ECHO's Approach to Innovative Research Practices in the Era of COVID-19
As the novel coronavirus pandemic continues to affect communities across the world, ECHO is committed to protecting the health and safety of its staff and participants while advancing our research mission of enhancing the health of children for generations to come.
ECHO’s contribution to COVID-19 research
ECHO is also conducting research on the effects—from biological to psychosocial—of the pandemic on pregnant women and children.
ECHO researchers are working together in record time to incorporate COVID-19 research in ongoing and new studies. This work is being led by a COVID-19 task force for ECHO ISPCTN and a COVID-19 working group for the ECHO Cohort.
ISPCTN (Intervention Research)
ECHO ISPCTN launched the Improving COVID-19 Vaccine Uptake Using mHEALTH Tools (MoVeUP) study to explore parental attitudes about the COVID-19 vaccine and test the effectiveness of a mobile app to help parents learn more about the vaccine for children. The study involved parent focus groups and individual interviews to assess the factors that influence COVID-19 pediatric vaccination decision making. Data from the focus groups and interviews informed development of a mobile health app to help parents learn and decide about vaccinating their children against COVID-19. The ISPCTN is testing this mobile app for its impact on pediatric COVID-19 vaccine uptake.
This study includes a focus on participants from rural and underrepresented racial and ethnic communities, which have experienced disproportionately lower vaccination rates and greater hardships due to the COVID-19 pandemic.
ECHO Cohort (Observational Research)
The ECHO Cohort rapidly produced COVID-19-specific questions that are now part of the ECHO Cohort Data Collection Protocol. To be maximally useful for other researchers, two public NIH websites feature these questionnaires: https://dr2.nlm.nih.gov and https://www.phenxtoolkit.org/covid19.
During the summer of 2020, the NIH Program Office issued a Notice of Special Interest (NOSI) to encourage and foster time-sensitive ECHO Cohort science related to the COVID-19 pandemic. In September 2020, NIH funded six projects, which include participation from 24 ECHO Pediatric Cohorts or Centers. The ECHO Cohort COVID-19 Working Group continues to facilitate implementation of these new projects, and to foster other COVID-19 related research questions that the ECHO cohort is uniquely suited to address.
ECHO COVID-19 Publications
Measuring pandemic-related stress in ECHO Cohort participants
ECHO investigators reported differences in pandemic-related traumatic stress among participants using a newly developed self-report survey.
A Look at Life Satisfaction in Pandemic-era Teens with Mental Health Histories
ECHO research suggests that, during the COVID-19 pandemic, teens with a history of depression, anxiety, autism, and ADHD experienced lower life satisfaction compared to their counterparts.
A Qualitative Exploration of COVID-19 Vaccine Hesitancy Among Parents
Parents considering vaccinating their child against COVID-19 were interested in receiving information from their child’s doctor on how well the vaccine protects children and how potential side effects could affect their child’s preexisting health conditions like asthma.
COVID-19 Pandemic Stress and Child Behavior: Examining Discrimination and Social Support in Racially Diverse ECHO Cohorts
Higher amounts of stress experienced by caregivers from the COVID-19 pandemic were associated with more child behavior problems.
Educational Background and Child Age Influenced Experiences of Caregivers During COVID 19 Pandemic
The primary causes of stress among caregivers during the pandemic varied depending on the caregiver’s level of education and the age of their children.
Were children born preterm more likely to use healthcare during the COVID-19 pandemic?
Children and adolescents who were born preterm (less than 37 weeks of gestation) were more likely to use healthcare services for symptoms related to COVID-19.
How did the COVID-19 pandemic affect mental health during pregnancy?
Participants who were pregnant during the pandemic reported more symptoms of stress and depression, but participants who reported more emotional support and engaged in physical activity before and during the pandemic had less stress and fewer symptoms of depression.
How did the COVID-19 pandemic affect the development of infants and toddlers?
Infants and toddlers who were developmentally on track prior to the pandemic showed signs of developmental delays during the pandemic, particularly in the area of language development.
How has children’s screen time changed during the COVID-19 pandemic?
Increases in screen time among children during the COVID-19 pandemic persisted more than one year into the pandemic, even when school closures and other restrictions had been lifted.
How have changes in family situations caused by the COVID-19 pandemic affected children’s behavior?
Children with parents who were able to change their work schedules to care for their children during the pandemic had less screen time and slept longer at night, while children with parents who were unable to adjust their work schedules due to stress about money and access to food drank more sugary drinks, were less active, and slept less at night.
Did COVID-19 pandemic experiences contribute to symptoms of traumatic stress in mothers in the U.S.?
Some mothers, particularly those with higher incomes and higher education, experienced symptoms of traumatic stress linked to life changes experienced during the COVID-19 pandemic. Many of these mothers reported that financial concerns contributed to their stress and that the pandemic affected their access to healthcare.
Changes in Children’s Sleep Habits during the COVID-19 Pandemic
Children went to bed later, woke up later, and took longer to fall asleep during the pandemic, but their overall time asleep did not change. Compared to other children, children in racial and ethnic minority communities went to bed later, slept less, and took naps more frequently.
How has the COVID-19 pandemic affected children’s health behaviors?
Children’s screen time increased during the pandemic with Hispanic children and non-Hispanic Black children having the most noticeable increase in screen time.
Changes in Body Mass Index (BMI) during the COVID-19 Pandemic
Children gained weight at an increased rate during the pandemic with children who had obesity before the pandemic gaining weight faster than children who were at a healthy weight pre-pandemic.
Youth Well-being During COVID-19
Families who faced more pandemic-related hardships had higher levels of both caregiver and child stress, but children who were more socially connected and engaged with their families were more likely to maintain high life satisfaction.
ECHO COVID-19 NOSI Projects
Aim 1: Examine if long term racial/ethnic inequities in sociodemographic resources contribute to more COVID-19 hardships and higher levels of school and social disruptions within communities of color.
Aim 2: Examine independent and joint impacts of COVID-19 hardships, school practices, and children’s emotional support on 4-18-year-old’s positive health, as measured by academic competence and well-being.
COVID-19 Related News
ECHO Program's COVID-19 Research Sheds Light on Child Health and Well-being
Program infrastructure allowed efficient data collection during the pandemic to provide real-time insight into how COVID-19 and related disruptions affected child health in the United States.
Read the full article here.
ECHO Program Director and ECHO Researchers Featured in Article on the Effects of Perinatal Stress on Babies
ECHO researchers Catherine Monk, PhD and Johnnye Lewis, PhD along with ECHO Program Director Matt Gillman, MD, were featured in a recent article published on Undark.org highlighting the impact of perinatal stress during the COVID-19 pandemic on infant health.
Read the full article here.
Questions
For more information, please email the NIH at NIHKidsandEnvironment@od.nih.gov.