Formative Evaluation of a Student Symptom Decision Tree for COVID-19

Objective: In support of restarting during the COVID-19 pandemic, some schools partnered with local experts in academia, education, community, and public health to provide decision-support tools for determining what actions to take when presented with students at risk for spreading infection at school. Methods: The Student Symptom Decision Tree, developed in Orange County, California, is a flow chart consisting of branching logic and definitions to assist school personnel in making decisions regarding possible COVID-19 cases in schools, which was repeatedly updated to reflect evolving evidence-based guidelines. A survey of 56 school personnel evaluated the frequency of use, acceptability, feasibility, appropriateness, usability, and helpfulness of the Decision Tree. Results: The tool was used at least 6 times a week by 66% of respondents. The Decision Tree was generally perceived as acceptable (91%), feasible (70%), appropriate (89%), usable (71%), and helpful (95%). Suggestions for improvement included reducing the complexity in content and formatting of the tool. Conclusion: The data suggest that school personnel found value in the Decision Tree, which was intended to assist them with making decisions in a challenging and evolving pandemic.