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. 2022 Aug 1;5(8):e2228885.
doi: 10.1001/jamanetworkopen.2022.28885.

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

Carly Herbert  1 , Qiming Shi  1   2   3 , Vik Kheterpal  4 , Chris Nowak  4 , Thejas Suvarna  4 , Basyl Durnan  4 , Summer Schrader  4 , Stephanie Behar  1 , Syed Naeem  1 , Seanan Tarrant  1 , Ben Kalibala  1 , Aditi Singh  1 , Ben Gerber  2 , Bruce Barton  2 , Honghuang Lin  1 , Michael Cohen-Wolkowiez  5 , Giselle Corbie-Smith  6 , Warren Kibbe  7 , Juan Marquez  8 , Jonggyu Baek  2 , Nathaniel Hafer  3 , Laura Gibson  9 , Laurel O'Connor  10 , John Broach  10 , William Heetderks  11 , David McManus  12 , Apurv Soni  1   2   13
Affiliations

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

Carly Herbert et al. JAMA Netw Open. .

Abstract

Importance: Widespread 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.

Objective: To 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 participants: This 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.

Interventions: Widespread community distribution of rapid antigen tests.

Main outcomes and measures: Number and proportion of tests logged and reported to the local department of health through the digital assistant.

Results: A 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 relevance: These 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.

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Conflict of interest statement

Conflict of Interest Disclosures: Mr Shi reported receiving grants from the National Institutes of Health (NIH) during the conduct of the study. Dr Kheterpal reported receiving an NIH contract to CareEvolution for integration of testing and digital health during the conduct of the study and being an employee and principal at CareEvolution. Mr Nowak reported being an employee of CareEvolution during the conduct of the study and outside the submitted work. Mr Durnan reported being employed by CareEvolution during the conduct of the study and being previously employed by AiCure outside the submitted work. Dr Naeem reported receiving grants from the NIH during the conduct of the study and outside the submitted work. Dr Barton reported receiving grants from the NIH during the conduct of the study. Dr Gibson reported receiving grants from Moderna outside the submitted work. Dr McManus reported receiving grants from the NIH and collaborative research support from CareEvolution during the conduct of the study and personal fees from Bristol Myers Squibb, Pfizer, Heart Rhythm Society, Avania Consulting, Boehringer Ingelheim, and Fitbit; grants from Bristol Myers Squibb and Pfizer; and collaborative research support from Apple outside the submitted work. No other disclosures were reported.

Figures

Figure 1.
Figure 1.. Intervention Workflow From Test Distribution to Department of Health (DoH) Reporting
Screenshots are from the web-based tool.
Figure 2.
Figure 2.. Reporting of Test Results Among Digital Assistant Users by State
Reported results include those reported anonymously and with personally identifiable information. Bars indicate 95% CIs.
See this image and copyright information in PMC

Update of

References

    1. The White House Fact sheet: the Biden Administration to begin distributing at-home, rapid COVID-19 tests to Americans for free. Accessed July 26, 2022. https://www.whitehouse.gov/briefing-room/statements-releases/2022/01/14/...
    1. Collins F. Learning to protect communities with COVID-19 home testing programs. National Institutes of Health. Accessed July 26, 2022. https://directorsblog.nih.gov/2021/10/07/learning-to-protect-communities...
    1. Say yes: COVID test: keep our communities safe. Accessed March 28, 2022. https://sayyescovidtest.org/
    1. Fleurence RL, DiNenno EA, Riley WT, McMahon MJ, Lauer MS. CDC–NIH initiative provides free COVID-19 rapid home tests in North Carolina, Tennessee. HealthAffairs. Accessed July 26, 2022. https://www.healthaffairs.org/do/10.1377/forefront.20211025.437195/full/ - DOI
    1. Ciccone EJ, Conserve DF, Dave G, et al. . At-home testing to mitigate community transmission of SARS-CoV-2: protocol for a public health intervention with a nested prospective cohort study. BMC Public Health. 2021;21(1):2209-2209. doi:10.1186/s12889-021-12007-w - DOI - PMC - PubMed

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