{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:40:32Z","timestamp":1788270032759,"version":"build-2803163510"},"reference-count":80,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A key challenge for schools throughout the COVID-19 pandemic was finding ways to monitor and prevent COVID-19 cases. While diagnostic testing and connecting students and their families to appropriate resources to mitigate the spread of COVID-19 were recommended, few schools had scalable infrastructure, including information technology systems, to implement these types of measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study tested a new approach to COVID-19 testing (SCALE-UP Counts) in school settings that used automated bidirectional text messages provided to the school community that alerted parents of students to COVID-19 testing options and guidance on when to test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The SCALE-UP Counts trial was designed as a Sequential Multiple Assignment Randomized Trial and final analyses compared results from parents who received intensive, fully automated, bidirectional text messaging about COVID-19 testing or usual care (control; fully automated unidirectional text messaging about COVID-19 testing), unblinded interventions. From the 16 selected schools, we enrolled all eligible participants who did not opt out of the study. The study provided schools from both arms of the trial with free at-home COVID-19 test kits. The primary outcome was the proportion of parents whose households tested for COVID-19, and the secondary outcome was the number of missed school days. The study asked parents to respond to self-report measures on testing outcomes and missed school days through web-based questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 7122 parents of students from 16 schools, half of which were title 1 schools; 2588 were randomized to usual care or control and 4534 to bidirectional text messaging. The SCALE-UP Counts intervention led to increased self-reported testing when compared with the control condition (22.8% vs 13.5%, relative testing rate=1.64, 95% CI 1.31-2.02; P&lt;.001). There was no observed difference in missed school days between the study arms (0.43 per month vs 0.28 in usual care, relative missed days rate=1.55, 95% CI 0.98-2.45; P=.06).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SCALE-UP Counts worked closely with schools and the state\u2019s public health system to implement and test a scalable health information technology approach that delivered automated text messages to students\u2019 parents around COVID-19 testing and provided access to free at-home test kits. Such an approach can help facilitate COVID-19 testing among school communities, including those that provide education and resources to students and their families from racial or ethnic minorities and with low socioeconomic status. Similar health information technology approaches could be used to increase ease of access to testing, reduce testing burden, and provide tailored information on health measures in school communities for a variety of illnesses or public health concerns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT05112900; http:\/\/clinicaltrials.gov\/ct2\/show\/NCT05112900<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/79775","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T13:45:06Z","timestamp":1757166306000},"page":"e79775","source":"Crossref","is-referenced-by-count":1,"title":["Mobile Intervention for Increasing COVID-19 Testing in K-12 Schools Serving Disadvantaged Communities: Randomized Controlled Trial of SCALE-UP Counts"],"prefix":"10.2196","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1571-6154","authenticated-orcid":false,"given":"Yelena P","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3021-2376","authenticated-orcid":false,"given":"Jonathan J","family":"Chipman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9464-5728","authenticated-orcid":false,"given":"Leighann","family":"Kolp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5045-1796","authenticated-orcid":false,"given":"Tammy K","family":"Stump","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8209-2577","authenticated-orcid":false,"given":"Tatyana V","family":"Kuzmenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-6799","authenticated-orcid":false,"given":"Guilherme","family":"Del Fiol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7263-0800","authenticated-orcid":false,"given":"Benjamin","family":"Haaland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2668-9080","authenticated-orcid":false,"given":"Kimberly A","family":"Kaphingst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2901-891X","authenticated-orcid":false,"given":"Roger","family":"Brooks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0148-046X","authenticated-orcid":false,"given":"Adam L","family":"Hersh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9320-383X","authenticated-orcid":false,"given":"Hannah L","family":"Brady","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1032-5680","authenticated-orcid":false,"given":"Kelly J","family":"Lundberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8214-9164","authenticated-orcid":false,"given":"Neng","family":"Wan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4906-549X","authenticated-orcid":false,"given":"Courtney","family":"Carroll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9312-0674","authenticated-orcid":false,"given":"Brian","family":"Orleans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6661-0774","authenticated-orcid":false,"given":"Jennifer","family":"Wirth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4013-1932","authenticated-orcid":false,"given":"David W","family":"Wetter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref1","unstructured":"Centers for Disease Control and PreventionCOVID data tracker20232023-08-22https:\/\/covid.cdc.gov\/covid-data-tracker"},{"key":"ref2","unstructured":"American Academy of PediatricsChildren's Hospital AssociationChildren and COVID-19: State Data Report20232023-05-31Itasca, ILAmerican Academy of Pediatricshttps:\/\/www.aap.org\/en\/pages\/2019-novel-coronavirus-covid-19-infections\/children-and-covid-19-state-level-data-report"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.12788\/jhm.3689"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.2091"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.5298"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.5888\/pcd18.210084"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01582-4"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-021-01092-7"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2023.101643"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111\/josh.13028"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/jora.12668"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1080\/10824669.2021.1906251"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30095-X"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.14745"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-022-13577-z"},{"key":"ref16","unstructured":"VohraDRowanPHotchkissJLimKLansdaleAO'NeilSImplementing