[Federal Register: December 22, 2008 (Volume 73, Number 246)]
[Notices]
[Page 78569-78586]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
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Part VII
Department of Health and Human Services
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Indian Health Service
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Native American Research Centers for Health (NARCH) Grants; Notice
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Native American Research Centers for Health (NARCH) Grants
Announcement Type: New and Competing Continuations.
Funding Announcement Number: HHS-2010-IHS-NARCHVI-0001.
Catalog of Federal Domestic Assistance Numbers (s): 93.933.
Key Dates: Letter of Intent Deadline: March 15, 2009.
Application Deadline Date: May 14, 2009.
Review Date: October, 2009.
Earliest Anticipated Start Date: June 1, 2010.
I. Funding Opportunity Description
The Indian Health Service (IHS), in conjunction with the National
Institute of General Medical Sciences (NIGMS) and other institutes of
the National Institutes of Health (NIH) announces competitive grant
applications for Native American Research Centers for Health (NARCH),
an initiative to support new and/or continuing centers or projects
funded under the NARCH grant program. This funding mechanism will
develop further opportunities for conducting research and research
training to meet the needs of American Indian/Alaska Native (AI/AN)
communities. This program is authorized under the Snyder Act, 25 U.S.C.
13, the Public Health Service Act, 42 U.S.C. 241 as amended, and the
Indian Health Care Improvement Act, 25 U.S.C. 1602(a)(b)(16). This
program is described at 93.933 in the Catalog of Federal Domestic
Assistance.
Background Information:
The AI/AN Tribal nations and communities have long experienced
health status worse than that of other Americans. Although major gains
in reducing health disparities were made during the last half of the
twentieth century, most gains stopped by the mid-1980s (Trends in
Indian Health 1998-99) and a few diseases, e.g., diabetes, worsened.
''All Indian'' rates contain marked variation among the IHS Areas or
regions (Regional Differences in Indian Health 1998-99); and variation
by Tribe exists within Areas as well. The Trends and Regional
Differences reference can be found at the IHS Web site at: http://
www.ihs.gov/NonMedicalPrograms/IHS_Stats. Although the AI/AN mortality
rates for all cancers are about 20 percent lower than the U.S. rates
for all races, there is variation among IHS Areas for specific cancers.
Moreover, the favorable AI/AN mortality rates for some cancers may be
due to markedly lower incidence rates partly offset by higher case-
fatality rates. Unfamiliarity with modern health care may adversely
influence health status among the elderly, the low-income elderly, and
Tribes, and also may reduce the acceptability of health research among
them. The daunting tasks confronting Tribes, researchers, and health
care and public health programs in the beginning of the twenty-first
century are to resume the reduction of health disparities that had
occurred through the 1980s, to reverse the worsening in a few diseases,
to maintain and strengthen the favorable status, and to reduce the
disparities among and within Areas and Tribes. Factors known to
contribute to health status and disparities are complex, and include
underlying biology, physiology, and genetics, as well as ethnicity,
culture, socioeconomic status, gender/sex, age, geographical access to
care, and levels of insurance.
Additional factors known to contribute to health status and
disparities include:
1. Family, home, and work environments;
2. General or culturally specific health practices;
3. Social support systems;
4. Lack of access to culturally appropriate health care; and
5. Attitudes toward health.
Yet none of these alone, or in combination, accounts for all
documented differences. Health disparities of AI/ANs may also reflect a
lack of in-depth research relevant to improving their health status.
Many AI/ANs distrust research for historical reasons. One approach that
combats this distrust is to ensure that Tribes are the managing
partners in training and research that involves them, as for example,
in community-based participatory research (i.e., a collaborative
research process between researchers and community representatives).
This approach is especially helpful to design both training relevant to
researchers from Tribal communities, and research relevant to the
health needs of the communities.
Research Objectives:
The NARCH initiative will support partnerships between Federally
recognized AI/AN Tribes or Tribal organizations (including national and
area Indian health boards, and Tribal colleges meeting the definition
of a Tribal organization as defined by 25 U.S.C. 1603(d) or (e)) and
institutions that conduct intensive academic-level biomedical,
behavioral and health services research. These partnerships are called
Native American Research Centers for Health (NARCH). Due to the
complexity of factors contributing to the health and disease of AI/ANs,
and to their health disparities compared with other Americans, the
collaborative efforts of the agencies of the Department of Health and
Human Services (HHS) and the collaboration of researchers and AI/AN
communities are needed to achieve significant improvements in the
health status of AI/AN people. To accomplish this goal, in addition to
objectives set by the Tribe, Tribal organization or Indian health
boards, the IHS NARCH program will pursue the following program
objectives:
To develop a cadre of AI/AN scientists and health
professionals--Opportunities are needed to develop more AI/AN
scientists and health professionals engaged in research, and to conduct
biomedical, clinical, behavioral and health services research that is
responsive to the needs of the AI/AN community and the goals of this
initiative. Faculty/researchers and students at each proposed NARCH
will develop investigator-initiated, scientifically meritorious
research projects, including pilot research projects, and will be
supported through science education projects designed to increase the
numbers of, and to improve the research skills of, AI/AN investigators
and investigators involved with AI/ANs.
To enhance partnerships and reduce distrust of research by
AI/AN communities--Recent community-based participatory research
suggests that AI/AN communities can work collaboratively in partnership
with health researchers to further the research needs of AI/ANs. Fully
utilizing all cultural and scientific knowledge, strengths, and
competencies, such partnerships can lead to better understanding of the
biological, genetic, behavioral, psychological, cultural, social, and
economic factors either promoting or hindering improved health status
of AI/ANs, and generate the development and evaluation of interventions
to improve their health status. Community distrust of research and
researchers will be reduced by offering the Tribe greater control over
the research process.
To reduce health disparities--In the Indian Health Care
Improvement Act, Public Law 94-437 (as amended), IHS was legislatively
mandated to improve the delivery of effective health care to AI/ANs. In
the NIH Revitalization Act of 1993, NIH was encouraged to increase
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the number of under-represented minorities participating in biomedical,
clinical, and behavioral research, including studies on drug abuse and
alcoholism, and the examination of the role of resiliency in the
prevention and treatment of those conditions. Also, the ``Initiative to
Eliminate Racial and Ethnic Disparities in Health'' by HHS (http://
www.omhrc.gov/rah) encouraged NIH to help reduce health disparities. In
response to these priorities, the IHS and NIH have established a
collaboration to support the NARCH.
Reducing health disparities among AI/AN communities and individuals
may be fostered by greater understanding of how to enhance their
strengths and resilience. While AI/AN communities have relied on health
research and medical science to reduce health disparities, they have
also relied on their own psychological, organizational, and cultural
assets and strengths to survive major harms and disruptions over the
centuries, and to rebound from insults to health.
The mission of NIH is to acquire new knowledge that will lead to
better health by understanding the processes underlying health and
disease that in turn will help prevent, detect, diagnose, and treat
disease and disability. The NARCH initiative works toward the NIH
mission by supporting research that discovers the interrelationships
among the many factors that contribute to health and disease, and by
helping to train and promote AI/AN researchers and researchers
concerned with AI/AN health.
II. Award Information
Type of Awards: Grant.
Estimated Funds Available: The estimated funds (total costs)
available for the first year of support for the entire initiative is
expected to be at least $2.0 million in Fiscal Year 2010. The actual
amount may vary, depending on the response to the request for
applications (RFA) and availability of funds. An applicant may request
a project period not to exceed four years of support, and direct costs
not to exceed $1,100,000 per center or $550,000 per project (research
or training) in the first year of each award. Direct costs to the
applicant include the total cost of each subcontract (subcontractor
direct plus subcontractor indirect costs).
Anticipated Number of Awards: An estimated five to fifteen awards
will be made under the program.
Award Amount: $100,000-$1,100,000 per year.
III. Eligibility Information
The new or existing NARCH must be a working partnership of the
eligible AI/AN organization and of the research-intensive institution.
Applicants eligible to receive the NARCH award are Federally recognized
Tribes and Tribal organizations as defined under the Indian Health Care
Improvement Act, 25 U.S.C. 1603 (d) or (e), including eligible Indian
health boards or Tribal colleges applying on behalf of eligible
Federally recognized Tribes or Tribal organizations. As the grantee,
the eligible AI/AN organization will define criteria and eligibility
for participation in all aspects of the partnership, consistent with
this announcement. A minimum of 30 percent of the grant funds must be
budgeted in the application to remain with the eligible AI/AN
organization(s); that is, no more than 70 percent of the application's
total budget may be contained in subcontract budgets of the non-
eligible subcontracting partner institutions or organizations.
1. Eligible Applicants--The AI/AN applicant must be one of the
following:
A federally recognized AI/AN Tribe, as defined under 25
U.S.C. 1603(d); or
A Tribal organization, as defined under 25 U.S.C. 1603(e),
including Tribal colleges or health boards meeting this definition; or
A consortium of two or more of those Tribes or Tribal
organizations. Applicants other than Tribes must provide proof of non-
profit status.
2. Cost Sharing or Matching--The NARCH program does not require
matching funds or cost sharing.
3. The Research-Intensive Partner--The Research-Intensive Partner
must be an accredited public or private nonprofit university, academic
medical center, or other institution that has an established record of
conducting research into the health problems of AI/AN; has demonstrated
a commitment to enhancing the capability of AI/AN faculty/researchers,
students, investigators, and communities to engage in biomedical,
behavioral, clinical and health services research; and has demonstrated
a commitment to mentoring AI/AN faculty/researchers, students, and
investigators.
4. Principal Investigator--The Principal Investigator, the
individual responsible for the administration (including fiscal
management) of the overall project, must have his/her primary
appointment with the AI/AN applicant organization. Special arrangements
of employment, such as inter-organizational personnel agreements, are
permissible. The Principal Investigator may be, but is not required to
be, the NARCH Program Director or a Research Project Investigator. The
NARCH Principal Investigator may or may not have formal academic/
research credentials, but if not, then the NARCH Program Director must
be so qualified.
The traditional NIH research project grant consists of a single
Principal Investigator (PI) working with a small group of subordinates
on an independent research project. Although this model clearly
continues to work well and encourages creativity and productivity, it
does not always work well for multidisciplinary efforts and
collaboration. Increasingly, health-related research involves teams
that vary in terms of size, hierarchy, location of participants, goals,
disciplines, and structure. There is growing consensus that team
science would be encouraged if more than one PI could be recognized on
individual awards. The NIH has adopted a multiple-PI model, as recently
directed by the Office of Science and Technology Policy. All agencies
that have research and research-related programs must offer the
multiple-PI model as an option. Note, it is only an option, not a
requirement. The traditional NARCH division of roles between PI and
Project Director will usually address these issues to a satisfactory
degree. For additional information regarding the new multiple-PI model,
please click on the following website: http://grants.nih.gov/grants/
multi_pi/index.htm.
5. NARCH Program Director--The NARCH Program Director is the
individual responsible for the day-to-day leadership and management of
the research and training programs within the proposed NARCH. The
Program Director may be, but is not required to be, the Student and
Faculty/Researcher Development Director or a Research Project
Investigator. The NARCH Program Director may or may not have formal
academic/research credentials, but if not, then the Principal
Investigator must be so qualified.
6. Student and Faculty/Researcher Development Director and
Participant--The NARCH initiative is an institutional developmental
grant mechanism that places an emphasis on the continual development of
students and faculty/researchers. If a new Student and/or Faculty/
Researcher Development Program is proposed in the current application,
then the Principal Investigator of that project is expected to be the
NARCH Student and Faculty Development Director. In order to be included
as the Student and Faculty
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Development Director, the prospective director must have a faculty/
researcher appointment at the research-intensive institution (or
equivalent appointment at the AI/AN organization or other consortium
partner) and must demonstrate that he/she has the knowledge, skills,
and capabilities to mentor students and faculty/researchers and to
generate and direct development and mentoring programs.
The Student and Faculty Development Director may be the NARCH
Program Director. Faculty/researchers and students should be supported
in research education activities that improve their skills and
abilities to be successful at the next stage of their professional
development. To be included as a participant for faculty/researcher
development in the proposed NARCH, the individual must have a faculty/
researcher appointment at the research-intensive institution or
equivalent appointment at the AI/AN organization or consortium partner.
