STIGMA AND GLOBAL HEALTH RESEARCH PROGRAM
RELEASE DATE: June 20, 2002
RFA: TW-03-001
PARTICIPATING INSTITUTES AND CENTERS (ICs):
Fogarty International Center (FIC)
(http://www.nih.gov/fic/)
Health Research Services Administration (HRSA)
(http://www.hrsa.gov)
National Center on Minority Health and Health Disparities (NCHMD)
(http://ncmhd.nih.gov/)
National Human Genome Research Institute (NHGRI)
(http://www.nhgri.nih.gov/)
National Institute of Allergy and Infectious Diseases (NIAID)
(http://www.niaid.nih.gov/default.htm)
National Institute of Dental and Craniofacial Research (NIDCR)
(http://www.nidcr.nih.gov/)
National Institute of Mental Health (NIMH)
(http://www.nimh.nih.gov/)
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
(http://www.niaaa.nih.gov/)
National Institute on Drug Abuse (NIDA)
(http://www.nida.nih.gov/)
Office of AIDS Research (OAR)/ NIH Office of the Director
(http://www.nih.gov/od/oar/)
Office of Behavioral and Social Science Research (OBSSR)/ NIH
Office of the Director
(http://obssr.od.nih.gov/)
Office of Research on Women's Health (ORWH)/ NIH Office of the Director
(http://www4.od.nih.gov/orwh/)
LETTER OF INTENT RECEIPT DATE: October 14, 2002
APPLICATION RECEIPT DATE: November 14, 2002
THIS RFA CONTAINS THE FOLLOWING INFORMATION
o Purpose of this RFA
o Research Objectives
o Mechanisms of Support
o Funds Available
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Special Requirements
o Where to Send Inquiries
o Letter of Intent
o Submitting an Application
o Peer Review Process
o Review Criteria
o Receipt and Review Schedule
o Award Criteria
o Required Federal Citations
PURPOSE OF THIS RFA
The purpose of this initiative is to
stimulate investigator-initiated research
on the role of stigma in health, and on
how to intervene to
prevent or mitigate its negative effects
on the health and welfare of individuals, groups and
societies world-wide. Collaborative
interdisciplinary applications are
particularly encouraged. The following Institutes
and Centers from the U.S. Department of Health and Human
Services (DHHS): the Health Research Services Administration (
HRSA), the NIH including: the Fogarty International Center (FIC), National
Center on Minority Health and Health Disparities (NCHMD),
National Institute of Neurological Disorders and Stroke
NINDS), National Human
Genome Research Institute (NHGRI), National Institute of
Alcohol Abuse and Alcoholism (NIAAA), National Institute
of Allergy and Infectious
Diseases (NIAID), National Institute of Dental and
Craniofacial Research (NIDCR), National Institute of Drug
Abuse (NIDA), National Institute of Mental Health (NIMH),
Office of AIDS Research,
Office of Behavioral and Social Science Research (OBSSR),
Office of Research on Women's Health (ORWH); and the Canadian
Institutes of Health
Research (CIHR), seek domestic and international applications
which address stigma-related issues, across a variety of global
public health
problems, among individuals and in society. Relevant issues
include:
1. How stigma and its consequences, such as discrimination
affect health (e.g. through physical and psychological abuse,
denial of economic
opportunities, poor provision and seeking of health care);
2. How stigma associated with specific health conditions
interacts with stigma associated with individual or group
characteristics (such as gender, race, religion, sexual
orientation and nationality);
3. How to prevent and mitigate the negative effects of
stigma and
4. Discrimination on health and health care;
5. Development of quantitative and qualitative methods and
techniques to investigate, measure and analyze the extent,
degree and effects of stigma and
6. The effectiveness of current and new interventions;
7. Examination of the cultural, social, political and economic
dimensions of stigma and its manifestations;
8. Methods and safeguards to ensure safety of vulnerable
research subjects.
