Home Testing Research Articles

An integrated sample-to-answer graphene microchip for ultrafast detection of multiple microorganisms

The integrated detection of nucleic acids is a molecular biological technology integrating the entire process of nucleic acid detection into a “sample-to-answer” system, which is widely used in microbial identification and disease diagnosis. Although the integrated detection of nucleic acids has the advantages of fully-enclosed system and simple operation, it still faces challenges like dependence on bulky equipment, complex design, and long detection time. To address these challenges, we have proposed and fabricated an integrated graphene microchip for ultra-fast detection of multiple microorganisms. This microchip is composed of two main regions: the electrolysis-extraction region and the isothermal amplification-detection region. In the electrolysis-extraction region, the microchip was equipped with the micron-structured graphene interdigital electrode and a regular battery for power supply, and the nucleic acids of H. pylori were extracted only in 1.0 s by electrolysis. Then in the isothermal amplification-detection region, the nucleic acids of H. pylori were detected in less than 9 min at a concentration of 10 CFU/µL. As a result, the detection time of the whole process were controlled in merely 9 min. In addition, this integrated graphene microchip has three parallel channels for simultaneous detection of oral microorganisms, e.g., C. albicans, S. aureus and H. pylori. These characteristics make our integrated graphene microchip promising to contribute to the development in integrated technology of nucleic acid detection and be widely used at various medical structures or on-site environments such as home testing.

Implementation of an intervention to reduce urine dipstick testing in aged care homes: a qualitative study of enablers and barriers, and strategies to enhance delivery

ObjectiveThe ‘To Dip or Not to Dip’ (TDONTD) intervention aims to reduce antibiotic prescribing for urinary tract infection (UTI) by reducing low-value dipstick testing. The aims of this study were...

Evaluation of the Amblyopia tracker app

PurposeThe Amblyopia tracker app has been developed to be a tool for parents to monitor changes in vision at home during amblyopia treatment. The aims of this study were to evaluate the feasibility and repeatability of parents testing their children at home and to compare home test results to an assessment in clinic by an orthoptist.MethodsChildren (age < 18 years) with amblyopia (interocular acuity difference of ≥ 0.2logMAR) were recruited. Parents were asked to test their child with the app three times during a two week period followed by an online questionnaire about the usability. Participants also tested within 48 h of their appointment where the measurement was repeated by an orthoptist.ResultsOut of 277 potential participants contacted, 37 completed three home measurements, mean age 6.8 years (SD 2.94). Home tests comparisons were made between test two and three to ensure familiarity with the process. Paired t-tests showed no statistically significant difference for either eye or the interocular acuity difference (IAD). However, 29% had a difference in IAD of more than 0.1logMAR on repeated testing, with a maximum of 0.4logMAR difference in the IAD. Questionnaire responses from the parents who participated were predominantly positive with 97% of respondents saying they would use it if were available. Comparison of home and clinical measurements (n = 23, mean age 6.72 SD 2.60) showed no statistically significant differences for either eye or interocular acuity difference (paired t-test, p > 0.3 in all cases).ConclusionResults show no statistically significant differences for the Amblyopia tracker app when used by parents at home on repeated testing, or between the home test by a parent and the test by a clinician. However, variability in the results does indicate that further improvements are required to ensure the results can be used as a reliable clinical tool.

Associations Among Cardiometabolic Risk Factors, Sleep Duration, and Obstructive Sleep Apnea in a Southeastern US Rural Community: Cross-Sectional Analysis From the SLUMBRx-PONS Study.