7. Research Project Investigators--The NARCH initiative is an
institutional developmental grant mechanism that places an emphasis on
continual improvement of the research competitiveness of the research
investigators. In order to be included as a research project
investigator in the NARCH, a prospective investigator must have a
faculty appointment at the research-intensive institution or equivalent
appointment at the AI/AN organization or other consortium partner, and
must show that he/she has the need, based on institutional,
departmental, and professional development plans, to enhance his/her
research knowledge, skills, and capabilities by engaging in the
proposed research program and associated activities.
8. Tribal Approval of the Application--It is the policy of the IHS
that all research involving AI/AN Tribes be approved by the Tribal
governments with jurisdiction. Therefore, the following documentation
is required as part of the application for new or continuing centers or
additional NARCH projects:
Tribal Resolution:
If the applicant is an Indian Tribe or Tribal organization, a
resolution supporting the project from the Tribal government of all
Tribes to be served must accompany the application submission.
Applications by Tribal organizations will not require resolutions if
the current Tribal resolutions under which they operate would encompass
the proposed activities. In this instance, a copy of the current
resolution must accompany the application. The listed Tribes to be
served by the project in the proposal must match the set of appended
resolutions. If a resolution from an appropriate representative of each
Tribe to be served is not submitted prior to October 1, 2009, the
application will be considered incomplete and will not be considered
for funding.
An official signed resolution must be received by October 1, 2009
by the Division of Grants Operations (DGO), IHS, at the Reyes Building,
801 Thompson Avenue, TMP 360, Rockville, MD 20852. A grant will not be
awarded unless the signed resolution is received. Please include the
funding opportunity number, as a reference to this announcement, if the
resolutions are submitted as a separate mailing.
9. Mechanism of Support--Awards under this initiative will be
administered using the competing institutional grant mechanism of the
IHS, and will be reviewed using the NIH S06 mechanism.
IV. Application and Submission Information
1. Address to Request Application Package: NARCH Program Official,
Reyes Building, 801 Thompson Avenue, Rockville, MD 20852 or by e-mail
to narch@ihs.gov. Applicants are strongly encouraged to establish
eligibility of their proposed applications prior to submission.
Inquiries about eligibility should be addressed to Alan Trachtenberg,
M.D., M.P.H., at (301) 443-0578 or by e-mail to narch@ihs.gov. The
application package, including supplemental instructions will be posted
on the IHS Research Program Web site, at: http://www.ihs.gov/
MedicalPrograms/Research/narch.cfm. Technical assistance will be made
available for applicants, and first time applicants are urged to take
advantage of it. To sign up for technical assistance, potential
applicants should e-mail their contact information to narch@ihs.gov
with the words ``technical assistance'' in the subject heading and full
contact information, including email address, listed in the body of the
e-mail.
The NIH instructions for the PHS 398 application form are available
in an interactive format at: http://grants.nih.gov/grants/funding/
phs398/phs398.html. Applicants must use the currently approved version
of the PHS 398. For further assistance contact GrantsInfo, Telephone
(301) 435-0714, e-mail: GrantsInfo@nih.gov, Telecommunications for the
hearing impaired: TTY 301-451-0088.
Submit a typed and signed original application, including the
Checklist, and one (1) single-sided photocopy of the entire application
(including Appendices and supporting documents) in one package to:
Division of Grants Operations, Indian Health Service, Reyes Building,
801 Thompson Avenue, TMP 360, Rockville, MD 20852-1627 (zip code is
unchanged for express/courier services), Telephone: (301) 443-5204.
``Native American Research Centers for Health'' and the RFA number
NOT-GM-09-010 must be typed on line 2 of the face page of the
application form and the YES box must be marked.
At the time of submission, applicants must also send four (4)
additional single-sided photocopied and signed applications, including
the Checklist, Appendices, and supporting documentation to: Center for
Scientific Review (CSR), National Institutes of Health, 6701 Rockledge
Drive, Room 6160--MSC 7892, Bethesda, MD 20892-7720, Bethesda, MD 20817
(for express or courier service). Telephone: (301) 435-0715. The CSR no
longer accepts hand delivered applications. E-mail or other electronic
applications will not be accepted under this announcement.
Specific supplementary instructions for the PHS 398 application and
budget preparation for the NARCH program may be obtained from the
initiative contacts listed under VII. Agency Contacts, and will be
posted at: http://www.ihs.gov/MedicalPrograms/Research/narch.cfm. They
will also be sent to any potential applicant who e-mailed their contact
information to narch@ihs.gov with the words ``technical assistance'' in
the subject heading.
There will be no acknowledgment of receipt of the application.
2. Content and Form of Application Submission:
A proposed NARCH may include any or all of the following
components: Student development projects; faculty/researcher
development projects; research projects (including pilot projects); and
``core'' administrative facilities.
The content of the application should explain the components of the
application, and how they help meet the purposes of the NARCH
initiative. A description should be provided of the current state of
the research and research training enterprise at the proposed NARCH and
its institutional and community partners, including faculty/researcher
and student profiles.
A clear statement should be presented of the overall goals,
specific measurable objectives, and anticipated milestones. These
elements should be presented in the context of needed improvements in
the partners' organizational
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infrastructure and environment for research. Documentation should be
provided to establish that the research-intensive partner is an
institution with a record of conducting research into the health of AI/
ANs, and that it has a demonstrated commitment to the special
encouragement of, and assistance to, AI/AN faculty/researchers,
students, investigators, and communities for enhancing their capacity
to engage in biomedical, behavioral and health services research. For
competitive renewals of existing NARCH grants, previous accomplishments
and progress from the time of the initial NARCH award must be
described. Documentation about the nature of the partnership itself
should be included, such as: the process to develop the application and
proposed NARCH itself, the past and future efforts to increase the
capacity of the partners to improve their partnership, and efforts to
contribute to the success of the NARCH. Applicants are encouraged to
articulate plans for the development of partnerships toward the
possible planning of a national native health research conference or
other national research training. The development of additional future
collaborative research and research training opportunities should also
be an integral part of each NARCH core proposal. For previously
existing NARCH centers, a specific and detailed list of accomplishments
and assessment of the benefits from the previous NARCH grant(s) is
required.
A plan for assessment of the benefits of the activities by the
proposed NARCH on specific, measurable outcomes identified in the
application should be provided. IHS and NIGMS recognize that Tribes,
Tribally-based organizations, and research-intensive institutions are
diverse in their missions, their health and economic status, and their
cultures. Such an assessment for a new NARCH could include a self-study
by the proposed NARCH and its partners, which focuses on fact-finding,
program evaluation, and recommendations for improvement in key areas.
Strategies for determining the initial and ongoing success of their
efforts for organizational development should also be presented. It is
expected that each proposed NARCH will develop its own set of
strategies that best match its circumstances. Guidance and suggestions
for program evaluation of a proposed NARCH can be obtained from http://
www.the-aps.org/education/promote/promote.html. For applications that
are competing renewals of existing NARCH centers, the report and
evaluation of the progress made under the previous NARCH grant(s) will
be a key part of the application.
Applicants are strongly urged to contact NARCH initiative staff at
an early stage to request the specific supplementary instructions for
the PHS 398 for the NARCH grants. Supplementary instructions may be
obtained from the initiative contacts listed under VII. Agency
Contacts, and will be posted at: http://www.ihs.gov/MedicalPrograms/
Research/narch.cfm. They will also be sent to any potential applicant
who e-mailed their contact information to narch@ihs.gov with the words
``technical assistance'' in the subject heading.
If Student Development Projects are proposed, the NARCH application
should describe new programs or modifications or additions to existing
programs of the partners that encourage and facilitate AI/AN students
to enter, advance, and remain in health research careers. Such projects
might include, but are not limited to, providing employment as research
assistants in research projects of research-active mentors with an
explicit mentoring plan, providing other mentoring with an explicit
mentoring plan, providing workshops to improve technical or
communication skills, providing motivating seminars or journal clubs
highlighting problems of interest to students, providing contact with
role models, and providing opportunities to travel to present results
at national scientific meetings. If research mentorships or
apprenticeships are proposed, the application should clearly document
the experience, proposed commitment, and quality of the mentors in
providing guidance and advice to students (including responsible
conduct of research and research integrity, teaching, and protection of
human subjects), and in fostering the development of academic and/or
community-based AI/AN researchers.
The application should describe how the development plans for the
students will meet both the individuals' professional development
goals, and one purpose of the NARCH initiative: To develop a cadre of
AI/AN scientists and health professionals. The application must have an
evaluation plan for the new project(s) that indicates the anticipated
outcomes relative to the current baseline data. For example, one
outcome might be the improved retention of AI/AN students in science
majors. The application should indicate the anticipated (quantitative)
improvement relative to the current retention rate. Accomplishments of
(and connections with) any previously funded NARCH student development
projects by the applicant or partners must be described.
A student in a NARCH Student Development Project must be a full-
time or part-time student officially enrolled in an educational program
leading to an undergraduate or graduate degree, or in a post-doctoral
educational program, or (if well justified) in late high school. A
helpful book about mentoring science students is found at http://
books.nap.edu/catalog/5789.html.
If Faculty/Researcher Development Projects are proposed, the NARCH
application should describe the need, proposed activity, and
anticipated outcomes. Faculty/researcher development projects might
include, but are not limited to, short-term mentored research
experiences in the lab of an active NIH-extramurally-funded researcher
with an explicit mentoring plan, long-term general mentoring under an
explicit mentoring plan, or attendance at workshops or courses or
national meetings needed for acquiring specific skills or methodologies
needed for prospective research. As with student development projects,
the application should document the experience, proposed commitment,
and quality of the mentors, teachers, or experience in providing
guidance and advice to faculty/researchers, and in fostering the
development of academic and community-based AI/AN research. The
application must also describe the evaluation plan for the faculty/
researcher development project. The application must clearly describe
how the development plans for faculty/researchers will meet both the
individuals' professional development goals, and two purposes of the
NARCH initiative:
To develop a cadre of AI/AN scientists and health
professionals, and
To enhance the partnership of the proposed NARCH.
For grantees with previous NARCH funding for faculty/researcher
development projects, a detailed list of the accomplishments of (and
connections with) any previously funded NARCH faculty/researcher
development projects by the applicant or partners must be described.
NARCH applications may include a maximum of five (5) regular
Research Projects and a maximum of five (5) Pilot Research Projects.
Unlike regular research projects, a pilot research project is limited
in scope and is not expected to have preliminary data. It is also
limited to a budget of no more than $75,000 direct costs per year for
four years. The pilot research project is intended for faculty/
researchers without current Federal research support.
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Support for faculty/researchers participating in pilot research
projects is preparatory to seeking more substantial funding from NIH
research grant programs (e.g., Academic Research Enhancement Award, K,
and R01 awards), as well as funding from other agencies and private
sources. Funds received from the proposed NARCH to support pilot
research projects may not be used to supplement ongoing research
projects. A NARCH application need not include both research projects
and pilot research projects. Applications for only pilot research
projects or for only research projects may be submitted. Individual
project investigators may propose either a research project or a pilot
research project, but not both. For research projects that are
continuations or modifications or outgrowths of research projects
(including pilot research projects) under previous NARCH grants, the
accomplishments of the previous research project(s) should be detailed
and a logical description given as to how the results of the previous
work has led to the current proposal.
Each research project or pilot research project should follow the
instructions provided in PHS 398 (Revised 11/2007) for preparing
research grant applications. The professional development goals must
clearly describe specific objectives and milestones which should
include, but are not limited to, improving competitiveness in acquiring
grant support. The applicant should describe how successful completion
of the proposed research project will improve the research skills and
will help develop the students and faculty/researchers, thus
contributing to the overall goals and specific measurable objectives of
the proposed NARCH.
Each research project or pilot research project must follow the IHS
policy concerning Tribal approval, that all research involving AI/AN
Tribes be approved by the Tribal governments with jurisdiction. That
is, each grantee must include a resolution of approval from the Tribal
government(s), or (if applicable) a letter of support signed by the
Executive Director or CEO of the eligible AI/AN organization, or both
(if applicable) for projects that involve people or community(ies) of
an AI/AN Tribe, or an eligible Tribal organization. For NARCH proposals
from multi-Tribal consortia with projects that involve only one or a
few of the Tribes of the consortium, some description should be
provided as to the process through which the particular Tribes were
chosen to participate.
