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OLDER AMERICANS INDEPENDENCE CENTERS (OAIC) APPLICATIONS (P30)

OLDER AMERICANS INDEPENDENCE CENTERS (OAIC)APPLICATIONS (P30) in Adobe PDF (46K)

SUPPLEMENTAL INSTRUCTIONS

NATIONAL INSTITUTE ON AGING

2003

.                NATIONAL INSTITUTE ON AGING

SUPPLEMENTAL INSTRUCTIONS FOR COMPLETING PHS FORM 398 (REV. 5/01 FOR AN OAIC APPLICATION

(Note: Be certain to attach the RFA label as described in the PHS Form 398 application kit.)

Follow the instructions in the Form 398 application kit for all items not addressed in these supplemental instructions.

SECTION 1.  INFORMATION FOR THE ENTIRE OAIC APPLICATION

Face Page, PHS 398

Item 2: Check "YES." cite the RFA number and "NIA Older Americans Independence Center" as the title in the appropriate places.

Page 2, PHS FORM 398

Description: The description serves as an overview of the entire application. The description should be brief and summarize the general plan and goals for the entire proposed Center or individual component. It should not be used to justify the application or component or provide an historical perspective. (Insert in the appropriate place, a separate page 2, renumbered according to its sequence in the application, for each core.)

Table of Contents (PHS 398, Form Page 3)

Do not use Form Page 3, "TABLE OF CONTENTS" of Form 398. It applies to grant applications for single projects. In its place, use the sample format provided in Attachment I of these instructions. Number all pages consecutively. Since the first page of the application is the "Title Page," begin the next page with the numeral "2." If necessary, disregard the preprinted page numbers. Do not use lettered numbers (e.g., 2A, 2B, etc.).

Place appendix material at the back of the proposal and identify it, as appropriate, by the principal investigator's name, core name and core leader's name. Send four complete sets of appendix materials, arranged for individual cores, directly to the NIA Scientific Review Office. Do not send any appendix material to the CSR. Also, do not insert appendices in the body of the application. Restrictions on material that may be included in appendices are found in PHS 398, Submitting Your Application, p. 29.

Budgets (PHS 398 Form, Pages 4 and 5) and Tables II and III:

To aid in the review of the application, insert a consolidated budget table, as shown in sample Attachment 3 (see Attachment 3. Table I. "CONSOLIDATED DIRECT COSTS FOR FIRST YEAR OF REQUESTED SUPPORT"). Attach a similar table for the entire proposed period for the overall program. Do not include detailed budgets for individual cores here: instead, place them with the corresponding component (see Section 3 of sample Attachment 1. "Table of Contents"). Justify all items carefully according to the Form 398 instructions: insufficient justification can result in the deletion of items by an initial review group. The period of support may not exceed five years.

Biographical Sketches (PHS 398, Preparing Your Application, p. 15)

Insert biographical sketches next.

Other Grant Support and Tables II and III.

"Other grant supportSupport" for the key personnel is included under Biographical Sketches.

Table II (See sample Attachment 4). "DISTRIBUTION OF PROFESSIONAL EFFORT (%) ON THIS APPLICATION."

Table III (See sample Attachment 5), "DISTRIBUTION OF PROFESSIONAL EFFORT (%) FOR ALL OTHER ACTIVE AND PENDING SUPPORT."

SECTION 2.  SUMMARY RESEARCH PLAN FOR THE ENTIRE APPLICATION

In this section, present a succinct plan for the entire application. These guidelines and instructions supplement those found in PHS 398, Preparing Your Application, beginning on page 15 ‑ Research Plan. Note that Section b (Background and Significance) and Section d (Research Design and Methods)in the Form 398 instructions are omitted from this overall summary.

1.     Introduction to the Application (Specific Aims).  This section is limited to 10 pages.

Describe the goals to be achieved by the OAIC, including:

  • the OAIC's  selected area(s) of focus, and basis for selection
  • crucial problems or limitations in knowledge, technology, infrastructure, and/or availability of researchers that the OAIC would address in the area(s) selected
  • advances in regard to these problems or limitations in knowledge, technology, infrastructure, and/or availability of researchers that the OAIC would achieve over its five‑year award period.