Short sleep and obstructive sleep apnea are underrecognized strains on the public health infrastructure. In the United States, over 35% of adults report short sleep and more than 80% of individuals with obstructive sleep apnea remain undiagnosed. The associations between inadequate sleep and cardiometabolic disease risk factors have garnered increased attention. However, challenges persist in modeling sleep-associated cardiometabolic disease risk factors. This study aimed to report early findings from the Short Sleep Undermines Cardiometabolic Health-Public Health Observational study (SLUMBRx-PONS). Data for the SLUMBRx-PONS study were collected cross-sectionally and longitudinally from a nonclinical, rural community sample (n=47) in the southeast United States. Measures included 7 consecutive nights of wrist-based actigraphy (eg, mean of 7 consecutive nights of total sleep time [TST7N]), 1 night of sleep apnea home testing (eg, apnea-hypopnea index [AHI]), and a cross-sectional clinical sample of anthropometric (eg, BMI), cardiovascular (eg, blood pressure), and blood-based biomarkers (eg, triglycerides and glucose). Correlational analyses and regression models assessed the relationships between the cardiometabolic disease risk factors and the sleep indices (eg, TST7N and AHI). Linear regression models were constructed to examine associations between significant cardiometabolic indices of TST7N (model 1) and AHI (model 2). Correlational assessment in model 1 identified significant associations between TST7N and AHI (r=-0.45, P=.004), BMI (r=-0.38, P=.02), systolic blood pressure (r=0.40, P=.01), and diastolic blood pressure (r=0.32, P=.049). Pertaining to model 1, composite measures of AHI, BMI, systolic blood pressure, and diastolic blood pressure accounted for 25.1% of the variance in TST7N (R2adjusted=0.25; F2,38=7.37; P=.002). Correlational analyses in model 2 revealed significant relationships between AHI and TST7N (r=-0.45, P<.001), BMI (r=0.71, P<.001), triglycerides (r=0.36, P=.03), and glucose (r=0.34, P=.04). Results from model 2 found that TST7N, triglycerides, and glucose accounted for 37.6% of the variance in the composite measure of AHI and BMI (R2adjusted=0.38; F3,38=8.63; P<.001). Results from the SLUMBRx-PONS study highlight the complex interplay between sleep-associated risk factors for cardiometabolic disease. Early findings underscore the need for further investigations incorporating the collection of clinical, epidemiological, and ambulatory measures to inform public health, health promotion, and health education interventions addressing the cardiometabolic consequences of inadequate sleep. RR2-10.2196/27139.

Language Acquisition in the Longitudinal Cambridge UK BabyRhythm Cohort

The Cambridge UK BabyRhythm project is a study of 122 infants as they age from 2 – 30 months, investigating cortical tracking and sensorimotor synchronisation to acoustic and visual rhythm in relation to language acquisition. As there are few standardised language tasks appropriate for this age range, the BabyRhythm project adapted a range of parent-report and infant-led experimental measures that could be used within a home testing environment. Here we present a rich description of infant performance on tasks intended to sample 5 linguistic domains: semantics, phonology, grammar, rhythmic timing and gesture. For each task we describe infant performance (mean, median, range), and we also report performance by sex (N female = 57) and by monolingual (N = 91) versus multilingual (N = 31) home environments. We report relations between measures. We share our unique longitudinal database (all data available on OSF), and ‘lessons learned’ on adapting language assessments for very young children. Critically, we identify the language tasks that will be utilised in our longitudinal brain-behaviour analyses, providing the benchmark upon which future neural and behavioural markers will be measured.

Analyzing the Costs and Impact of the TakeMeHome Program, a Public-Private Partnership to Deliver HIV Self-Test Kits in the United States.

HIV testing is an entry point to access HIV care and prevention services. Building Healthy Online Communities developed a website ( TakeMeHome.org ) where participants can order HIV home test kits. The purpose of this study was to analyze the costs and impact of the TakeMeHome program. We estimated the costs of TakeMeHome across all participating jurisdictions for the first year of the program. We estimated program costs using purchase orders and invoices, contracts, and allocation of staff time, and the costs included website design, participant recruitment, administration and overhead, HIV self-test kits, and shipping and handling. Primary outcomes of the analysis were total program cost, cost per HIV test, and cost per new HIV diagnosis. The TakeMeHome program distributed 5323 HIV self-tests to 4859 participants over a 12-month period. The total program cost over this period was $314,870. The cost per HIV test delivered was estimated at $59, and the cost per person tested was $65. The program identified 18 confirmed new HIV diagnoses (0.6% positivity) verified with surveillance data in 7 health jurisdictions at $169,890. The cost per confirmed new HIV diagnosis was estimated at $9440. The TakeMeHome program delivered HIV self-testing at a reasonable cost, and the program may be a cost-effective use of HIV prevention resources. The public-private partnership can be an effective mechanism to validate HIV diagnoses identified with self-testing and provide HIV prevention and linkage to care services.

Quantification of SARS‐CoV‐2 viral load in patients using time‐to‐results in antigen lateral flow tests

AbstractBased upon clinical observations and recent reports, we anticipated there would be an inverse dose–response relationship between the severe acute respiratory syndrome‐coronavirus 2 (SARS‐CoV‐2) viral load and the time‐to‐positivity after application of the nasal swab sample in two popular home coronavirus disease 2019 (COVID‐19) antigen tests, BinaxNOW COVID‐19 Antigen Self‐Test and Flowflex COVID‐19 Antigen Home Test, both of which are sensitive to the nucleocapsid protein (NP). The relationship among the concentration of NP, WA1, and Omicron XBB.1.5 viral strains and the time‐to‐positive result by visual assessment in the tests was examined. The correlation between reverse transcription‐polymerase chain reaction cycle threshold (Ct) values and time‐to‐positivity in clinical samples (training set) also was determined. Strong inverse correlations were obtained between the concentration of the NP, WA1, XBB.1.5, Ct values for dilutions of both WA1 and XBB.1.5, as well as Ct values from the clinical samples and time‐to‐positivity in both antigen tests. The correlation between the actual and predicted Ct values interpolated from the training set was high with both tests in a second set of clinical samples. These results, together with those of other investigations with similar tests, suggest that the time‐to‐positive visual result in most, if not all, lateral flow COVID‐19 antigen tests can be utilized to estimate SARS‐CoV‐2 viral concentrations.

P473 Comparison of clinical performance of fecal calprotectin of laboratory methods with lateral flow based POC and home tests

Abstract Background To confirm an IBD diagnosis and manage IBD patients, endoscopy is the gold standard to assess mucosal inflammation. Fecal calprotectin (fCAL) is a reliable biomarker of intestinal inflammation that highly correlates with endoscopic and histological findings. Fecal calprotectin testing is recommended in most IBD guidelines for diagnosis and disease course evaluation. Different assay technologies exist that need to measure fecal calprotectin comparably. These range from classic enzyme linked immunosorbent assays (ELISA), particle enhance turbidimetric immuno assays (PETIA), and rapid lateral flow assays (LFIA). LFIA[AL1] [RC2] s can be read by conventional tabletop readers or by everyday smartphone applications using the phone’s camera to acquire an image, detect the test cassette and calculate a quantitative result. As there is no international standard to date, fecal calprotectin assay manufacturers rely on their own internal calprotectin standardization. This study compared four different assays measuring the same clinical samples. Methods The 128 raw stool samples that were analyzed in this study were obtained from patients that presented with signs and symptoms suggesting intestinal inflammation and underwent endoscopic evaluation to establish or exclude an IBD diagnosis. Samples were extracted with the BÜHLMANN CALEX® Cap stool extraction device. Each extract was then measured on the BÜHLMANN fCAL® ELISA, fCAL® turbo (PETIA), Quantum Blue® fCAL extended lateral flow assay and smartphone based IBDoc® fCAL home test. For the home test, two phones, iPhone 11 and Samsung Galaxy S7, were used to measure the lateral flow test cassettes. Each sample was measured one time on each assay and Receiver Operating Characteristic (ROC) curve analysis was performed and total agreement between each method was calculated. Results ROC curves were generated to assess the ability of each assay to differentiate between IBS and IBD with area under the curve (AUC) values ranging from 0.827 (Samsung Galaxy S7 to 0.835 (fCAL turbo). There was no significant difference between the methods. Commonly used cut-offs in the assessment of IBD patients are 100 and 250 µg/g, respectively. Positive and negative percent agreement (PPA/NPA) between the smartphone-based home test and the laboratory assays was calculated. The PPA was above 90% for all methods while the NPA was above 88% for all methods. Conclusion The results presented here show that the four BÜHLMANN assays measure fecal calprotectin extremely comparably and show an excellent clinical performance. This allows for the use of the methods interchangeably, depending on the needs of the patients and their care team.