Such research, which may range from basic to clinical and
operational, requires expertise across a broad range of
bio-medical, social and behavioral science fields. The participants
in this RFA therefore encourage interdisciplinary, domestic and
international collaboration to build the scientific foundation of
stigma research related to health. Meritorious applications must
also be relevant to the mission and interests of one or more of
the participating Institutes or Centers.
This RFA is based on recommendations developed in conjunction with
the NIH sponsored International Conference on Stigma and Global
Health: Developing a Research Agenda, September 5-7, 2001, Bethesda,
MD. Applicants are encouraged to refer to the stigma conference website
(www.stigmaconference.nih.gov) for extensive information related to
the topic of this RFA including the agenda with links to speaker
abstracts, commissioned background papers and a video-cast of the conference.
RESEARCH OBJECTIVES
The objectives of this initiative are to encourage research across a
variety of scientific disciplines including the biomedical, social
and behavioral sciences, to elucidate the etiology of stigma in
relation to public health as well as to develop and test interventions
to mitigate the negative effects of stigma on health outcomes.
Studies may examine stigma and public health in domestic, international
and cross-cultural contexts, with an emphasis on studies that are
relevant to global health issues. Applicants are encouraged to
undertake interdisciplinary studies, where possible, using behavioral,
social and biomedical science approaches.
The initiative is also designed to attract investigators across a
broad range of biomedical and non-biomedical fields, including but
not limited to anthropology, epidemiology, infectious and non-infectious
diseases, geography, sociology, psychology, psychiatry, neuroscience,
law, genetics, ethics, economics, political science, biostatistics,
evaluation and others.
Background
According to a seminal work by sociologist Erving Goffman (1963
"Stigma: Notes on the Management of Spoiled Identity") a stigma is
an attribute that — according to prevailing societal attitudes - is
deeply discrediting and reduces a person to one who is in some way
tainted and can therefore be denigrated. Individuals may internalize
the stigmas applied to them by others. Researchers, therefore,
differentiate between the "felt" stigma a person perceives and "enacted"
stigma, which refers to actions upon the individual expressed through
various forms of discrimination.
Stigma, when applied to health conditions, is a globally pervasive
problem threatening psychological and physical health at the individual
and group level. Stigma helps to perpetuate health inequalities.
The poor treatment of an individual because of the stigma of the
condition itself, or of another aspect of that individual's being or
position in society (such as gender, race, sexual orientation or
socio-economic status), leads to poor outcomes and perpetuates other
adverse health, social and economic consequences for the individual,
their families and communities. Felt stigma prevents
individuals from coming forward for timely diagnosis and treatment and
impairs their ability for self-care, to access care or to participate
in research studies designed to find solutions. Enacted stigma
perpetuates public health problems and prevents societies from
appropriately addressing health care issues at the community and national
levels with the appropriate delivery, funding and support of research,
health care services and legal and educational interventions.
Many diseases and conditions, which persist or worsen if left untreated,
affect a person's ability to fulfill necessary, culturally expected and
economically productive roles in society. The burden of their continued
care may then fall upon families and communities lacking adequate resources
or support. For this reason, stigma and discrimination may greatly magnify
the social and economic, as well as personal consequences of such diseases
and conditions, often well beyond their prevalence in the population.
In the case of infectious disease (for example, sexually transmitted diseases),
stigma and discrimination related to the mode of transmission and preexisting
attitudes towards some affected individuals can lead to fear of disclosure,
inadequate and inappropriate treatment of all affected, and the further spread
of a disease which might otherwise be contained. The effects on individuals,
families, communities and nations can be devastating, as illustrated by the
HIV/AIDS epidemic, particularly in Sub-Saharan Africa.
