Implementation of a national testing policy in Dutch nursing homes during SARS-CoV-2 outbreaks

Factors influencing uptake of diagnostic test interventions for SARS-CoV-2: A qualitative review

Background

Diagnostic tests for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may be performed based on symptomatic presentation or for screening of asymptomatic persons. Testing can limit spread by enabling rapid identification of cases leading to containment measures. However, views regarding diagnostic test as a containment intervention vary across different settings.

Aim

To synthesise the findings of qualitative studies on the perceptions and factors influencing the uptake of diagnostic test interventions for SARS-CoV-2.

Setting

Healthcare facilities, care homes, communities including households.

Method

We searched MEDLINE database and the (WHO) SARS-CoV-2 Research database from 01 January 2020 to 06 September 2022. Qualitative data were synthesised thematically while data for barriers and facilitators were synthesised using the SURE framework. The GRADE-CERQual approach was used to assess the confidence in each review finding, while the ENTREQ checklist was used to report the QES. The quality of included studies was assessed with the CASP tool.

Results

Twenty two studies were included for QES. Two were conducted in the health facility setting, 2 in care homes, and 18 in the community. Twenty of the studies came from high-income countries, 2 from low- and middle-income countries. In all, 13 analytical and 31 descriptive themes of low to moderate quality evidence emerged; mainly around fear of contracting COVID-19, test procedure and socio-economic implications of a positive test result.

Conclusion

Low to moderate quality evidence of barriers to uptake of diagnostic test were largely due to misconceptions about the interventions.

Contribution

Sensitising and engaging communities and stakeholders in the healthcare system, will help mitigate the fear barrier and enhance policy coordination.

Factors that influence the implementation of innovation in aged care: a scoping review

OBJECTIVE

The objective of this scoping review is to identify factors that influence the implementation of innovation in aged care.

INTRODUCTION

Aged care is a dynamic sector experiencing rapid change. Implementation of innovations in aged care has received relatively little research attention compared to health care.

INCLUSION CRITERIA

This review included studies of any design, that examined the implementation of innovations in aged care settings.

METHODS

Searches were conducted in MEDLINE, CINAHL, AgeLine, and ProQuest Social Sciences Premium Collection for studies published between January 1, 2012 and December 31, 2022. The titles and abstracts of retrieved citations were screened by two independent reviewers. Full-text articles were screened by one reviewer to determine inclusion. Data were extracted in NVivo using a tool developed by the research team. Factors that influenced implementation were inductively coded, interpreted, and grouped into categories in a series of workshops.

RESULTS

Of the 2530 studies that were screened, 193 were included. Of the included papers, the majority (74%) related to residential aged care, 28% used an implementation theory or framework, and 15% involved consumers. Five key categories of factors influencing implementation were identified: organizational context including resourcing and culture; people's attitudes and capabilities; relationships between people; the intervention and its appropriateness; and implementation actions such as stakeholder engagement and implementation strategies.

CONCLUSIONS

Our findings can be used to develop practical resources to support implementation efforts, and highlight the importance of resourcing for successful implementation. Attention to community-based aged care, and greater engagement with theory and community is needed to promote research rigor, relevance and applicability.

The significance of advanced COVID-19 diagnostic testing in pandemic control measures

During the 2 years since the start of the novel coronavirus disease 2019 (COVID-19) pandemic, the scientific world made an enormous effort to fight against this disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has high transmissibility. Advancements in vaccine and treatment strategies have reduced both the hospitalization and mortality rates. However, the virus has shown its ability to evolve and evade from our COVID-19 combating armamentaria by the most common evolution mechanism—mutation. Diagnostic testing has been the first line of defense following the identification of the causative agent. Ever since, the scientific community has developed nuclei acid-based, antigen-based, and antibody-based diagnostic tests, and these testing methodologies are still playing a central role in slowing down viral transmission. These testing methods have different sensitivity and specificity and could be optimally used in areas facing different challenges owing to different level and conditions of COVID-19 outbreak. In this review, we discuss these testing methodologies as well as the considerations on how to apply these diagnostic tests optimally in the community to cope with the ever-changing pandemic conditions.