NCI – Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) (Collaborative U54 Clinical Trial Optional)

May 22, 2018 by School of Medicine Webmaster

The NCI’s mission is to conduct and support research, training, health information dissemination, and other programs with respect to cancer. This funding opportunity seeks to support the Comprehensive Partnerships to Advance Cancer Health Equity (CPACHE) Program. The CPACHE Program develops and maintains comprehensive, long-term, and mutually beneficial partnerships between institutions serving underserved health disparity populations and underrepresented students (ISUPSs) and NCI-designated Cancer Centers (CCs). To underscore their commitment to the partnership, linked application from each other partnering institutions are required. The program aims to achieve a stronger national cancer program and address challenges in cancer and cancer disparities research, education, and outreach, as well as their impact on underserved populations.

The institutions in each partnership are expected to work collaboratively to:

  1. increase the cancer research and cancer research education capacity of the ISUPSs;
  2. increase the number of students and investigators from underrepresented populations engaged in cancer research;
  3. improve the effectiveness of CCs in developing and sustaining research programs focused on cancer health disparities and increase the number of investigators and students conducting cancer health disparities research; and
  4. develop and implement cancer-related activities that benefit the surrounding underserved communities.
Background

Every facet of the United States scientific research enterprise—from basic laboratory research to clinical and translational research to policy formation–requires superior intellect, creativity and a wide range of skill sets and viewpoints. NIH’s ability to help ensure that the nation remains a global leader in scientific discovery and innovation is dependent upon a pool of highly talented scientists from diverse backgrounds who will help to further NIH’s mission.

Research shows that diverse teams working together and capitalizing on innovative ideas and distinct perspectives outperform homogenous teams. Scientists and trainees from diverse backgrounds and life experiences bring different perspectives, creativity, and individual enterprise to address complex scientific problems. There are many benefits that flow from a diverse NIH-supported scientific workforce, including: fostering scientific innovation, enhancing global competitiveness, contributing to robust learning environments, improving the quality of the researchers, advancing the likelihood that underserved or health disparity populations participate in, and benefit from health research, and enhancing public trust.

Despite tremendous advancements in scientific research, information, educational and research opportunities are not equally available to all.

This program encourages institutions to diversify their student and faculty populations and thus to enhance the participation of individuals currently underrepresented in the biomedical, clinical, behavioral and social sciences research enterprise, as described in NOT-OD-15-053.

A disproportionate burden of cancer exists among many population groups, including African Americans, American Indians and Alaska Natives, Hispanics or Latinos, Native Hawaiians and other Pacific Islanders, individuals with disabilities and individuals from socioeconomically disadvantaged backgrounds. For example, the American Cancer Society Cancer Facts & Figures 2016 shows that Non-Hispanic Black has higher overall cancer incidence and death rates compared to Non-Hispanic White, while Hispanic/Latino and Asian and Pacific Islander indicate higher incidence and death rates in cancers of the liver and intrahepatic bile duct (Incidence and Death Rates for Selected Cancers by Site, Race, and Ethnicity, US, 2008-2012). Additionally, trends in cancer mortality rates showed that greater progress in cancer control was achieved for White populations compared with American Indian/Alaska Native populations over the last 2 decades. These same population groups where cancer health disparities exist are also significantly underrepresented in the U.S. biomedical research and health care workforce, which contributes to and exacerbates the cancer health disparities. The 2004 report from the Sullivan Commission indicated that African Americans, Hispanics and Native Americans together make up 25% of the U.S. population, but only 6% of physicians, 8% of registered nurses and 5% of dentists (Sullivan_Report_ES.pdf). With at least 90% of the U.S. population growth between 2010 and 2050 expected to come from underrepresented groups (Workforce Diversity), the issue of workforce diversity is more urgent than ever. A cancer research workforce that reflects the communities being served, supported in an environment that nurtures their success, is essential to creating an environment that is truly conducive to advancing cancer and cancer health disparities research, and in turn, cancer health equity.

While ISUPSs have enhanced the education of underrepresented population groups, they often lack the research infrastructure and resources to support a highly competitive cancer research program. Many ISUPSs are limited in achieving sufficient numbers of senior scientific leaders in cancer research, have limited resources to maintain a state-of-the-art research environment, and have a limited group of scientists with success in obtaining independent NIH funding. Through collaboration with the CCs, the CPACHE Program aims to enhance research infrastructure, capabilities, and resources at ISUPSs, by strengthening cancer research faculty, augmenting cancer research education, and improving institutional capacity to support and manage external research grant proposals and awards.

