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Objective: In April 2021, the US government made substantial investments in students' safe return to school by providing resources for school-based coronavirus disease 2019 (COVID-19) mitigation strategies, including COVID-19 diagnostic testing. However, testing uptake and access among vulnerable children and children with medical complexities remained unclear., Methods: The Rapid Acceleration of Diagnostics Underserved Populations program was established by the National Institutes of Health to implement and evaluate COVID-19 testing programs in underserved populations. Researchers partnered with schools to implement COVID-19 testing programs. The authors of this study evaluated COVID-19 testing program implementation and enrollment and sought to determine key implementation strategies. A modified Nominal Group Technique was used to survey program leads to identify and rank testing strategies to provide a consensus of high-priority strategies for infectious disease testing in schools for vulnerable children and children with medical complexities., Results: Among the 11 programs responding to the survey, 4 (36%) included prekindergarten and early care education, 8 (73%) worked with socioeconomically disadvantaged populations, and 4 focused on children with developmental disabilities. A total of 81 916 COVID-19 tests were performed. "Adapting testing strategies to meet the needs, preferences, and changing guidelines," "holding regular meetings with school leadership and staff," and "assessing and responding to community needs" were identified as key implementation strategies by program leads., Conclusions: School-academic partnerships helped provide COVID-19 testing in vulnerable children and children with medical complexities using approaches that met the needs of these populations. Additional work is needed to develop best practices for in-school infectious disease testing in all children., (Copyright © 2023 by the American Academy of Pediatrics.)

Objectives: Outbreaks in vaccine-preventable diseases among children have increased, primarily among under- or unvaccinated subgroups. The influence and interaction of a child's school community on parental health care decisions, such as vaccination, has not been explored. Our study examined childhood coronavirus disease 2019 (COVID-19) vaccine hesitancy within the context of school communities., Methods: This study combines data from 4 independent research studies funded by the National Institutes of Health Rapid Acceleration of Diagnostics Underserved Populations Return to School Initiative. We examined focus group data to better understand the apprehension surrounding parental and child COVID-19 vaccination among underserved school populations., Results: Across all study sites, 7 main themes emerged with regard to COVID-19-related vaccination concerns for children: (1) potential side effects, (2) vaccine development, (3) misinformation (subthemes: content of vaccine and negative intent of the vaccine), (4) vaccine effectiveness, (5) timing of vaccine administration/availability for children, (6) fear of needles, and (7) mistrust., Conclusions: School settings offered unique access to youth and family perspectives in underserved communities. Our studies highlighted several factors contributing to COVID-19 vaccine hesitancy in school communities, which align with existing literature on vaccine hesitancy. These concerns centered primarily on potential harm of vaccines, as well as misinformation, mistrust, and timing of vaccines. Related recommendations for increasing vaccination rates are provided. Developing specific strategies that address parent and child concerns will be critical to reducing health inequities related to COVID-19 vaccination., (Copyright © 2023 by the American Academy of Pediatrics.)

Objectives: Understanding the motivators and barriers to testing enrollment from different stakeholder perspectives is essential to increasing participation in school-based testing programs, particularly among underserved populations. This multistudy analysis aimed to identify facilitators and barriers to enrollment in school-based testing for coronavirus disease 2019 (COVID-19)., Methods: Four independent studies collected and analyzed qualitative data from study participants regarding: (1) motivators, benefits, and/or reasons for enrolling and/or participating in COVID-19 testing in schools; and/or (2) concerns, barriers, and/or negative outcomes related to COVID-19 testing in schools. Study authors conducted a retrospective review of findings from the independent studies to identify themes related to testing motivators and concerns that emerged across the studies., Results: The analysis identified 10 distinct themes regarding the perceived motivators of COVID-19 testing in schools and 15 distinct themes regarding concerns and barriers to COVID-19 testing in schools. Common motivators across multiple studies included convenience of testing in school and the desire to keep self and others safe from COVID-19. Concerns about the implications of receiving a positive test result was a barrier identified by multiple studies., Conclusions: Themes from 4 independent studies revealed insights about the motivations and barriers to enrolling and participating in COVID-19 testing programs in kindergarten through 12th grade school settings. Study findings can be used to improve enrollment and participation in new and existing school-based testing programs to reduce transmission of COVID-19 and other infectious diseases in schools., (Copyright © 2023 by the American Academy of Pediatrics.)