P1046 Home calprotectin testing: An east London experience

Abstract Background Monitoring of inflammatory bowel disease (IBD) using home faecal calprotectin (FCP) testing kits was adopted widely during the Sars-Cov-2 pandemic. CalproSmart is a kit which allows patients to measure FCP at home and upload the results to a smart phone application allowing remote monitoring. Recent NHS long term recovery plan has highlighted the importance of ensuring equity of access with service development1. Following the British Society of Gastroenterology guidance during the pandemic we introduced the system to our hospital in Newham, one of the most ethnically diverse regions of the UK2. The aim of this pilot study was to evaluate the uptake of the kits, patient acceptability and how they impacted on IBD care. Methods 62 patients with stable IBD were invited to take part in the study over a 12 month period. They were sent four FCP tests and instructions on how to enrol onto the CalproSmart portal. The participants who enrolled on the portal were then sent a post-study questionnaire. Results 28 of the 62 patients invited (45%) enrolled onto the CalproSmart portal. 14 of these 28 patients (50%) completed the post-study questionnaire. The patients invited to take part were from a variety of ethnic backgrounds, the average age was 36 and there were a mix of Ulcerative Colitis (60%) and Crohn’s (40%) diagnoses. When comparing those invited and those who used the home kit, uptake varied according to gender and ethnicity. 57% of women invited used the home kit compared to 34% of males. Additionally, despite 69% of the borough’s population being non-white, 50% of those using the home tests were white (see table 1). The post –study questionnaire showed that both the sample kit and the application were found easy to use by 12 (86%) and 13 (93%) of the patients, respectively. 11 patients (79%) reported they found the results of the FCP home kit helpful and 6 patients (50%) felt the FCP home kit improved the treatment of their disease (see figure 1).10 patients (71%) reported they preferred a home test to dropping stool samples at the hospital. The reasons for this were the convenience of not having to visit the hospital (90%) and the speed in which they got the results (80%). Conclusion This study demonstrates that home FCP tests are an easy-to-use tool and patients prefer them to attending the hospital. The home kit was well received in a diverse area of London with a mix of ethnic groups and socio-economic backgrounds. However, the ethnicity of patients using the home tests did not reflect the diversity of the invited participants or the borough. This suggests there needs to be additional exploration into their barriers to access and consider any extra support needed to improve uptake of patient initiated monitoring.

Comparison of home detection algorithms using smartphone GPS data

Estimation of people’s home locations using location-based services data from smartphones is a common task in human mobility assessment. However, commonly used home detection algorithms (HDAs) are often arbitrary and unexamined. In this study, we review existing HDAs and examine five HDAs using eight high-quality mobile phone geolocation datasets. These include four commonly used HDAs as well as an HDA proposed in this work. To make quantitative comparisons, we propose three novel metrics to assess the quality of detected home locations and test them on eight datasets across four U.S. cities. We find that all three metrics show a consistent rank of HDAs’ performances, with the proposed HDA outperforming the others. We infer that the temporal and spatial continuity of the geolocation data points matters more than the overall size of the data for accurate home detection. We also find that HDAs with high (and similar) performance metrics tend to create results with better consistency and closer to common expectations. Further, the performance deteriorates with decreasing data quality of the devices, though the patterns of relative performance persist. Finally, we show how the differences in home detection can lead to substantial differences in subsequent inferences using two case studies—(i) hurricane evacuation estimation, and (ii) correlation of mobility patterns with socioeconomic status. Our work contributes to improving the transparency of large-scale human mobility assessment applications.

The Sukaribit Smartphone App for Better Self-Management of Type 2 Diabetes: Randomized Controlled Feasibility Study.

A new app, Sukaribit, was designed to enable contact between the caregiver and the patient with the intent to improve self-care and glycemic control (hemoglobin A1c [HbA1c]). This study investigated the feasibility of the study methodology and the intervention in preparation for a larger effectiveness study. Adults with type 2 diabetes were recruited in this randomized controlled feasibility study with a mixed methods design. The intervention group (n=28) tried Sukaribit for 2 months. They were encouraged to report blood glucose levels and medications, and they received feedback from a physician. The control group (n=31) received standard care. Both groups were evaluated with pre and postmeasurements of glycemic control (HbA1c), diabetes distress, physical activity, and self-care. Feasibility was evaluated against 5 progression criteria regarding recruitment, study methods, and active participation. Of the 5 progression criteria, only 2 were met or partially met. The recruitment process exceeded expectations, and data collection worked well for self-reported data but not for HbA1c measured with a home testing kit. The participants were less active than anticipated, and the effect sizes were small. Only the number of blood glucose tests per day was positively affected by the intervention, with 0.6 more tests per day in the intervention group. Recruitment of participants to a future fully powered study may work with minor adjustments. The collection of HbA1c using home testing constituted a major problem, and an alternative strategy is warranted. Finally, the app was not used as intended. In order to proceed with a larger study, the app and study procedures need improvement.