The NCI-designated Cancer Centers are recognized for their outstanding resources and the depth and breadth of their cancer research programs in basic, clinical, translational and/or population science, as well as effective cancer training programs. Cancer Center investigators are highly successful in obtaining research funding from NCI and other agencies. However, there has been limited focus on cancer health disparities research, and access to and interactions with underserved communities is often lacking. While thousands of patients are enrolled in cancer clinical trials at the CCs each year, participation of underrepresented and underserved populations has been a longstanding problem. These underrepresented and underserved groups comprise more than 30% of the U.S. population, but only less than 18% of Phase I-III cancer clinical trial participants and 17% of FDA clinical trial participants in 185 studies of new molecular entities over a 5-year period. The disproportionate clinical trial participation not only limits the generalizability of research findings but also undermines equity in the provision of cancer-related health care in the U.S. Through collaboration with the ISUPSs, the CPACHE Program provides the CCs with unparalleled access to patients and scientists from these populations, and opportunities to observe whether concordance between researchers and clinical subjects increases participation in clinical trials and improves satisfaction and compliance with clinical regimens. The CPACHE Program further aims to increase cancer health disparities research at the CCs.

CPACHE as a Partnership Program

The CPACHE Program is about building and sustaining excellence through mutually beneficial partnerships between ISUPSs and CCs. The program serves as a nurturing environment and “incubator” to allow for the development of new projects/programs. This partnership program provides long-term support for cancer research infrastructure (e.g., key personnel recruitment, equipment, clinical accrual cores, tissue cores, etc.) and limited (not to exceed three years) support for pilot and full research projects.

Research Team: The PD(s)/PI(s) are preferred to be mid-to-senior-level scientists who have records of obtaining grants and will serve as role models and mentors to the partnership participants. However, a less experienced investigator at an ISUPS can be designated as one of multiple PDs/PIs, if there is an appropriate institutional investment in this investigator, and a demonstrable collaboration (active or planned) of the less experienced investigator with a more experienced PD/PI.

The partnership must target cancer research, cancer research education and outreach. These activities combined are expected to lead to vigorous efforts aimed at securing independent peer-reviewed funding from NIH and other funding agencies.

Each partnership program is expected to include:

  1. Administrative Core: Each partnering institution must have an Administrative Core that will provide the day-to-day administrative support for the partnership.
  2. Full and Pilot Research Projects: Each partnership must be centered on specific well-developed research projects (further referred to as “Full Research Projects”) and pilot, exploratory projects. Each application, new or competing renewal, should propose at least two Full Research Projects and at least one Pilot Research Project.
  3. Planning and Evaluation Core: Partnership awardees will be required to conduct (as a continuous process) planning and evaluation of partnership activities and monitoring of trainees.
  4. Research Education Core: This core supports joint research education programs between the partner institutions that offer research experiences or curriculum development or both. Such programs link the faculty and students of the partner institutions.
  5. Outreach Core: It is expected that both partnering institutions will engage in outreach efforts that would benefit communities with cancer health disparities. Such efforts are strongly encouraged to be connected to cancer-relevant outreach research (e.g., through pilot projects or research development activities) conducted by the partnership.
  6. Shared Resources: Applicants may propose the development of resources/infrastructure that augment the cancer research capability of the ISUPSs, the collaborative research of both partner institutions, and/or specifically enhance research focused on cancer health disparities issues.

It is expected that all activities should be planned to eventually reach sustainability in terms of the ability to:

  • Increase the participation of the ISUPSs in the nation’s cancer research and research education enterprise;
  • Increase competitive research capacity of ISUPSs;
  • Produce more competitive grant applications from underrepresented scientists;
  • Enhance research in cancer health disparities at CCs;
  • Increase involvement and effectiveness of Cancer Centers in cancer health disparities research;
  • Increase the role of CC on augmenting education related to underserved populations;
  • Develop more effective outreach and education initiatives that will have an impact on the underserved populations and individuals from underrepresented backgrounds;
  • Identify and share innovative methods and approaches that strengthen and sustain each partnership.

Each partnership must have a common Internal Advisory Committee (IAC) shared across the partner institutions. The IAC will be composed of qualified faculty members from the partner institutions, and must have equal numerical representation of members from each partner institution. Each partnership is also required to have a Program Steering Committee (PSC), who will serve as the primary advisory board of the partnership program. The PSC will be composed of qualified external members with the appropriate scientific expertise.

Success of the CPACHE Program will be assessed based on several tangible metrics including, but not limited to, at the ISUPSs, increased infrastructure support, faculty/student recruitment and retention in cancer research, and cancer research-relevant curriculum developed and sustained; at the CCs, increased cancer health disparities research projects and funding, and cancer health disparities courses or curriculum developed and sustained. In addition, for both ISUPSs and CCs, indicators of success will include an increase in the number of underrepresented students and investigators in cancer research, an increase in the number of peer-reviewed publications, an increase in cancer-related grants submitted and awarded, as well as an increased number of cancer-related education and awareness outreach activities to underserved communities and development of community partnerships. The CPACHE Program may promote participation of underrepresented and underserved individuals in cancer clinical trials and bio-specimen donation via the development and implementation of innovative methodologies. In addition to these metrics, each partnership is encouraged to identify metrics unique to their program when designing their approaches.

Deadlines:  January 9, 2019; January 9, 2020 (letters of intent due 45 days prior to deadline)

URL:  https://grants.nih.gov/grants/guide/pa-files/PAR-18-767.html

Filed Under: Funding Opportunities