Nationwide program aims to build innovative and sustainable solutions to expand test access and uptake in underserved and vulnerable communities
The Duke Clinical Research Institute (DCRI), in partnership with the Center for Health Equity Research at UNC-Chapel Hill and Community-Campus Partnerships for Health, has received an $80 million award to serve as the coordinating and data collection center for a four-year program that will overcome barriers and increase uptake of testing among underserved and vulnerable populations across the U.S.
The program, funded by the National Institutes of Health (NIH), is one arm of a wider billion-dollar effort called Rapid Acceleration of Diagnostics (RADx). The arm to be coordinated by the DCRI and its partners is called Rapid Acceleration of Diagnostics for Underserved Populations (RADx-UP).
The RADx-UP program will support research that aims to better understand COVID-19 testing patterns among underserved and vulnerable populations; strengthen the data on disparities in infection rates, disease progression, and outcomes; and develop strategies to reduce the disparities in COVID-19 testing.
“It is critical that all Americans have access to rapid, accurate diagnostics for COVID-19, especially underserved and vulnerable populations who are bearing the brunt of this disease,” said NIH Director Francis S. Collins, MD, PhD. “The RADx-UP program will help us better understand and alleviate the barriers to testing for those most vulnerable and reduce the burden of this disease.”
The program’s core components will center on community engagement to build robust and sustainable programs that advance COVID-19 testing. Objectives of RADx-UP include:
- Creation of a community-centered, flexible program infrastructure;
- Support of a participatory and inclusive community engagement program;
- Support of research projects through COVID-19 testing guidance and emerging science; and
- Collection, harmonization, integration, and dissemination of data to local and scientific communities.
The program is overseen by a diverse leadership team that includes Michael Cohen-Wolkowiez, MD, PhD, head of pediatric research at the DCRI; Warren Kibbe, PhD, chief of translational biomedical informatics for Duke’s Department of Biostatistics and Bioinformatics; Giselle Corbie-Smith, MD, MSc, the founder and director of the UNC Center for Health Equity Research; and Al Richmond, MSW, executive director of Community-Campus Partnerships for Health.
“Working with our partners and the NIH, we will introduce customized programs that help communities expand testing for their residents, many of whom are being disproportionately impacted by the novel coronavirus,” Cohen-Wolkowiez said. “We are proud to support this national response with innovative clinical research and community-based outreach to help improve outcomes for our most vulnerable patients.”
Racial and ethnic minorities that will be served by the RADx-UP program include African Americans, American Indians/Alaskan Natives, Latinos/Latinas, and Native Hawaiians.
“Health disparities have always been a critical issue, and today these challenges are amplified by the COVID-19 pandemic,” said Corbie-Smith. “Structural inequalities have led to higher rates of comorbidities such as cardiovascular disease or diabetes for racial and ethnic minorities, putting them at increased risk of contracting severe cases of COVID-19. Therefore, we’ve seen both higher infection rates and mortality rates in these communities.”
Also as part of the program, researchers will also work to address challenges faced by other underserved and vulnerable populations such as older adults, those who are incarcerated, pregnant women, and those experiencing homelessness.
“We look forward to partnering with Duke and UNC-Chapel Hill on this important work,” Richmond said. “At Community-Campus Partnerships for Health, our mission is to foster partnership between communities and academic institutions to promote health equity and social justice, and our participation in RADx-UP presents an outstanding opportunity to deliver on this mission.”