitative study, we used a nested process evaluation to aid interpretation of the trial and provide insight into factors influencing use of tests, understanding of test results, and how tests were used to inform behavioural decisions. Interviews were conducted with 60 participants (42 randomised to DCT and 18 randomised to self-isolation) who had been in close contact with a confirmed SARS-CoV-2 carrier and had consented to take part in the trial. Data were organised into three overarching themes: (1) assessing the risks and benefits of DCT (2) use of testing during the study period and (3) future use of testing. Attitudes toward DCT as an alternative to self-isolation and behaviour during the testing period appeared to be informed by an assessment of the associated risks and benefits. Participants reported how important it was for them to avoid isolation, how necessary self-isolation was considered to be, and the ability of LFTs to detect infection. Behaviour during the testing period was modified to reduce risks and harms as much as possible. Testing was considered a potential compromise, reducing both risk of transmission and the negative impact of self-isolation, and was regarded as a way to return to normal. Participants in this study viewed DCT as a sensible, feasible, and welcome means of avoiding unnecessary self-isolation. Although negative LFTs provided reassurance, most people still restricted their activity as recommended. DCT was also highly valued by those in vulnerable households as a means of providing reassurance of the absence of infection and as an important means of detecting infection and prompting self-isolation when necessary.

Sections du résumé

BACKGROUND
In July 2021, a randomised controlled trial was conducted to compare the effect on SARS-CoV-2 transmission of seven days of Daily Contact Testing (DCT) using Lateral Flow Test (LFT) and two Polymerase Chain Reaction (PCR) tests as an alternative to 10 days of standard self-isolation with one PCR, following close contact with a SARS-CoV-2 carrier. In this qualitative study, we used a nested process evaluation to aid interpretation of the trial and provide insight into factors influencing use of tests, understanding of test results, and how tests were used to inform behavioural decisions.
METHODS
Interviews were conducted with 60 participants (42 randomised to DCT and 18 randomised to self-isolation) who had been in close contact with a confirmed SARS-CoV-2 carrier and had consented to take part in the trial.
RESULTS
Data were organised into three overarching themes: (1) assessing the risks and benefits of DCT (2) use of testing during the study period and (3) future use of testing. Attitudes toward DCT as an alternative to self-isolation and behaviour during the testing period appeared to be informed by an assessment of the associated risks and benefits. Participants reported how important it was for them to avoid isolation, how necessary self-isolation was considered to be, and the ability of LFTs to detect infection. Behaviour during the testing period was modified to reduce risks and harms as much as possible. Testing was considered a potential compromise, reducing both risk of transmission and the negative impact of self-isolation, and was regarded as a way to return to normal.
CONCLUSION
Participants in this study viewed DCT as a sensible, feasible, and welcome means of avoiding unnecessary self-isolation. Although negative LFTs provided reassurance, most people still restricted their activity as recommended. DCT was also highly valued by those in vulnerable households as a means of providing reassurance of the absence of infection and as an important means of detecting infection and prompting self-isolation when necessary.

Identifiants

pubmed: 35850742
doi: 10.1186/s12889-022-13800-x
pii: 10.1186/s12889-022-13800-x
pmc: PMC9294818
doi:

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1373

Subventions

Organisme : Department of Health
Pays : United Kingdom

Informations de copyright

© 2022. The Author(s).

Références

Lancet. 2021 Oct 2;398(10307):1217-1229
pubmed: 34534517
Expert Rev Respir Med. 2022 Mar;16(3):263-272
pubmed: 35245149
Public Health. 2022 Mar;204:54-62
pubmed: 35176622
Expert Rev Respir Med. 2022 Apr;16(4):399-407
pubmed: 35041796
BMC Public Health. 2022 Apr 13;22(1):742
pubmed: 35418065
Front Public Health. 2021 Aug 03;9:714041
pubmed: 34414160
Expert Rev Respir Med. 2021 Aug;15(8):993-1002
pubmed: 33896332
BMC Public Health. 2021 Jun 5;21(1):1067
pubmed: 34090404
Lancet. 2020 Mar 14;395(10227):912-920
pubmed: 32112714

Auteurs

Sarah Denford (S)

Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK. sarah.denford@bristol.ac.uk.
Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK. sarah.denford@bristol.ac.uk.
School of Psychological Science, University of Bristol, Bristol, UK. sarah.denford@bristol.ac.uk.

Alex F Martin (AF)

Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK.

Lauren Towler (L)

School of Psychological Science, University of Bristol, Bristol, UK.
School of Psychology, University of Southampton, Southampton, UK.

Fiona Mowbray (F)

Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK.

Rosie Essery (R)

Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK.
School of Psychological Science, University of Bristol, Bristol, UK.
School of Psychology, University of Southampton, Southampton, UK.

Rachael Bloomer (R)

Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK.

Derren Ready (D)

Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.
UK Health Security Agency, London, England, UK.

Nicola Love (N)

Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.
UK Health Security Agency, London, England, UK.

Richard Amlôt (R)

Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.
Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK.
UK Health Security Agency, London, England, UK.

Isabel Oliver (I)

Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.
UK Health Security Agency, London, England, UK.

G James Rubin (GJ)

Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK.

Lucy Yardley (L)

Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.
Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK.
School of Psychological Science, University of Bristol, Bristol, UK.
School of Psychology, University of Southampton, Southampton, UK.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH