RESEARCH ON PSYCHOPATHOLOGY IN INTELLECTUAL DISABILITIES (MENTAL RETARDATION)

RELEASE DATE:  December 23, 2003

PA NUMBER:  PA-04-044

Update:
-March 2, 2006 (NOT-OD-06-046) – Effective with the June 1, 2006 submission date, 
all R03, R21, R33 and R34 applications must be submitted through Grants.gov using 
the electronic SF424 (R&R) application. This announcement will stay active for 
only the May 1, 2006 AIDS and AIDS-related application submission date for these 
mechanisms. The non-AIDS portion of this funding opportunity for these mechanisms 
expires on the date indicated below. Other mechanisms relating to this announcement 
will continue to be accepted using paper PHS 398 applications until the stated 
expiration date below, or transition to electronic application submission. Parent 
R03 (PA-06-180) and R21 (PA-06-181) funding opportunity announcements have been 
issued for the submission date of June 1, 2006 and submission dates for AIDS and 
non-AIDS applications thereafter. Applications relating to R33 and R34 activities 
must be in response to NIH Institute/Center (IC)-specific announcements.

-This PA has been reissued as PA-06-431 for submission of R01 applications as of 
May 23, 2006

EXPIRATION DATE for R03 and R21 Non-AIDS Applications: March 2, 2006
EXPIRATION DATE for R03 and R21 AIDS and AIDS-Related Applications: May 2, 2006 
EXPIRATION DATE for R01 Applications: May 23, 2006
EXPIRATION DATE for R01 Collaborative Applications: October 2006, unless reissued.


Department of Health and Human Services (DHHS)

PARTICIPATING ORGANIZATION:
National Institutes of Health (NIH)
 (http://www.nih.gov)

COMPONENT OF PARTICIPATING ORGANIZATION:
National Institute of Mental Health (NIMH)
 (http://www.nimh.nih.gov)

CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER(S):  93.242

THIS PA CONTAINS THE FOLLOWING INFORMATION

o  Purpose of the PA
o  Research Objectives
o  Mechanism(s) of Support
o  Eligible Institutions
o  Individuals Eligible to Become Principal Investigators
o  Where to Send Inquiries
o  Submitting an Application
o  Peer Review Process
o  Review Criteria
o  Award Criteria
o  Required Federal Citations

PURPOSE OF THIS PA

This Program Announcement replaces PA-01-028.

The National Institute of Mental Health (NIMH) invites research grant applications 
for research designed to elucidate the epidemiology, etiology, treatment, and 
prevention of mental disorders, including emotional and behavioral problems, in 
persons of any age with intellectual disabilities (mental retardation).  This 
announcement uses the preferred term “intellectual disabilities” to designate 
conditions that in the past have been referred to with the term “mental 
retardation”, thus these two terms are to be understood as equivalent.

Though precise epidemiological data regarding persons with both mental illness and 
intellectual disabilities are not available, clinical experience has shown that the 
full range of psychiatric disorders can be found among individuals with 
intellectual disabilities.  This includes co-occurrence with schizophrenia, 
affective disorders, obsessive-compulsive disorder, anxiety disorders, and behavior 
disturbances with injurious and aggressive behavior directed towards self, others, 
or objects.  Proper identification and effective treatment of these mental 
disorders are especially important for people with intellectual disabilities.  In 
fact, while it is usually not possible to correct and reverse the underlying 
cognitive deficits, treatment of the behavioral and emotional problems often 
associated with intellectual disabilities can significantly improve functioning and 
quality of life.

Both basic research into the pathogenesis of mental disorders among individuals 
with intellectual disabilities and studies aimed at clinical diagnosis, treatment, 
rehabilitation, and service delivery are of interest.  This initiative calls for 
more research on:  (1) the prevalence rates of mental and emotional disturbance 
among persons with intellectual disabilities; (2) the improvement of current 
diagnostic categories and the development of appropriate psychiatric assessment 
instruments for use with persons who are mentally retarded; (3) the precursors of 
childhood behavioral and emotional disorders in children who are mentally retarded 
or who are at risk for intellectual disabilities; (4) the effectiveness of mental 
health services for persons with intellectual disabilities, including the 
monitoring of drug effects and methods for enhancing treatment compliance while 
living in the community or attending special education classes; (5) early 
intervention programs designed to prevent emotional and behavioral problems in 
infants with intellectual disabilities; (6) integrated service delivery models that 
provide a range of supportive and therapeutic services to those suffering from both 
mental illness and intellectual disabilities; and (7) translation of basic 
neuroscience findings into clinical applications and development of novel 
approaches to diagnosing and treating mental illness in the context of intellectual 
disabilities.

Although intellectual disabilities and autism often co-occur, a separate program 
announcement is relevant for investigators interested in autism:  RESEARCH ON 
AUTISM AND AUTISM SPECTRUM DISORDERS (PA-01-051).  (See
http://grants.nih.gov/grants/guide/pa-files/PA-01-051.html)

The research objectives of this PA have been stimulated by meetings held during the 
past few years.  These include:

A workshop entitled Emotional and Behavioral Health in Persons with Mental 
Retardation/Developmental Disabilities (November 29 -December 1, 2001) was convened 
by the National Institute of Neurological Disorders and Stroke (NINDS), the 
National Institute of Child Health and Human Development (NICHD), the National 
Institute of Mental Health (NIMH), the National Institutes of Health (NIH) Office 
of Rare Diseases, and the Joseph P. Kennedy Jr. Foundation.  A report of this 
workshop can be found at 
http://www.ninds.nih.gov/news_and_events/proceedings/Emotional_Behavioral_Health_2001.htm

A workshop entitled Mental Health Aspects of Fragile X Syndrome: Treatment Research 
Perspectives (November 16-17, 2001) was convened by the NIMH and the FRAXA 
Foundation.  A report of this workshop can be found at 
http://www.nimh.nih.gov/research/fragilex.cfm

A conference entitled Closing the Gap: A National Blueprint to Improve the Health 
of Persons with Mental Retardation (2002), was convened by the United States 
Surgeon General.  A report of the Surgeon General's Conference on Health 
Disparities and Mental Retardation can be found at 
http://www.nichd.nih.gov/publications/pubs/closingthegap/index.cfm

RESEARCH OBJECTIVES

Background

Prevalence estimates of mental and emotional disturbance among persons with 
intellectual disabilities in community and institutional settings vary widely 
depending on how the data were collected.  The most often quoted figures indicate 
that mental disorders occur substantially more often in persons with intellectual 
disabilities than they do in populations without intellectual disabilities.

Among the reasons for the difficulty in estimating these prevalence rates are 
sampling bias due to self-selection and difficulty in making reliable and valid 
psychiatric diagnoses. Research designs that can remedy these and other problems 
are needed.  Inherent in efforts to improve our knowledge of the epidemiology of 
emotional disturbance among persons with intellectual disabilities is the 
development of more valid approaches to identifying mental disorders in the context 
of intellectual disabilities.

One of the most important elements in prevention of mental disorders among 
individuals with intellectual disabilities is early identification.  Research that 
can illuminate the precursors of childhood behavioral and emotional disorders in 
children who are mentally retarded or who are at risk for intellectual disabilities 
is lacking.  Early identification and diagnosis of co-existing mental and emotional 
disorders in those with intellectual disabilities may provide an opportunity for 
early intervention and mitigation of psychopathology.

Since many individuals with intellectual disabilities are already receiving 
treatment and support services, the development of effective regimens for treatment 
of behavioral and emotional dysfunction is of high priority.  For instance, many 
individuals with intellectual disabilities are treated with psychotropic 
medications, but very few studies of the effectiveness of these interventions have 
been conducted.  Careful analysis of both positive and negative effects of these 
drugs, such as effects on learning and adaptive behaviors, or emergence of tardive 
dyskinesia and other unwanted side effects, is especially needed.

Persons with intellectual disabilities who also exhibit emotional problems may 
present great difficulties to their families, whether they live at home or 
elsewhere.  Research on family structure, process, and interaction may illuminate 
ways in which family-focused treatment and intervention programs might be devised.

One of the most difficult problems faced by persons with intellectual disabilities 
and emotional disturbance is their relationship with the service delivery systems.  
Since many local jurisdictions have separate service systems for those with 
intellectual disabilities and mental illness, the extent of coordination between 
these systems is an important area for study.

Some illustrative examples of research topics that may be addressed under this 
program announcement are:

o  Research on prevalence estimates of mental and emotional disturbance in the 
mentally retarded that controls for common problems such as sampling bias due to 
self-selection and difficulty in making reliable and valid psychiatric diagnoses

o  Developing animal models to explore how genetic abnormalities give rise to 
intellectual disabilities

o  Research on genetic and environmental factors that influence the heritability of 
cognitive and behavioral traits, and treatment outcomes

o  Research using neuroimaging techniques to assess treatment outcomes

o  Research that identifies behavioral features, emotional problems, and 
psychiatric diagnoses and increases understanding of the interaction between genes, 
brain, and behavior in specific neurodevelopmental syndromes that are typically 
accompanied by intellectual disabilities, such as Down syndrome, Fragile X, and 
Prader Willi syndrome

o  Longitudinal studies that describe the developmental trajectory of behavior and 
skill acquisition in genetic disorders or syndromes associated with intellectual 
and developmental disabilities

o  Developing and adapting appropriate diagnostic instruments and procedures 
applicable to individuals with intellectual disabilities and developmental 
disabilities and improving the validity of the diagnosis of mental disorders in 
persons with intellectual disabilities

o  Understanding the factors of prenatal and perinatal pathophysiology as well as 
psychosocial and ecological variables that might precede, mediate or moderate the 
emergence of emotional and behavioral disorders in children with intellectual 
disabilities

o  Developing and testing early intervention programs designed to prevent emotional 
and behavioral problems in infants and young children with intellectual 
disabilities, using a variety of research methodologies

o  Studying the precursors of childhood behavioral and emotional disorders in 
children who are mentally retarded or who are at risk for intellectual disabilities

o  Developing treatment interventions for individuals with intellectual 
disabilities who suffer from behavioral and emotional dysfunction, and testing 
their effectiveness

o  Comparing the relative effectiveness of behavioral, psychosocial, educational, 
natural supports, and pharmacological treatment programs and their combinations for 
individuals with intellectual disabilities who suffer from behavioral and emotional 
dysfunction

o  Careful analysis of both positive and negative effects of psychotropic 
medications.
 
o  Studying how manifestations of particular emotional, behavioral and psychiatric 
disorders and the response to treatment may vary as a function of cognitive or 
functional disability or developmental level

o  Studying how the applications of human subject protection provisions including 
the “Common Rule,” “minimal risk rule” and informed consent process impact research 
in persons with intellectual disabilities 

o  Studying the effectiveness of mental health services for persons with 
intellectual disabilities

o  Developing and testing methods for enhancing treatment compliance while living 
in the community or attending special education classes

o  Examining family structure, process, and interaction in order to 
illuminate ways in which family-focused treatment and intervention programs might 
be devised

o  Examining models of family involvement in delivery of services

o  Identifying and characterizing individual, family, and/or cultural factors that 
facilitate or impede early identification, detection, and treatment of mental 
illness in persons with intellectual disabilities

o  Identifying and characterizing current practice patterns for persons with 
intellectual disabilities with chronic and impairing mental illness, studying 
variables that affect quality of care, and developing and testing interventions 
designed to improve quality of care for persons with these disorders

o  Comparing family-driven service delivery with provider-driven services 

o  Investigating integrated service delivery models that provide a range of 
supportive and therapeutic services to persons suffering from both mental illness 
and intellectual disabilities (may include broad survey studies as well as smaller, 
more focused clinical investigations)

o  Examining the cost-effectiveness of various models of coordinated services

MECHANISM(S) OF SUPPORT

This PA will use the NIH Research Project Grant (R01), Collaborative R01, 
Exploratory/Development Grant (R21), Clinical Trial Planning Grant (R34), and Small 
Research Grant (R03) award mechanisms.  As an applicant, you will be solely 
responsible for planning, directing, and executing the proposed project.

The total project period for an R01 application submitted in response to this PA 
may not exceed five years.  Awards made under the R21, R34, and R03 support 
mechanisms are not renewable past the original project period.

The Small Grant (R03) provides 2 years of funding with a maximum of $50,000 direct 
costs for each year.  Instructions for the R03 application can be found at 
(http://grants.nih.gov/grants/guide/pa-files/PA-03-108.html).

The Exploratory/Developmental Grant (R21) provides 2 years of funding with a 
maximum of $275,000 direct costs over the entire budget period; with no 1 year 
exceeding $200,000.  Instructions for the R21 application may be found at:  
http://grants.nih.gov/grants/guide/pa-files/PA-03-107.html.

The R34 mechanism provides up to $450,000 direct costs for 3 years with no one year 
exceeding $225,000 for research on 1) the development and/or pilot testing of new 
or adapted interventions, 2) pilot testing interventions with demonstrated efficacy 
in broader scale effectiveness trials, or 3) innovative services research 
directions that require preliminary testing or development.  Instructions for R34 
applications can be found at 
(http://grants.nih.gov/grants/guide/pa-files/PAR-03-078.html).

This PA uses just-in-time concepts.  It also uses the modular budgeting as well as 
the non-modular budgeting formats (see 
http://grants.nih.gov/grants/funding/modular/modular.htm).  Specifically, if you 
are submitting an application with direct costs in each year of $250,000 or less, 
use the modular budget format.  Otherwise follow the instructions for non-modular 
budget research grant applications.  This program does not require cost sharing as 
defined in the current NIH Grants Policy Statement at 
http://grants.nih.gov/grants/policy/nihgps_2001/part_i_1.htm.

ELIGIBLE INSTITUTIONS

You may submit (an) application(s) if your institution has any of the following 
characteristics:

o  For-profit or non-profit organizations
o  Public or private institutions, such as universities, colleges, hospitals, and 
laboratories
o  Units of State and local governments
o  Eligible agencies of the Federal government
o  Domestic or foreign institutions/organizations
o  Faith-based or community-based organizations

INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS

Any individual with the skills, knowledge, and resources necessary to carry out the 
proposed research is invited to work with their institution to develop an 
application for support.  Individuals from underrepresented racial and ethnic 
groups as well as individuals with disabilities are always encouraged to apply for 
NIH programs.

WHERE TO SEND INQUIRIES

We encourage your inquiries concerning this PA and welcome the opportunity to 
answer questions from potential applicants.  Inquiries may fall into two areas:  
scientific/research and financial or grants management issues:

o  Direct your questions about scientific/research issues to:

Rebecca DelCarmen-Wiggins, Ph.D.
Division of Mental Disorders, Behavioral Research and AIDS
National Institute of Mental Health
6001 Executive Boulevard, Room 6191, MSC 9617
Bethesda, MD  20892-9617
Telephone:  (301) 443-9230
FAX:  (301) 480-4415
Email:  rdelcarm@mail.nih.gov

Edgardo Menvielle, M.D.
Division of Services and Intervention Research
National Institute of Mental Health
6001 Executive Boulevard, Room 7147, MSC 9633
Bethesda, MD  20892-9633
Telephone:  (301) 443-4283 
FAX:  (301) 443-4045 
Email:  emenviel@mail.nih.gov

o  Direct your questions about financial or grants management matters to:

Joy R. Knipple
Grants Management Branch
National Institute of Mental Health
6001 Executive Boulevard, Room 6115, MSC 9605
Bethesda, MD  20892-9605
Telephone:  (301) 443-8811
FAX:  (301) 443-6885
Email:  jk173r@nih.gov

SUBMITTING AN APPLICATION

Applications must be prepared using the PHS 398 research grant application 
instructions and forms (rev. 5/2001).  Applications must have a Dun and Bradstreet 
(D&B) Data Universal Numbering System (DUNS) number as the Universal Identifier 
when applying for Federal grants or cooperative agreements.  The DUNS number can be 
obtained by calling (866) 705-5711 or through the web site at 
http://www.dunandbradstreet.com/.  The DUNS number should be entered on line 11 of 
the face page of the PHS 398 form.  The PHS 398 is available at 
http://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive format.  
For further assistance contact GrantsInfo, Telephone (301) 435-0714, Email: 
GrantsInfo@nih.gov.

The title and number of this program announcement must be typed on line 2 of the 
face page of the application form and the YES box must be checked.

APPLICATION RECEIPT DATES:  Applications submitted in response to this program 
announcement will be accepted at the standard application deadlines, which are 
available at http://grants.nih.gov/grants/dates.htm.  Application deadlines are 
also indicated in the PHS 398 application kit.