The disability and loss of productivity due to treatable mental illnesses
and neurological disorders (such as depression, schizophrenia, epilepsy,
movement disorders, substance abuse disorders, mental retardation and cerebral
palsy), when inadequately treated due to stigma and discrimination, contribute
greatly to the burden of illness on societies around the world (for more
information please see the "World Health report 2001: Mental Health-New
Understanding, New Hope" and the Institute of Medicine report on "Neurological,
Psychiatric and Developmental Disorders: meeting the Challenge
of the Developing World", 2001, available at
http://books.nap.edu/books/0309071925/html/).
The same is true of other physical and developmental health conditions
(including those which are disfiguring such as craniofacial disorders, and
those that are physically disabling, such as spinal cord injury leading to
paralysis) which if treated, mitigated or accommodated need not serve as
barriers to full and productive lives. Yet stigma and discrimination often
prevent the necessary societal action to treat, research and accommodate such
conditions. Other public health problems, such as domestic violence and abuse,
when ignored because of the associated stigma, perpetuate the same problems in
individuals and across generations, along with other, often stigmatized
health problems such as mental illnesses,
drug and alcohol addiction and abuse.
To have an impact, research on stigma-related health problems requires
the participation of investigators across a broad range of biomedical
and non-biomedical fields. Interdisciplinary studies are needed which
use current behavioral, social and biomedical approaches to elucidate the
etiology of stigma in relation to health as well as develop and test
interventions to mitigate the negative effects of stigma on health outcomes.
Finally, researchers must better understand the policy-making process so
they can work to ensure that research results have an impact.
Understanding the causes, consequences and effective interventions for
stigma-related issues and problems has the potential to significantly
improve treatment and care particularly for public health problems of
global importance. In the same way that the effects of stigma magnify
the personal and societal problems related to such diseases and disorders,
preventing or mitigating stigma and its effects can profoundly improve the
lives of individuals and, by extension, their families and the larger society.
The public health community has demonstrated increasing awareness of the
role of stigma in many diseases and disorders. Recent conferences have
focused on the role of stigma in mental illnesses including depression
and schizophrenia, HIV/AIDS and epilepsy. These conferences were convened
by organizations including the Health and Development Networks with UNAIDS,
the United States Substance Abuse and Mental Health Services Administration,
the World Health Organization, and the World Psychiatric Association.
This RFA is informed as well by the recent U.S. National Institutes of
Health International Conference on Stigma and Global Health: Developing
a Research Agenda (www.stigmaconference.nih.gov). This conference was
convened by the Fogarty International Center of the NIH in partnership
with various other NIH institutes and offices along with other U.S.
agencies, and domestic and international organizations. More than 250
participants from 30 nations, including 23 developing countries, discussed
stigma associated with a variety of illnesses and conditions including
HIV/AIDS, mental health, epilepsy, physical anomalies, alcohol and drug
abuse, physical
and sexual abuse, genetics, race and gender. Scientists and other experts
encompassing the health, social and behavioral
sciences, media, law, politics and economics focused on stigma as it
relates to global public health. They examined both what is known about
the causes and consequences of stigma and what can be done to prevent or
minimize its negative effects on the health of individuals and societies.
One outcome of the conference was a set of research recommendations for
stigma and its relationship to a variety of global public health problems.
The recommendations include research to:
o Further elucidate the etiology of stigma;
o Investigate the health consequences of stigma;
o Develop methodology for studying stigma with respect to health;
o Evaluate and develop new effective interventions to deal with stigma;
o Lay the groundwork for guidelines on ethical conduct of studies on
o stigmatized individuals and groups who may face further negative effects,
including physical violence or social isolation, because of their
participation in such studies.
Research Topics
Studies of stigma are encouraged across physical and mental health
conditions (including addictions), care settings, groups, outcomes and
interventions, including research on the social, economic, cultural and
political factors in both creating and intervening in stigmatization of
health conditions. This RFA encourages interdisciplinary studies throughout
whenever appropriate to the research question. Ethnographic and other areas
of social science research in particular will be necessary to fully understand
the role of stigma within a given society
or group and to design appropriate interventions. The ways stigma is applied,
perceived and measured in other cultures are relevant avenues of inquiry and
ethnographic and comparative studies are encouraged alone or as components
of other studies.