Describe the OAIC's overall strategy for serving as a sustained resource to the research program in its selected area(s). Describe how it will accomplish the innovation, intellectual leadership, translational, interdisciplinary, collaborative, and career development functions expected of an OAIC (see page 4 of these Instructions).

Describe the specific activities that the OAIC will undertake to accomplish the goals and strategy described above, how the different components of the OAIC will interact to help accomplish them, mechanisms to ensure the coherence of the Center and maintain an interdisciplinary focus, and the mechanisms to be used in assessing progress toward the OAIC's goals. (Where appropriate, timelines and organizational charts should be provided.) Note the major OAIC cores and other activities, referencing appropriate subsequent sections of this application that contain more detail.)

Discuss the relation of the Center to other activities in the applicant institution (such as related research projects) and the extent of institutional, departmental, and interdepartmental cooperation. Summarize the major resources available to the Center and the environment in which it will be conducted. In addition, describe the administrative relationships of the proposed Center to the institution. Issues relating to institutional commitment and settings are relevant.

Present the scientific expertise of the Principal Investigator in the proposed OAIC's area(s) of focus and his/her capacity for the leadership of a core center of excellence in aging research.

2.  Preliminary Studies/Progress Report (Form 398, Preparing Your Application, p. 17c).

For all applications: Include a brief summary of aging and other active and recent aging related research, and career development programs, at the applicant institution that are relevant to the proposed Center, including sources of support and selected recent references.

For applications from institutions previously awarded a P60 Older Americans Independence Center: Describe activities conducted by the Center that are relevant to the goals of the proposed new P30 Center.

Information in the above sections should be provided in very brief form. Additional information may be provided as appropriate in description of proposed cores.

3.  Human Subjects.  Approval must be by each individual protocol for, if applicable human research not having human subjects approval elsewhere, e.g. developmental and pilot projects (Form 398, Preparing Your Application, p. 18). 

Describe fully the general principles and policies that will apply to human subjects.  List all components of the application that involve human subjects and page numbers for

the relevant human subjects sections. Include in the appendix all consent forms for human subjects research which apply to development projects and pilot/exploratory studies.

4. Vertebrate Animals, if applicable.  Approval must be by each individual protocol for projects not having approval elsewhere (Form 398, Preparing Your Application, p. 28).

List the components in the application that involve vertebrate animals and page numbers for the relevant vertebrate animal sections.

5. Literature Cited (Form 398, Preparing Your Application, section g, p. 29).

List only those references cited in this section. Include appropriate full citations with each core and project.

6. Consortium/Contractual Arrangements (Form 398, Preparing Your Application,

section h, p. 29.

Before submitting an application that contains a consortium arrangement, the applicant institution and each collaborating institution should reach at least tentative agreement on the scientific, administrative, financial, and reporting requirements for the grant. For consortium arrangements, the application must include the following additional information:

a.     A list of all performance sites, including the applicant institution and the collaborating institutions.

b.   A separate, detailed budget for the initial and future years for each institution and, where appropriate, for each unit of activity at each institution. Request F&A costs for the consortium institution as a direct cost and include them in the "Other" category. Insert the amounts requested in the appropriate budgets for the applicant institution. The detailed consortium/contract budgets follow those for the appropriate applicant institution budgets.

c.   A composite budget for all units of activity at each institution for each year, as shown under section b above, as well as a composite budget for the total proposed funding for each year. Insert these budget pages after the composite budgets for the applicant institution.

d.   An explanation of the programmatic, fiscal, and administrative arrangements made between the grantee institution and the collaborating institutions.

e.   Include the following statement, accompanied by signatures of the appropriate administrative officials, from each of the collaborating institutions:

"The appropriate programmatic and administrative personnel of each institution involved in this grant application are aware of the NIH consortium grant policy and are prepared to establish the necessary inter‑institutional agreement(s) consistent with that policy."

Include this information here or with individual projects, as appropriate.

7.  Consultants (Form 398, Preparing Your Application, section I, p. 29).

Summarize this information for all components of the Center. Indicate the consultants by name. Include biographical sketches and signed letters of agreement to serve. Advisory committee members should not be recruited until after the review is complete. However, include criteria to be used to select advisors. Advisors/ consultants already employed or with whom prospective employment has already been discussed must be named and their institution identified.

