Integrating social services with disease investigation: A randomized trial of COVID-19 high-touch contact tracing

PLoS One. 2023 May 16;18(5):e0285752. doi: 10.1371/journal.pone.0285752. eCollection 2023.

Abstract

COVID-19 exposed and exacerbated health disparities, and a core challenge has been how to adapt pandemic response and public health in light of these disproportionate health burdens. Responding to this challenge, the County of Santa Clara Public Health Department designed a model of "high-touch" contact tracing that integrated social services with disease investigation, providing continued support and resource linkage for clients from structurally vulnerable communities. We report results from a cluster randomized trial of 5,430 cases from February to May 2021 to assess the ability of high-touch contact tracing to aid with isolation and quarantine. Using individual-level data on resource referral and uptake outcomes, we find that the intervention, randomized assignment to the high-touch program, increased the referral rate to social services by 8.4% (95% confidence interval, 0.8%-15.9%) and the uptake rate by 4.9% (-0.2%-10.0%), with the most pronounced increases in referrals and uptake of food assistance. These findings demonstrate that social services can be effectively combined with contact tracing to better promote health equity, demonstrating a novel path for the future of public health.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Contact Tracing / methods
  • Health Promotion
  • Humans
  • SARS-CoV-2
  • Social Work
  • Touch

Grants and funding

This research was supported in part by the Stanford Office of Community Engagement’s seed funding (community.stanford.edu) and the Stanford Institute for Human-Centered Artificial Intelligence (hai.stanford.edu). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.