SPECIFIC INSTRUCTIONS FOR MODULAR BUDGET GRANT APPLICATIONS:  Applications 
requesting up to $250,000 per year in direct costs must be submitted in a modular 
budget grant format.  The modular budget grant format simplifies the preparation of 
the budget in these applications by limiting the level of budgetary detail.  
Applicants request direct costs in $25,000 modules.  Section C of the research 
grant application instructions for the PHS 398 (rev. 5/2001) at 
http://grants.nih.gov/grants/funding/phs398/phs398.html includes step-by-step 
guidance for preparing modular grants.  Additional information on modular grants is 
available at http://grants.nih.gov/grants/funding/modular/modular.htm.

SPECIFIC INSTRUCTIONS FOR APPLICATIONS REQUESTING $500,000 OR MORE PER YEAR:  
Applications requesting $500,000 or more in direct costs for any year must include 
a cover letter identifying the NIH staff member within one of NIH institutes or 
centers who has agreed to accept assignment of the application.

Applicants requesting more than $500,000 must carry out the following steps:

1) Contact the IC program staff at least 6 weeks before submitting the application, 
i.e., as you are developing plans for the study;

2) Obtain agreement from the IC staff that the IC will accept your application for 
consideration for award; and,

3) Identify, in a cover letter sent with the application, the staff member and IC 
who agreed to accept assignment of the application.

This policy applies to all investigator-initiated new (type 1), competing 
continuation (type 2), competing supplement, or any amended or revised version of 
these grant application types.  Additional information on this policy is available 
in the NIH Guide for Grants and Contracts, October 19, 2001 at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-004.html.

SENDING AN APPLICATION TO THE NIH:  Submit a signed, typewritten original of the 
application, including the checklist, and five signed photocopies in one package 
to:

Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (for express/courier service)

APPLICATION PROCESSING:  Applications must be mailed on or before the receipt dates 
described at http://grants.nih.gov/grants/funding/submissionschedule.htm.  The CSR 
will not accept any application in response to this PA 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 a substantial 
revision of an unfunded version of an application already reviewed, but such 
application must include an Introduction addressing the previous critique.

Although there is no immediate acknowledgement of the receipt of an application, 
applicants are generally notified of the review and funding assignment within 8 
weeks.

PEER REVIEW PROCESS

Applications submitted for this PA will be assigned on the basis of established PHS 
referral guidelines.  Appropriate scientific review groups convened in accordance 
with the standard NIH peer review procedures (http://www.csr.nih.gov/refrev.htm) 
will evaluate applications for scientific and technical merit.

As part of the initial merit review, all applications will:

o  Undergo a selection process in which only those applications deemed to have the 
highest scientific merit, generally the top half of applications under review, will 
be discussed and assigned a priority score
o  Receive a written critique
o  Receive a second level review by the appropriate national advisory council or 
board

REVIEW CRITERIA

The goals of NIH-supported research are to advance our understanding of biological 
systems, improve the control of disease, and enhance health.  In the written 
comments, reviewers will be asked to evaluate application in order to judge the 
likelihood that the proposed research will have a substantial impact on the pursuit 
of these goals.  The scientific review group will address and consider each of the 
following criteria in assigning the application’s overall score, weighting them as 
appropriate for each application.

o  Significance
o  Approach
o  Innovation
o  Investigator
o  Environment

The application does not need to be strong in all categories to be judged likely to 
have major scientific impact and thus deserve a high priority score.  For example, 
an investigator may propose to carry out important work that by its nature is not 
innovative but is essential to move a field forward.

SIGNIFICANCE:  Does this study address an important problem?  If the aims of the 
application are achieved, how will scientific knowledge be advanced?  What will be 
the effect of these studies on the concepts or methods that drive this field?

APPROACH:  Are the conceptual framework, design, methods, and analyses adequately 
developed, well-integrated, and appropriate to the aims of the project?  Does the 
applicant acknowledge potential problem areas and consider alternative tactics?

INNOVATION:  Does the project employ novel concepts, approaches or methods?  Are 
the aims original and innovative? Does the project challenge existing paradigms or 
develop new methodologies or technologies?

INVESTIGATOR:  Is the investigator 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 (if any)?

ENVIRONMENT:  Does the scientific environment in which the work will be done 
contribute to the probability of success?  Do the proposed experiments take 
advantage of unique features of the scientific environment or employ useful 
collaborative arrangements?  Is there evidence of institutional support?