8. Table IV (See Attachment 6) "PERCENTAGE DISTRIBUTION OF RESEARCH RESOURCES CORES TO OAIC AND EXTERNALLY FUNDED RESEARCH PROJECTS."

SECTION 3. PLAN OF INDIVIDUAL CORES

Prepare each core as a separate section that begins on a new page of the application.  Begin each with a title page (see Attachment2) and a detailed first year and summary budget for all years.  Continue to number the pages consecutively.

Title Page for Individual Cores

Use the format of sample Attachment 2.  Do not use the face page of Form 398.

PHS Form 398, Page 2

Follow instructions in the Form 398 application kit and the instructions in Section 1 of these guidelines for the “Description.”  “Performance Sites” and “Key Personnel.”  For Key Personnel, include after each name, in parentheses, the page number where the individual Biographical Sketch can be found.  Do Not insert additional copies in this section.

PHS Form 398, Pages 4 and 5

Budgets for the first 12-month budget period and for the entire grant period for individual cores (including a detailed budget justification).

The individual responsible for a component is the “core leader.”  Refer to other scientific staff as “senior investigators” or other titles, as appropriate.  Since only one individual is recognized as the responsible person, “do not use “Co-investigator.”

Budgets and Justification pertaining to Consortium/Contractual Arrangements (See Preparing Your Application, section h, Consortium/Arrangements, p. 29 of the PHS 398).  Provide documentation, if applicable.

Biographical Sketches of Project Leader and Other Key Personnel

State the pages in the application where the appropriate biographical sketches can be found.  Do not insert additional copies here.

Indicate the pages in the application where the appropriate “Other Support” pages can be found.  Do not insert another copy here.

Resources and Environment (self-explanatory)


INDIVIDUAL PLAN FOR EACH CORE

PLAN OF RESEARCH CORES (RC)

Research Cores (RCs) should be identified by titles (Recruitment Core, Biostatistics Core, etc.)  and by consecutive numbers (RC 1, RC 2, etc.).

Each RC should be presented in the following format.

Title page (see Attachment 2.)  Do not use page 1 of PHS Form 398.

Description and Key Personnel – Use page 2 of PHS 398.

Budgets for First 12‑month Budget Period and for Entire Period for Individual Core ‑ Use pp 4, 5 of PHS 398. If other than inflationary increases are requested in future years, detailed budgets should be provided for all years.

Presentation of Proposed Core Activities:

a.      Specific Aims of Core ‑ Explain the purpose and functions of the core. Present a clear statement of how the core will contribute to the goals of the OAIC.

b.      Administration ‑ Describe the administration of the core, and how projects eligible for core support will be selected and prioritized for access to core resources. A discussion of the role and qualifications of the proposed Core Leader should be included here.

c.      Background and Significance ‑ Include brief descriptions of the research projects for which the core is to provide support, and how research quality and efficiency would be enhanced by use of core services, specifying any pertinent uses of cores by junior faculty and how such use will promote research leading to increased independence of older persons.  The core resources requested for each project from the RC and the other cores will be summarized in Table IV (Attachment 6).

d.      Summary of Services, Experimental Design and Methods. Include descriptions of core services and methods/techniques employed and a completed Gender and Minority Inclusion Table, Attachment 8. This table may also be found in PHS‑398 (Rev 5/01).

These items (a‑d) may not exceed 25 pages.

e.      Development Projects.

1)    Present development projects proposed for the 01 year of the OAIC Grant and justify their selection in terms of the overall goals of the OAIC. (These must be prepared on the 5/01 revision of the PHS 398 application package and included in the OAIC proposal as part of an RC.) If human subjects are involved, include plans for the protection of human subjects in accordance with NIH and NIA policies.

2)      Present a general plan for the selection of development activities for subsequent years of the grant period that includes the use of an advisory committee with at least one third of the members external to the OAIC and the grantee institution.  (Plans for the constitution, and function for this committee, along with a budget request for its support, will be more completely presented as part of the Leadership/Administrative Core (see below).

The specific aims, background and significance, preliminary studies, and experimental design and methods sections should not exceed eight pages total for each development project. This is in addition to the 25 pages that may be used for items a‑d above.

