A Mixed-methods Study to Identify Behaviors of High-performing Contact Tracers.

Objectives: Contact tracing is vital to disease surveillance and has been a major public health activity during disease outbreaks. This study focused on identifying optimal contact tracing practices and behaviors that differentiate high- and average-performing contact tracers (CTs) for infectious disease.

Design: A mixed-methods study was conducted using program administrative data, qualitative interviews, and ratings of audio-recorded calls with CTs in a city-wide COVID-19 contact tracing operation.

Methods: Optimal contact tracing practices were identified through qualitative interviews. Audiorecorded ratings of high- and average-performing CTs were blinded rated by researchers on key behaviors.

Setting: Contact tracers for COVID-19 in San Antonio, Texas. Participants: Qualitative interviews were conducted with 8 CTs. Thirty-one CTs, including 7 high- and 24 average-performing CTs, were blindly rated on live contact tracing calls on frequency of key behaviors.

Main outcome measures: Optimal contact tracing practices.

Results: Qualitative analysis identified several key themes of optimal contact tracing, including Empathy over Efficiency, Need for Regular Monitoring and Supervision, and Importance of Adaptability. Quantitative analysis revealed high-performing CTs were found to use moderately more statements of empathy and assurances of confidentiality than average-performing CTs.

Conclusions: Optimal contact tracing activities rely on CTs balancing different dimensions of behavior that include rapport building, efficiency, comprehensive data collection, and adaptability in interactions. These indicators may be useful to monitor and measure regularly to ensure CTs effectively engage members of the public in disease containment activities.