ADDITIONAL REVIEW CRITERIA:  In addition to the above criteria, the following items 
will be considered in the determination of scientific merit and the priority score:

PROTECTION OF HUMAN SUBJECTS FROM RESEARCH RISK:  The involvement of human subjects 
and protections from research risk relating to their participation in the proposed 
research will be assessed. (See criteria included in the section on Federal 
Citations, below).http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm

INCLUSION OF WOMEN, MINORITIES AND CHILDREN IN RESEARCH:  The adequacy of plans to 
include subjects from both genders, all racial and ethnic groups (and subgroups), 
and children as appropriate for the scientific goals of the research will be 
assessed.  Plans for the recruitment and retention of subjects will also be 
evaluated. (See Inclusion Criteria in the sections on Federal Citations, below).

CARE AND USE OF VERTEBRATE ANIMALS IN RESEARCH:  If vertebrate animals are to be 
used in the project, the five items described under Section f of the PHS 398 
research grant application instructions (rev. 5/2001) will be assessed.

ADDITIONAL REVIEW CONSIDERATIONS

SHARING RESEARCH DATA:  Applicants requesting more than $500,000 in direct costs in 
any year of the proposed research are expected to include a data sharing plan in 
their application.  The reasonableness of the data sharing plan or the rationale 
for not sharing research data will be assessed by the reviewers.  However, 
reviewers will not factor the proposed data sharing plan into the determination of 
scientific merit or priority score.  A description of the requirements can be found 
at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-032.html.

BUDGET:  The reasonableness of the proposed budget and the requested period of 
support in relation to the proposed research.

AWARD CRITERIA

Applications submitted in response to a PA will compete for available funds with 
all other recommended applications.  The following will be considered in making 
funding decisions:

o  Scientific merit of the proposed project as determined by peer review
o  Availability of funds
o  Relevance to program priorities

REQUIRED FEDERAL CITATIONS

HUMAN SUBJECTS PROTECTION:  Federal regulations (45CFR46) 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.
http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm

DATA AND SAFETY MONITORING PLAN: Data and safety monitoring is required for all 
types of clinical trials, including physiologic, toxicity, and dose-finding studies 
(phase I); efficacy studies (phase II), efficacy, effectiveness and comparative 
trials (phase III).  The establishment of data and safety monitoring boards (DSMBs) 
is required for multi-site clinical trials involving interventions that entail 
potential risk to the participants.  (NIH Policy for Data and Safety Monitoring, 
NIH Guide for Grants and Contracts, June 12, 1998: 
http://grants.nih.gov/grants/guide/notice-files/not98-084.html).

SHARING RESEARCH DATA:  Starting with the October 1, 2003 receipt date, 
investigators submitting an NIH application seeking more than $500,000 in direct 
costs in any single year are expected to include a plan for data sharing or state 
why this is not possible (http://grants.nih.gov/grants/policy/data_sharing).  
Investigators should seek guidance from their institutions, on issues related to 
institutional policies, local IRB rules, as well as local, state and Federal laws 
and regulations, including the Privacy Rule.  Reviewers will consider the data 
sharing plan but will not factor the plan into the determination of the scientific 
merit or the priority score.

INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH:  It is the policy of the 
NIH that women and members of minority groups and their sub-populations must be 
included in all NIH-supported clinical research projects unless a clear and 
compelling justification is provided indicating 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 Public Law 
103-43).

All investigators proposing clinical research should read the "NIH Guidelines for 
Inclusion of Women and Minorities as Subjects in Clinical Research - Amended, 
October, 2001," published in the NIH Guide for Grants and Contracts on October 9, 
2001
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html); a 
complete copy of the updated Guidelines are available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.  The 
amended policy incorporates: the use of an NIH definition of clinical research; 
updated racial and ethnic categories in compliance with the new OMB standards; 
clarification of language governing NIH-defined Phase III clinical trials 
consistent with the new PHS Form 398; and updated roles and responsibilities of NIH 
staff and the extramural community.  The policy continues to require for all NIH-
defined Phase III clinical trials that: a) all applications or proposals and/or 
protocols must 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 b) investigators must report annual accrual and 
progress in conducting analyses, as appropriate, by sex/gender and/or racial/ethnic 
group differences.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS:  The 
NIH maintains a policy 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 and ethical reasons not to include them.  This policy 
applies to all initial (Type 1) applications submitted for receipt dates after 
October 1, 1998.