Research projects (including pilot research projects) proposed
under this initiative must be in research areas normally funded by any
of the NIH or other research agencies in the HHS. Research projects
addressing health disparities and the health priorities of the AI/AN
partner are especially encouraged.
A listing of grants recently funded by NIH may be found at Computer
Retrieval of Information on Scientific Projects (CRISP), a searchable
database of Federally-funded biomedical research projects conducted at
universities, hospitals, and other research institutions. It may be
accessed at http://report.nih.gov/crisp/crispquery.aspx. The following
agencies, institutes, offices, and centers have stated particular
interests in supporting research under the NARCH Program as follows:
National Institute of Dental and Craniofacial Research (NIDCR)
Oral Health Research
NIDCR is committed to reducing the disproportionate burden of oral
diseases experienced by AI/ANs. The focus of NIDCR's health disparities
research is on improving oral health status and quality of life by
understanding and addressing oral diseases that are prevalent in AI/AN
communities, specifically caries (including early childhood caries),
oral and pharyngeal cancer, and periodontal disease. Interdisciplinary
research teams and the full participation of communities are viewed by
NIDCR as essential components of any health disparities research.
Data that document oral disease prevalence are readily available
for some populations, but not for others. Homogeneity in subgroups of
populations cannot be assumed. For instance, there are national data
for Mexican Americans, but not for the numerous other Hispanic
subgroups. Similarly, data regarding the oral health status of various
AI/AN Tribes are unavailable. Moreover, available data provide little
insight into the etiology or determinants of oral disease and oral
health. The paucity of quality data and conceptual models concerning
the broad array of potential determinants and risk-factors inhibits
progress toward preventing disease, and improving oral health status
and quality of life. The NIDCR invites applications that, in
preparation for intervention research, explore the complex array of
social, behavioral, psychological, contextual, environmental, and
biological factors and their interactions that may contribute to oral
health disparities within AI/AN communities. Including oral health
status measures within broader epidemiologic studies is encouraged.
However, applications that are limited to the assessment of disease
prevalence and that explore a very limited range of potential
determinants will be considered non-responsive.
The NIDCR has particular interest in intervention research that
will provide clinically meaningful outcomes and essential information
needed to inform clinical practice, public health policy, health care
provision, community and/or individual action. Intervention studies
that are grounded in theory are needed. Both basic and applied
intervention research applications are invited. Studies may need to
intervene at multiple levels within communities. The NIDCR encourages
the use of the strongest research design possible and recognizes that
not all intervention research is amenable to randomized clinical
trials. Examples of health disparities intervention research of
interest to the NIDCR includes but are not limited to:
Effectiveness studies that tailor/target preventive
approaches to communities/individuals;
Research that intervenes in novel ways on macro- or
intermediate level determinants of oral health status;
Health services research that explores alternative
approaches to delivering preventive oral health care;
Studies that intervene on common risk factors or that take
a systems approach;
Studies that explore multifaceted strategies to intervene
at several levels within society;
Dissemination and implementation research at multiple
organizational levels; and
Research that uses appropriate technology for translation,
implementation, adoption, adherence, and acceptance of oral disease
prevention programs in defined populations, clinics, and communities.
Intervention research should be reasonably applicable to a specific
AI/AN population. To facilitate adequate enrollment and
generalizability, intervention studies may need to be conducted at
multiple sites. Studies may be conducted at a single site only if
enrollment is adequate and if sufficient numbers of participants are
available to allow extrapolation of clinically meaningful results to
the specific AI/AN population of interest.Pilot research projects that
are designed to lead to larger research projects funded as part of a
center or as
[[Page 78575]]
free-standing NIH grants may be proposed.
For additional information about oral health research contact: Ruth
Nowjack-Raymer, M.P.H., PhD, Director, Health Disparities Research
Program, National Institute of Dental and Craniofacial Research, 6701
Democracy Blvd., Room 640, Bethesda, MD 20892-4878, Phone: (301) 594-
5394, Fax: (301) 480-8322, e-mail: nowjackr@mail.nih.gov.
National Institute on Drug Abuse (NIDA)
Neuroscience and Drug Abuse Research:
AI/ANs demonstrate higher rates of drug abuse, particularly
methamphetamine, tobacco and alcohol abuse, relative to other racial
subgroups. According to 2002-2006 National Survey on Drug Use and
Health (NSDUH) data, AI/AN past year methamphetamine use was 1.4%
compared to 0.1% for African Americans, 0.6% for Hispanics or Latinos
and 0.7% for Whites. Prevalence of use is high in both men and women.
Drug abuse patterns among AI/AN are complex and can vary by factors
such as Tribe and geographic location. While some datasets are
available that can provide general epidemiological data regarding use
and abuse rates in this group, data are needed that better clarify
where use rates are highest, among which Tribes, age and gender groups
and the factors that predict drug abuse in these locales and groups.
These data will assist in developing more targeted interventions and in
identifying mechanisms related to drug abuse which can then serve as
focal points for intervention.
In addition to scarce data on patterns of use, limited data are
available assessing drug abuse prevention and treatment interventions
for AI/AN. The matrix model has been proposed in particular to address
methamphetamine abuse, but few data are available to assess the
efficacy of this approach with this population. Several preventive
interventions have been designed particularly for this population and
results from them indicate their value, but more research is needed to
clarify why these sometimes don't work in expected ways and whether the
interventions that are being used but have not been evaluated are
working to reduce drug use.
The NIDA is committed to reducing health disparities in drug abuse
and related health and social consequences among AI/AN. Further, the
Institute supports methodologies required by the NARCH, expecting that
studies be developed and implemented using community participatory
approaches.
Research topics of interest include but are not limited to:
Studies that explore a range of behavioral, cultural,
environmental, and individual factors that contribute to drug abuse;
Studies that explore the consequences of drug abuse among
AI/ANs;
Studies that consider the full context of drug abuse,
including poverty, family factors, school factors, intergenerational
trauma, etc.;
Studies that explore the role of traditional practices and
spirituality in protecting against drug abuse;
Studies that explore other factors that protect against
use in those groups for whom use rates are lower;
Studies that explore the efficacy and/or effectiveness of
culturally relevant preventive interventions;
Studies that explore the efficacy and/or effectiveness of
culturally relevant treatment interventions;
Studies that assess factors related to service
utilization, including use rates and access to services, either in
reservation or urban settings; and
Studies that explore the organization, management and
delivery of interventions.
For additional information about neuroscience or drug abuse
research contact: Kathy Etz, PhD, National Institute on Drug Abuse,
6001 Executive Blvd., Room 5153 MSC 9589, Bethesda, MD 20852, Phone:
(301) 402-1749, Fax: (301) 480-2543, e-mail: Kathleen.Etz@nih.hhs.gov.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Alcohol Research
NIAAA is committed to reducing the disproportionately high burden
of illness associated with alcohol use, abuse, and dependence among AI/
AN people. Alcohol-associated disability-adjusted life years (DALYs)
remain highest among AI/ANs in comparison to all other U.S. ethnic
groups. AI/AN people suffer from unacceptably high rates of alcohol
abuse and dependence, alcohol-related morbidity and mortality, and
intentional and unintentional injuries associated with alcohol use.
Nevertheless, AI/AN people are heterogeneous on many dimensions with
over 562 Federally-recognized Tribal entities. To address alcohol-
related health disparities of AI/AN people, more needs to be known
about how differences between Tribes, geographic regions, residence on
reservations, urban or rural areas, as well as more typical demographic
variables such as age, education, income, and gender influence alcohol
use and associated health status outcomes. Such information can guide
the development of more effective and culturally appropriate ways of
identifying and intervening with those who suffer from alcohol-related
problems, as well as preventing alcohol problems before they occur.
Additional research is also needed to understand how to best advance
the dissemination of research findings on alcohol and health, so that
AI/AN people can benefit from the latest research discoveries. Finally,
NIAAA is aware that oftentimes researchers who conduct investigations
among communities of color are members of these cultural, racial or
ethnic groups themselves. NIAAA is committed to identifying and
providing training and mentoring experiences to help AI/AN alcohol
researchers advance the science of alcohol use and give back to their
communities.
The NIAAA is committed to reducing alcohol related health
disparities and is committed to the NARCH program. Research topics of
interest to NIAAA include but are not limited to:
--Studies that assess the differing needs of various Tribal groups,
considering variations in rates of alcohol use, misuse and abstinence.
--Studies that develop new interventions or adapt existing prevention
and/or treatment interventions that take strengths of the AI/AN culture
into consideration.
--Studies that investigate the application/adaptation of evidence based
interventions among AI/AN groups.
--Studies that investigate how traditional spiritual and medical
treatments can be applied/adapted to improve intervention outcomes
among AI/AN peoples.
--Studies that explore the effectiveness and/or efficacy of commonly
used interventions such as screening and brief intervention or referral
among AI/AN populations.
--Studies that investigate the risk and protective factors associated
with drinking among women of childbearing age so as to inform
culturally sensitive, effective FASD prevention.
--Studies that investigate ways to delay onset of youth drinking among
AI/AN young people.
--Studies that investigate the association between alcohol use and
suicide among AI/AN people, especially youth. Studies may attempt to
understand the individual and
[[Page 78576]]
group level variables that contribute to ``epidemics'' of suicide among
AI/AN youth.
--Studies that explore the consequences of alcohol use and misuse among
AI/AN peoples; these consequences may include but are not limited to
other social and health problems (i.e., diabetes, obesity, poor
nutrition, cancer, liver disease, etc.), interfamilial violence,
intentional and unintentional injury, and driving under the influence.
--Studies that investigate the acceptance and efficacy of
pharmacotherapy for alcohol abuse and dependence within integrated
health counseling approaches.
--Studies that investigate the influence of alcohol use on the spread
and treatment of Human Immunodeficiency Virus (HIV)/Acquired Immune
Deficiency Syndrome (AIDS) among AI/AN peoples.
For additional information contact:
Judith A. Arroyo, PhD, Minority Health and Health Disparities
Coordinator, Project Official, Division of Epidemiology and Prevention
Research, National Institute on Alcohol Abuse and Alcoholism, 5635
Fishers Lane Room 2079, Bethesda, MD 20892-9304, (for Fed Ex use
Rockville, MD 20852-1705), Office: 301-402-0717, Fax: 301-443-8614, e-
mail: Judith.Arroyo@nih.hhs.gov.
National Cancer Institute (NCI)
Cancer Health Disparities Research
The Center to Reduce Cancer Health Disparities (CRCHD) is committed
to reducing cancer health disparities among AI/ANs. Investigators are
encouraged to submit research projects addressing every aspect of
cancer and cancer health disparities research. CRCHD welcomes
investigations in basic, clinical, translational, and population-based
research addressing cancer health disparities among AI/AN. The CRCHD is
central to the NCI's efforts to reduce the unequal burden of cancer in
our society. As part of these efforts, the Diversity Training Branch,
CRCHD, has been supporting NARCH projects with cancer relevance since
2003.
For additional information contact:
Dr. Peter Ogunbiyi, Program Director, Diversity Training Branch,
Center to Reduce Cancer Health Disparities, National Cancer Institute,
6116 Executive Boulevard, Suite 602, Bethesda, MD 20892-8341 (U.S.
Postal Service), Phone: 301-496-7344, Fax: 301-435-9225, e-mail:
po43t@nih.gov.
