Social Mixing And Respiratory Transmission in Schools

The Social Mixing And Respiratory Transmission (SMART) in Schools study is being conducted to help us work out how the flu and other respiratory diseases are spread in school. It may provide valuable information to help us to deal with both seasonal flu and pandemic flu (like H1N1), and other common diseases.
Why are we running this study?
You may think that we know all we need to know about how flu is spread, but we don't. We know that children spread the flu, and that hand washing and covering coughs and sneezes can reduce transmission. We think that personal touch, germs on surfaces, and airborne viruses all spread flu, but we don't know their relative importance. This study will help us get more information on this.
Closing schools is widely thought to be an effective control measure to prevent the spread of pandemic flu or other serious outbreaks. Unfortunately, we currently have a poor understanding of how well closures would work or how best to implement them. The SMART study will help us answer important questions surrounding the effectiveness of school closures.
Who is involved in this study?
Propel Schools and Canon McMillan School District have agreed to work with the University of Pittsburgh Graduate School of Public Health on the SMART Schools project. The study is funded by the US Centers for Disease Control and Prevention (CDC). Our other partners include the Johns Hopkins School of Public Health and the Institute of Infection and Global Health at the University of Liverpool (UK).
Our research team previously worked on the Pittsburgh influenza Prevention Project (PIPP), where we placed hand sanitizer in 5 Pittsburgh city schools, and taught children about hand washing, covering coughs and sneezes, and other ways to avoid the flu. See for more information.
What are the aims of this study, and how will it be conducted?
The purpose of this research is to understand how children come in contact with each other, and how this may affect flu transmission. This includes holding a conversation, sharing items, and being close together.
We plan to learn about these contacts and interactions in several ways:

  1. Schools participating in "Mote Days". A mote is a small, lightweight battery powered device that senses when another such device is nearby, and records this event. On particular days we will ask children in school to wear a mote during the school day. The motes use weak radio signals (like in a cordless phone) to recognize other motes nearby. These will let us measure the social proximity network of the children.
  2. Asking some children to fill out a contact diary for a day. This survey asks how many people they met during a day, and some other characteristics of those encounters (such as how long they took). Only selected classes will fill out these surveys, not the entire school. No names of children's contacts will be collected.
  3. Taking a few short videos (15 minutes) of normal activity in a few selected classrooms. These recordings will be done in at most 1 class per grade. This will act as a gold-standard of information collected, and help us assess and interpret correctly the data from the other two methods. This will be done in compliance with existing school policies.
  4. Testing children with flu-like symptoms for the flu. This is done by simple nasal swab to collect some mucus from their nose. We will do this to see what role their social contacts may have had in exposing them to the flu.

All of this research will be done confidentially, meaning we are not collecting any information about who you/your child is, or any personal information about your specific family. Participating students will be assigned code numbers. In the end, we may have information about the student, but this information will not be linked to his or her name, so we will not know who he or she is.
This research is being conducted in partnership with the Propel Charter Schools and Canon McMillan School District, and in a way that best fits into the school day. Additionally, our team is working with these schools to create educational opportunities for the students to understand how research is done, germs are spread, and communicable diseases are prevented.
At every step, we are listening to and incorporating the opinions of the school leaders, students, parents, and teachers. We believe this will be a very successful partnership between the schools and the University of Pittsburgh and we are excited to work with all involved parties!
Guclu H, Read J, Vukotich CJ Jr, Galloway DD, Gao H, Rainey JJ, et al. (2016) Social Contact Networks and Mixing among Students in K-12 Schools in Pittsburgh, PA. PLoS ONE 11(3): e0151139. doi:10.1371/journal.pone.0151139