The description below was taken from the R01 version of this FOA.
Although scientific and technological discoveries have improved the health of the U.S. population overall, racial/ethnic minority populations, socioeconomically disadvantaged populations, and rural populations continue to experience a disproportionate burden of disease and other adverse health conditions.
As the Nation’s steward of biomedical and behavioral research, NIH has devoted considerable resources to characterize the root causes of health disparities, uncovering a complex and multi-factorial web of interconnected and overlapping factors (i.e., biological, behavioral, environmental, and societal). As an important next step, research is needed that capitalizes upon this knowledge about causal pathways to directly and demonstrably contribute to the reduction of health disparities. Of particular importance is research that moves beyond an exclusive focus on the health status of individuals to examine and address how larger systemic factors cause, sustain, or minimize health disparities in communities, regions, and the Nation as a whole. Disparities in health care settings are a clear contributor to disparities in health outcomes. Differences in utilization patterns and quality of care indicators between health disparity populations and the general population have been well documented. More work is needed to understand how best to eliminate these inequities.
The purpose of this FOA is to encourage system-level health services research that can directly contribute to the improvement of minority health and/or the reduction of health disparities in health care settings.
Research encouraged under this FOA includes examination of health care services in health care systems such as private and public health insurance plans; physician groups; hospitals, nursing homes and assisted living facilities; academic medical centers; integrated delivery systems; and criminal justice settings. Projects may address health services pertaining to the treatment of particular health conditions, multiple health conditions, specific segments of the population, or more general indicators (e.g., access to primary care services, etc.) that may not be condition-specific. Projects may include observational/descriptive, simulation, or interventional studies and may involve primary data collection and/or secondary analysis of existing datasets. It is expected that all projects will involve the use of relevant health system-level data in some way. Projects that also use patient-reported data are encouraged, but projects that rely exclusively on patient-reported data are not a programmatic priority for funding under this FOA. Projects should include a focus on one or more NIH-designated health disparities populations, which include Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asian Americans, Native Hawaiians and other Pacific Islanders, socioeconomically disadvantaged populations, and underserved rural populations.
The focus of this FOA is on system-wide health services research that encompasses the diversity of individuals served within these systems. It is expected that projects will include patient or participant samples that are representative of the population served by the particular health care system(s). Projects that focus on individual clinics or other treatment settings in isolation of the larger system(s) in which they are embedded are not a programmatic priority for funding under this FOA; examples of such projects include but are not limited to the following:
- Projects that recruit participants from health care systems but do not involve the examination of the organization, operation, or service delivery of those systems.
- Projects that test interventions, procedures, or service delivery approaches in a single health care setting, such an individual clinic. This applies to multi-site studies as well, if the sites reflect individual clinical sites rather than the larger health care systems to which they belong.
- Projects that include a single hospital may be considered if hospital-wide services or practices are examined (e.g., the incorporation of automated patient/provider reminders in Electronic Health Records) rather one particular clinic or service within the hospital.
Note: Projects that examine the financing of health care or the cost and efficiency of health care service delivery, without linking such economic analysis to measurable health outcomes, are considered outside of NIH’s mission and will not be supported. See NOT-OD-16-025 for more information.
Research topics of specific interest include but are not limited to:
- Strategies to organize, manage, finance, and deliver health care to improve minority health or reduces health disparities.
- Health information technologies to improve access to or utilization of health care services and/or improve quality of care.
- Strategies to ensure that health disparity populations receive clinical preventive services consistent with national evidence-based recommendations.
- Strategies to ensure that health disparity populations receive clinical services consistent with national evidence-based recommendations for management of specific chronic conditions, such as but not limited to diabetes mellitus, coronary artery disease, cerebrovascular disease, cognitive impairment, asthma, and mental and substance use disorders.
- Strategies to improve patient safety and reduce medical errors in health disparity populations.
- The use of allied health professionals, paraprofessionals or peer-led health services to supplement existing health care services.
- Interventions to improve cultural competence of clinicians that demonstrate a clear link to improvement in patient outcomes.
- Strategies to improve quality of health care for individuals with limited-English proficiency.
- Analysis of efforts to implement National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards).
- Analysis of local, state, or national policies relevant to health care systems that increase or reduce health disparities, such as those related to insurance coverage or reimbursement, language access policies, or organization of government-run or -funded health care services.
- Analysis of initiatives to increase the supply of health care practitioners in medically underserved areas.
- The incorporation of specific research tools or methodologies into system-level service delivery practices that identify or measure patient reported outcomes such as health-related quality of life, preference-based decision making, functional status, symptoms and adherence in health disparity populations.
- Simulations that model the interaction of patient-, clinician-, system-,and community-level factors impacting health disparity outcomes to identify appropriate targets for intervention.
In addition to the topics above, NIDA has a specific interest in the following topics:
- Strategies to integrate evidence-based drug abuse and related behavioral health prevention interventions for health disparity populations into health care systems with supports for implementation and sustainability, including health system/community collaborations.
- Strategies that leverage expansion of behavioral health prevention services under health reform to reduce health disparities, including those that take advantage of requirements for community health needs assessment and delivery of health services through the community benefit.
- Strategies to improve the appropriateness, effectiveness, safety, and efficiency of prevention, treatment, and recovery interventions, and services delivered to individuals in a variety of settings including substance abuse and mental health treatment programs; schools; general health care settings; criminal and juvenile justice systems; child welfare systems, and social service agencies.
- Implementation Research studies that seek to explain and ultimately improve the uptake of evidence-based prevention and treatment practices, including HIV prevention and treatment in real-world service delivery settings.
- Studies that may have implications of policy change for service quality; such research may examine the impact (including unintended consequences) of local, state, and/or national policies that affect the organization or management of prevention and treatment services on quality of care and patient access, utilization, retention, and outcomes.
Deadlines: August 9, 2016; April 11, 2017; April 11, 2018; April 11, 2019 (both FOAs)
Filed Under: Funding Opportunities