Utilization of at-home tests for coronavirus disease 2019 (COVID-19) among healthcare workers in Chicago.

To describe utilization of at-home coronavirus disease 2019 (COVID-19) testing among healthcare workers (HCW). Serial cross-sectional study. HCWs in the Chicago area. Serial surveys were conducted from the Northwestern Medicine (NM HCW SARS-CoV-2) Serology Cohort Study. In April 2022, participants reflected on the past 30 days to complete an online survey regarding COVID-19 home testing. Surveys were repeated in June and November 2022. The percentage of completed home tests and ever-positive tests were reported. Multivariable Poisson regression was used to calculate prevalence rate ratios (PRR) and univariate analysis was used for association between participant characteristics with home testing and positivity. Overall, 2,226 (62.4%) of 3,569 responded to the survey in April. Home testing was reported by 26.6% of respondents and 5.9% reported having at least one positive home test. Testing was highest among those 30-39 years old (35.9%) and nurses (28.3%). A positive test was associated (P < .001) with exposure to people, other than patients with known or suspected COVID-19. Home testing increased in June to 36.4% (positivity 19.9%) and decreased to 25% (positivity 13.5%) by November. Our cohort findings show the overall increase in both home testing and ever positivity from April to November - a period where changes in variants of concern of SARS-CoV-2 were reported nationwide. Having an exposure to people, other than patients with known or suspected COVID-19 was significantly associated with both, higher home testing frequency and ever-test positivity.

Distribution of COVID-19 Home Testing Through Community Health Centers: Results of the COVID CoNOce MÁS Study.

To assess acceptability and feasibility of rapid at-home COVID-19 testing and reporting of test results among individuals seeking care at community health centers (CHCs) and their household members. Participants were recruited from 2 Community Health Centers during a clinic visit or a community event. Over-the-counter COVID-19 tests were distributed to participants for self-testing and to offer testing to household members. Separate surveys were administered to collect baseline information on the study participant and to collect test results on the study participant and household members. We calculated the proportion of individuals who agreed to complete COVID home testing, those who reported test results, and the test positivity. For household members, we calculated the proportion who completed and reported results and the positivity rate. We assessed reasons for undergoing COVID-19 testing and the action taken by participants who reported positive tests. A total of 2189 individuals were approached by CHC staff for participation and 1013 (46.3%) agreed to participate. Among the 959 participants with complete sociodemographic data, 88% were Hispanic and 82.6% were female. The proportion providing test results was 36.2% and the test positivity was 4.2%. Among the 1927 test reports, 35.3% for the index participant and 64.4% were for household members. The largest proportion of test results were for index participants (35.3%) and the second largest was for the participant's children (32.1%), followed by parents (16.9%), and spouse/partner (13.2%). The 2 most common reasons for testing were symptoms (29%) and attending family gatherings (26%). Among test-positive individuals (n = 80), most (83.3%) noted that they isolated but only 16.3% called their provider and 1.3% visited a clinic. Our results show interest in at-home COVID-19 testing of multiple household members, as we headed into the endemic phase of the pandemic. However, reporting of test results was modest and among test-positive individuals, reporting results to a provider was very low. These results underscore the challenges with reporting and following guidelines among people undergoing home testing for COVID-19, which may have implications for future pandemics.

Information Accessibility in the Form of Braille.

Braille is often proposed by the uninformed as the optimal solution to providing an alternative to visual information to the visually impaired. The purpose of this article is to highlight the complexity of the braille user population and discuss the importance of understanding the use of braille as a solution for equal access of information. As part of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) Rapid Acceleration of Diagnostics (RADx) Tech program and its goal to make home tests accessible to people with disabilities, a series of interviews with industry experts was conducted to better understand braille technologies and the braille user space. Published literature findings provided additional context and support to these interviews. It was found that expert consensus and data from published literature vary. The braille user population is complex and lacks consistent characterization. Visually printed media should not be solely relied on to communicate information. In conclusion, braille is one solution for improving access to information. Understanding the unique needs of braille users and how they engage with information in a world that is heavily reliant on visual content, is a critical step in developing and implementing non-visual alternatives that will collectively address information access.

A long-term case study on marginal diabetes: demonstrating the need for effective calibration of home test devices

A long-term case study on marginal diabetes: demonstrating the need for effective calibration of home test devices

UbiNAAT: a multiplexed point-of-care nucleic acid diagnostic platform for rapid at-home pathogen detection.