Other relevant research topics include but are not limited to the following:
1. The role of stigma in specific public health problems, diseases or
disorders; and its implications for issues from etiology to interventions
and public policy;
2. The implications of stigma for access to care and treatment, and how
stigma affects outcomes across health conditions;
3. Systematic studies to determine psychological, social, economic,
cultural and political factors that operate in the creation of stigma and
how they link to stereotypes, discrimination and mistreatment in the
context of health problems and health care systems;
4. Approaches to ensure that medical advances, which can be used to treat
or prevent stigmatized conditions, effectively reach appropriate populations;
5. Development of tools to study and document stigma and its impact on
accurate determination of incidence and prevalence of health conditions;
and to estimate the risk for over- or under-diagnosis as a result of
stigma-related influences;
6. Evaluation of which interventions work for stigma-related health
problems, the characteristics of successful interventions, demonstration
of successful interventions that can be scaled up or generalized to
other stigmatized public health problems and/or to other populations
and cultures;
7. The role of stigma in provision of health care including, quality
and extent of available treatment and care, the quality of the
patient/health care practitioner relationship, the role of the provider's
attitude in perpetuating stigma and the role of stigma in disclosure of
disease status during medical visits;
8. The role of disclosure of disease in an individuals' personal or
professional life and its relationship to perceived stigma;
9. Identification of methods to minimize (or eliminate) the consequences
of stigma/stigmatization on the recognition and diagnosis of health
conditions and on options for treatment and/or rehabilitation;
10.Social, cultural and environmental influences on perceptions of and
reactions to stigma/discrimination among individuals, families and communities;
and on the resources available for coping with or ameliorating its negative
health consequences;
11.The interaction of social systems including gender, culture, politics,
economics and the law in creating stigmas and the examination of the
interplay between different kinds of stigmas as well as the combined
impact on individuals, families, and groups;
12.The involvement of social, political, economic and legal systems in
creating appropriate, effective and culturally sensitive interventions
to combat stigma and the negative effects of stigma;
13.The actual and potential roles of media in creating, disseminating
and intervening in stigma-related attitudes and actions;
14.The relationship between attributions about the causes/etiologies
of particular diseases and disorders and the degree to which those
with, or at risk for, the disorder are stigmatized. For example: does
the public view a disease or disorder as more or less stigmatizing when
it may be associated with a specific genetic predisposition; is this
perception different for different diseases and disorders, for example
diseases such as cancer, neurological
and neuropsychiatric disorders such as epilepsy, movement disorders,
schizophrenia and bipolar disorder, or conditions in which there is a
clear behavioral component (e.g. drug abuse, obesity)?
Specific Research Areas of Interest to Stigma and Global Health RFA Sponsors:
The FIC is interested in applications on stigma and health topics relevant
to and involving low to middle income countries of the developing world.
Special consideration will be given to meritorious interdisciplinary
applications from, or in collaboration with, developing country investigators.
NCMHD would like to encourage applications that have minority health or
health disparity focus.
NIAAA is interested in supporting applications that address the
association of stigma with the detection, prevention and treatment of
alcohol use disorders. Of particular interest are applications that address
alcohol abuse and addiction in populations that bear a greater burden of
stigma (i.e. pregnant women) and alcohol related birth defects (such as
Fetal Alcohol Syndrome). Applications that address the stigma associated
with alcohol and other health conditions, such as HIV AIDS, will also be
considered. Studies on the role of stigma in the development of
alcohol-related policies and the delivery of services are also encouraged.
NIAID encourages applications addressing the impact of stigma on control
and treatment of infectious diseases. Of particular interest is research
to develop and evaluate strategies to prevent or minimize the negative
physical, cognitive, and social consequences of HIV infection, including
the stigmatization of persons with or at risk for HIV infection. NIAID is
particularly interested in applications with an international/developing
country focus.
