Use of a Digital Assistant to Report COVID-19 Rapid Antigen Self-test Results to Health Departments in 6 US Communities

Abstract

ImportanceWidespread distribution of rapid antigen tests is integral to the US strategy to address COVID-19; however, it is estimated that few rapid antigen test results are reported to local departments of health.ObjectiveTo characterize how often individuals in 6 communities throughout the United States used a digital assistant to log rapid antigen test results and report them to their local departments of health.Design, Setting, and ParticipantsThis prospective cohort study is based on anonymously collected data from the beneficiaries of the Say Yes! Covid Test program, which distributed more than 3 000 000 rapid antigen tests at no cost to residents of 6 communities (Louisville, Kentucky; Indianapolis, Indiana; Fulton County, Georgia; O’ahu, Hawaii; Ann Arbor and Ypsilanti, Michigan; and Chattanooga, Tennessee) between April and October 2021. A descriptive evaluation of beneficiary use of a digital assistant for logging and reporting their rapid antigen test results was performed.InterventionsWidespread community distribution of rapid antigen tests.Main Outcomes and MeasuresNumber and proportion of tests logged and reported to the local department of health through the digital assistant.ResultsA total of 313 000 test kits were distributed, including 178 785 test kits that were ordered using the digital assistant. Among all distributed kits, 14 398 households (4.6%) used the digital assistant, but beneficiaries reported three-quarters of their rapid antigen test results to their state public health departments (30 965 tests reported of 41 465 total test results [75.0%]). The reporting behavior varied by community and was significantly higher among communities that were incentivized for reporting test results vs those that were not incentivized or partially incentivized (90.5% [95% CI, 89.9%-91.2%] vs 70.5%; [95% CI, 70.0%-71.0%]). In all communities, positive tests were less frequently reported than negative tests (60.4% [95% CI, 58.1%-62.8%] vs 75.5% [95% CI, 75.1%-76.0%]).Conclusions and RelevanceThese results suggest that application-based reporting with incentives may be associated with increased reporting of rapid tests for COVID-19. However, increasing the adoption of the digital assistant may be a critical first step.

Self-tests for COVID-19: What is the evidence? A living systematic review and meta-analysis (2020–2023)

“…Across fifteen studies, COVIDST digital supports used were: online platforms (n = 6), app-based COVIDST (n = 6), video-based instructions (n = 5), and online supervised COVIDST (n = 6) [ 22 – 24 , 32 , 34 , 38 – 40 , 45 , 46 , 49 – 51 , 59 – 62 , 64 , 71 , 83 ].…”

“…In four studies, app-assisted COVIDST allowed 98%-100% of participants to successfully interpret their test results [ 38 , 50 , 60 , 83 ]. while video-taped self-testing process increased participants’ confidence (76%) in COVIDST results [ 71 ].…”

Integrating the results of at-home diagnostic testing with public health surveillance to better track COVID-19 and future public health threats

“…Digital tools are the obvious choice for streamlining results reporting; one study found that 75% of digital assistant users reported their COVID-19 rapid test results to health departments. 3 , 4 The optimal reporting route will differ based on the setting, but should consist of a variety of user-friendly options, aimed at minimizing the effort and time required for individuals to complete the reporting process. Available tools such as QR codes, photo uploads of results, self-tracking apps, and/or phoning healthcare providers should be prioritized to ease reporting.…”

“…A diverse array of options ensures smoother integration into public health surveillance systems and facilitates broader participation by individuals. 4 …”

“…In addition, there is an urgent need to determine into how best to encourage individual reporting of self-test results via the adoption of digital health tools, the use of incentives, or other methods. 3 , 4 Furthermore, public education about the importance of self-testing for individuals and for communities plays a pivotal role in this context. Comprehensive awareness campaigns emphasizing the value of public health surveillance and the key role that individuals can play in contributing data to help characterize changing epidemiologic trends and community-level risk estimates combined with clearly highlighted reporting guidelines on testing kit packaging are vital.…”