Health Literacy Research:
The HHS, in its Healthy People 2010 initiative, defines health
literacy as, ``the degree to which individuals have the capacity to
obtain, process, and understand basic health information and services
needed to make appropriate health decisions.'' (Please see: http://
www.healthypeople.gov/document/HTML/Volume1/11HealthCom.htm). Health
literacy is a complex phenomenon that involves individuals, families,
communities, and systems. For instance, consumers, patients,
caregivers, traditional healers, or other laypersons may vary with
respect to:
Access (e.g., to audience-appropriate information, media
or professionals);
Skills (e.g., to gather and comprehend health information;
to speak and share personal information about health history and
symptoms; to act on information by initiating appropriate follow-up
visits and conveying understanding back to the information source; to
make decisions about basic healthy behaviors, such as healthy eating
and exercise; to engage in self-care and chronic disease management);
Knowledge (e.g., of health and medical vocabulary,
concepts such as ``risk'', the organization and functioning of
healthcare systems, cultural beliefs and possible differences in
traditional and current medical systems about disease causation,
prevention and treatment);
Abilities (e.g., sensory, communication, cognitive, or
physical challenges or limitations);
Features of health care providers and public health
systems (e.g., the communication skills of health professionals,
platforms employed for patient education, built environments, and
signage);
Traditional healers and their role, especially in relation
to the existing medical systems which could lead to different
understanding in health and disease progression;
Demographics (e.g., developmental or life stage, cultural,
linguistic, or educational differences that affect health beliefs,
knowledge, and communication).
Too often people with the greatest health burdens have limited
access to relevant health information. One reason is the complex and
cumbersome ways in which health information is presented. Health care
professionals may not communicate effectively with individuals. For
instance, achieving informed consent for treatment is difficult when
health care personnel cannot explain biological processes or treatment
procedures in simplified language and patients cannot interpret health
information. These situations hamper the effectiveness of health
professionals' efforts to prevent, diagnose, and treat medical
conditions, and limit many health care consumers' abilities to make
important health care decisions. Another reason is due to individuals'
limited abilities to fully interpret and understand complex health
terminology and instructions. This could be further exacerbated by
different belief systems and adoption of methods for prevention and
treatment. Limited numeracy can also impede the ability to make
personal decisions related to risk, risk avoidance, and risk reduction.
For instance, to follow health care instructions, patients need to be
able to comprehend written and oral prescription instructions,
directions for self-care, and plans for follow-up tests and
appointments.
Specific Objectives
Researchers are strongly encouraged to review the general
illustrative examples of topics relevant to health literacy provided
below. Applications should address health promotion, prevention,
treatment, or management of diseases or health conditions, and/or the
improvement of health or health care outcomes. The research must
involve at least one of the following:
Health literacy, or one of its many components, as a key
outcome;
Health literacy as a key explanatory variable for some
other outcome;
Methodological or technological improvement to strengthen
research on health literacy; and/or
Prevention and/or intervention strategies that focus on
health-literacy.
Studies to develop, or evaluate, the readability or utility of
specific materials that are intended for single uses or single
audiences are not responsive to this program announcement unless these
investigations are integral to testing a significant research
hypothesis related to health literacy.
Approaches
A wide variety of research approaches are encouraged:
Basic research that investigates or describes the nature
of health literacy and the magnitude of health literacy problems;
Applied research addressing issues pertinent to health
literacy practices (e.g., systems level interventions) and research-in-
practice (e.g., active
[[Page 78577]]
potential end users participate as supportive research partners);
Develop theoretical models, refine research constructs,
improve methods and measurements, and establish causal relationships
(e.g., between low health literacy and lack of effective health
promotion);
Evaluation research that develops and tests the
effectiveness of interventions, or adapts and tests existing programs
(including those that are implemented by health care systems and
systems outside of health care), to reduce low health literacy and its
adverse consequences;
Secondary analyses of existing datasets as well as meta-
analytic studies; and
Multilevel, multidisciplinary, interdisciplinary, and
transdisciplinary research is encouraged, especially studies that
incorporate individual, family, community and societal mediators of
health literacy in childhood and adulthood, or state-of-the-art health
communication theory and knowledge.
For additional information about NCI health literacy research
contact: Sabra F. Woolley, Ph.D., Program Director, Health
Communication and Informatics Research Branch, National Cancer
Institute, 6130 Executive Blvd. Room 4084, Bethesda, Maryland 20892-
7365, Phone: 301-435-4589, Fax: 301-480-2087, E-mail:
Sabra.Woolley@nih.hhs.gov.
Tobacco Control Research
AI/ANs have been documented to have the highest smoking rate of any
major racial/ethnic group in the U.S. According to the 2005 National
Health Interview Survey of adults 18 and over, 32% of AI/AN are current
smokers, compared with 21.9% of non-Hispanic whites, 21.5% of non-
Hispanic blacks, 13.3% of Asians and 16.2% of Hispanics. Prevalence of
smoking is high among both men (37.5%) and women (26.8%).\(1)\ A
similar pattern can be seen among youth, where AI/AN youth have
substantially higher smoking prevalence (23.1%) than non-Hispanic
whites (14.9%), Hispanics (9.3%), non-Hispanic blacks (6.5%), and
Asians (4.3%), according to data from the National Survey on Drug Use
and Health. These data also show that non-smoking AI/AN youth
demonstrated higher susceptibility to experimenting with smoking than
most other racial/ethnic groups.\(2)\
At the same time, however, tobacco use patterns among the AI/AN
population are complex and can vary substantially among subgroups of
this population. Smoking rates among AI/ANs vary widely by region,
being highest in the northwestern United States, in Canada, and in
Alaska. Additionally, use of smokeless tobacco is higher among AI/AN
adults compared with other racial/ethnic groups. Some studies have
found particularly high rates of smokeless tobacco use (greater than
50%) among AN populations, including pregnant women, due to the use of
Iqmik, a traditional form of smokeless tobacco.\(3)\
Understanding tobacco use among Native American populations is also
complicated by the fact that tobacco has had a substantial role in
Native American culture and tradition. Historically, tobacco has been
used in medicinal and healing rituals and in ceremonial and religious
practices. It is important to distinguish the traditional, ceremonial
uses of tobacco, which are limited to specific occasions, from
addictive use of tobacco products. However, the relationship between
these different contexts of tobacco use and their impact on behavior
has not received sufficient scientific study.
Moreover, limited data are available on the effectiveness of
tobacco use cessation interventions targeted to AI/ANs. Preliminary
focus group studies suggest that Native American smokers are more
likely to have negative attitudes towards pharmacotherapies, such as
concerns about side effects and lack of trust in conventional
medicine.\(4)\ Thus, there is a need to develop culturally-appropriate
interventions targeted to this population.
The NCI Tobacco Control Research Branch is committed to supporting
transdisciplinary research aimed at reducing disparities in tobacco use
and related health outcomes. The NARCH provides a unique mechanism to
support collaborative research involving researchers from multiple
disciplines to address a complex scientific and public health
challenge.
Sample research areas of interest include but are not limited to
the following:
Studies to understand the role of a range of behavioral,
cultural, and environmental factors that lead to initiation of tobacco
use among AI/AN populations;
Development and evaluation of culturally appropriate
interventions for tobacco use prevention and cessation targeted to AI/
AN populations;
Studies of how tobacco related attitudes and behaviors in
youth and adults are influenced by ceremonial tobacco use and other
cultural factors;
Studies of tobacco use behavior in relation to different
products, including dual use of cigarettes and smokeless tobacco;
Research on the characteristics, use, and health effects
of traditional tobacco products, such as Iqmik;
Research to understand disparities in tobacco use within
AI/AN populations given substantial variations by region and other
factors; and
Studies to identify and address barriers to treatment
among AI/ANs.
References
1. Tobacco Use Among Adults--United States, 2005. MMWR. October
27, 2006; 55: 1145-1148.
2. Racial/Ethnic Differences Among Youths in Cigarette Smoking
and Susceptibility to Start Smoking--United States, 2002-2004. MMWR.
December 1, 2006; 55; 1275-1277.
3. Renner CC, Patten CA, Day GE, Enoch CC, Schroeder DR, Offord
KP, Hurt RD, Gasheen A, Gill L. Tobacco use during pregnancy among
Alaska Natives in western Alaska. Alaska Med. 2005;47:12-16.
4. Burgess D, Fu SS, Joseph AM, Hatsukami DK, Solomon J, van Ryn
M. Beliefs and experiences regarding smoking cessation among
American Indians. Nicotine Tob Res. 2007;9 Suppl 1:S19-28.
For additional information about NCI tobacco research contact: Mark
Parascandola, PhD, Epidemiologist, Tobacco Control Research Branch,
National Cancer Institute, 6130 Executive Blvd. MSC 7337, Executive
Plaza North, Room 4039, Bethesda, MD 20892, Phone: 301-451-4587, Fax:
301-496-8675, E-mail: paramark@mail.nih.gov.
National Heart, Lung, and Blood Institute (NHLBI)
Cardiovascular and Respiratory Research
The NHLBI has a strong history of supporting research to document
and intervene on health disparities among AI/ANs, including the Strong
Heart Study, Pathways, Genetics of Coronary Artery Disease in Alaska
Natives (GOCADAN), the Stop Atherosclerosis in Native Diabetics Study
(SANDS), and Community-Responsive Interventions to Reduce
Cardiovascular Risk in AI/ANs.
The Strong Heart Study showed that many AI/AN communities bear a
heavy burden of cardiovascular disease (CVD) and cardiovascular risk
factors (e.g., obesity, diabetes) that could be reduced through
effective interventions on modifiable risk factors. The high burden of
disease will worsen unless behaviors and lifestyles affecting CVD risk
can be changed. Prevalence of obesity in AI/AN communities is about 50%
higher than in the U.S. general population, in which obesity is often
described as being of epidemic proportions. In some AI/AN communities,
cigarette smoking,
[[Page 78578]]
sedentary lifestyle, and stress augment the adverse effects of obesity.
AI/ANs are particularly vulnerable to Type 2 diabetes, a problem
exacerbated by high rates of obesity. Diabetes prevalence is 3-20 fold
higher among AI/ANs than in the general U.S. population. It is an
important cause of coronary heart disease, cardiomyopathy, end-stage
renal disease, non-traumatic amputation, and vision impairment. Lipid
abnormalities also are common in Type 2 diabetics, particularly high
triglycerides and low HDL-cholesterol levels. Dyslipidemia and blood
pressure can be improved by appropriate changes in diet and by
increased exercise. CVD risk is also substantially improved by smoking
cessation. In addition, attention to high stress levels, untreated
sleep disordered breathing, short sleep duration, and depression may be
warranted, because of evidence that they may influence the health
behaviors of interest. For example, poorer diet, higher smoking rates,
and physical inactivity are more prominent in those with high stress,
sleep disorders, or depression. These psychosocial factors also are
associated with CVD progression in observational epidemiologic studies,
and there is evidence from smaller clinical studies that they may
affect mechanisms leading to CVD. NHLBI is interested in supporting
research in AI/AN communities that promotes the adoption of healthy
lifestyles and/or improves behaviors related to cardiovascular risk,
such as weight reduction, regular physical activity, and smoking
cessation. These behaviors and lifestyles are known to affect
biological cardiovascular risk factors, such as hypertension,
dyslipidemia, obesity, glucose intolerance, and diabetes. In addition,
control of these risk factors by guideline-based use of
antihypertensive, lipid lowering, and hypoglycemic drugs can reduce
their adverse consequences. However, these pharmacological
interventions are often suboptimally utilized in AI/AN communities. The
NHLBI is interested in reducing cardiovascular disease mortality and
morbidity in AI/AN, whether by lifestyle changes, drug interventions,
or combinations thereof.
Lifestyles characterized by sleeping less than 7 hours per night
are associated with increased risk of CVD, obesity, diabetes, and all-
cause mortality. Insufficient sleep and poor sleep quality is
associated with abnormalities in hypothalamic-pituitary axis function
and behavioral stress. Sleep deprivation compromises vigilance,
judgment, mood, emotional expression, and other aspects of cognition
increasing the risk of unstable patterns of behavior. The ability of
sleep deprivation to enhance the encoding and recall of emotional
(relative to neutral) memories may profoundly influence social
interactions and stress. Insufficient sleep is associated with an
increased risk of new onset substance abuse and relapse, and new onset
depression and relapse. Intervention studies to assess the efficacy of
improving sleep as part of a healthy lifestyle or assessing how
improving sleep disorders could improve CVD outcomes would be of
interest to NHLBI. Sleep disordered breathing appears to be 30-60% more
common among American Indians than other racial and ethnic groups.
Sudden infant death syndrome occurs 2.5 times more frequently in AI/AN
children than in white children, and 2.0 times more frequently than in
the U.S. population as a whole.
