This Funding Opportunity Announcement (FOA) invites applications for center grants to support Advanced Laboratories for Accelerating the Reach and Impact of Treatments for Youth and Adults with Mental Illness (ALACRITY) Centers. The purpose of these research Centers is to support transdisciplinary teams of clinical and mental health services researchers, behavioral scientists, social scientists, health information and communications technologists, health systems engineers, decision scientists, and mental health stakeholders (e.g., service users, family members, clinicians, payers) to engage in high-impact studies that will significantly advance clinical practice and generate knowledge that will fuel transformation of mental health care in the United States. Successful ALACRITY Centers will address major mental health problems observed among children, youth, and/or adults (including older adults), and foster innovative research aimed at increasing the effectiveness of existing interventions, improving delivery and quality of evidence-based services, and accelerating the diffusion, implementation, and continuous improvement of new practices in diverse settings. Centers proposed should reflect a deployment-focused model of intervention and services design and testing, i.e., studies that take into account key characteristics of the settings and providers where optimized mental health interventions and services will be implemented.
The ALACRITY Centers program is intended to support research that demonstrates an extraordinary level of synergy across disciplines and has a high potential for increasing the public health impact of existing and emerging mental health interventions and service delivery strategies. The Centers are intended for transdisciplinary projects that could not be achieved using standard research project grant mechanisms. Support is provided both for individual research projects and for cores that are critical for the integration across ALACRITY components. Centers are expected to provide plans for rapid, widespread sharing of relevant data, methods, and resources that will promote near-term improvements in clinical practice, as well as plans that further advance research in treatment effectiveness and/or services research. A strong vision of how the ALACRITY Center will advance the field beyond the goals of the individual projects is essential for successful applications.
ALACRITY Centers also provide opportunities for graduate students, postdoctoral researchers, and investigators in early stages of independent careers to participate in interdisciplinary research.
Mental disorders affect approximately 15-20 percent of the U.S. population annually. According to recent estimates, mental illnesses account for 21.3 percent of all years lived with disability in the United States. An estimated 9.6 million American adults suffer from a serious mental illness (SMI) in which the ability to function in daily life is significantly impaired. Those with SMI die 10 years earlier than individuals in the general population, on average. Furthermore, over 40,000 Americans die each year from suicide, more than twice the annual mortality from homicide. Suicide attempts and ideation far exceed these numbers. Beyond the morbidity and mortality, a conservative estimate places the direct and indirect financial costs associated with mental illnesses in the United States at well over $300 billion annually. Mental illnesses rank as the third most costly medical conditions in terms of overall health care expenditure, behind heart conditions and traumatic injury. In addition, between two and four hundred thousand men and women with SMI are incarcerated in U.S. jails and prisons, where they receive inadequate treatment and often no aftercare following release to the community. This public health burden demands that we combine current knowledge about effective mental disorder treatments with emerging health information and communication technologies, health care informatics, data science tools, and novel organizational structures for delivering health care to achieve significantly better outcomes for these disabling conditions.
The primary purpose of each ALACRITY Center is to support rapid development, testing, and refinement of innovative approaches for (1) optimizing the effectiveness of therapeutic or preventive interventions for mental disorders within well-defined target populations; (2) organizing and delivering optimized mental health services within real world treatment settings; and (3) continuously improving the quality, impact, and sustainability of optimized interventions and service delivery strategies within diverse care systems. To achieve these ambitious goals, each ALACRITY Center aims to support multidisciplinary teams of leading clinical and mental health services researchers, and experts from allied disciplines such as behavioral scientists, social scientists, health information and communications technologists, health systems engineers, decision scientists, and mental health stakeholders (e.g., service users, family members, clinicians, payers) to engage in studies focused on selected populations for whom existing interventions or services do not adequately address urgent, unmet mental health needs.
The NIMH Strategic Plan for Research (http://www.nimh.nih.gov/about/strategic-planning-reports/index.shtml) was developed to inspire and support research that takes advantage of recent technological advances and opportunities, and to bring into sharper focus questions and perspectives that will transform the diagnosis, treatment, and prevention of mental disorders. Strategic Research Objectives 3.2, 3.3, and 4.1 – 4.4, which focus on optimizing existing and new interventions, translating effective interventions to community practice settings, and strengthening the public health impact of NIMH-supported research, are particularly relevant to ALACRITY Centers. Specific research priorities recently identified for Strategic Research Objectives can be found at http://www.nimh.nih.gov/about/strategic-planning-reports/strategic-research-priorities/index.shtml.
