Children and adolescents' experiences of mandatory SARS-CoV-2 testing in schools: a cross-sectional survey

BMJ Paediatr Open. 2024 Nov 7;8(1):e002974. doi: 10.1136/bmjpo-2024-002974.

Abstract

Background: Public health measures during the COVID-19 pandemic had dramatic consequences for children and adolescents. However, policy-makers and healthcare researchers did not give sufficient weight to children's perspectives. One common public health measure was mandatory SARS-CoV-2 tests in schools. This study examines the evaluation of such mandatory testing.

Methods: We investigated the effects of test type (pooled PCR tests vs antigen rapid tests) and demographic and psychological factors on evaluations of the experience of being tested. A total of 569 children (8-17 years) in two major German cities completed online questionnaires between October and December 2021. Participants answered questions addressing test evaluation, vaccination status, pandemic-related stress, mental health difficulties and health-related quality of life.

Results: Our results showed that overall test ratings were better for pooled PCR tests (p<0.001). Vaccine-willing students evaluated SARS-CoV-2 tests more positively than vaccine-unwilling students, regardless of test type (p<0.001). Children with mental health difficulties (abnormal/borderline Strength and Difficulties Questionnaire (SDQ) scores) evaluated SARS-CoV-2 tests more negatively than children with normal SDQ scores (p<0.001). Additionally, children who reported better health-related quality of life and children with less pandemic-related stress rated the tests more positively.

Conclusions: Our results suggest that there are differences in the appraisal of the test types and that specific subgroups' experiences of regular testing vary. Our study provides insights for policy-makers in future pandemics and raises questions regarding parallels between testing and vaccination hesitancy. Moreover, our study demonstrates the feasibility and value of collecting data directly from a large cohort of children in order to understand their experiences.

Keywords: Adolescent Health; COVID-19; Child Health; Health Policy.

MeSH terms

  • Adolescent
  • COVID-19 Testing / methods
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • COVID-19* / psychology
  • Child
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Mandatory Programs
  • Quality of Life / psychology
  • SARS-CoV-2* / immunology
  • Schools
  • Students / psychology
  • Surveys and Questionnaires
  • Vaccination / psychology