dbGaP Study Accession: phs003126

NIH Institute/Center: NIDA

RADx Data Program: RADx-UP

Release Date: 02/21/2023

DOI: 10.60773/ewt6-jf83

Study Description: Throughout the COVID-19 pandemic in the U.S., persons in jails have borne a share of disease 3-fold or greater than that seen in the general population. While many cases have been imported from surrounding communities, crowding in these congregate settings has led to rapid in-house transmission, especially since testing in jails has been sparse. Vaccine hesitancy among staff and those detained mean the population is ill prepared for new waves of infection, perhaps from virus variants. Better surveillance could warn systems earlier, and allow jails to stem the tide of a new outbreak. At least half, if not more, of infected persons shed coronavirus in their stool. Monitoring wastewater is a promising practice that only a few jails have adopted. The overarching goal was to introduce or refine Wastewater Based Surveillance (WBS) as an evidence-based strategy for SARS-CoV-2 surveillance in the jails of Atlanta, Chicago, suburban Boston and Washington DC. It was adapted to the needs of jail settings and evaluated the implementation with the Consolidated Framework for Implementation Research. Implementation teams were formed of both correctional staff and formerly incarcerated individuals. Project aims: (1) To assess the barriers to and facilitators of implementing WBS for SARS-CoV-2 detection in 4 jail demonstration sites. Guided by CFIR, an informational webinar was held followed by focus groups. Four were with leaders at each of the jails; these discussed the site-specific context in which WBS was introduced or refined. A fifth, cross-site focus group of jail workers, and a sixth, cross-site group of persons with lived jail experience, reflected on characteristics of WBS approaches and implementation strategies in jail settings. (2) To measure implementation outcomes associated with WBS and use these outcomes to inform key stakeholders, using a knowledge to action framework. The study examined uptake, acceptability, appropriateness and feasibility of WBS as a sensitive early warning system and a way of quantifying SARS-CoV-2 levels to monitor trends in COVID-19 prevalence. Feasibility, the suitability of how WBS data are acted upon, was of utmost importance. The study used the Knowledge to Action process model, leveraging implementation outcomes to further engage stakeholders and characterize the adaptions needed to successfully implement WBS in jails. (3, Pilot) To study the process and the perceived effectiveness of incorporating diverse stakeholders, including the formerly incarcerated, on the WBS implementation team. The study used the Research Engagement Survey Tool (REST), to survey early in the implementation process and eight months later, individuals on the implementation team who have lived experience in jail; all other consenting implementation team members were surveyed once early in the implementation process. Successfully completing the aims determined factors that promote WBS implementation to improve disease.

Updated Date: 02/21/2023

Principal Investigator: Spaulding, Anne C

Has Data Files: Yes

Study Domain: Wastewater Surveillance

Data Collection Method: Interview or Focus Group; Survey

Keywords: COVID Transmission; Congregate Settings

Study Design: Longitudinal Cohort

Multi-Center Study: Yes

Study Sites: Albert Einstein College of Medicine; Cook County HHS; Tufts Medicine

Data Types: Questionnaire or Survey; Social

Study Start Date: 01/15/2022

Study End Date: 12/31/2023

Species: Human

Sample Size: 2

Study Population Focus: Adults; Incarcerated or Institutionalized Populations; Older Adults or Elderly; Underserved or Vulnerable Populations

Acknowledgement Statement: This study was supported through funding, 5U01DA056000-02, for the National Institute on Drug Abuse (NIDA) as part of the RADx-UP program. We acknowledge participating staff members, contractors and former residents of Fulton County Jail (Atlanta, GA), Washington, DC Jail (Washington, D.C DOC), Middlesex County Jail (Billerica, MA), Cook County Jail (Chicago, IL). Approved users should acknowledge the provision of data access by dbGaP for accession phs003126.v1.p1, and the NIH RADx Data Hub. Approved users should also acknowledge the specific version(s) of the dataset(s) obtained from the NIH RADx Data Hub.

Funding Opportunity Announcement (FOA) Number: RFA-OD-21-009

NIH Grant or Contract Number(s): 5U01DA056000-02

Consent/Data Use Limitations: General Research Use