COVID-19 in Underserved Populations (UPs)

Girl wearing protective face mask.People with disabilities—whether they be intellectual and developmental disabilities (IDDs), physical disabilities and movement problems, or learning and other disabilities—have been a focus of NICHD research since the institute’s founding. Because disparities in outcomes and disproportionate effects among people with disabilities has been more pronounced during the pandemic, the institute is redoubling its efforts to better understand why and what can be done to mitigate these issues.

The Trans-NIH COVID-19 Workgroup on Pregnant & Lactating Women and Children, co-led by NICHD and the National Institute on Drug Abuse, is supporting projects to better understand the effects of the COVID-19 pandemic on at-risk children and adolescents, such as the effects of learning loss among youth with developmental dyslexia. Investigators also are focused on better understanding the impact of the pandemic among populations already stressed due to other health crises, poverty, and racism. These projects, which focus on children and adolescents from low-income families of color, include COVID-19’s effect on substance use among American Indian adolescents; trauma-informed intervention to improve mental health and school success for urban eighth graders; preventive models on parent adjustment, parent-child relational health, and child psychosocial development post COVID-19; and universal strengths-based parenting support in pediatric healthcare for families with very young children following the Flint Water Crisis.

NICHD is also participating in RADx-UP, a nationwide program involving more than 60 research teams and a Coordination and Data Collection Center that is part of the NIH’s Rapid Acceleration of Diagnostics (RADxSM) initiative. The RADx-UP program aims to understand the factors associated with disparities in COVID-19 morbidity and mortality and to reduce disparities for underserved and vulnerable populations disproportionately affected by, have the highest infection rates of, and/or are most at risk for complications or poor outcomes from COVID-19.

The RADx-UP program will work closely with and within communities to develop and rapidly implement interventions and increase access and use of U.S. Food and Drug Administration-approved tests for COVID-19 and antibody testing for present and past infections among UPs. RADx-UP is also collaborating with the NIH Community Engagement Alliance (CEAL) Against COVID-19 Disparities to further amplify NIH’s focus on hardest-hit communities.

The objective of RADx-UP is to collect high-quality testing data to understand the prevalence, treatment, and outcome disparities of COVID-19 and to identify the effects of public health measures on underserved populations. To learn more about RADx-UP, read the NICHD Director’s Corner blog post, NIH One Step Closer to Speeding Delivery of COVID-19 Testing Technologies to Those Who Need It Most Through RADx-UP.

NICHD is also studying how people with IDDs are disproportionately affected by COVID-19. Read more about what researchers in the NICHD-funded Eunice Kennedy Shriver Intellectual & Developmental Disabilities Research Centers (EKS-IDDRC) Network are learning about COVID-19 in this community.

In addition, several EKS-IDDRCs recently collaborated with the Special School District of St. Louis County to compile Safe Return to School For All external link, which summarizes current evidence and best practices to help administrators, educators, and families and students—including students with disabilities—return to school safely in the context of COVID-19. The following two studies will focus on assisting children with IDDs in their safe return to the classroom:

  • COV-IDD: Testing for COVID-19 in High-Risk Children with IDDs
    Awardee Organization: University of Rochester
    Principal Investigator (PI): John Foxe
    This study will utilize systems simulation modeling to develop an efficient virological and serological testing regimen and to optimize tracing and isolation processes via in-school and mobile testing. It also will address psychological barriers to inform highest safe school participation for children with moderate to severe IDDs and school staff.
  • Washington University IDDRC and Kennedy Krieger Institute (KKI) Safe Return to School
    Awardee Organization: Washington University
    PI: Christina Gurnett
    Expanding upon an ongoing RADx-UP project of testing at the Special School District of St. Louis, this study will evaluate the impact of implementation strategies on the uptake of weekly surveillance testing in students with IDDs and staff at KKI in Baltimore and understand communication strategies to promote return to in-person instruction though parent survey and fuzzy cognitive mapping methodology.

Learn more about RADx-UP as well as all RADx initiative activities by reading the NIH Director’s Blog post, One Year of Rapid Acceleration of Diagnostics, and Anticipating New Challenges, a collaborative effort by leadership across NIH on their unified effort to meet COVID-19’s testing-related challenges.