CONtact TrAcing in Care homes using digital Technology (CONTACT)

A pragmatic cluster randomised controlled trial, cost-effectiveness evaluation and theory-informed process evaluation.

At the start of the COVID-19 pandemic, around four hundred thousand people lived in some form of a care home. In some homes, up to 8 out of every 10 residents have been infected with COVID-19 and up to half of these people have died. Family visiting has largely stopped, to try and make the risks of infection smaller. Many residents - especially with dementia - have suffered as a result.

As restrictions begin to be relaxed, homes and families are keen to find ways to start safe visits again. There is no vaccine for COVID-19; even if a vaccine is developed, older people may react differently and may not be as well protected as the rest of the population. It is important that care homes know who has the virus but also who they have come into contact with so they can use infection control methods to slow its spread and reduce the chances of residents, staff and wider community members dying too soon.

The NHS uses a system called Test and Trace, and people call "contact tracers" to interview people that have tested positive for or come into contact with COVID-19. For people living and working in care homes this way of contact tracing may not work very well. Many people that live in care homes have memory and communication difficulties. Care home staff sometimes have more than fifty contacts with residents and other staff each day. Remembering the details of contacts, even from the same day, can be difficult and so the information provided to NHS Test and Trace cannot be relied upon and the system will not work properly.

We want to use small wearable devices, like a Fitbit/digital watch or a small broach, to record contacts between staff, residents and visitors in homes more reliably and without people having to do anything other than wearing the device. Over one year, we will ask 32 care homes in Yorkshire and the Midlands to encourage staff, residents and visitors to wear the devices and 32 others to wait a while and work with NHS Test and Trace.

In the study called CONTACT, we will record and analyse the data on contacts in homes and summarise it for them so homes (and NHS Test and Trace) can see how patterns and trends of contacts are changing. We will measure how many residents test positive for COVID-19, how many die and how much money and time is involved in homes using the CONTACT devices. We want to understand how best to encourage homes to use the CONTACT technology and to understand why and if it works as it should, so we will look at the things about the care homes, the staff and the technology that make using the devices and equipment easier or more difficult.

CONTACT will mean that care homes will be able to play their part in reducing the risk of COVID-19 infection to/from the communities in which they are located, including how they work with hospitals to reduce risks to residents and staff, deal with residents, staff or visitors testing positive for COVID-19 more effectively and how they can safely manage visits to increase the quality of life for residents families and staff through more and safer social contact.

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