A Qualitative Evaluation of the Barriers and Enablers for Implementation of an Asymptomatic SARS-CoV-2 Testing Service at the University of Nottingham: A Multi-Site Higher Education Setting in England

Abstract

Asymptomatic testing for SARS-CoV-2 RNA has been used to prevent and manage COVID-19 outbreaks in university settings, but few studies have explored their implementation. The aim of the study was to evaluate how an accredited asymptomatic SARS-CoV-2 testing service (ATS) was implemented at the University of Nottingham, a multi-campus university in England, to identify barriers and enablers of implementation and to draw out lessons for implementing pandemic response initiatives in higher education settings. A qualitative interview study was conducted with 25 ATS personnel between May and July 2022. Interviews were conducted online, audio-recorded, and transcribed. Participants were asked about their experience of the ATS, barriers and enablers of implementation. Transcripts were thematically analysed. There were four overarching themes: (1) social responsibility and innovation, (2) when, how and why people accessed testing, (3) impact of the ATS on the spread of COVID-19, and (4) lessons learned for the future. In establishing the service, the institution was seen to be valuing its community and socially responsible. The service was viewed to be broadly successful as a COVID-19 mitigation approach. Challenges to service implementation were the rapidly changing pandemic situation and government advice, delays in service accreditation and rollout to staff, ambivalence towards testing and isolating in the target population, and an inability to provide follow-up support for positive cases within the service. Facilitators included service visibility, reduction in organisational bureaucracy and red tape, inclusive leadership, collaborative working with regular feedback on service status, flexibility in service delivery approaches and simplicity of saliva testing. The ATS instilled a perception of early ‘return to normality’ and impacted positively on staff feelings of safety and wellbeing, with wider benefits for healthcare services and local communities. In conclusion, we identified common themes that have facilitated or hindered the implementation of a SARS-CoV-2 testing service at a university in England. Lessons learned from ATS implementation will inform future pandemic response interventions in higher education settings.

Assessment of COVID‐19 Messaging Strategies to Increase Testing for Students With Intellectual and Developmental Disabilities

“…We had many interactions with our community and encouraged community input into our services. Like this study, many others saw success when champions were culturally responsive and organized into working groups or a CAB that was representative of their study population 31,33–35 . Particularly, these groups helped identify testing locations for each study; advise on developing materials that were culturally appropriate, such as specific images and wording; and helped their community navigate the ever‐changing guidance on COVID‐19 precautions 31,33–35 …”

“…Like this study, many others saw success when champions were culturally responsive and organized into working groups or a CAB that was representative of their study population. 31,[33][34][35] Particularly, these groups helped identify testing locations for each study; advise on developing materials that were culturally appropriate, such as specific images and wording; and helped their community navigate the ever-changing guidance on COVID-19 precautions. 31,[33][34][35] Finally, the presence of study team members within the schools allowed for a direct relationship between researchers and participants in a familiar setting.…”

“…31,[33][34][35] Particularly, these groups helped identify testing locations for each study; advise on developing materials that were culturally appropriate, such as specific images and wording; and helped their community navigate the ever-changing guidance on COVID-19 precautions. 31,[33][34][35] Finally, the presence of study team members within the schools allowed for a direct relationship between researchers and participants in a familiar setting. Building these partnerships throughout the study resulted in a continuous increase in school community participation.…”

From disgusting and complicated to simple and brilliant: Implementation perspectives and lessons learned from users and rejectors of mail-in SARS-CoV-2 gargle tests

“…Qualitative studies in relation to SARS-CoV-2 testing largely focused on barriers and facilitators to testing, the experiences of awaiting and receiving a test result, and implementation experiences in specific study settings such as hospitals, schools, universities and homeless-shelters in Germany, the UK and Denmark (18,(23)(24)(25)(26)(27)(28).…”