ReOpening Schools Safely and Educating Youth (ROSSEY)

While public health measures with school closure helped mitigate the spread of COVID-19, Latino children from rural agricultural communities are experiencing learning gaps due to disproportionate access to resources. Analyzing data collected from SARS-CoV-2 test results of students returning to in-person learning in the Yakima School District, combined with risk communication, may provide a mechanism to identify outbreaks early and stop transmission, as well as provide reassurance to families and to staff about the safety of on-site instruction. Risk communication will be used as a tool to educate the community on the benefits of the testing program, while addressing social, behavioral, and ethical concerns for testing and vaccine hesitancy to prepare them for vaccine readiness.

The study has three aims and involves a clustered randomized controlled trial (RCT) where K-5 elementary schools will be the unit of randomization. We will collaborate with Yakima School District in the Yakima area and plan to enroll at least 900 participants.

Aim 1. Identify the rural Latino community’s social, ethical, behavioral needs and resources for students to return to school and maintain onsite learning using qualitative assessments with school stakeholders, parents, and students.

Aim 2. Evaluate the effectiveness of risk communication on student attendance using a cluster randomized controlled trial (RCT) with two intervention arms: current learning model (comparison) and risk communication). Prior to launching Aim 2, a pilot study will be conducted in April – June 2021 with one school to understand the implementation steps and workflow. The larger RCT trial will be implemented in 14 elementary schools in Fall 2021 – Spring 2022 school year. Schools will be randomized to receive the intervention (risk communication) or serve as a comparison or control group (continue the current practice).

Participants in the intervention group will receive comic books once every three months. Participants randomly selected into the control group will be given comic books at the end of the study. Parents of participants randomized to the Intervention group will be given two health educational videos focused on COVID-19 throughout the school year. Caregivers of participants randomized to the control group will receive the two videos at the end of the study period. Primary outcomes for children will be absenteeism (hours per week missing onsite learning).

Secondary outcomes will be assessed via surveys with 300 parents, with 150 parents of children from the control and 150 parents of children from the intervention group. Parents will be asked about their children’s physical activity and emotional regulation; parents will be assessed for their perceived stress, COVID-related stress, and depressive symptomatology. Secondary outcome survey assessments will be optional and offered to participants to be completed at time of enrollment, halfway through the study, and towards the end of the school year.

Parents will be provided the option to have their children enrolled in the Yakima School District’s weekly SARS-CoV-2 testing program, separate from our study. We will create a Data Use Agreement (DTUA) with the Yakima School District’s approval to access the SARS-CoV-2 test results of students enrolled in our research study. Access to student test information and results will allow our team to observe the effect that participation in weekly COVID-19 testing has on the primary and secondary outcomes being assessed in this study.

Aim 3. Assess implementation outcomes of the program with school stakeholders, parents, and children guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Aim 3 will occur after Aim 1 and 2 are completed.