The COVID-19 pandemic increased demands for respiratory disease testing to facilitate treatment and limit transmission, demonstrating in the process that most existing test options were too complex and expensive to perform in point-of-care or home scenarios. Lab-based molecular techniques can detect viral RNA in respiratory illnesses but are expensive and require trained personnel, while affordable antigen-based home tests lack sensitivity for early detection in newly infected or asymptomatic individuals. The few home RNA detection tests deployed were prohibitively expensive. Here, we demonstrate a point-of-care, paper-based rapid analysis device that simultaneously detects multiple viral RNAs; it is demonstrated on two common respiratory viruses (COVID-19 and influenza A) spiked onto a commercial nasal swab. The automated device requires no sample preparation by the user after insertion of the swab, minimizing user operation steps. We incorporated lyophilized amplification reagents immobilized in a porous matrix, a novel thermally actuated valve for multiplexed fluidic control, a printed circuit board that performs on-device lysis and amplification within a cell-phone-sized disposable device. Reverse transcription loop-mediated isothermal amplification (RT-LAMP) products are visualized via fluorescent dyes using a modified cell phone, resulting in detection of as few as 104 viral copies per swab across both pathogens within 30 minutes. This integrated platform could be commercialized in a form that would be inexpensive, portable, and sensitive; it can readily be multiplexed to detect as many as 8 different RNA or DNA sequences, and adapted to any desired RNA or DNA detection assays.

Lithium treatment for affective disorders: Exploring the potential of salivary therapeutic monitoring

Lithium is one of the most effective medications for treatment-resistant depression and bipolar disorder. However, lithium has a narrow therapeutic window: overdosing can lead to life-threatening lithium intoxication while underdosing results in a lack of desired therapeutic effects. Therefore, lithium treatment requires close monitoring with regular laboratory assessments of blood serum concentrations. An alternative method for monitoring lithium at home would increase the safety and empowerment of patients. In our project, we are investigating the potential of saliva as a readily accessible medium. We are exploring a) the best method for collecting and processing saliva, b) methods to measure salivary lithium levels, and c) the correlation between blood serum and saliva concentrations of lithium, and influencing factors; with the aim to develop a Point-of-care home testing device.

(Invited) Pathogen Agnostic Biodetection at the Point of Need

Emerging pathogens are a constant threat to global health and human life, as exemplified by the recent COVID-19 pandemic. The availability of rapid testing - including in home tests - was instrumental in facilitating return to our 'normal' way of life. Diagnostics - especially those that can quickly and effectively inform on the condition at the point of need, enhance situational awareness and guide decision making and mitigation strategies can greatly impact our ability to counter emerging threats, epidemics and pandemics. Yet, current diagnostics are largely targeted- meaning they are tailored to identify a limited repertoire of anticipated threats. For true preparedness, it is important that the strategies we develop are pathogen agnostic and can be readily used against any organism quickly. Our team has sought inspiration from the human innate immune system in order to develop truly agnostic diagnostics. Innate immunity is medicated by pattern recognition receptors that have evolved to recognize evolutionarily conserved signatures on pathogens - allowing for their early identification. These germline receptors bind with conserved pathogen associated molecular patterns – PAMPs – produced by all pathogens, and result in the development of an associated cytokine and chemokine response. Innate immunity is thus a universal biosensor. Drawing inspiration from this natural system, our team has developed diagnostic assays for all pathogens. This involved understanding of common mechanisms of host-pathogen interactions, which then lead to the design of curated novel assay modalities - membrane insertion and lipoprotein capture - for the detection of pathogen. Beyond assay development and characterization of the response, we have evaluated the feasibility of these methods to detect signatures in blinded clinical samples for a variety of diseases (tuberculosis, invasive Salmonella, Shiga toxin carrying E. coli, Staphylococcal bacteremia, and others) with excellent sensitivity as compared to benchmark assays. These outcomes and strategies for pathogen agnostic detection will be presented.Transitioning this platform for field use, our team engineered a portable waveguide-based optical biosensor platform with integrated microfluidics for sample processes. The platform named Portable EnGineered Analytical Sensor with aUtomated Sampling (PEGASUS, R&D100 2021). This platform uses single mode planar optical waveguides as the sensing element, and builds on a bench top instrument that has been developed at the Los Alamos National Laboratory. PEGASUS miniaturizes this benchtop sensor, with integrated sample processing, moving us toward the goal of developing a truly fieldable biosensor. PEGASUS uses a different, smaller waveguide mounting apparatus, miniaturized robust components, sensing hardware and software.PEGASUS integrates Catch-all, the first ever sample processing system capable of lipid separation with ultra-sensitive optical detection of complex bioanalytes at the point of need. a microfluidic device capable of centrifugal separation of serum from blood at the point of need with a system that is compatible with biomarkers that are both hydrophilic and hydrophobic. The cross-flow filtration device separates serum from blood as efficiently as traditional methods and retains amphiphilic biomarkers in serum for detection.Whereas the scope of targets is extremely broad, the platform still relies on the use of reagents, which complicates field use in some instances. Therefore, we are beginning to explore multi-wavelength spectroscopy as a tool for the measurement of complex clinical signatures - within seconds, without reagents. Preliminary data from this development will also be presented.