A proposed RC may request support of up to $105,000 (first year direct costs) per year for Development Projects. The minimum budget request for each proposed Development Project is $35,000 with the maximum being $105,000 (first year directs costs). Thus, a maximum of three Development Projects can be requested as part of a Research Core.  Specific developmental projects to be conducted by an RC using these funds may last from one to five years.  NIA requires that programs be notified when a developmental grant award is made.  This can be done at the time of the progress report.

PLAN OF RESEARCH CAREER DEVELOPMENT CORE (RCDC)

The Research Career Development Core should be presented in the following format:

Title page (see Attachment 2)   Do not use page 1 of PHS Form 398.
Description and Performance Sites Key Personnel ‑ Use page 2 of PHS 398.

Budgets for‑ First 12‑month Budget Period and for Entire Period ‑ Use pp 4-5 of PHS 398.

Overview:   Describe the purpose, function, leadership and administrative mechanisms planned to achieve the objectives of this core including:

1)  Its contribution to the OAIC's overall goals

2)  A discussion of the role and qualifications of the proposed Core Leader

3)  A general plan for recruiting, selecting, mentoring, and monitoring the progress of individuals who will receive RCDC support. This plan should include the use of an advisory panel with at least one third of the members external to the OAIC and the grantee institution. (Plans for the constitution, and function of this committee, along with a budget request for its support, will be more completely presented as part of the Leadership/Administrative Core.)

4) The abilities that junior faculty who are recipients of this support are expected to acquire during their period of support by the core.

Career Development Plans:  Present the RCDC's career development plans for at least some of the junior faculty and research associates to be supported. The Career Development Plans should:

1)   Identify the individuals selected for at least the first year of RCDC support, and should describe for each:

a)   the candidate's preparation (include a biosketch) proposed research and other career development activities, and the nature of institutional commitments to the individual's development:

b)   the mentor's research activities and past history of research training (include a biosketch) and the commitments to training and supervising the candidate and,

c)   the OAIC's goals for the individual's career progression by the end of the OAIC award period. The description should explain how the proposed use of OAIC funds (including funds for Pilot/Exploratory Studies Core funding, if this is also proposed for the individual) will contribute to OAIC program goals for research career development in its selected research area.

Other Educational Activities:

1)   Describe other educational activities of the RCDC such as regular research meetings, conferences, workshops, availability of formal courses. etc., which will be used to achieve the objectives of this core and for which support is requested.

A maximum of $400,000 in first-year direct costs may be requested for the Research Career Development Core. Budget increments in future years will generally be limited to one percent. 

PLAN OF PILOT/EXPLORATORY STUDIES CORE (P/E C)

The Pilot/Exploratory Studies Core should be presented in the following format:

Title page (see Attachment 2) Do not use page 1 of PHS Form 398.

Description and Performance Sites Key Personnel ‑ Use page 2 of PHS 398.

Budgets for First 12‑month Budget Period and for Entire Period ‑ Use pp 4, 5 of PHS 398.

Overview:  The purpose and function of this core should be fully described.

1)   Describe how the activities of this core will promote progress in the OAIC's area(s) of research focus.

2)   Present the qualifications and experience of the proposed core leader.

3)   Present a general plan for the selection of studies proposed for the Pilot/exploratory Studies Core that includes the use of an advisory committee with at least one third of the members external to the OAIC and the grantee institution.  (Plans for the constitution, and function of this committee, along with a budget request for its support, will be more completely presented as part of the Leadership/Administrative Core.)

4)   Describe how, together with the OAIC PI, the Core Leader will monitor ongoing progress of studies and assist in the planning for the development of pilot/exploratory studies, where appropriate, into independently funded grant applications.

5)   If human subjects are involved, include plans for the protection of human subjects in accordance with NIH and NIA policies.

The presentation of the above aspects of the P/E C should be limited to 15 pages.

Pilot/Exploratory Core Studies:

A maximum of $250,000 in direct first-year costs may be requested for the Pilot/Exploratory Studies Core.  The method for the selection of all Pilot/Exploratory studies (including small studies) should be described (See 3, above).

