Dr. Alisa Stephens Shields is an Associate Professor of Biostatistics in Biostatistics and Epidemiology at the Hospital of the University of Pennsylvania, whose research focuses on clinical trials and health equity. Her latest study, published in JAMA Network Open, examines the impact of self-test kit distribution for COVID-19 in underserved communities.
Widespread access to testing was a key component of controlling the COVID-19 pandemic. The COVID-19 Self-Testing Through Rapid Network Distribution study was a randomized clinical trial conducted between May 2021 and September 2023 to evaluate the effect of self-test (ST) kit distribution on COVID-19 testing in medically underserved communities. Participants were randomized to receive 5 COVID-19 ST kits or 5 clinic test referral cards to distribute to contacts in their social network, and testing among their social network contacts was measured. A total of 776 participants were included in the study, of whom 388 participants were randomized to the self-test (ST) intervention group, and 388 participants were randomized to the control group.
There was no difference between study groups in the primary outcome, with 5 participants (1.3%) in the ST group vs 2 participants (0.5%) in the control group having at least 2 contacts confirmed to have been tested at the 8-week follow-up (risk difference, 0.0077; 95% CI ā0.0056 to 0.0210; Pā=ā.45). Despite these null findings, the study provides insight that may be useful when designing and implementing ST trials.