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Introduction During the COVID-19 pandemic, decision-making on measures to reduce or prevent transmission of SARS-CoV-2 in schools was rendered difficult by a rapidly evolving and uncertain evidence base regarding their effectiveness and unintended consequences. To support decision-makers, an interdisciplinary panel of scientific experts, public health, and school authorities as well as those directly affected by school measures, convened in an unprecedented effort to develop an evidence- and consensus-based public health guideline. This study sought to assess the extent to which this guideline impacteddecision-making processes. Methods This study comprised three components: 1) We sent inquiries according to the Freedom of Information Acts of each federal state to ministries or departments of education, family, and health. 2) We conducted semi-structured interviews with individuals involved in decision-making regarding school measures in two federal states. 3) We conducted semi-structured interviews with members of the guideline panel. The content of response letters in component 1 was analysed descriptively; data for components 2 and 3 were analysed using deductive-inductive thematic qualitative content analysis according to Kuckartz. Results Responses to the Freedom of Information Act inquiries showed that the guideline was recognised as a relevant source of information by ministries of education in nine federal states and used as a reference to check existing directives for school measures in five federal states. It was consulted by participants who advised policymakers (5 interviews). Overall, perceptions regarding the guideline’s impact were, however, mixed. All participants (20 interviews) discussed the value of the guideline given its evidence- and consensus-based development process but also noted limitations in its usability and usefulness, e.g., lack of context-specificity. Conclusions Our findings suggest that the guideline was widely known in federal decision-making bodies, but that its actual use was relatively limited. We suggest that further research to evaluate the impact of public health guidelines on (political) decision-making is warranted, and that guideline development processes may need to be adapted to account for the realities of decision-making during public health emergencies and beyond. |