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 is available at 
http://grants.nih.gov/grants/funding/children/children.htm.

REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS:  NIH policy 
requires education on the protection of human subject participants for all 
investigators submitting NIH proposals for research involving human subjects.  You 
will find this policy announcement in the NIH Guide for Grants and Contracts 
Announcement, dated June 5, 2000, at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

HUMAN EMBRYONIC STEM CELLS (hESC):  Criteria for federal funding of research on 
hESCs can be found at http://stemcells.nih.gov/index.asp and at  
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html.  Only research 
using hESC lines that are registered in the NIH Human Embryonic Stem Cell Registry 
will be eligible for Federal funding (see http://escr.nih.gov).  It is the 
responsibility of the applicant to provide, in the project description and 
elsewhere in the application as appropriate, the official NIH identifier(s)for the 
hESC line(s)to be used in the proposed research.  Applications that do not provide 
this information will be returned without review.

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT:  The Office 
of Management and Budget (OMB) Circular A-110 has been revised to provide public 
access to research data through the Freedom of Information Act (FOIA) under some 
circumstances.  Data that are (1) first produced in a project that is supported in 
whole or in part with Federal funds and (2) cited publicly and officially by a 
Federal agency in support of an action that has the force and effect of law (i.e., 
a regulation) may be accessed through FOIA.  It is important for applicants to 
understand the basic scope of this amendment.  NIH has provided guidance at 
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.

Applicants may wish to place data collected under this PA in a public archive, 
which can provide protections for the data and manage the distribution for an 
indefinite period of time.  If so, the application should include a description of 
the archiving plan in the study design and include information about this in the 
budget justification section of the application.  In addition, applicants should 
think about how to structure informed consent statements and other human subjects 
procedures given the potential for wider use of data collected under this award.

STANDARDS FOR PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION:  The 
Department of Health and Human Services (DHHS) issued final modification to the 
“Standards for Privacy of Individually Identifiable Health Information”, the 
“Privacy Rule,” on August 14, 2002.  The Privacy Rule is a federal regulation under 
the Health Insurance Portability and Accountability Act (HIPAA) of 1996 that 
governs the protection of individually identifiable health information, and is 
administered and enforced by the DHHS Office for Civil Rights (OCR). Those who must 
comply with the Privacy Rule (classified under the Rule as “covered entities”) must 
do so by April 14, 2003 (with the exception of small health plans which have an 
extra year to comply).

Decisions about applicability and implementation of the Privacy Rule reside with 
the researcher and his/her institution.  The OCR website (http://www.hhs.gov/ocr/) 
provides information on the Privacy Rule, including a complete Regulation Text and 
a set of decision tools on “Am I a covered entity?”.  Information on the impact of 
the HIPAA Privacy Rule on NIH processes involving the review, funding, and progress 
monitoring of grants, cooperative agreements, and research contracts can be found 
at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-025.html.

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.  Furthermore, we caution reviewers that 
their anonymity may be compromised when they directly access an Internet site.

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 PA 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/.

AUTHORITY AND REGULATIONS:  This program is described in the Catalog of Federal 
Domestic Assistance at http://www.cfda.gov/ and is not subject to the 
intergovernmental review requirements of Executive Order 12372 or Health Systems 
Agency review.  Awards are made under the authorization of Sections 301 and 405 of 
the Public Health Service Act as amended (42 USC 241 and 284) and under Federal 
Regulations 42 CFR 52 and 45 CFR Parts 74 and 92.  All awards are subject to the 
terms and conditions, cost principles, and other considerations described in the NIH 
Grants Policy Statement.  The NIH Grants Policy Statement can be found at 
http://grants.nih.gov/grants/policy/policy.htm

The PHS strongly encourages all grant recipients to provide a smoke-free workplace 
and discourage the use of all tobacco products.  In addition, Public Law 103-227, 
the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some 
cases, any portion of a facility) in which regular or routine education, library, 
day care, health care, or early childhood development services are provided to 
children.  This is consistent with the PHS mission to protect and advance the 
physical and mental health of the American people.

Weekly TOC for this Announcement
NIH Funding Opportunities and Notices

	Office of Extramural Research (OER)			National Institutes of Health (NIH) 9000 Rockville Pike Bethesda, Maryland 20892			Department of Health and Human Services (HHS)
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