What is the effectiveness of financial support schemes for individuals requested to self-isolate following a positive Covid test or positive contact: A rapid review

Testing for COVID-19 has been deployed globally as a tool to interrupt transmission through isolating positive contacts from the broader population. Financial support systems have been deployed to increase the isolation compliance, there is uncertainty as to the effectiveness of these measures. Three reviews were identified, as well as four primary studies that were published after the review search dates. Six studies showed that financial support for isolation was associated with a higher compliance to isolate. Two epidemiological modelling studies found that increased levels of social isolation were associated with a reduction in COVID-19 transmission. The findings from a DCE demonstrated a positive relationship with longer isolation duration and higher financial requirements. An economic model showed that support programmes have the potential to be a cost-effective intervention. A retrospective observational study offered evidence supporting the viability of delivering medically assisted isolation hotels for people unable to isolate at home. Further to the COVID-19 literature, two household surveys found that financial support and improved social restriction information was associated with compliance with H1N1 isolation Policy and practice implications: There is limited evidence to suggest that financial support for isolation can increase compliance, lower social engagement, and reduce infection levels. There is insufficient evidence to inform the optimal scale of financial support required. There was no evidence related to effectiveness of financial support for disadvantaged populations who are required to isolate or any insight to the impact of financial support on equality The overall certainty in the evidence is relatively low. Most studies relied on participant reported data on preference or behaviour, and where observational data were used there were issues with data quality and unobserved cofounders. O_TEXTBOXRapid Review DetailsO_ST_ABSReview conducted byC_ST_ABSHealth Technology Wales Review TeamLauren Elston, Jenni Washington, Elise Hasler, Tom Winfield Review submitted to the WCEC on27th July 2022 Stakeholder consultation meeting13th June 2022 Rapid Review report issued by the WCEC onAugust 2022 WCEC TeamO_LIAdrian Edwards, Alison Cooper, Ruth Lewis, Jane Greenwell and Micaela Gal involved in drafting Topline Summary and editing C_LI This review should be cited asRR00020.Wales COVID-19 Evidence Centre. A rapid review of the effectiveness of financial support schemes for individuals requested to self-isolate following a positive Covid test or positive contact. August 2022 This report can be accessed from the WCEC library: https://healthandcareresearchwales.org/wales-covid-19-evidence-centre-report-library DisclaimerThe views expressed in this publication are those of the authors, not necessarily Health and Care Research Wales. The WCEC and authors of this work declare that they have no conflict of interest. C_TEXTBOX O_TEXTBOXTOPLINE SUMMARYO_ST_ABSWhat is a Rapid Review?C_ST_ABSOur rapid reviews use a variation of the systematic review approach, abbreviating or omitting some components to generate the evidence to inform stakeholders promptly whilst maintaining attention to bias. They follow the methodological recommendations and minimum standards for conducting and reporting rapid reviews, including a structured protocol, systematic search, screening, data extraction, critical appraisal, and evidence synthesis to answer a specific question and identify key research gaps. They take 1-2 months, depending on the breadth and complexity of the research topic/ question(s), extent of the evidence base, and type of analysis required for synthesis. Who is this summary for?Welsh Government Background / Aim of Rapid ReviewTesting for COVID-19 has been deployed globally as a tool to interrupt transmission through isolating positive contacts from the broader population. Financial support systems have been deployed to increase the isolation compliance, there is uncertainty as to the effectiveness of these measures. Key FindingsThree reviews were identified, as well as four primary studies that were published after the review search dates. Due to the diversity and paucity of evidence identified, the primary studies included in the reviews (n = 5) were extracted and reported alongside the other primary evidence. This resulted in 9 primary studies extracted and summarised in this report. Extent of the evidence baseO_LIThe primary studies focused mainly on the COVID 19 pandemic (n=7) with two studies set in the context of the H1N1 pandemic. C_LIO_LIThe study types included: epidemiological modelling studies (n=2), economic modelling study (n=1), questionnaire-based publication (n=1), discrete choice experiments (DCEs) (n=2), retrospective observational study (n=1), and household surveys (both H1N1, n=2). C_LIO_LIThe studies were conducted in the USA (n=3), Brazil (n=1), Iran (n=1), Australia (n=2, H1N1 studies), or across multiple countries (USA, Mexico, and Kenya; n=1). No UK-based studies were identified. C_LIO_LIMost studies (n=7) included a general population, but one study focused on a homeless population, and one study included staff and students at university. C_LI Recency of the evidence baseO_LI7 primary studies were conducted in the last 2 years; the 2 studies from the H1N1 pandemic were conducted in 2011-12. C_LI Evidence of effectivenessO_LISix studies showed that financial support for isolation was associated with a higher compliance to isolate. C_LIO_LITwo epidemiological modelling studies found that increased levels of social isolation were associated with a reduction in COVID-19 transmission. C_LIO_LIThe findings from a DCE demonstrated a positive relationship with longer isolation duration and higher financial requirements. C_LIO_LIAn economic model showed that support programmes have the potential to be a cost-effective intervention. C_LIO_LIA retrospective observational study offered evidence supporting the viability of delivering medically assisted isolation hotels for people unable to isolate at home. C_LIO_LIFurther to the COVID-19 literature, two household surveys found that financial support and improved social restriction information was associated with compliance with H1N1 isolation. C_LI Policy ImplicationsO_LIThere is limited evidence to suggest that financial support for isolation can increase compliance, lower social engagement, and reduce infection levels. C_LIO_LIThere is insufficient evidence to inform the optimal scale of financial support required. C_LIO_LIThere was no evidence related to effectiveness of financial support for disadvantaged populations who are required to isolate or any insight to the impact of financial support on equality C_LI Strength of EvidenceThe overall certainty in the evidence is relatively low. Most studies relied on participant reported data on preference or behaviour, and where observational data were used there were issues with data quality and unobserved cofounders. C_TEXTBOX