In-home direct antigen rapid testing (DART) plays a vital role in COVID-19 mitigation and policy. However, attitudes toward DART within high-risk, mentally disabled child populations remain unknown. That paucity of study could negatively influence DART uptake and utility among people who stand to benefit most from it. The goal of this study was to report caregivers’ perspectives of an in-home COVID-19 DART regimen in children with medical complexity, including the benefits and limitations of DART administration. This qualitative study was a subproject of the NIH Rapid Acceleration of Diagnostics for Underserved Populations research initiative at the University of Wisconsin. Researchers used survey data and the thematic analysis of semi-structured interview data to evaluate caregivers’ impressions of in-home COVID-19 testing and motivators to do testing. Caregivers of children with medical complexity were recruited via the Pediatric Complex Care Program (PCCP) at the University of Wisconsin. Data were obtained between May and August 2021. Among 20 caregivers, 16/20 (80%) of their children had neurologic disorders, and 12/20 (60%) used home oxygen. Survey data suggested that the main caregiver motivators to test their child were to receive early treatment if positive (18/20 [90%] of respondents agreed) and to let the child’s school know if the child was safe to attend (17/20 [85%] agreed). Demotivators to testing included the fact that the child could still obtain COVID-19 later (7/20 [35%] agreed) and the requirement for officials to reach out to close contacts (6/20 [30%] agreed). From interview data, 4 main themes reflected impressions of in-home COVID-19 testing: Caregivers perceived DART on a range of benign to distressing and simple to complex. The degree to which DART boosted caregivers’ mental health and the weight they gave the child’s test findings varied widely. While many users praised DART for its simplicity and the sense of calm it brought them, others pointed out serious drawbacks. More research is needed to determine how to simplify DART for high-risk populations while still taking advantage of its potential to help medically complicated children with special needs attend school without endangering their health or the well-being of their caregivers.

Source: bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03550-5