NIH – Addressing Health Disparities through Effective Interventions among Immigrant Populations (R01, R21 Clinical Trial Optional)

November 6, 2017 by School of Medicine Webmaster


The following description was taken from the R01 version of this re-issued FOA:

Given the scientific literature documenting health inequities among immigrant populations, this announcement calls for research focusing on the design and implementation of effective interventions that will address immigrant-specific factors to reduce health disparities among immigrants, particularly among migrant workers, recent and 1st generation immigrants.

The intervention research under this FOA should be aimed at improving the health outcome among immigrant groups by targeting the causes or consequences of health disparities. Multi-level interventions that include a combination of individual, group (such as peers, family members, etc.), and/or community-level intervention components have been shown to be effective in improving health outcomes. Therefore, this FOA strongly encourages multi-level interventions (i.e., ranging from individuals to societies) in addressing immigrant health disparities.

A life-course perspective is encouraged with interventions focusing attention on transition points across the lifespan and associated risk and protective factors for immigrant populations. Such an approach emphasizes the fact that early life disadvantage need not lead to later negative health outcomes, provided there are compensating experiences in the intervening years. This would also allow consideration of the reasons and the conditions under which the individuals migrated to the U.S.  Attention should be given to the positive aspects of lives of immigrants that may buffer the effects of adversity.

Projects should involve collaborations among relevant stakeholders in US immigrant population groups, such as researchers, community organizations, healthcare providers, public health organizations, consumer advocacy groups, and faith-based organizations.  As appropriate for the research questions posed, inclusion of key immigrant community members in the conceptualization, planning and implementation of the research is encouraged (but not required) to generate better-informed hypotheses and enhance the translation of the research results into practice.

Interventions that are culturally sensitive and community based addressing population level factors to overcome barriers to improve overall health and reduce health disparities among immigrants are encouraged. Research projects are encouraged to utilize rigorous innovative multidisciplinary approaches including biological assessments (such as genomics, epigenomics, microbiome, telomere length, allostatic load, or other biomarkers) to show whether they may serve as measurable indicators for excess risk or health outcomes. Interventions that include health information technology applications (e.g. behavior monitoring tools, decision aids, health information portals, etc.) and/or social media elements to improve immigrant health are encouraged. Studies to conduct only needs assessments or interventions designed to increase knowledge as a sole outcome will not be supported under this FOA.

The focus of this FOA is specifically on immigrants who, once residing in the U.S., belong to one or more U.S. racial/ethnic minority populations (i.e. Blacks/African Americans, Hispanics/Latinos, Asians, or Pacific Islanders). Research is encouraged among distinct immigrant sub-populations based on the country of origin, rather than larger racial/minority populations when feasible (e.g., Koreans, Vietnamese, Cambodian, etc., rather than Asian Americans). For projects involving comparisons across populations, these comparisons should illuminate immigrant-specific phenomena rather than representing more global comparisons between immigrants with the non-Hispanic whites or the US general population. Examples of appropriate comparisons include:

  • immigrant subgroups within the same racial/ethnic minority group (e.g., Nicaraguan immigrants vs. Mexican immigrants)
  • immigrants across racial/ethnic minority groups that share similar experiences in the US (e.g. Asian immigrant garment workers vs. Latino immigrant garment workers)
  •  immigrants with their US-born counterparts (Chinese immigrants vs. US-born Chinese Americans)

For this FOA, residents of U.S. territories (Guam, Puerto Rico, American Samoa, Commonwealth of the Northern Mariana Islands, and US Virgin Islands) who migrate to the U.S. mainland are also considered as immigrants. Research on refugees is not supported under this FOA.

Specific Areas of Research Interest

Research topics of specific interest on interventions may include but are not limited to:

  • Improve health care access and utilization among newly arrived immigrant populations or migrant workers and 1st generation immigrants;
  • Address stress related to stigma, discrimination, social isolation, other experiences faced by immigrants that affect health;
  • Address adversity and chronic stress that result in worsened health outcomes;
  • Address culture specific beliefs and practices for health promotion and disease prevention among various immigrant sub-populations, specifically where traditional health practices may be the preferred and/or used with western healthcare systems;
  • Develop culturally consistent ways of treating and/or preventing the spread of infectious diseases that increase health risks among recent immigrants or migrant workers or immigrants that travel back and forth between the US and the native country;
  • Utilize technology to address language and other barriers in accessing health care and health information among immigrant populations with limited English proficiency;
  • Design and implement culturally appropriate strategies to address immigrant specific risk factors to improve the health and quality of life of immigrant populations;
  • Examine patterns and quality of health care for immigrants who travel back and forth from the U.S. to the native country and receive care in both countries;
  • Address health care team or organizational-level factors (systems) that facilitate the treatment delivery and follow up care to medically underserved immigrants;
  • Address systematic barriers to care and accommodate cultural and individual diversity for multiple immigrant sub-populations;
  • Adapt evidence-based interventions to ensure cultural relevance for those with Limited-English proficiency and low health literacy in low-resource settings to improve quality of care and health outcomes among immigrants;
  • Develop and test health behavior interventions aiming at reducing illness risks, including interventions in tobacco control, diet and physical activity, and other health promotion efforts;
  • Develop tailored prevention strategies for different immigrant sub-populations to address screening disparities for preventable diseases or conditions;
  • Develop strategies focusing on key transition points across the lifespan and associated risk and protective factors for immigrant populations to improve overall health;
  • Examine how multilevel intervention components may address social determinants (such as housing, employment and educational systems) to increase reach/access to prevention and care in low-resource settings for immigrant (sub)populations;
  • Studies that test prevention and treatment interventions for excessive drinking, alcohol use disorders, other substance use other substance use and other common co-occurring mental health disorders (e.g., depression, PTSD, other anxiety disorders, etc.) among U.S. based immigrant populations.



Filed Under: Funding Opportunities