NIDA is interested in supporting applications that address the causes and
consequences of stigma in drug abusing and addicted individuals and
populations, including the impact on stigma on the availability and provision
of treatment and prevention services. Studies on interventions directed at
reducing stigma in these populations are encouraged as well.
NIDCR is interested in supporting research to identify, prevent, or
ameliorate consequences of stigma related to socially perceived variations
or changes in orofacial appearance or function. Such changes may, for example,
result from orofacial injuries or from congenital craniofacial anomalies,
such as cleft lip and palate, disfiguring infectious diseases such as noma,
oral facial cancers or ablative cancer surgeries affecting orofacial
structures, edentulousness, malocclusion, or other orofacial diseases/
conditions.
NHGRI would like to encourage applications on stigma-related issues
related to genetic disorders.
NIMH encourages research on stigma related to neuropsychiatric disorders
and research on AIDS stigma and prevention of HIV transmission and its
consequences including descriptive cross-sectional studies of stigma,
longitudinal research studies and intervention studies.
NINDS encourages research on stigma related problems across the spectrum
of neurological disorders to reduce the burden of neurological disease
borne by every age group and segment of society all over the world.
OAR is interested in supporting applications that address the role of
stigma and discrimination in the HIV/AIDS pandemic. This includes basic
research on the causes and consequences of HIV/AIDS-associated stigma and
discrimination, as well as intervention research to ameliorate them.
ORWH would like to encourage applications, across the spectrum of
possible research topics, which include in the research design scientific
analyses aimed at delineating sex/gender differences. The results of such
analyses are expected to be particularly important when designing and
testing appropriate interventions to have the best possible outcomes.
The HIV/AIDS Bureau, HRSA, is interested in supporting the evaluation of
interventions to reduce stigma as a barrier to the care and treatment of
those living with HIV/AIDS. Examples of potential interventions include
training of health care providers, community involvement in HIV program
planning, and the inclusion of people living with HIV/AIDS in program
planning and as staff or volunteers in care and support programs.
Programs that tie decreases in stigma to increased access to care and
improved quality of care are of particular interest.
The Institute of Neurosciences, Mental Health and Addiction (INMHA) of
the Canadian Institutes of Health Research (CIHR) is interested in
supporting applications from Canadians or, in collaboration with the Canadian
International Development Research Center (IDRC), in co-sponsoring proposals
originating in and responding to priorities of developing countries and with
a Canadian component. Eligible applications for CIHR/INMHA include those
dealing with research on stigma related to neurological disorders, mental
illnesses and addictions which are aimed at finding innovative, effective
and evidence-based means to reduce discrimination, improve access to
services and to raise public awareness through education.
Contact the representatives of the participating Agencies, Institutes or
Centers (ICs) listed in the "Where to Send Inquiries" section of this RFA
or visit individual Agency and IC websites for more information about topics
of interest to each. Additional research questions and other information
of specific interest to individual participating Agencies and ICs in the
context
of this RFA can be found at: http://www.nih.gov/fic/programs/stigma.html.
MECHANISM OF SUPPORT
This RFA will use the National Institutes of Health (NIH) research
project grant (R01) and the developmental/exploratory grant (R21) award
mechanisms. Note that the R21 mechanism is specifically intended to
support innovative ideas where preliminary data as evidence of feasibility
are sparse or do not exist. R21 grants are not intended for large-scale
undertakings or to support or supplement ongoing research. Rather,
R21-supported projects are intended to serve as a basis for planning and
strengthening future research project grant applications (R01).
This RFA also uses just-in-time concepts and the modular grant format
(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 format (modules of $25,000). Otherwise
follow the instructions for non-modular research grant applications.
Applications submitted by foreign institutions can request facilities and
administrative (F&A) costs up to a maximum of eight percent. Please see
the web site http://grants.nih.gov/grants/guide/notice-files/NOT-OD-01-028.html
for more information on allowable F&A costs for foreign grants and domestic
grants with foreign components.