Pilot/Exploratory Studies

Applicants may propose up to five P/E studies in the first year.  The minimum budget request for such studies is $25,000 for each study in first year direct costs.  Each of these projects is limited to no more than $150,000 (direct costs) over its entire period of support, which should be for no more than three years.  (Thus, there is an inverse relationship between the amount of yearly support and the duration of the project.)  Increments in future years will generally be limited to one percent.

Present these projects and budgets for the 01 year of the proposal.  These studies must be prepared on the 5/01 revision of the PHS 398 application package and included in the OAIC proposal.  However, the specific aims, background and significance, preliminary studies, and experimental design and methods sections should not exceed eight pages total for each study presented.  This is in addition to the 15 pages for the overall presentation of the P/E C.  Budgets for all 5 years should be prepared.  NIA requires that programs be notified when a pilot grant award is made.  This can be done at the time of the progress report. 

Small Pilot/Exploratory Studies

Up to $50,000 of the $250,000 budget may be set aside for small studies (less than $10,000 each in first year direct costs).  Scientific presentations of these small studies should not be included in the proposal. 

Participating researchers in OAICs are also encouraged to consider seeking additional sources of funding for pilot or exploratory studies, such as the NIA Pilot Research Grant Program or the NIA Small Research Grant Program and NIH Exploratory/Developmental Research Grant Award (http://www.nia.nih.gov/GrantsAndTraining/FundingOpportunities/ResearchProjects.htm#r03). 

PLAN OF LEADERSHIP/ADMINISTRATIVE CORE (LAC)

The Leadership/Administrative Core should be presented in the following format:

Title page (see Attachment 2 of these guidelines). Do not use page 1 of PHS Form 398 for individual components.)

Description, Performance Sites and Key Personnel ‑ Use page 2 of PHS 398.

Budgets for First 12‑month Budget Period and for Entire Period for Individual Core ‑ Use pp 4-5 of PHS 398. (Be sure to include a request for travel to the NIH for the yearly meeting of Center Directors. Center Administrators and NIA Program Staff.)

Overview:

1)    Describe the Administrative structure and activities of this core.

2)   Describe the administrative relationships between the LAC and all other OAIC components, and how they will operate to achieve the OAIC's goals and maintain quality of the OAIC as a whole and its individual components.

3)   Describe the activities and role of the LAC Leader (who is also the PI of the OAIC), the Center Administrator, and other LAC staff, in carrying out the functions of the LAC. A description of the activities of the LAC Leader in monitoring, stimulating, sustaining, evaluating, and reporting the OAIC’s progress toward the overall goals of the OAIC is a crucial component of this description.

OAIC Advisory Panels:

1) Present plans and budget requests for the establishment and operation of OAIC advisory panels including:

a)    An External Advisory Committee composed of experts from outside the OAIC and the grantee institution who will meet yearly to review the progress of the OAIC and provide a written report to the OAIC Director for inclusion in the OAIC’s annual progress report to NIA.

b)    Other advisory panels to assist in the selection of development projects, pilot/exploratory studies and selection of junior faculty for salary support.

Do not name the members of the required advisory panels in the application. However, the operating procedures of these groups. Including the frequency of their meetings and the methods for the identification of members should be specified.

The presentation of the LAC is limited to 15 pages.

A maximum of $150,000 in direct costs per year for salary, travel, and other expenses of the LAC director, administrator and appropriate administrative staff may be requested. Future year annual increases will generally be limited to no more than one percent.

SPECIAL REQUIREMENTS

Participation of OAIC investigators at an annual scientific meeting is mandatory.  Participants will include the PI, Center Administrator, Core Leaders and others, as appropriate for purposes of programmatic coordination and scientific exchange.  Applications must include budget requests for attendance at these meetings as part of the budget for the LAC.

SPECIAL NOTE:  Required Components of an OAIC.  In order to qualify for an OAIC Award, the minimum required components which must be recommended by the peer reviewers to be eligible for consideration for funding are 1) one or more Research Cores; 2) a Research Career Development Core and 3) a Leadership/Administrative Core.  All OAICs must support a significant amount of clinical research with human subjects.  Support for animal and in vitro studies, and for secondary data set analyses, is also appropriate.  All required components, as well as the support of research utilizing human subjects, must be recommended for the full five years in order for the applications to be considered for funding.


