Table 2 Overview of themes

 Motivation to keep children in schools and avoid unnecessary isolation

• DCT was highly valued by parents and students who are motivated to enable school attendance.• Those in exam years and those who had missed a lot of school were particularly keen to avoid additional periods of self-isolation.• Staff, students and parents were keen to avoid “unnecessary” periods of isolation (i.e., isolation during which the student does not test positive).

 Safety of daily testing at home and school

• A barrier to acceptability of daily testing was concern about the accuracy of tests and the safety of the test-to-release policy.

• Many people had complex, well-informed reasons for choosing to test or to isolate, based on their personal risk assessments, including perceived risk of exposure and perceived vulnerability of household members.

• Those who believed that they were at high risk of catching the virus reported feeling that their household was protected as a result of daily testing (particularly if living in a vulnerable household), but acknowledged it made it less safe for others at school.

• Those who thought it unlikely that they had caught the virus were less concerned about passing the virus to others at school, but reported increased concerns that they would catch the virus from their classmates, thus increasing the risk to their household.

 Disruption following a positive test result

• Some people preferred the certainty of a period of self-isolation in terms of infection risk management and planning their activities. For example, some parents preferred to accept that their child would be isolating for 10 days, rather than face the uncertainty of not knowing whether their child would be sent home each day.

• Some parents and pupils were concerned about the risk of a positive test, which might extend their isolation period, and/or have a negative impact on the household (who would also have to isolate).

 Preference for online working

• Some people decided to self-isolate because they felt that school attendance was not important (for example, if home schooling is preferred).

 Space and capacity

• Some schools found it more difficult to implement testing, due to a lack of resources (e.g., limited space and staff capacity – particularly to cope with large outbreaks) or the nature of their school population (for example, parents and students with lower levels of IT and health literacy).

Test results

 Communication of test results

• There was considerable variation between schools regarding how test results and associated information were communicated.

• There was a desire for better information about what positive and negative test results mean, how accurate tests are, and the rules and regulations for relating to contact outside of school hours during the testing period (e.g., travelling to and from school / after school clubs).

 Confidence in accuracy of tests

• There was considerable variation between participants in perceived accuracy of tests.

• Confidence in the accuracy of tests appeared to be reinforced by a corresponding lack of symptoms, a lack of contact with the confirmed case, and/or multiple test results.

• Confidence was reduced through exposure to conflicting test results.

Adherence

 Adherence to avoiding contact behaviour

• Most participants reported that they had adhered to the rules or engaged only in low risk activities during the testing period.

• This included making attempts to avoid vulnerable relatives as much as possible.

• Parents considered the risks associated with their child’s engagement in outdoor activities against the social / mental health benefits for their child.

• There were some concerns that others may not always follow the rules, particularly if they did not understand that a negative test result does not mean that they do not have the virus.