Abstract
Background Widely available population testing is critical to public health efforts to control the ongoing COVID-19 pandemic. However, COVID-19 testing has been low in underserved communities disproportionately affected by COVID-19. One approach to increase testing rates is through the secondary distribution of self-collection kits, where an individual distributes test kits to contacts in their social network and encourages them to self-collect test specimens. We outline a randomized clinical trial, COVID-19 Self-testing Through Rapid Network Distribution (C-STRAND), and a cohort study of individuals with COVID-19, to determine the impact of a secondary distribution strategy on COVID-19 testing among medically underserved populations. Methods The clinical trial will seek to enroll 1048 adult index participants from federally health qualified centers in Philadelphia, PA seeking COVID-19 testing. Eligible participants will be randomized 1:1 to receive multiple self-collection test kits or multiple referrals for standard clinic-based tests to distribute to contacts within their social network. The primary outcome will be testing among at least two network contacts at 8 weeks. Index participants and network contacts who test positive for COVID-19 from C-STRAND will be eligible to join the COVID-19 Close Contact Self-testing Study (CloseST), assessing the secondary distribution of self-collection test kits among individuals with COVID-19. The primary outcome of this cohort will be the number of close contacts who test positive at 8 weeks. Conclusion Novel strategies to promote COVID-19 testing are necessary, particularly among underserved populations most affected by COVID-19. We will determine the efficacy of a self-testing secondary distribution strategy. The results may inform efforts to increase testing rates during the current pandemic.
Keywords: COVID-19; Clinical trials; Self-testing; Social networks; Testing.
【저자키워드】 COVID-19, clinical trials, Testing, social networks, self-testing, 【초록키워드】 public health, randomized clinical trial, Efficacy, clinical trial, pandemic, COVID-19 pandemic, Population, cohort study, Randomized, Cohort, Health, COVID-19 testing, clinical, Rapid, Community, network, Philadelphia, novel, distribution, Critical, specimens, close contact, Contact, index, Primary outcome, effort, participant, positive, approach, populations, affected, determine, promote, receive, 1:1, eligible, individuals with COVID-19, seeking, 【제목키워드】 Randomized controlled trial, Population, COVID-19 testing, Rapid, network,