'Like brushing teeth' - Implementation experiences with opt-in, at-home screening for SARS-CoV-2 among schoolchildren in Germany (preprint)

ABSTRACT

Background: Over the course of the pandemic, many countries have repeatedly closed schools and shifted students to remote learning. However, evidence for negative mental and physiological health consequences of such measures for students is increasing, highlighting the need for evidence-based recommendations on how to safely reopen schools. This study presents experiences when implementing opt-in, at-home SARS-CoV-2 screening using rapid diagnostic tests (RDTs) to facilitate safe face-to-face-teaching during a pandemic. Methods: We present data form a prospective study implementing an RDT-based screening program at a primary school in southwest Germany. We conducted qualitative in-depth interviews with participating children, parents, and school stakeholders to elicit implementation experiences and screening perception. Results: The screening intervention was highly accepted and appreciated among participants; no positive RDT was reported over the duration of the study. Self-testing at home before coming to school was feasible, but more positive consequences of screening participation (e.g., easing of mask mandates) besides a personal feeling of safety would be appreciated. Participants preferred home-based RDTs over some other measures, particularly mask mandates. Despite the RDTs being licensed as self-tests in Germany, additional training can help avoid mistakes, and ensuring intervention ownership and improving pre-implementation communication can facilitate buy-in. Conclusions: Ag-RDT-based SARS-CoV-2 screening programs relying on self-testing at home proved feasible and accepted among primary school students, parents, and school staff who participated in this study.