AI/AN also have been documented to exhibit high rates of chronic
respiratory disease. AI/AN adults have the highest asthma rate among
single-race groups. Recent evidence suggests that 11.6 percent of AI/AN
suffer from asthma. This is significantly higher than the national
average of 7.5 percent, and much higher than every other single racial
or ethnic group. Chronic obstructive pulmonary disease (COPD), which
includes emphysema and chronic bronchitis, is the sixth leading cause
of death from chronic disease for AI/AN men and the seventh leading
cause of death for women. AI/AN have the second highest rates of cystic
fibrosis following whites. One in 10,500 AI/AN has cystic fibrosis
compared with one in 3,200 whites. Pueblo Indians and Zuni Indians have
higher incidence than among other AI/AN Tribes. NHLBI is interested in
supporting research in AI/AN communities that includes studies of
approaches to improve clinical delivery of efficacious treatments of
chronic lung disease and their risk factors, improved methods of
chronic lung disease self-management, studies to promote or maintain
respiratory health or improved methods of rehabilitation for diseases
of the lungs and airways, such as asthma, COPD, cystic fibrosis; sleep
disordered breathing, occupational lung diseases, pulmonary vascular
disease or pulmonary complications of AIDS.
In addition to these areas of research, the NHLBI recognizes a
unique and compelling need to promote diversity in the biomedical,
behavioral, clinical, and social sciences research workforce. The NHLBI
expects efforts to diversify the workforce to lead to:
The recruitment of the most talented researchers from all
groups;
An improvement in the quality of the educational and
training environment;
A more balanced perspective in the determination of
research priorities;
An improved capacity to recruit subjects from diverse
backgrounds into clinical research protocols; and
An improved capacity to address and eliminate health
disparities.
For more information, please contact: Jared B. Jobe, Ph.D.
(Cherokee), Program Director, Clinical Applications and Prevention
Branch, Division of Prevention and Population Sciences, National Heart,
Lung, and Blood Institute, 6701 Rockledge Drive, Suite 10018, MSC 7936,
Bethesda, Maryland 20892-7936 (20817 express), Phone: (301) 435-0407,
Fax: (301) 480-5158, E-mail: JobeJ@mail.nih.gov.
National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS)
Research in Osteoporosis and other Bone Diseases, Osteoarthritis,
Rheumatoid Arthritis and Skin Disease Within the NIAMS Mission
The NIAMS supports efforts to conduct research into the causes,
treatment, and prevention of arthritis and musculoskeletal and skin
diseases; the training of basic and clinical scientists to carry out
this research; and the dissemination of research progress to improve
the public health. Goals specific to the AI/AN communities involve
research addressing the training of underrepresented minority AI/AN
researchers and ensuring inclusion of Native communities in clinical
research studies. NIAMS actively monitors the inclusion of minority
populations in clinical research and will highlight any grants that
specifically target AI/AN populations. The mission of the NIAMS is to
support research into the causes, treatment, and prevention of
arthritis and musculoskeletal and skin diseases, the training of basic
and clinical scientists to carry out this research, and the
dissemination of information on research progress in these diseases.
Studies in these mission areas as they relate to the AI/AN population
may be proposed.
For additional information about research in these areas contact:
Dr. Phil Tonkins, National Institute of Arthritis and Musculoskeletal
and Skin Diseases, 6701 Democracy Blvd., Suite 800, Bethesda, MD 20912,
Phone: (301) 594-4979, Fax: (301) 480-1284, E-mail:
tonkinsw2@mail.nih.gov.
[[Page 78579]]
National Center for Complementary and Alternative Medicine (NCCAM)
Research on Traditional Healing Practices
Many AI/AN communities use traditional healing practices to prevent
and/or treat diseases and to maintain health. NCCAM is interested in
supporting research on traditional healing practices with these goals
in mind. NCCAM is also interested in research on the safe and effective
integration of conventional care with traditional healing practices for
AI/AN communities. The methodological feasibility for integration has
yet to be addressed for many traditional healing practices.
Consequently, NCCAM is interested in supporting developmental studies
to identify and address difficult methodological and design issues
particular to traditional healing practices, as well as to allow for
the development of contextually and culturally sensitive research
mirroring the values of AI/AN communities.
Examples of study areas of interest include, but are not limited
to:
Qualitative research to characterize and document healing
practices and diagnostic approaches of indigenous peoples, and study
the feasibility of research on those practices and approaches in future
clinical studies;
Observational studies to explore patient and care provider
preferences, beliefs, attitudes, and patient-provider interactions;
Case-control, observational, and other studies to
understand traditional healing strategies from multiples perspectives,
including: (a) Optimal dosing, duration, and frequency of treatment;
(b) type of treatment; (c) examinations of different healing practices
to treat a particular disease/condition; (d) comparisons of complex
versus simple interventions; (e) evaluation of adherence among patient
populations to interventions with varying levels of complexity; and (f)
examination of potentially important individual differences that
mediate or moderate treatment outcome;
Studies to determine if traditional healing practices can
be translated into a broader clinical setting, in terms of:
Reliability, responsiveness and utility; assessment procedures,
instruments, and tools in psychosocial, functional, and physiological
domains;
Studies to construct and validate culturally sensitive
data collection instruments; to design and pilot outcome measures
consistent with the tenets of traditional, indigenous systems of
medicine and comparisons of these outcome measures to those commonly
used by conventional biomedicine; and
Health services research of established AI/AN traditional
healing practices to explore the factors that influence access to and
use of such therapies; the nature, cost effectiveness, and quality of
such care; and ultimately the effects on health and well-being.
For additional information on NCCAM-supported research topics,
contact:
Sheila A. Caldwell, Ph.D., Program Officer, Office of Special
Populations, National Center for Complementary and Alternative
Medicine, 6707 Democracy Boulevard, Suite 401, MSC 5475, Bethesda MD,
20892-5475, Phone: (301) 594-3396, Fax: (301) 480-3621, E-mail:
caldwells@mail.nih.gov.
Office of Research on Women's Health (ORWH)
Women's Health Research
The ORWH at the NIH supports research related to women's health and
the study of sex and gender differences. Detailed information about the
NIH Research Priorities for Women's Health, can be found at http://
orwh.od.nih.gov/research.html.
For additional information on women's health research, contact:
Lisa Begg, Dr. P.H., R.N., Director of Research Programs, NIH Office of
Research on Women's Health, 6707 Democracy Blvd., Suite 400, Bethesda,
MD 20892-5484, Phone: (301) 496-7853, Fax: (301) 402-1798, E-mail:
beggl@od.nih.gov.
National Insitute of Mental Health (NIMH)
Research projects aimed at understanding the burden, treatment,
intervention or prevention of mental disorders and Human
Immunodeficiency Virus (HIV)/AIDS in AI/AN populations
Indigenous people in the United States are disproportionately
affected by mental illness and HIV infection, as are the larger racial
and ethnic populations such as African Americans and Latinos. AI/ANs
are highly underrepresented in the physician workforce, as researchers,
and in health research in general, numbering fewer than one hundred.
Other factors that contribute to disparities that affect these
communities include geographic isolation, poor access to health
services, underutilization of health services, insufficient screening
and partner management services, social and cultural norms,
linguistics, stigma, and gender. Research is needed to identify and
address the impact as well as the specific and unique aspects of mental
disorders and HIV infection upon Native American communities. A
critical component of response to mental health and HIV infection in
Native American communities will be to identify, train, mentor, and
develop Native American investigators. Towards these ends, a promising
model is community-based participatory research together with community
capacity building.
Areas of interest to the NIMH that can contribute to scientific
knowledge about mental health and HIV interventions in Native Americans
include, but are not limited to research studies:
To investigate the clinical epidemiology of mental
disorders and HIV infection across all clinical and service settings
(e.g., primary care);
To investigate research methods/community assessment to
eliminate mental health disparities;
To evaluate the impact of traumatic stress and other
social, cultural, interpersonal, and environmental factors on risk for
and course of mental disorders;
To examine patient, provider, and contextual factors that
influence diagnosis, help-seeking decisions and preferences, and the
helping relationship;
To understand processes underlying HIV and mental illness
stigmas and discrimination in Native American communities;
To develop and assess effective strategies and approaches
for reducing HIV and mental illness stigmas and discrimination;
To evaluate the effectiveness of treatment, pharmacologic,
psychosocial (psychotherapeutic and behavioral), somatic,
rehabilitative, and combination interventions on mental and behavior
disorders--including acute and longer-term therapeutic effects on
functioning for children, adolescents, and adults;
To develop and tailor/target interventions to communities/
individuals of Native Americans;
To employ interventions that improve quality and outcomes
of care (including diagnostic, treatment, preventive, and
rehabilitation services);
To conduct scientifically rigorous investigations of
culturally appropriate interventions, prevention, and control
strategies;
To employ services interventions that remove barriers to
care leading to the elimination of mental health disparities;
To conduct studies of services organization, delivery
(process and receipt of care), and related health economics at the
individual, clinical,
[[Page 78580]]
program, community, and systems levels in specialty mental health,
general health, and other delivery settings (such as the workplace,
schools);
To enhance research infrastructure and build research
capacity for conducting intervention and services research;
To explore alternative approaches (e.g., telehealth) to
translating, delivering, implementing, and disseminating mental health
care;
To investigate adaptation, evaluation, safety, and costs
of proven interventions;
To explore dissemination and implementation strategies at
multiple organizational levels; and
To examine the role of community stakeholders in the
research process, especially readiness for change.
For additional information on NIMH NonAIDS Applications contact:
Carmen P. Moten, Ph.D., Chief, Primary Care, Socio Cultural and
Disparities Research Programs, Division of Services and Intervention
Research, National Institute of Mental Health, 6001 Executive
Boulevard, Room 7131, MSC 9631, Bethesda, MD 20892-9631, Phone: (301)
443-3725, Fax: (301) 443-4045, E-mail: cmoten@mail.nih.gov.
For additional information on NIMH HIV/AIDS-related applications
contact: David M. Stoff, Ph.D., Chief, HIV/AIDS Neuropsychiatry
Program, AIDS Research Training and HIV/AIDS Disparities Program,
Division of AIDS and Health and Behavior Research, National Institute
of Mental Health, 6001 Executive Boulevard, Room 6210, MSC 9619,
Bethesda, MD 20892-9619, Phone: (301) 443-4625, Fax: (301) 443-9719, E-
mail: dstoff@mail.nih.gov.
For additional information on NIMH research on Stigma and Health
Disparities contact: Emeline Otey, Ph.D., Chief, Stigma and Health
Disparities Program, Division of AIDS and Health and Behavior Research,
National Institute of Mental Health, 6001 Executive Boulevard, Room
6227, MSC 9615, Bethesda, MD 20892-9615, Phone: (301) 443-9284, Fax:
(301) 480-2920, E-mail: eotey@mail.nih.gov.
National Institute of Biomedical Imaging and Bioengineering (NIBIB)
Research in Technology for Health
The National Institute of Biomedical Imaging and Bioengineering
(NIBIB) is committed to reducing health disparities through the
development of new and affordable biomedical technologies. To this end,
the NIBIB is interested in supporting the translation of biomedical
technologies that target the health needs of AI/AN communities.
Specifically, the NIBIB is interested in supporting the development of
technologies that have broad therapeutic and interventional
applications as well as technologies that complement technology
development in all program areas of the NIBIB, http://
www.nibib.nih.gov/Research/ProgramAreas.
For additional information about NIBIB programs contact: John W.
Haller, Ph.D., National Institute of Biomedical Imaging and
Bioengineering, NIH/DHHS, 6707 Democracy Blvd., Suite 200, Bethesda, MD
20892-5649, Phone: (301) 451.4780, Fax: (301) 480.1614, E-mail:
John.Haller@nih.hhs.gov.
National Eye Institute (NEI)
Vision Research
The NEI supports research and health information dissemination with
the goal of protecting and prolonging the vision of the American
people. Examples of such activity that may be of interest include, but
are not limited to:
Epidemiological studies to determine the prevalence and
possible risk factors of eye diseases and disorders among AI/AN
populations;
Basic research studies into the causes and mechanisms of
eye diseases and visual impairments in AI/AN, research into disparities
in access to ophthalmic/optometric health services; and,
Development and evaluation of culturally appropriate
health education and intervention.