Safely returning underserved youth to school during the coronavirus disease 2019 (COVID-19) pandemic through diagnostic testing and health education is imperative to mitigate the ongoing negative impact of COVID-19 and reduce health inequalities in underserved communities. The Rapid Acceleration of Diagnostics-Underserved Populations program is a consortium of research projects across the United States funded by the National Institutes of Health to understand the factors associated with the disproportionate burden of the pandemic among underserved populations and to leverage mitigation strategies, including diagnostic testing, with a focus on reducing health disparities. In this article, we provide an overview and introduce the articles from 8 Rapid Acceleration of Diagnostics-Underserved Populations projects featured in the supplement "Navigating a Pandemic in the K-12 Setting: Keeping Our School Communities Safe" published in Pediatrics. These projects funded in the program's first phase focus on COVID-19 diagnostic testing approaches for youth and employees at schools in underserved communities to support safe in-person learning. In the articles comprising the supplement, researchers present barriers and facilitators of the community engagement process necessary to establish school-academic partnerships. These efforts showcase school-based implementation testing strategies during the COVID-19 pandemic but are translatable to tackling other challenges related to reducing health disparities., (Copyright © 2022 by the American Academy of Pediatrics.)

The coronavirus disease 2019 pandemic has led to drastic public health measures, including school closures to slow the spread of severe acute respiratory syndrome coronavirus 2 infection. Reopening educational settings by using diagnostic testing approaches in schools can help accelerate the safe return of students and staff to on-site learning by quickly and accurately identifying cases, limiting the spread of severe acute respiratory syndrome coronavirus 2, and ultimately preventing unnecessary school and work absenteeism. Although the National Institutes of Health has identified community partnerships as the foundation for reducing health disparities, we found limited application of a community-based participatory research (CBPR) approach in school engagement. Guided by the CBPR conceptual model, we provide case studies of 2 established and long-standing school-academic partnerships built on CBPR processes and practices that have served as a research infrastructure to reach underserved children and families during the coronavirus disease 2019 pandemic. The process described in this article can serve as an initial platform to continue to build capacity toward increasing health equity., (Copyright © 2022 by the American Academy of Pediatrics.)

Evidence suggests that coronavirus disease 2019 (COVID-19) testing in schools can add a layer of protection to reduce the spread of Severe Acute Respiratory Syndrome Coronavirus 2 and facilitate a safer return to in-person learning. Despite this evidence, implementation of testing in school settings has been challenging initially because of a lack of funding and limited availability of testing, but, as the pandemic has progressed and more funding and resources have been devoted to testing, other implementation challenges have arisen. We describe key implementation barriers and strategies that have been operationalized across 5 projects working to help schools with predominantly underserved populations who have faced significant COVID-19-related health disparities. We leveraged a key framework from the implementation science field to identify the challenges and used a matching tool to align implementation strategies to these challenges. Our findings suggest that the biggest obstacles to COVID-19 testing were the perceived relative advantages versus burden of COVID-19 testing, limited engagement with the target beneficiaries (eg, families, students, staff), and innovation complexity. Common strategies to overcome these challenges included identifying and preparing testing champions, altering incentive and allowance structures, assessing for readiness, and identifying barriers and facilitators. We aim to augment existing implementation guidance for schools by describing common barriers and recommended solutions from the implementation science field. Our results indicate a clear need to provide implementation support to schools to facilitate COVID-19 testing as an added layered mitigation strategy., (Copyright © 2022 by the American Academy of Pediatrics.)