ADDRESSES, TELEPHONE NUMBERS, AND FAX NUMBERS


Director, OAIC Program
National Institute on Aging
Gateway Building, Suite 3C307
Bethesda, Maryland 20892‑9205
Telephone: (301) 496-‑6761
FAX: (301) 402‑-1784
Email: SlaterS@nia.nih.gov

Chief, Scientific Review Office
Office of Extramural Activities
National Institute on Aging
Gateway Building. Suite 2C212, MSC9205
Bethesda, Maryland 20892‑9205
Telephone: (301) 496‑-9666
FAX: (301) 402-‑0066

Grants and Contracts Management Office
Office of Extramural Activities
National Institute on Aging
Gateway Building, Suite 2N212, MSC9205
Bethesda, Maryland 20892‑9205
Telephone: (301) 496-‑1472
FAX: (301) 402-‑3672

Extramural Outreach and Information Resources Office
Office of Extramural Research
Office of Extramural Programs
National Institutes of Health
Telephone: (301) 435-‑0714



ATTACHMENT 1

SAMPLE FORMAT

Table of Contents

SECTION 1.  INFORMATION FOR THE ENTIRE APPLICATION

Face Page..................................................................................................................................

Description, Performance Sites and Key Personnel ................................................................

Table of Contents.....................................................................................................................

Detailed Budget for First 12-Month Grant Period for the Entire Application.........................

Table I, Consolidated Direct Costs for First Year of Requested Support................................

Budget for Entire Proposed Project Period for the Application...............................................

Budgets for Consortium/Contractual Arrangements for the Entire Application.....................

Biographical  Sketch – Principal Investigator (not to exceed four pages)..............................

Biographical Sketches – All Other Professional Personnel in the Application
(in alphabetical order,   not to exceed four pages for each)                                                        

Table II, Distribution of Professional Effort (%) on this Application.....................................

Table III, Distribution of Professional Effort (%) for All Other Active
and Pending Support..............................................................................................................

Table IV, Percentage Distribution of Research Cores to OAIC & Externally Funded Research Projects .....................................................................................................

Table V, OAIC Summary Guide to Application......................................................................

Resources ................................................................................................................................

SECTION 2.  SUMMARY RESEARCH PLAN FOR THE ENTIRE APPLICATION

1.  Introduction to the Application (Specific Aims)................................................................

2.  Background and Significance ............................................................................................

3.  Preliminary Studies/Progress Report .................................................................................

4.  Human Subjects ................................................................................................................

5.  Vertebrate Animals............................................................................................................

6.  Literature Cited..................................................................................................................

7.  Consortium/Contractual Arrangements ............................................................................

8.  Consultants .......................................................................................................................

Checklist                                                                                                                                

Personnel Report (Competing continuation applications only.  See Page 20, PHS Form 398 Instructions)          

Personal Data ........................................................................................................................

SECTION 3.  PROPOSALS FOR INDIVIDUAL CORES
(Provide a separate plan according to this outline for each core.)

Note:  Each research project and core should not exceed the page limit stated in the PHS Form 398 instructions (25 pages for Sections a-d).

Core or Project Number, Title, and Core or Project Leader

Title Page (See attachment 2 – Do not use the Face Page of PHS Form 398 for individual components.) .......................................................................................................................

Description, Performance Sites and Personnel on Component .............................................

Budgets for First 12-Month Budget Period and for Entire Project Period for Individual Core ...................................................................................................

Budgets for Consortium/Contractual Arrangements .............................................................

Other Support .........................................................................................................................

Resources and Environment ...................................................................................................


Research Plan

a.    Specific Aims ..................................................................................................................

b.    Background and Significance .........................................................................................

c.    Progress Report/Preliminary Studies ..............................................................................

d.    Research Design and Methods  .......................................................................................

e.    Human Subjects  .............................................................................................................

f.     Vertebrate Animals  ........................................................................................................

g.    Literature Cited  ..............................................................................................................

h.    Consortium/Contractual Arrangements  .........................................................................

i.     Consultants .....................................................................................................................

SECTION 4.  APPENDIX


ATTACHMENT 2

SAMPLE TITLE PAGE FOR INDIVIDUAL CORE
(Do not use Face Page from PHS Form 398.)