For additional information on vision research topics contact:
Jerome R. Wujek, Ph.D., National Eye Institute, 2020 Vision Place,
Bethesda, MD 20892-3655, Phone: (301) 451-2020, Fax: (301) 402-0528, E-
mail: wujekjer@nei.nih.gov.
THE OMISSION ABOVE OF ANY NIH INSTITUTE, CENTER, OFFICE, OR
RESEARCH AREA SHOULD NOT BE TAKEN AS A LACK OF AVAILABILITY OF SUPPORT
FOR PROJECTS IN THOSE AREAS. NARCH is an NIH-wide partnership, led at
NIH by the National Institute of General Medical Sciences (NIGMS).
General research priorities for all of the individual NIH Institutes,
Centers, Divisions and Offices can be found on their respective Web
sites at: http://www.nih.gov/icd/index.html. However, applicants and
potential academic partners are reminded that the NARCH program is
focused on the research needs of the tribes and not those of the
federal or academic partners.
Previous NARCH grants have been funded by the following partners:
National Institute of General Medical Sciences (NIGMS);
National Cancer Institute (NCI);
National Heart, Lung, and Blood Institute (NHLBI);
National Human Genome Research Institute (NHGR);
National Institute on Alcohol Abuse and Alcoholism
(NIAAA);
National Institute of Allergy and Infectious Diseases
(NIAID);
National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS);
National Institute of Dental and Craniofacial Research
(NIDCR);
National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK);
National Institute on Drug Abuse (NIDA);
National Center for Complementary and Alternative Medicine
(NCCAM);
National Center on Minority Health and Health Disparities
(NCMHD);
NIH Office of Behavioral and Social Sciences Research
(OBSSR);
NIH Office of Research on Women's Health (ORWH); and
Agency for Healthcare Research and Quality (AHRQ).
In addition to these partners within HHS, the Federal Collaborative
on Health Disparities Research (FCHDR), Headquartered in the HHS Office
of Minority Health (OMH) is in the process of seeking co-funding
partnerships for the NARCH program with other departments and agencies
of the Federal Government. Any additional information that develops
after the publication of this announcement will be posted on the NARCH
program Web site at http://www.ihs.gov/MedicalPrograms/Research/
narch.cfm and disseminated to the TECHASSISTANCE-NARCH listserve
developed from persons e-mailing their contact information to
narch@ihs.gov.
Public Policy Requirements: All Federal-wide public policies apply
to IHS grants with exception of the Lobbying and Discrimination public
policy.
3. Submission Dates and Times
A. Letter of Intent Deadline: March 15, 2009
Prospective applicants are asked to submit a letter of intent that
includes the title of the new project(s) proposed, the name, address,
and telephone number of the project Principal Investigator(s), the
identities of the partners and of key personnel, and the number and
title of this RFA. The letter of intent should be received before 5
p.m. Eastern Standard Time on March 15, 2009, by Mushtaq A. Khan,
D.V.M.,
[[Page 78581]]
Ph.D., Chief, Digestive and Respiratory Sciences IRGs, Center for
Scientific Review, MSC 7818, Room 2176; 6701 Rockledge Drive; Bethesda,
MD 20892 (20817 for express or courier service). Phone: (301) 435-1778;
Fax (301) 451-2043; E-Mail: khanm@csr.nih.gov.
Letters may be submitted by mail, fax or e-mail. Although a letter
of intent is not required, is not binding, and does not enter into the
review of a subsequent application, the information that it contains
allows the IHS and NIH Center for Scientific Review (CSR) staffs to
estimate the potential review workload and avoid conflict of interest
in the review.
B. Application Deadline: May 14, 2009
The applications must be received before 5 p.m. Eastern Standard
Time on May 14, 2009, at the Center for Scientific Review (CSR)
National Institutes of Health, 6701 Rockledge Drive, Room 6160--MSC
7892, Bethesda, MD 20892-7720, Bethesda, MD 20817 (for express or
courier service). Phone: (301) 435-0715) and at the IHS Division of
Grants Operations (DGO) Indian Health Service, Reyes Building, 801
Thompson Avenue, TMP Suite 360, Rockville, MD 20852-1627 [zip code is
unchanged for express/courier services], Phone: (301) 443-5204.
Applications received after this date will be returned to the
applicant. Competing applications not meeting the deadline date
specified in the announcement are considered late applications and will
not be considered for funding under this announcement. The CSR will not
accept any application in response to this RFA that is essentially the
same as one currently pending initial review, unless the applicant
withdraws the pending application.
The CSR will not accept any application that is essentially the
same as one already reviewed. This does not preclude the submission of
substantial revisions of applications already reviewed, but such
applications must include an introductory letter addressing the
previous critique.
4. Intergovernmental Review
This funding opportunity is not subject to Executive Order 12372,
``Intergovernmental Review of Federal Programs.'' A State approval is
not required.
5. Funding Restrictions
Pre-award costs are allowable pending prior approval from
the awarding agency. However, in accordance with 45 CFR part 74 all
pre-award costs are incurred at the recipient's risk. The awarding
office is under no obligation to reimburse such costs if for any reason
the applicant does not receive an award or if the award to the
recipient is less than anticipated.
The available funds are inclusive of direct and
appropriate indirect costs.
Only one grant/cooperative agreement will be awarded per
applicant under this announcement.
IHS will not acknowledge receipt of applications.
Grantees are allowed a reasonable period of time in which
to submit required financial and performance reports. Failure to submit
required reports within the time allowed may result in suspension or
termination of an active grant, withholding of additional awards for
the project, or other enforcement actions such as withholding of
payments or converting to the reimbursement method of payment.
Continued failure to submit required reports may result in the
imposition of special award provisions, or cause other eligible
projects or activities involving that grantee organization, or the
individual responsible for the delinquency to not be funded. Failure to
obtain prior approval for change in Scope, Principal Investigator,
Grantee Institutions, Successor in Interest, or Recipient Institute
Name, undertaking any activities disapproved or restricted as a
condition of the award, may result in fund restrictions.
6. Other Submission Requirements
Each submitted research project (including pilot research projects)
must be budgeted so that it could stand on its own. That is, each
project should be fundable under its own budget so that it could be
completed even if none of the rest of the NARCH is funded. All things
vital to each project should be included in the budget of that project
and not included in the core. The NARCH core should include only
administrative, training or other items that are non-essential to the
research projects. The core should also include the capacity to take
advantage, for training purposes, of any new research opportunity that
becomes available to the grantee, whether through NARCH funding or
other new resources. The core should be budgeted as if it were an
additional project and the total amounts requested on the face page of
the NARCH application should represent the sum of the projects plus the
core. Each subcontractor participating in each project (or core) should
submit its budget as part of that project's budget, using appropriate
form pages from the PHS 398. Each project submission should include a
set of budget pages from each of the institutional partners
participating in that project. Each research project budget should
explicitly include that portion of the grantee's indirect costs that
are associated with activities under that project, including direction
and oversight of the subcontracts. Each project (and core) must include
a checklist and face page for that project. Only the main face page for
the entire NARCH is required to have the signatures of the NARCH
principal investigator and official signing for the applicant
organization.
Submit a typed and signed original application, including the
checklist, and one single-sided photocopy of the entire application
(including Appendices and supporting documents) in one package to:
Division of Grants Operations, Indian Health Service, Reyes Building,
801 Thompson Avenue, TMP Suite 360, Rockville, MD 20852-1627 (zip code
is unchanged for express/courier services), Phone: (301) 443-5204.
At the time of submission, applicants must also send four
additional single-sided photocopied and signed applications, including
the Checklist, Appendices, and supporting documentation to: Center for
Scientific Review, National Institutes of Health, 6701 Rockledge Drive,
Room 6160--MSC 7892, Bethesda, MD 20892-7720, Bethesda, MD 20817 (for
express or courier service). Phone: (301) 435-0715. The CSR no longer
accepts hand delivered applications. E-mail or other electronic
applications will not be accepted under this announcement.
Specific supplementary instructions for the PHS 398 application and
budget preparation for the NARCH program may be obtained from the
initiative contacts listed under VII. Agency Contacts, and will be
posted at http://www.ihs.gov/MedicalPrograms/Research/narch.cfm. They
will also be sent to any potential applicant who e-mailed their contact
information to narch@ihs.gov with the words ``technical assistance'' in
the subject heading.
DUNS Number
Applicants are required to have a Dun and Bradstreet (DUNS) number
to apply for a grant or cooperative agreement from the Federal
Government. The DUNS number is a nine-digit identification number,
which uniquely identifies business entities. Obtaining a DUNS number is
easy and there is no charge. To obtain a DUNS number, access http://
www.dunandbradstreet.com or call 1-
[[Page 78582]]
866-705-5711. Interested parties may wish to obtain their DUNS number
by phone to expedite the process.
A DUNS number is required before Central Contractor Registry (CCR)
registration can be completed. Many organizations may already have a
DUNS number. Please use the number listed above to investigate whether
or not your organization has a DUNS number. Registration with the CCR
is free of charge.
Applicants may register by calling 1-888-227-2423. Please review
and complete the CCR Registration Worksheet located at http://
www.grants.gov/CCRRegister.
More detailed information regarding these registration processes
can be found at http://www.grants.gov.
Electronic Research Administration (eRA) User Name
Each NARCH Application's Principal Investigator is required to have
a user name with the NIH eRA system. This also requires that the
applicant institution (Tribe or Tribal organization) be an eRA Commons
Registered Organization. A list of eRA Commons Registered Organizations
can be found at http://era.nih.gov/commons/quick_queries/commons_
registered_orgs.cfm. More information on the eRA Commons system can be
found at http://era.nih.gov/.
V. Application Review Information
Upon receipt, IHS and NIH staff will administratively review
applications for completeness and responsiveness. Applications that are
incomplete, non-responsive to this RFA, or do not follow the guidelines
of the PHS form 398 (revised 11/2007) or of the supplementary
instructions for NARCH grants (available at: http://www.ihs.gov/
MedicalPrograms/Research/narch.cfm or from narch@ihs.gov), may be
returned to the applicant without further consideration. Applications
will be evaluated in accordance with the criteria stated below for
scientific and technical merit by appropriate peer review groups
convened by the CSR. The National Advisory General Medical Sciences
Council will conduct the second level of review.
1. Criteria
Priorities for funding will be based on the scientific and
technical merit of the application, the assessed potential of
investigators in the developmental stages of their careers, and the
likelihood that the proposed project(s) can further the purposes of the
NARCH initiative. Awards will be made only to organizations with
financial management systems and management capabilities that are
acceptable under HHS policy. Awards will be administered under the HHS
Grants Policy Statement, January 2007.
A. Review of Student and Faculty/Researcher Development Plans
The anticipated effectiveness of the proposed NARCH in making a
difference relative to the current base-line data (based in part on
previous experience of the NARCH) will be assessed. Factors to be
considered include:
The appropriateness of the content, phasing, quality, and
duration of the student or faculty/researcher development plans in the
NARCH application to achieve the scientific development of the faculty/
researcher, post-doctoral, pre-doctoral, undergraduate, and (if well
justified) high school students; and
The research experience and expertise, proposed
commitment, and quality of the mentoring plan and of individual mentors
of the partners in providing mentoring, guidance, and advice to
candidates (including training in responsible conduct of research and
research integrity, teaching, and protection of human subjects), and in
fostering the development of academic and community-based AI/AN
researchers.
B. Review of Research Projects
The NIH has announced procedures to be used for the review of
research grant applications (NIH Guide, Volume 26, Number 22, June 27,
1997 or see http://grants.nih.gov/grants/guide/notice-files/not97-
010.html and http://grants.nih.gov/grants/guide/notice-files/NOT-OD-05-
002.html for additional updated information.) For NARCH applications,
the five criteria listed in this announcement will be used for the
scientific review of research projects and pilot research projects. The
review of research projects and pilot research projects will be the
same except that applications for pilot studies may be smaller in scope
and would not be expected to have preliminary data.
