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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

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
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
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.
Covid-19, Lateral flow device, Process evaluation, Qualitative, Testing
1471-2458
Denford, Sarah
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Martin, Alex
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Towler, Lauren B
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Mowbray, Fiona M
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Essery, Rosie
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Bloomer, Rachael
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Ready, Derren
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Love, Nicola
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Amlot, Richard
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Oliver, Isabel
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Rubin, G.J.
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Yardley, Lucy
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Denford, Sarah
8970b5a7-8cad-4356-ad0e-88297b67db37
Martin, Alex
e137f6f2-bc93-4939-b56c-9ff52b8d9fd9
Towler, Lauren B
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Mowbray, Fiona M
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Essery, Rosie
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Bloomer, Rachael
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Ready, Derren
bc11ef15-b8f9-4372-9750-fd9c55981796
Love, Nicola
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Amlot, Richard
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Oliver, Isabel
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Rubin, G.J.
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Yardley, Lucy
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Denford, Sarah, Martin, Alex, Towler, Lauren B, Mowbray, Fiona M, Essery, Rosie, Bloomer, Rachael, Ready, Derren, Love, Nicola, Amlot, Richard, Oliver, Isabel, Rubin, G.J. and Yardley, Lucy (2022) 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. BMC Public Health, 22 (1), [1373]. (doi:10.1186/s12889-022-13800-x).

Record type: Article

Abstract

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.

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Accepted/In Press date: 12 July 2022
Published date: 18 July 2022
Additional Information: Funding Information: LY is an NIHR Senior Investigator and her research programme is partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit (HPRU) for Behavioural Science and Evaluation, and the NIHR Southampton Biomedical Research Centre (BRC). Funding Information: LY is an NIHR Senior Investigator and her research programme is partly supported by NIHR Applied Research Collaboration (ARC)-West, NIHR Health Protection Research Unit (HPRU) for Behavioural Science and Evaluation, and the NIHR Southampton Biomedical Research Centre (BRC). SD, RA, RAE, and IO are funded by the NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between UKHSA and the University of Bristol. GJR and RA are also funded by the NIHR Health Protection Research Unit (HPRU) in Emergency Preparedness and Response at King’s College London, a partnership between UKHSA and Kings College London. AFM is supported by the Economic and Social Research Council Grant Number ES/J500057/1 Funding Information: AFM is supported by the Economic and Social Research Council Grant Number ES/J500057/1 Funding Information: This study was funded by the National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Emergency Preparedness and Response, a partnership between UK Health Security Agency (UKHSA), King’s College London and the University of East Anglia, and Behavioural Science and Evaluations, a partnership between UKHSA and the University of Bristol. The views expressed are those of the author(s) and not necessarily those of the NIHR, UK Health Security Agency or the Department of Health and Social Care. Funding Information: SD, RA, RAE, and IO are funded by the NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between UKHSA and the University of Bristol. Publisher Copyright: © 2022, The Author(s).
Keywords: Covid-19, Lateral flow device, Process evaluation, Qualitative, Testing

Identifiers

Local EPrints ID: 468890
URI: http://eprints.soton.ac.uk/id/eprint/468890
ISSN: 1471-2458
PURE UUID: 73abfe68-09d3-4021-8d52-6e1c5a4d5300
ORCID for Fiona M Mowbray: ORCID iD orcid.org/0000-0002-3297-4163
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 31 Aug 2022 16:53
Last modified: 22 Nov 2022 02:34

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Contributors

Author: Sarah Denford
Author: Alex Martin
Author: Lauren B Towler
Author: Fiona M Mowbray ORCID iD
Author: Rosie Essery
Author: Rachael Bloomer
Author: Derren Ready
Author: Nicola Love
Author: Richard Amlot
Author: Isabel Oliver
Author: G.J. Rubin
Author: Lucy Yardley ORCID iD

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