COVID-19 test-to-stay program for K-12 schools: Opt-in versus opt-out consent model

Anton Ivanov; Ujjal Kumar Mukherjee; Subhonmesh Bose; Sridhar Seshadri; Ronald Watkins; Albert Charles England; Jacqueline Suriano; Mehmet Eren Ahsen; Sebastian Souyris

doi:10.1016/j.isci.2023.108770

COVID-19 test-to-stay program for K-12 schools: Opt-in versus opt-out consent model

iScience. 2023 Dec 20;27(1):108770. doi: 10.1016/j.isci.2023.108770. eCollection 2024 Jan 19.

Authors

Anton Ivanov¹, Ujjal Kumar Mukherjee^{1

2}, Subhonmesh Bose³, Sridhar Seshadri^{1

2}, Ronald Watkins⁴, Albert Charles England⁵, Jacqueline Suriano⁴, Mehmet Eren Ahsen^{1

2}, Sebastian Souyris⁶

Affiliations

¹ Department of Business Administration, University of Illinois at Urbana-Champaign, Champaign, IL 61821, USA.
² Health Innovation Professor Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, USA.
³ Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Champaign, IL 61821, USA.
⁴ Shield Illinois, University of Illinois System, Champaign, IL 61821, USA.
⁵ OSF HealthCare Heart of Mary Medical Center, Urbana, IL 61801, USA.
⁶ Lally School of Management, Rensselaer Polytechnic Institute, Troy, NY 12180, USA.

Abstract

The Centers for Disease Control and Prevention promoted the Test-to-Stay (TTS) program to facilitate in-person instruction in K-12 schools during COVID-19. This program delineates guidelines for schools to regularly test students and staff to minimize risks of infection transmission. TTS enrollment can be implemented via two different consent models: opt-in, in which students do not test regularly by default, and the opposite, opt-out model. We study the impacts of the two enrollment approaches on testing and positivity rates with data from 259 schools in Illinois. Our results indicate that after controlling for other covariates, schools following the opt-out model are associated with 84% higher testing rate and 30% lower positivity rate. If all schools adopted the opt-out model, 20% of the total lost school days could have been saved. The lower positivity rate among the opt-out group is largely explained by the higher testing rate in these schools, a manifestation of status quo bias.

Keywords: Research methodology social sciences; Social sciences; System management.