In the written comments, reviewers will be asked to discuss the
following aspects of the application in order to judge the likelihood
that the proposed research will have a substantial impact on the
pursuit of these purposes. Each of these criteria will be addressed and
considered in assigning the overall score, weighting them as
appropriate for each application.
Significance: Does this study address an important
problem? If the aims of the application are achieved, how will
scientific knowledge or clinical practice be advanced? What will be the
effect of these studies on the concepts, methods, technologies,
treatments, services, or preventative interventions that drive this
field?
Approach: Are the conceptual or clinical framework,
design, methods, and analyses adequately developed, well integrated,
well reasoned, and appropriate to the aims of the project? Does the
applicant acknowledge potential problem areas and consider alternative
tactics?
Innovation: Is the project original and innovative? For
example: Does the project challenge existing paradigms or clinical
practice; address an innovative hypothesis or critical barrier to
progress in the field? Does the project develop or employ novel
concepts, approaches, methodologies, tools, or technologies for this
area?
Investigators: Are the investigators appropriately trained
and well suited to carry out this work? Is the work proposed
appropriate to the experience level of the principal investigator and
other researchers? Does the investigative team bring complementary and
integrated expertise to the project (if applicable)?
Environment: Does the scientific environment in which the
work will be done contribute to the probability of success? Do the
proposed studies benefit from unique features of the scientific
environment, or subject populations, or employ useful collaborative
arrangements? Is there evidence of institutional support?
In reviewing the overall Center, the initial scientific review
group will examine evidence of the partners' commitment to the purposes
of the NARCH initiative to develop a cadre of AI/AN scientists and
health professionals engaged in biomedical, clinical, behavioral and
health services research that is competitive for Federal funding; to
increase the capacity of both research-intensive institutions and AI/AN
organizations to work in partnership to reduce distrust by AI/AN
communities and people toward research; and to encourage competitive
research linked to the health priorities of the AI/AN partner and to
reducing health disparities.
The evidence will include:
The quality of the partnership of the institutional and
community partners, and the quality of the involvement of the Community
and Scientific Advisory Council, as demonstrated by documentation of
(for instance): The intellectual and tangible contributions and
activities of the partners, and of the
[[Page 78583]]
Council, in developing the application and the proposed NARCH; the
interactions of the partners, and of the members of the Council, in
meetings (such as those to develop the application and proposed NARCH);
the past activities and future plans to increase the capacity of the
partners and of the Council; the plans for future contributions and
activities by the partners, and by the Council, in furthering the goals
of the proposed NARCH; and the plans for future development of the
partnership itself;
The experience and commitment of the institutional and
community partners to recruit, retain, and advance AI/AN faculty/
researcher and students, to support faculty/researcher and student
research efforts, and to increase the role of the involved AI/AN
communities in the plans of the proposed NARCH;
The appropriateness of the plan for evaluating the impact
of the proposed NARCH, including the quality of baseline data and
milestones for accomplishments, and a system to track the future course
of program participants; and
The potential of the proposed NARCH to be a regional and
national resource, including: Capacity to provide quality research
training and mentoring for integrated promotion and development of AI/
AN research careers from undergraduate (or if well justified, high
school) through post-doctoral levels; attainment of quality research
linked to health priorities of the AI/AN partner and to reducing health
disparities; plans for research information dissemination and education
activities; and plans for the development of research networks to
support the scientific aims of the proposed NARCH. For competitive
renewal applications, reviewers will also assess the previous
accomplishments and progress of the applicants.
In addition to the above criteria, in accordance with NIH policy,
all applications will also be reviewed with respect to the following:
The adequacy of plans, if research on human subjects is
involved, to include both genders and children as appropriate for the
scientific goals of the research. Plans for the recruitment and
retention of subjects will also be evaluated.
For applications that are competing renewals of existing
NARCH centers, has significant progress been achieved toward each of
the originally proposed projects?
The reasonableness of the proposed budget and duration in
relation to the proposed research.
The adequacy of the proposed protection for humans,
animals or the environment, to the extent they may be adversely
affected by the project proposed in the application.
The adequacy of the proposed plan to share data, if
appropriate.
VI. Award Administration Information
1. Award Notices
The Notice of Award (NoA) will be initiated by the IHS Division of
Grants Operations (DGO) and will be mailed via postal mail to each
entity that is approved for funding under this announcement. The NoA
will be signed by the Grants Management Officer and this is the
authorizing document for which funds are dispersed to the approved
entities. The NoA will serve as the official notification of the grant
award and will reflect the amount of Federal funds awarded, the purpose
of the grant, the terms and conditions of the award, the effective date
of the award, and the budget/project period. The NoA is a legally
binding document. Applicants who are approved but unfunded or
disapproved based on their objective review score will receive a copy
of the Executive Summary which identifies the weaknesses and strengths
of the application submitted.
2. Administrative and Policy Requirements
A. Grants are administrated in accordance with the following
documents:
This Announcement.
Administrative Requirements: 45 CFR part 92, (Uniform
Administrative Requirements for Grants and Cooperative Agreements to
State, Local and Tribal Governments, (or 45 CFR part 74, (Uniform
Administrative Requirements for Awards to Institutions of Higher
Education, Hospitals, Other Non-Profit Organizations, and Commercial
Organizations.
Grants Policy Guidance: HHS Grants Policy Statement,
January 2007.
Cost Principles: OMB Circular A-87, (State, Local, and
Indian (Title 2 Part 225).
Cost Principles: OMB Circular A-122, (Non-profit
Organizations (Title 2 Part 230).
Audit Requirements: OMB Circular A-133, (Audits of States,
Local Governments, and Non-profit Organizations).
B. Inclusion of Women and Minorities in Research Involving Human
Subjects:
It is the policy of the NIH that women and members of minority
groups and their subpopulations must be included in all NIH supported
biomedical, clinical, behavioral, and health services research projects
involving human subjects, unless a clear and compelling rationale and
justification is provided that inclusion is inappropriate with respect
to the health of the subjects or the purpose of the research. This
policy results from the NIH Revitalization Act of 1993 (Section 492B of
Pub. L. 103-43). Because the NARCH initiative targets AI/AN people and
communities, a minority population, only the policy of inclusion of
women applies to this RFA. The IHS has fully accepted the Office for
Human Research Protections (OHRP) policy regarding human subjects. The
OHRP Web site is http://www.hhs.gov/ohrp/. All investigators proposing
research involving human subjects should read the Updated NIH
Guidelines for Inclusion of Women and Minorities as Subjects in
Clinical Research, published in the NIH Guide for Grants and Contracts
on August 2, 2000. (http://grants.nih.gov/grants/guide/notice-files/
NOT-OD-00-048.html). The complete Guidelines are available at: http://
grants1.nih.gov/grants/funding/women_min/guidelines_amended_10_
2001.htm . The revisions relate to NIH defined Phase III clinical
trials and require:
All applications or proposals and/or protocols to provide
a description of plans to conduct analyses, as appropriate, to address
differences by sex/gender and/or racial/ethnic groups, including
subgroups if applicable; and
All investigators to report accrual, and to conduct and
report analyses, as appropriate, by sex/gender and/or racial/ethnic
group differences.
C. Inclusion of Children as Participants in Research Involving Human
Subjects
It is the policy of NIH that children (i.e., individuals under the
age of 21) must be included in all human subjects research, conducted
or supported by the NIH, unless there are scientific or ethical reasons
not to include them. This policy applies to all initial (Type 1)
applications submitted. All investigators proposing research involving
human subjects should read the NIH Policy and Guidelines on the
Inclusion of Children as Participants in Research Involving Human
Subjects that was published in the NIH Guide for Grants and Contracts,
March 6, 1998, and is available at the following URL address: http://
grants.nih.gov/grants/guide/notice-files/not98-024.html. Investigators
may obtain copies of these policies from the initiative staff listed
under VII. Agency Contacts. Initiative staff may also provide
additional
[[Page 78584]]
relevant information concerning the policy.
D. URLS in NIH Grant Applications or Appendices
All applications and proposals for NIH funding must be self-
contained within specified page limitations. Unless otherwise specified
in an NIH solicitation, Internet addresses (URLs) should not be used to
provide information necessary to the review because reviewers are under
no obligation to view the Internet sites. Reviewers are cautioned that
their anonymity may be compromised when they directly access an
Internet site.
E. Allowable Administrative Costs
Certain administrative costs for managing a comprehensive program
are allowable and may vary, depending upon the size and complexity of
the program's activities. The costs budgeted for NARCH grants and
subcontracts may not duplicate items already budgeted in other cost
centers of the AI/AN, research-intensive, and subcontracted
organizations and institutions, such as accounts which make up the
Facilities and Administration (F&A) cost pool. The grantee organization
receiving the award must be prepared to provide documentation showing
the direct relationship of proposed costs to the program, and that
costs of this type are charged in a uniform manner to all other grants
at all institutions and organizations participating in the award.
Limited salary support for secretarial or clerical help is
allowable only when in direct support of the proposed NARCH project.
For guidance, applicants should refer to the OMB Circular appropriate
for them, A-87 (Cost Principles for State, local, and Indian Tribal
Governments), at http://www.whitehouse.gov/omb/circulars or A-122 (Cost
Principles for Non-Profit Organizations), at http://
frwebgate.access.gpo.gov/cgi-bin/
leaving.cgi?from=leavingFR.html&log=linklog&to=http://http://
www.whitehouse.gov/omb/circulars, or should contact the Grants
Management Officer listed under VII. Agency Contacts.
Costs for evaluation activities are allowable, as are costs for the
Community and Scientific Advisory Council. All research project
applications must include costs associated with one annual meeting per
year in Rockville, MD, of the project Principal Investigator(s) and
their key scientific personnel. Research project applications should
also include costs associated with attendance for key personnel and
presenters to the annual Native Health Research Conference. NARCH core
and/or training budgets should include these travel costs for key NARCH
personnel and trainees who are not associated with specific research
projects.
Student Development Costs: Student (graduate, undergraduate, and
high school if well justified) remuneration through salary/wages for
participation in research experiences may be requested, provided all
the following conditions are met:
I. The student is performing necessary work involved in the
research;
II. There is an employer-employee relationship between the student
and the proposed NARCH or its partners;
III. The total compensation is reasonable for the work performed;
and
IV. It is the practice of the proposed NARCH or its partners to
provide compensation for all students in similar circumstances,
regardless of the source of support for the activity.
Graduate students, but not undergraduate students, are allowed
tuition costs as part of a compensation package. When requesting
support for a graduate student, the NARCH application should provide,
in the budget justification section of the application, the basis for
the compensation level. The IHS staff will review the requested
compensation level and, if it is reasonable and justified, will provide
compensation up to a maximum of $45,000 (http://grants.nih.gov/grants/
guide/notice-files/not98-168.html). Post-doctoral students should be
compensated at a rate commensurate with that of other post-doctoral
employees with similar degrees and experience at the research-intensive
institution. It is the expectation of the IHS and NIGMS that students
who are enrolled in a accredited graduate program, as part of a
proposed NARCH, will not be excluded from support from other non-
Federal or Federal graduate training sources (such as loans and
assistance under the Veterans' Adjustment Benefit Act or Pell Grants)
for which they are eligible.
Graduate and post-doctoral students cannot concurrently hold other
Federally-sponsored stipends or fellowship or any other Federal award
that duplicates the NARCH support.
Faculty/Researcher Development Costs
Costs to support faculty/researcher development activities, such as
workshops or courses, national meetings, or short-term research
experiences in the laboratory of an active NIH-extramurally-funded
researcher needed for acquiring specific skills or methodologies needed
for prospective research, are allowable. Such costs might include
tuition, travel and per diem costs, as well as salary support
appropriate to the percent effort needed for the activity.
Research Project Costs
Direct costs associated with research and pilot research projects
are allowable when adequate justification is provided. These include
faculty/researcher salaries, reimbursed according to percent effort.
Summer salary support can be paid provided the institution's academic
schedule permits such release and when the institution approves. The
maximum summer-salary support provided by the program cannot exceed the
equivalent of three months at 100 percent effort, or time specified by
the institution as its policy. Grant funds may not be used to increase
or supplement faculty/researcher academic year salaries. Salary support
for technical assistance and costs for consultants, if justified, are
allowable. Costs for equipment to be used to carry out the proposed
research are allowable.