The ALACRITY Centers program provides a mechanism for maximizing synthesis and potential synergies across various components of the mental health research ecosystem, including new discoveries in basic and clinical research, transformative health care technologies, advances in information science, behavioral economic strategies for influencing health behaviors, and new federal and state mechanisms for organizing and financing mental health care. ALACRITY Centers provide a unique opportunity for addressing T2 translational priorities outlined in the NIMH Strategic Plan, i.e., effective transfer of findings from clinical studies to practice settings and communities, where research findings can be applied to improve public health.
Some general characteristics of ALACRITY Centers are listed below:
- ALACRITY Centers are intended to support a program of science that is defined in terms of (a) a target population for whom existing interventions or services do not adequately address mental health needs; (b) the therapeutic or preventive interventions or service delivery strategies to be studied and optimized; and (c) the service settings intended to implement optimized interventions and/or services.
- The scope of science for ALACRITY Centers spans interventions science (optimizing the effectiveness of therapeutic or preventive interventions for mental illness within well-defined target populations) through services research (innovative strategies to improve access, engagement, coordination and quality of service delivery). It is not necessary for an individual Center to emphasize intervention refinement and health services research activities equally. An ALACRITY Center may include (a) intervention enhancement projects only, (b) a combined program of interventions and services research, or (c) mental health services research projects only. In all cases, however, research studies should address necessary features for rapid dissemination, adoption, and implementation of new approaches in clinical and community settings, thus facilitating T2 translation from research to practice.
- Regardless of where the Center’s focus falls on the continuum of research spanning optimization of therapeutic/preventive interventions through services research, ALACRITY Centers are intended to support research that reflects a deployment-focused model of intervention and services design and testing. Deployment-focused studies take into account the perspective of relevant stakeholders and key characteristics of settings intended to implement optimized mental health interventions. This attention to end-user perspectives and characteristics of intended clinical and/or community practice settings is intended to ensure that the resultant interventions and service delivery strategies are feasible and scalable, and to ensure that the research results will have utility for end users.
- The goal of ALACRITY Centers is to support transdisciplinary research that brings together diverse teams of clinical scientists, mental health services researchers, and experts from allied disciplines that bring new perspectives and tools relevant to enhancing the effectiveness, delivery, reach, and continuous improvement of mental health interventions for children, youth, and adults (including older adults) with unmet mental health needs. ALACRITY teams should also include members with real world experience of care within target clinical and/or community practice settings, including service users, family members, mental health care providers, program administrators, and payers.
- Given the explicit goal of encouraging synergies across diverse areas of science and technology, and in partnership with relevant stakeholders and end-users, ALACRITY Centers are intended to provide research infrastructure and coordination in the form of Cores that provide support for overall organization, administration, and collaboration with stakeholders (Administrative Core), and support for implementing the Center’s transdisciplinary research projects and additional pilot studies, as well as support for methodological development and consultation (Methods Core). Each Core should also facilitate the development of new collaborative research opportunities and future directions that extend the Center’s activities.
- The scope of science should comprise three exploratory planning research projects modeled on the NIMH R34 grant program. These projects should propose innovative, transdisciplinary approaches that address ALACRITY Center goals of optimizing the effectiveness of therapeutic or preventive interventions for well-defined target populations; organizing and delivering optimized mental health services within real world treatment settings; and/or continuously improving the quality, impact, and durability of optimized interventions within diverse care systems. (Funding Opportunity Announcements RFA-MH-18-706, Pilot Effectiveness Trials for Treatment, Preventive and Services Interventions (R34) and PAR-18-267, Pilot Services Research Grants Not Involving Interventions (R34) provide examples regarding the focus and scope of potential pilot projects).
- ALACRITY Centers are intended to facilitate emerging opportunities for additional pilot research through a process for soliciting, reviewing, and selecting promising pilot feasibility projects of 1-2 years duration similar in scope to the NIH R03 grant mechanism that can be launched within the project period. Accordingly, the scope of science should include such pilot feasibility projects that can be proposed by new or established investigators to address innovative, interdisciplinary research that is consistent the Center’s focus, in order to position the investigator(s) for subsequent research that aligns with the Center’s program of research.
- ALACRITY Centers are intended to support transdisciplinary science through research projects and cores at a single institution or across multiple institutions. Collaborations among mental health interventions research programs, services research programs, behavioral and social science programs, and healthcare technology research programs are encouraged, even if this means that investigators are geographically distributed.
- ALACRITY Centers are expected to provide opportunities for graduate students, postdoctoral researchers, and investigators in early stages of independent careers to participate in T2 translational mental health research.
Deadlines: May 17, 2018, May 17, 2019, May 18, 2020 (letters of interest due 30 days prior to the deadline)
Filed Under: Funding Opportunities