Measuring societal attitudes and behaviours towards radon indoors: A case study of Slovenia

Public opinion surveys play a crucial role in assessing public awareness, knowledge, and radon risk perception in the context of national Radon Action Plans. However, many of these surveys are constructed without a solid foundation in behavioural theories, health protection theory, or social science methodology. This lack of foundation can lead to misguided priorities in radon mitigation interventions and ineffective communication strategies, ultimately resulting in low compliance with testing and mitigation in private homes. By developing and testing scales that measure a wide range of theory-based socio-psychological concepts influencing protective behaviour of individuals facing radon risk, this study provides researchers, authorities, and practitioners with a useful and versatile survey tool to explore the complexity of human behaviour in the context of radon. The results of this survey, conducted in Slovenia with a representative sample of respondents from low, middle, and high radon risk areas (N = 2012), offer a foundation for assessing gaps and strategies to increase testing and remediation of homes. The findings suggest that communication interventions need to be more precisely tailored to specific population groups and should go beyond enhancing awareness, knowledge and radon risk perception. Effective strategies should evoke emotions, share personal stories, highlight successful mitigation cases, and use personal testimonies from individuals affected by lung cancer. Moreover, incorporating positive social norms can inspire more individuals to engage in testing and mitigation measures. Assessing theory-driven socio-psychological concepts through a survey allows researchers and policymakers to craft more effective strategies aimed at promoting radon testing and mitigation, thereby enhancing overall public health.

P94: Co-design of a theory-based implementation plan for a digital holistic assessment and decision support framework for people with dementia in care homes

Background:Despite positive findings around the use of eHealth in dementia care, evidence for its efficacy is insufficient to ensure its adoption into routine care. Early involvement of end-users in the design of an implementation plan is a key strategy for promoting translation of findings into practice.Objective:This study aimed to identify the requirements for use of an eHealth intervention to support assessment and decision making for use with people with dementia in care homes, and co-design strategies for its implementation.Methods:A qualitative co-design method was applied through a series of workshops. Participants included family carers of people with dementia, and health and social care practitioners with direct experience of working with people with dementia. The workshops focused on identifying requirements for use and co-developing implementation strategies in response to factors identified to influence implementation. A deductive thematic analytic approach was taken, guided by the key concepts of the Normalisation Process Theory.Results:Three workshops were conducted from July’21-November’21, attended by 39 participants. Three overarching phases of requirements were identified: 1) incentivising adoption of eHealth; 2) enabling operation of an eHealth intervention; 3) sustaining use of eHealth. Initial adoption requires promotion of the interventions benefits to engage stakeholders, and its alignment with national recommendations for good quality dementia care. Operationalising eHealth involves ensuring its compatibility with current care home processes and technology, provision of sufficient training and support from ‘champions’. To sustain its use, ongoing monitoring of the implementation plan and provision of feedback to allow stakeholders to appraise its effects is required.Conclusions:Implementing eHealth across a complex system of care homes is a multifaceted process. Using the key requirements identified in the workshops, we have developed a multi-strategy plan centered around three phases of implementation, to promote uptake of eHealth to support assessment and decision making for people with dementia in care homes. This is strengthened through collaborating with end-users to increases its value, credibility and real-world relevance. The theoretically informed strategies target mechanisms previously demonstrated to shape the implementation process and outcomes, ready for testing in care homes.