Evidence suggests that coronavirus disease 2019 (COVID-19) testing in schools can add a layer of protection to reduce the spread of Severe Acute Respiratory Syndrome Coronavirus 2 and facilitate a safer return to in-person learning. Despite this evidence, implementation of testing in school settings has been challenging initially because of a lack of funding and limited availability of testing, but, as the pandemic has progressed and more funding and resources have been devoted to testing, other implementation challenges have arisen. We describe key implementation barriers and strategies that have been operationalized across 5 projects working to help schools with predominantly underserved populations who have faced significant COVID-19-related health disparities. We leveraged a key framework from the implementation science field to identify the challenges and used a matching tool to align implementation strategies to these challenges. Our findings suggest that the biggest obstacles to COVID-19 testing were the perceived relative advantages versus burden of COVID-19 testing, limited engagement with the target beneficiaries (eg, families, students, staff), and innovation complexity. Common strategies to overcome these challenges included identifying and preparing testing champions, altering incentive and allowance structures, assessing for readiness, and identifying barriers and facilitators. We aim to augment existing implementation guidance for schools by describing common barriers and recommended solutions from the implementation science field. Our results indicate a clear need to provide implementation support to schools to facilitate COVID-19 testing as an added layered mitigation strategy.

中文翻译：

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在服务不足的人群中实施基于学校的 COVID-19 检测计划。

有证据表明，在学校进行 2019 年冠状病毒病 (COVID-19) 检测可以增加一层保护，以减少严重急性呼吸系统综合症冠状病毒 2 的传播，并促进更安全地恢复面对面学习。尽管有这些证据，但由于缺乏资金和测试的可用性有限，在学校环境中实施测试最初一直充满挑战，但随着疫情的发展以及更多的资金和资源投入到测试中，出现了其他实施挑战。我们描述了已在 5 个项目中实施的主要实施障碍和策略，这些项目旨在帮助那些面临与 COVID-19 相关的重大健康差距的服务不足人群的学校。我们利用实施科学领域的关键框架来识别挑战，并使用匹配工具使实施策略与这些挑战保持一致。我们的研究结果表明，COVID-19 检测的最大障碍是相对于 COVID-19 检测负担的感知相对优势、与目标受益人（例如家庭、学生、工作人员）的参与有限以及创新复杂性。克服这些挑战的常见策略包括确定和准备测试冠军、改变激励和津贴结构、评估准备情况以及确定障碍和促进因素。我们的目标是通过描述实施科学领域的常见障碍和推荐的解决方案来增强学校现有的实施指导。我们的结果表明，明确需要向学校提供实施支持，以促进 COVID-19 测试，作为附加的分层缓解策略。