4.1. Programme Evaluation
Almost all students and staff in this study would take part in an asymptomatic SARS-Cov-2/COVID-19 testing programme again and would recommend it to others. PCR self-testing using throat swab or saliva was highly acceptable (as shown in other community samples) [15]. Testing adherence was high and 4 out of 5 students were confident in their test result. Antibody testing using finger-prick samples was acceptable although lack of communication of antibody test results reduced adherence to finger-prick tests towards programme end. There were no significant problems related to the logistics around the collection of test kits and venues for sample return for students or staff, although there had been a brief period of depleted test kit stock, and one third of first years experienced the occasional difficulty returning the test kit by the required time which was primarily associated with academic timetabling. The process of repeat self-testing was seen to be acceptable to students and staff, and we have demonstrated the acceptability of a mass testing approach over a significantly longer period of time than shown elsewhere [6].
Students and staff were largely satisfied with the information received about the testing programme, how information was communicated to them around testing and test kit collection, and the communication of test results. However, in some cases there had been inconsistency in communications from staff to students (e.g., with variations in guidance given to students around self-isolation between those who were operationalising the testing service and academic tutors). One third of participants were dissatisfied with the approach to communicating negative PCR test results taken during the pilot programme although this “batch” approach to communications has been modified since the study end. In our survey, 1 in 5 students reported that they were not confident in their test results, and confidence in test results was related to the number of (antibody) tests completed. This is explained by the qualitative data, which suggests that a lack of confidence in the test results relates to the way in which results had been communicated to individuals by the university during the pilot programme. For example, late or non-receipt of antibody test results, coupled with “batch” communication of negative test outcomes led to uncertainty among students and staff as to whether they had correctly completed the self-testing, or whether their samples had been lost in the laboratory. Timely communication of test outcomes and individual-level communication of all test results may therefore increase confidence in test results, and this may have implications for future testing adherence and COVID-19 vaccine roll-out.
Moving forwards, it may be useful to review and standardise the communication plan for the provision of guidance around the testing processes, test results and self-isolation, taking into account the importance of student and staff mental wellbeing and perceived risk, as well as the impact of specific wording used in communications which is known to influence individuals’ understanding of health test results [16]. More broadly, communications have been shown to be critical, since perceived sufficiency of information provided has been shown to influence anxiety and behavioural responses to COVID-19 [17], as well as other pandemics (e.g., influenza) [18]. However, the volume of information per communication may be important, since our qualitative findings highlight students’ desires for information to be reiterated due to receipt of over-length emails which, for some, resulted in them missing information. Providing a clear timeframe for communication of all test results (in our case, the antibody tests) would reassure students and reduce their anxiety, which may consequently impact their future testing behaviour.
Many students reported that they gained new knowledge about COVID-19 and testing procedures from taking part, particularly students in their first year. Although students who had self-isolated at some point during the pilot appeared to be more adherent to the testing (i.e., completed on average more tests), this should be interpreted with caution, due to limited statistical power and restricted sampling from the target population.