Core:  ________________

Title of Core (not to exceed 56 spaces):

Core Leader:  (Last Name, First Name, Middle Initial)

Position Title:

Department, service, laboratory, or equivalent:

Mailing Address:

Human Subjects (yes or no):

If yes, state pages where a description of the plan for protection of human subjects can be found and the pages where a description detailing the participation by minority and female subjects can be found.

Vertebrate Animals Involved (yes or no):

If "yes," identify by common names and underline primates. State pages where a description of the plan for the protection of animals can be found.  Also, if available, state the page number where the IACUC approval can be found.  Otherwise, Just-In-Time procedures are applicable. 

Dates of Entire Proposed Project Period (if different from that of the entire application):

ATTACHMENT 3

SAMPLE TABLE I

CONSOLIDATED DIRECT COSTS FOR FIRST YEAR OF REQUESTED SUPPORT

BUDGET CATEGORY

RC 1 CL:

RC 2 CL:

RCDC
CL:

P/E
C
CL:

LAC
PI:

     

TOTALS

Personnel

                 

Consulting Costs

                 

Equipment

                 

Supplies

                 

Domestic Travel

                 

Foreign Travel

                 

Patient Care Costs

                 

Alterations/Renovations

                 

Contractual Costs

                 

Other Expenses

                 
                   

TOTALS

                 

ATTACHMENT 4

SAMPLE TABLE II

DISTRIBUTION OF PROFESSIONAL EFFORT (%) ON THIS APPLICATION

Participating Investigators

RC  1 CL:

RC  2 CL:

RCDC
CL:

P/E
C
CL:

LAC
PI:

     

TOTALS

Dr. A (Program Director)

                 

Dr. B

                 

Dr. C

                 

Dr. D

                 

Dr. E

                 

Dr. F

                 
                   
                   

TOTALS

                 

CL = Core Leader

ATTACHMENT 5

SAMPLE TABLE III

DISTRIBUTION OF PROFESSIONAL EFFORT (%) FOR ALL OTHER ACTIVE AND PENDING SUPPORT

PARTICIPATING INVESTIGATORS

ACTIVE

PENDING

NIH

OTHER
GOVERNMENT

PRIVATE

TOTAL

NIH

OTHER
GOVERNMENT

PRIVATE

TOTAL

Dr. A (Program Director)

               

Dr. B

               

Dr. C

               

Dr. D

               
                 
                 

TOTALS

               

      ATTACHMENT 6 

SAMPLE TABLE IV

PERCENTAGE DISTRIBUTION OF RESEARCH CORES TO OAIC & EXTERNALLY FUNDED RESEARCH PROJECTS

RESEARCH PROJECTS

PI;
PROJECT TERM;
CURRENT YEAR DIRECT COST

RC 1:
TITLE

RC 2:
TITLE

RC 3:
TITLE

ADMIIN
CORE

EXTERNAL PROJECT 1

         

EXTERNAL PROJECT 2

         

EXTERNAL PROJECT 3

         

EXTERNAL PROJECT 4

         

development study 1

         

development study 2

         

pilot/exploratory study 1

         

pilot/exploratory study 2

         

NOTE:  Leave ADMINISTRATIVE CORE blank.


ATTACHMENT 7

SAMPLE TABLE V

OAIC SUMMARY GUIDE TO APPLICATION

Title of the Core

Leadership Core

Research Career Development

(RC1):
…..

(RC2):
….

(RC3):
….

Pilot & Exploratory

Core PI:

           

Page #:

           

Project Title:

           

Project PI:

           

Page #

           

ATTACHMENT 8
GENDER AND MINORITY INCLUSION RECRUITMENT GOALS

TARGETED/PLANNED ENROLLMENT: Number of Subjects

 

Ethnic Category

SEX/GENDER

Females

Males

Total

       

Hispanic or Latino

     

Not Hispanic or Latino

     
Ethnic Category: Total of All Subjects*      
       

                             Racial Categories

American Indian/Alaska Native

     

Asian

     

Native Hawaiian or Other Pacific Islander

     

Black or African American

     

White

     
Racial Categories: Total of All Subjects*      

* The “Ethnic Category Total of All Subjects” must be equal to the “Racial Categories total of All Subjects.”

PHS 2590 (Rev. 05/01)

 


Page last updated Feb 16, 2008