COVID-19 Routine Testing in K-12 Schools: Lessons and Recommendations From Pilot Sites2021072023-04-02New York, NYThe Rockefeller Foundationhttps:\/\/www.rockefellerfoundation.org\/wp-content\/uploads\/2021\/07\/implementing_covid-19_routine_testing_in_k-12_schools_lessons_and_recommendations_from_pilot_sites.pdf"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021-054268G"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060352F"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060352I"},{"key":"ref20","unstructured":"LadyzhetsBAlbertyEHere's why Utah's COVID-19 testing in schools went from national model to abandoned failure202203072024-07-02Salt Lake City, UTThe Salt Lake Tribunehttps:\/\/www.sltrib.com\/news\/2022\/03\/07\/heres-why-utahs-covid\/"},{"key":"ref21","unstructured":"Utah Department of Health and Human ServicesCOVID-19 report: a focus on schools and hospitals202109022022-09-02Salt Lake City, UTUtah Department of Health and Human Serviceshttps:\/\/coronavirus-download.utah.gov\/Health\/COVID-19_Reposrt_Schools-Hospitals.pdf"},{"key":"ref22","unstructured":"Utah Department of Health and Human ServicesCoronavirus dashboardCOVID-19 data20222023-11-01Salt Lake City, UTUtah Department of Health and Human Serviceshttps:\/\/coronavirus-dashboard.utah.gov\/schools.html"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060352J"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-020-0967-2"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibab114"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.2196\/36316"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25774"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-019-00777-7"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.38293"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-021-01395-7"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2023.0053"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.08.009"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2022.798025"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2018.1558042"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1177\/1740774514536795"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v085.i08"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1080\/03610928308828586"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-021-01303-z"},{"key":"ref39","author":"Miller, WR","year":"2002","journal-title":"Motivational Interviewing"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1177\/0141076818764320"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2022-060352E"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-067732"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibac101"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2024.307770"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2016.10.009"},{"key":"ref46","author":"Miller, WR","year":"1991","journal-title":"Motivational Interviewing: Preparing People to Change Addictive Behavior"},{"key":"ref47","author":"Marlatt, GA","year":"2005","journal-title":"Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.59.4.224"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.1080\/14622200500266080"},{"key":"ref50","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntq001"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22360"},{"key":"ref52","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"ref53","unstructured":"National Institutes of HealthNIH Common Data Elements (CDE) repository20252025-06-23https:\/\/cde.nlm.nih.gov\/home"},{"key":"ref54","unstructured":"National Institute of Environmental Health SciencesDisaster Research Response (DR2) program20252025-06-25National Institutes of Healthhttps:\/\/www.niehs.nih.gov\/research\/programs\/disaster"},{"key":"ref55","unstructured":"Environmental Systems Research InstitutionsArcGIS Pro: release 3.320232024-06-12Environmental Systems Research Institutionshttps:\/\/www.esri.com\/arcgis-blog\/products\/arcgis-pro\/announcements\/whats-new-in-arcgis-pro-3-3\/"},{"key":"ref56","unstructured":"Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry, Geospatial Research Analysis and Services ProgramCDC\/ATSDR Social Vulnerability Index 2022 Database Utah20232023-03-10Atlanta, GAUnited States Department of Health and Human Serviceshttps:\/\/svi.cdc.gov\/dataDownloads\/data-download.html"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2022.09.030"},{"key":"ref58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2020.11.024"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024414"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.36462"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.1101\/2020.04.10.20060962"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-023-01683-1"},{"key":"ref63","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4757-3462-1","author":"Harrell, FE","year":"2001","journal-title":"Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-8-32"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3944"},{"issue":"1","key":"ref66","doi-asserted-by":"crossref","first-page":"98","DOI":"10.2307\/2533148","volume":"52","author":"Little, RJ","year":"1996","journal-title":"Biometrics"},{"key":"ref67","unstructured":"Utah State Board of EducationSchool Year 2023 attendance20242025-09-11https:\/\/www.schools.utah.gov\/prevention\/_absenteeismandtruancyprevention\/2023AttendanceByGradeAndDemographicsStateCountyLEASchool.xlsx"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1923"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1017\/ash.2021.249"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001793"},{"key":"ref71","unstructured":"FahertyLJMasterBKSteinerEDKaufmanJHPredmoreZStelitanoLLeschitzJTPhillipsBSchwartzHLWolfeRLCOVID-19 testing in K-12 schools: insights from early adopters202103092025-03-03RAND Corporationhttps:\/\/www.rand.org\/pubs\/research_reports\/RRA1103-1.html"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7211a3"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.2196\/16993"},{"key":"ref74","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007458.pub3"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2020-214401"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa638"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.22491"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1097\/PHH.0000000000001263"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-06527-1"},{"key":"ref80","unstructured":"Pew Research CenterMobile fact sheet20242025-04-06https:\/\/www.pewresearch.org\/internet\/fact-sheet\/mobile\/"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2025\/1\/e79775","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:12:59Z","timestamp":1782843179000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2025\/1\/e79775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,11]]},"references-count":80,"URL":"https:\/\/doi.org\/10.2196\/79775","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.79775","asserted-by":"object"}]},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,11]]}}}