# Provision of COVID-19 Self-Test Kits to Patients for Distribution to Social Contacts: A Randomized Clinical Trial

## TL;DR

A study found that giving people extra COVID-19 self-test kits to share with others did not significantly increase testing rates among their social contacts.

## Contribution

This study evaluates the effectiveness of secondary distribution of self-test kits in medically underserved communities.

## Key findings

- Secondary distribution of self-test kits did not increase confirmed testing among social contacts.
- Only 1.3% of the intervention group had at least two contacts tested, compared to 0.5% in the control group.
- Confirmed testing rates remained low in both groups despite the intervention.

## Abstract

Can secondary distribution of COVID-19 self-test kits increase testing among medically underserved adults?

In this randomized clinical trial of 776 adult participants at federally qualified health centers, secondary distribution of COVID-19 self-test kits did not expand test uptake among their social network contacts compared with distribution of clinic test referral cards. In the intervention group, 1.3% of participants had at least 2 network contacts who successfully tested, compared with 0.5% of participants in the control group that received clinic test referrals.

This randomized clinical trial found that secondary distribution of COVID-19 self-test kits did not increase confirmed testing among social network contacts.

This randomized clinical trial assesses whether distribution of multiple COVID-19 self-test kits to patients at federally qualified health centers increases COVID-19 testing among social network contacts.

Widespread and equitable access to testing remains critical to controlling the COVID-19 pandemic, which has disproportionately affected medically underserved communities.

To determine whether secondary distribution of COVID-19 self-test (ST) kits, in which an individual distributes ST kits to contacts in their social networks, increases COVID-19 testing.

The COVID-19 Self-Testing Through Rapid Network Distribution study was a randomized clinical trial conducted between May 2021 and September 2023 at 4 federally qualified health centers serving medically underserved populations in Philadelphia, Pennsylvania. Participants were adults aged 18 years or older presenting to federally qualified health centers without SARS-CoV-2 infection in the past 90 days. Participants were randomized 1:1 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. Investigators were masked to study group assignment. Data were analyzed from December 11, 2023, to August 23, 2024.

Participants in the intervention group received 5 COVID-19 ST kits; control participants received 5 clinic test referral cards.

The primary outcome was confirmed testing among at least 2 network contacts 8 weeks after randomization. Secondary outcomes included the proportion of participants with at least 1 network contact tested and total number of network contacts reached.

A total of 776 participants (median [IQR] age, 44 [32-57] years; 428 [55.2%] cisgender female) were included in the study, of whom 388 participants were randomized to the ST intervention group and 388 participants were randomized to the control group. There were 112 Hispanic or Latine participants (14.4%), 459 non-Hispanic Black participants (59.1%), and 120 non-Hispanic White participants (15.5%). 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 tested at the 8-week follow-up (risk difference, 0.0077; 95% CI −0.0056 to 0.0210; P = .45).

This randomized clinical trial found that secondary distribution of COVID-19 ST kits had no effect on confirmed testing rates among network contacts, which were low in both study groups. Despite these null findings, the study provides insight that may be useful when designing and implementing ST trials.

ClinicalTrials.gov Identifier: NCT04797858