Cost for Supplies
Costs for supplies, including costs for animals necessary to carry
out the proposed research, may be included. Travel costs for the
investigator(s) and staff are permitted to required meetings or when
direct benefits to the program are expected, and when adequate
justification is provided. Alterations and renovations costs (up to
$40,000) are allowable only when essential for conduct of the proposed
research. Other permitted costs include animal maintenance (unit care
costs and number of care days), donor fees, publication costs, computer
charges, rentals and leases, equipment maintenance, and service
contracts.
Consortium and Contract Arrangements
Consortium arrangements that may involve personnel costs, supplies,
and other allowable costs, including overhead costs; contractual costs
for support services, such as the laboratory testing of biological
materials, clinical services, data processing, or core administrative
services, are allowable expenses. Consortia and contractual costs with
Native health organizations, Tribes and/or research institutions in
Canada or Mexico are allowable expenses.
Pilot Research Projects
The intent of pilot research projects is to lead to regular
research projects funded as part of the center grant or as freestanding
grants. For pilot research projects, applications may request
[[Page 78585]]
support for up to $75,000 (direct costs) per year for up to four years.
Pilot research investigators considering project periods of less than
four years are encouraged to consider the fact that initiation of a new
research activity in a new population often takes much longer than
originally anticipated and that the creation of a trusting relationship
between the investigator and the community is both vital and time
consuming. NARCH pilot research support is non-renewable. However,
NARCH research projects based on prior NARCH pilot research projects
are encouraged.
Subcontracts
The grant recipient may issue subcontracts to other organizations
(such as the research-intensive institution of the partnership), as
long as a minimum of 30 percent of the grant funds are budgeted in the
application to remain with the eligible AI/AN organization(s); that is,
no more than 70 percent of the application's total budget may be
contained in subcontract budgets of the non-eligible subcontracting
partner institutions or organizations.
F. Unallowable Costs
Unallowable costs for research projects (including for pilot
projects) include costs for student development, textbooks, journals,
memberships, and Internet subscription costs, as well as other costs
prohibited by OMB Circulars A-87 or A-122 as applicable. Employees of
the applicant organization may not serve as paid consultants but may be
paid. The pilot research project is intended for faculty/researcher
without current Federal research support. Therefore, investigators with
significant current support from other mechanisms such as the R01 and
research funding from other extramural sources are not eligible, and
the costs therefore are not allowable. Release time for preparing
proposals or mini-research projects, not submitted as pilot projects,
is not allowed.
G. Research Subjects Protection
Under governing policy, Federal funds administered by the HHS shall
not be expended for research involving live vertebrate animals without
prior approval by the NIH Office of Laboratory Animal Welfare (OLAW),
of an assurance to comply with the Public Health Service (PHS) Policy
on Humane Care and Use of Laboratory Animals. This restriction applies
to all performance sites (e.g., collaborating institutions,
subcontractors, subgrantees) without OLAW-approved assurances, whether
domestic or foreign. Funds included in this award may not be used to
support studies using live vertebrate animals until approval from the
Institutional Animal Care and Use Committee (IACUC) has been received
by the IHS Grants Management Officer (GMO).
Federal Regulations (45 CFR, Part 46) require that applications and
proposals involving human subjects must be evaluated with reference to
the risks to the subjects, the adequacy of protection against these
risks, the potential benefits of the research to the subjects and
others, and the importance of the knowledge gained or to be gained.
Under governing regulations 45 CFR part 46, found at http://
www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm, Federal funds
administered by HHS shall not be expended for research involving human
subjects, and individuals shall not be enrolled in such research,
without prior approval by the Office for Human Research Protections
(OHRP), of an appropriate Federal Wide Assurance (FWA) and prior
approval by an Institutional Review Board (IRB) recognized and listed
by the OHRP. Funds included in this award may not be used to support
studies using human subjects until evidence of IRB approval has been
received by the IHS GMO. Grantees are expected to provide their own
institutional FWA.
H. Research Integrity
Grantees shall comply with Public Health Service Policies on
Research Misconduct (42 CFR part 93) which require grantees to have
procedures for responding to allegations of research misconduct that
comply with those policies, to submit their procedures to the Office of
Research Integrity (ORI) (http://ori.hhs.gov) upon request for review,
and revise their procedures in accordance with ORI comments. In
addition, grantees shall file the Annual Report on Possible Research
Misconduct with ORI at http://www.ori.dhhs.gov/assurance/electronic_
submission.shtml.
Grantees shall file documentation of their Annual Reports with the
IHS GMO.
I. Healthy People 2010
The Public Health Service (PHS) is committed to achieving the
health promotion and disease prevention objectives of Healthy People
2010, a PHS led national activity for setting priority areas. This RFA
announcement is related to one or more of the priority areas. Potential
applicants may obtain a copy of Healthy People 2010 at: http://
www.healthypeople.gov.
3. Indirect Costs
This section applies to all grant recipients that request
reimbursement of indirect costs in their grant application, but not to
the indirect costs that may be negotiated by the grantees with their
subcontractors (which become direct costs to the grantee). In
accordance with HHS Grants Policy Statement, Part II-27, IHS requires
applicants to have a current indirect cost rate agreement in place
prior to award. The rate agreement must be prepared in accordance with
the applicable cost principles and guidance as provided by the
cognizant agency or office. A current rate means the rate covering the
applicable activities and the award budget period. If the current rate
is not on file with the DGO at the time of award, the indirect cost
portion of the budget will be restricted and not available to the
recipient until the current rate documentation is provided to the DGO.
Generally, indirect costs rates for IHS grantees are negotiated
with the Division of Cost Allocation http://rates.psc.gov/ and/or the
Department of the Interior (National Business Center) http://
www.nbc.gov/acquisition/ics/icshome.html. If your organization has
questions regarding the indirect cost policy, please contact the DGO at
(301) 443-5204.
4. Reporting
A. Progress Report. Program progress reports are required semi-
annually. These reports will include a brief comparison of actual
accomplishments to the goals established for the period, or, if
applicable, provide sound justification for the lack of progress, and
other pertinent information as required. A final annual progress
report, cumulative from the beginning of the project period, must be
submitted within 90 days of expiration of each budget period.
B. Financial Status Report. Quarterly financial status reports must
be submitted within 30 days of the end of each quarter. Final financial
status reports are due within 90 days of expiration of the budget/
project period. Standard Form 269 (long form) will be used for
financial reporting.
C. Reports. Grantees are responsible and accountable for accurate
reporting of the Progress Reports and Financial Status Reports.
Financial Status Reports (SF-269) are due 90 days after each budget
period and the final SF-269 must be verified from the grantee records
on how the value was derived. Grantees must submit reports in a
reasonable period of time.
Failure to submit required reports within the time allowed may
result in
[[Page 78586]]
suspension or termination of an active grant, withholding of additional
awards for the project, or other enforcement actions such as
withholding of payments or converting to the reimbursement method of
payment. Continued failure to submit required reports may result in one
or both of the following: (1) The imposition of special award
provisions; and (2) the non-funding or non-award of other eligible
projects or activities. This applies whether the delinquency is
attributable to the failure of the grantee organization or the
individual responsible for preparation of the reports.
5. Telecommunication for the Hearing Impaired is Available at: TTY
(301) 443-6394.
VII. Agency Contact(s)
1. Questions on the initiative regarding IHS NARCH issues and
policies may be directed to: Alan Trachtenberg, M.D., M.P.H., Division
of Planning, Evaluation and Research, Indian Health Service, 801
Thompson Avenue, TMP Suite 450, Rockville, MD 20852, Phone: (301) 443-
4700, Fax: (301) 443-0114, e-mail: narch@ihs.gov.
2. Questions on grants management and fiscal matters may be
directed to: Sylvia Ryan, Division of Grants Operations, Indian Health
Service, Reyes Building, 801 Thompson Avenue, TMP Suite 350, Rockville,
MD 20852, Phone: (301) 443-5204, Fax: (301) 443-9602, e-mail:
narch@ihs.gov.
3. Questions on NIH and NIGMS issues and policies, may be directed
to: Clifton A. Poodry, Ph.D., Minority Opportunities in Research
Division, National Institute of General Medical Sciences, 45 Center
Drive, Suite 2AS.37, MSC 6200, Bethesda, MD 20892, Phone: (301) 594-
3900, Fax: (301) 480-2753, e-mail: poodryc@nigms.nih.gov.
4. Questions on the review of applications may be directed to:
Mushtaq A. Khan, D.V.M., Ph.D., Chief, Digestive and Respiratory
Sciences IRGs, Center for Scientific Review, MSC 7818, Room 2176; 6701
Rockledge Drive; Bethesda, MD 20892 (20817 for courier or express
service) Phone: (301) 435-1778; Fax: (301) 451-2043; e-mail:
khanm@csr.nih.gov.
VIII. Other Required Documents
If the applicant is a federally-recognized Tribe, Tribal
organization, or a Tribal college, letters of support from the
Chairman, President, Governor, or Tribal Health Director is required of
all Tribes to be served to show their support of the grant project.
Letters of support are intended to document that applicants have Tribal
support for the specific grant for which they are applying. All letters
of support must accompany the grant application.
IX. Other Information
References for Background Information:
Anderson, N.B. Levels of analysis in health science: A framework
for integrating sociobehavioral and biomedical research. Annals of
the New York Academy of Sciences, 1998, 840, 563-576.
Ballantine, B., Ballantine, I. (Eds.), Thomas, D.H., Miller, J.,
White, R., Nabokov, P., Deloria, P.J. (Text by), Joseph, A.M.
(Intro.) The Native Americans: An Illustrated History. Turner
Publishing, Inc. Atlanta, GA, 1993.
Freeman, W.L. The role of community in research with stored
tissue samples. Weir R (Ed.) Stored tissue samples: Ethical, legal,
and public policy implications. University Iowa Press. Iowa City,
IA, 1998, 267-301.
Gazmararian, J.A., Baker, D.W., Williams, M.V., Parker, R.M.,
Scott, T.L., Green, D.C., Fehrenbach, S.N., Ren, J. & Koplan, J.P.
Health literacy among Medicare enrollees in a managed care
organization. Journal of the American Medical Association, 1999,
281, 545-551.
Haynes, M.A. & Smedley, B.D. (Eds.) The Unequal Burden of
Cancer: An Assessment of NIH Programs for Ethnic Minorities and the
Medically Underserved. Institute of Medicine. National Academy
Press. Washington, DC, 1999.
Macaulay, A.C., Commanda, L.E., Freeman, W.L., Gibson, N.,
McCabe, M.L., Robbins, C.M., & Twohig, P.L., (for the) North
American Primary Care Research Group. Participatory research
maximizes community and lay involvement. British Medical Journal,
1999, 319, 774-778.
Minority Economic Profiles. U.S. Bureau of the Census,
Population Division. Issued July 24, 1992. (Tables 1990 CPH-L-92,
93, 94 and 95).
NIH Publication 98-4247. Women of Color Health Data Book. Office
of Research On Women's Health, National Institutes of Health, 1998.
Trends in Indian Health 1998-99. Program Statistics Team, Office
of Public Health, Indian Health Service, 2001.
Regional Differences in Indian Health 1998-99. Program
Statistics Team, Office of Public Health, Indian Health Service,
2000.
Weiss, B.D., Reed, R.L., & Kligman, E.W. Literary skills and
communication methods of low-income older persons. Patient Education
and Counseling, 1995, 25, 109-119.
Williams, D.R. & Collins, C. U.S. Socioeconomic and Racial
Differences in Health: Patterns and Explanations. Annual Review of
Sociology, 1995, 21, 349-386.
Williams, M.V., Parker, R.M., Baker, D.W., Parikh, N.S., Pitkin,
K., Coates, W.C., & Nurss, J.R. Inadequate functional health
literacy among patients at two public hospitals. Journal of the
American Medical Association, 1995, 274, 1677-1682.
Dated: December 15, 2008.
Robert G. McSwain,
Director, Indian Health Service.
[FR Doc. E8-30300 Filed 12-19-08; 8:45 am]
BILLING CODE 4165-16-P