Factors Influencing the Results of COVID-19 Case Outreach-Results From a California Case Investigation/Contact Tracing Program.

ABSTRACT

CONTEXT Considerable research has examined impacts of case investigation and contact tracing (CI/CT) programs on the spread of infectious diseases such as COVID-19, but there are few reports on factors affecting the ability of these programs to obtain interviews and acquire key information. OBJECTIVE: To investigate programmatic and case-specific factors associated with CI outcomes using data from the Public Health Institute's Tracing Health CI/CT program. Analyses were designed to detect variability in predictors of whether interviews and key information were obtained rather than quantify specific relationships. DESIGN: Logistic regression models examined variability in the predictive value of interview timeliness and respondent characteristics on outreach outcomes and interview results. SETTING AND PARTICIPANTS: Participants were members of a large California health care network with a positive laboratory test for COVID-19 and outreach from January 1 to July 31, 2021. MAIN OUTCOME MEASURES: The primary outcome was the result of outreach attempts completed interview, refused interview, or failure to reach the infected person. Secondary outcomes considered whether respondents provided information on symptom onset, employment, and contact information or a reason for declining to provide information, and whether resource support was requested or accepted. RESULTS: Of 9391 eligible records, 65.6% were for completed interviews, 6.0% were refusals, and 28.3% were failed outreach. One-third of respondents (36.7%) provided information on contacts (mean = 0.97 contacts per respondent, 2.6 for those naming at least 1). Privacy concerns were the most common reasons for not providing contact information. Among respondent characteristics and interview timeliness, only race and number of symptoms showed statistically significant effects in all adjusted analyses. CONCLUSIONS: Significant variation existed in outreach outcomes by subject characteristics and interview timeliness. CI/CT programs carefully focused to characteristics and needs of specific communities will likely have the greatest impact on the spread of COVID-19 and other communicable diseases.