Due Date: 12/15/20
Funder: National Institutes of Health
About the National Institutes of Health
The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency — making important discoveries that improve health and save lives.
About the Opportunity
Across the life span, the COVID-19 pandemic will result in social, behavioral, and economic changes that impact health. These adverse effects are compounded by disruptions in the provision and access to healthcare including access to allied health providers, such as therapists and visiting nurses. In response, the healthcare landscape in the United States and around the world has shifted dramatically to a rapid uptake of digital health technologies delivered online across a variety of platforms for addressing health and disease management.
Existing digital health interventions [e.g., mobile health (mhealth), telemedicine and telehealth, health information technology (IT), wearable devices, and personalized medicine] provide opportunities to help consumers and clinicians manage and improve health during and following population level healthcare and other critical disruptions. Most importantly, digital health interventions offer the potential to increase access to screening, self-management and prevention services for individuals at risk or who currently need but are unable to access treatment and other services, particularly populations who experience health disparities, to bridge the treatment gap and provide evidence-based interventions.
This notice is not intended to support the development of novel digital health interventions. Interventions may utilize phone delivery, app-based approaches, video delivery, web-based platforms, wearable devices, and/or new technologies.
Scope of Work
In order to significantly improve near term impact of treatment and identification of individuals at risk for, or experiencing worsening health secondary to the COVID-19 pandemic across the full lifespan, supplements will focus particularly on NIH-designated health disparity (racial/ethnic minorities, less privileged socioeconomic status, rural residents and sexual and gender minorities) and other populations with medical or social vulnerabilities. The latter include residents of chronic care facilities, community-dwelling older adults, pregnant women, children, individuals with cognitive impairment or dementia, homeless, and those incarcerated or involved with the criminal justice system, individuals with substance use disorder or severe mental illness, those who are deaf or with visual, hearing, communication, or mobility impairment, and uninsured individuals. Those on the frontlines of healthcare during the COVID-19 pandemic also are vulnerable populations. Research may evaluate the effects of the pandemic on vulnerable frontline health care workers and first responders, including physicians in direct patient care, nurses, dentists, respiratory therapists, mental health therapists, other support staff, home health aides, police officers, firefighters, emergency medical technicians, and all workers with direct patient contact, as well as family or informal caregivers. Research on frontline vulnerable populations also extends to those working in essential business operations (e.g., grocery, pharmacy, and transit workers, postal and other delivery service workers, sanitation workers) who may be disproportionately impacted by the pandemic and its social, behavioral, and economic impacts on health.
Applications are expected to describe how research outcomes will lead to a tangible difference within 6 months to a year of completing the supplement work, with respect to improving how NIH identifies, treats, or provides services for health conditions secondary to the COVID-19 pandemic for health disparate and vulnerable populations. Submission of applications to address the following areas of scientific interest are encouraged:
- Strategies to increase the reach, access, engagement, efficiency, quality, and sustainability of existing evidence-based or validated digital health interventions to address healthcare needs of health disparate and other vulnerable populations including screening, prevention, self-management, wellness behaviors, and treatment both during and following the pandemic.
- Clinical trials that incorporate strategies to address the digital divide (e.g., augmented digitalor alternative interventions with non-digital components) as it relates to vulnerable populations, including elderly and low-income communities, as well as the caregiver community, that cannot easily use or access many digital interventions.
- Studies that use existing implementation science strategies and methods to identify individual and intervention-level characteristics that are associated with discontinuation vs sustained use across health disparities and vulnerable populations to promote adherence, engagement, and sustained use of digitally-assisted interventions.
- Strategies to extend the reach and uptake of services of established digital health interventions in medically underserved geographic areas and populations.
- Approaches for matching individuals to digital health interventions of appropriate intensity, including studies that use existing data to inform algorithms for intervention assignment (e.g., stepped-care approaches, adaptive interventions).
- The use of digital health strategies to identify healthcare workers at high risk of behavioral or other secondary health symptoms, conduct diagnostic screening, refer to the appropriate level of care, and provide just in time and tailored interventions.
- Integration and analysis of data from multiple digital health platforms leveraging common data elements to identify population-level trends, the long-term health impact, and the cost-effectiveness of providing digital health care at scale.
- Studies that investigate the influence of sex and gender on the use of digital health interventions for disease prevention, identification, self-management, and treatment and that ultimately contribute to a more individualized approach to health care.
- Integration of stigma indicators into digital health interventions.
- Studies to evaluate the near-term impact of replacement (or substitution) of face to face services with digital health as a result of the pandemic to address health disparities and vulnerable population needs.
- Strategies to understand if changes in service delivery as a result of the pandemic will yield durable and sustainable system level changes in practice that improve or maintain access and quality care.
- Strategies to identify previously understudied or unknown services and care delivery pathways that emerged as a result of the pandemic and how to capitalize on these novel digital health pathways, such as ways to segment levels of care (e.g., crisis line support that could transfer to higher levels of telehealth psychiatric/ addiction/ urgent medical care for more complex cases when in person treatment is not feasible).
- The use of existing validated digital health platforms to rapidly identify individuals at high risk of behavioral health symptoms, disorder or crisis (e.g., suicide attempt, overdose, medication withdrawal, acute symptom return), conduct diagnostic screening, refer to the appropriate level of care, and provide just in time and tailored interventions.
Applications are accepted on a rolling basis until December 15, 2020.