Saliva testing among teachers during the COVID-19 pandemic: Effects on health concerns, well-being, and precautionary behavior

RATIONALE: At the start of 2021, several SARS-CoV-2 cluster outbreaks in schools threatened in-person education and created a fairly chaotic and frightening environment for school personnel. To keep the schools open while preventing COVID-19 outbreaks, intensive diagnostic testing in teachers and school personnel was strongly recommended but missing at the time. OBJECTIVES: A project was launched in Belgian schools to weekly analyze the morning saliva of school personnel using PCR-testing to detect and prevent COVID-19 positive cases. In this quasi-experimental study, we aimed to examine whether the implementation of this saliva testing project impacted school personnel's pandemic-related health concerns, well-being, and adherence to the health-protective measures, contrasting experimental with control schools. METHODS: The data were collected during the third wave (Alpha-wave, February–March 2021) of the pandemic. The sample consisted of 435 participants from 34 different schools across Flanders (Belgium) (78.8% female; M age = 43.87 years, range = 21–67) of which 82% participated in the weekly saliva tests (i.e., experimental group) and 18% took part in the control group. RESULTS: Results from a series of linear mixed regression models showed that saliva testing buffered against an increase in health concerns among tested school personnel but did not affect participants' general well-being. Slight declines in adherence to the health-protective behaviors were observed, yet this was only the case for participants who felt less supported by their school principal. High degrees of principals' support also fostered the sharpest decreases in school staff's pandemic-related health concerns. CONCLUSIONS: When keeping the schools open in unstable pandemic times, weekly saliva testing is a promising strategy to prevent cluster outbreaks while simultaneously safeguarding health concerns among school personnel. School principals appear to play a critical role in the implementation of saliva testing to secure positive effects.