This RFA is issued for fiscal year (FY) 2003 and the anticipated award start
date is July 2003. Applications submitted in response to this RFA may
have a project period of up to five years for R01 and up to three years
for R21 grant applications. As an applicant you will be solely responsible
for planning, directing, and executing the proposed project.
At this time, it is not known if this RFA will be reissued. Any future
unsolicited competing continuation applications based on this project may
compete with all NIH investigator-initiated applications and be reviewed
according to the customary peer review procedures.
FUNDS AVAILABLE
The participating ICs intend to commit approximately $2.5 million in FY
2003 to fund up to 12 new competitive grants in response to this RFA.
R21 grant applicants may request a project period of up to three years
with a total direct cost of $100,000 per year.
R01 grant applicants may request a project period of up to five years. An
applicant may request a budget up to
1) $500,000 direct costs per year for applications in which comparative
or intervention studies at two or more international sites are planned,
and which involve an international team of investigators. No one site
may be allocated more that half the budget.
2) $200,000 direct costs per year for all other projects (i.e. those that
will take place only in a single country, do not propose comparative or
intervention studies, do not involve an international collaboration).
Because the nature and scope of the proposed research will vary from
application to application, it is anticipated that the size and duration
of each award will also vary, with multidisciplinary collaborative,
international applications requiring more funding and time. Although the
financial plans of the IC(s) provide support for this program, awards pursuant
to this RFA are contingent upon the availability of funds and the receipt
of a sufficient number of meritorious applications. Each award will be
administered by one of the participating NIH ICs or other participating
agencies although several may participate in funding of any given application.
The Canadian Institute for Health Research (CIHR) along with the Canadian
International Development Research Centre (IDRC) will consider meritorious
applications, relevant to their missions, from Canadian applicant institutions.
CIHR will make the award of grants for meritorious applications of interest
to them. Applicants who wish to have their projects considered for funding by
CIHR should include with their application a letter stating that their
application and summary statement may be shared with CIHR
and IDRC.
ELIGIBLE INSTITUTIONS
You may submit (an) application(s) if your institution is in one of the
following categories:
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 Agencies of the Federal government
o Domestic or foreign institutions or organizations
o Faith-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.
SPECIAL REQUIREMENTS
Two meetings of grantees of these awards will be held in the Washington,
D.C. area (one in the second year and one in the fourth year of the grant
period) to share information and discuss new insights on stigma and health,
in particular, stigma intervention strategies. For these meetings, funds
should be budgeted for travel by the PI and/or other relevant individuals
with significant day-to-day involvement in the activities performed under
this award.
WHERE TO SEND INQUIRIES
We encourage inquiries concerning this RFA and welcome the opportunity to
answer questions from potential applicants. Inquiries may fall into three
areas: scientific/research, peer review, and financial or grants management
issues.
o GENERAL INQUIRIES regarding the scope and content of this Request for
Applications should be directed to:
Kathleen Michels, Ph.D.
Program Director
Division of International Training and Research
Fogarty International Center
Building 31, Room B2C39
31 Center Drive, MSC 2220
Bethesda, MD 20892-2220
Telephone: 301-435-6031
Fax: 301-402-0779
Email: Michelsk@nih.gov
o Direct your questions about SCIENTIFIC/RESEARCH ISSUES to the contacts
below (additional specific research questions of interest to participating
ICs can be found in the "Research Topics" section of this RFA and at
http://www.nih.gov/fic/programs/stigma.html):
CANADA:
CANADIAN INSTITUTES OF HEALTH RESEARCH and
INTERNATIONAL DEVELOPMENT RESEARCH CENTER
Astrid Eberhart
Institute Liaison
Institute of Neurosciences, Mental Health and Addiction
Canadian Institutes of Health Research
410 Laurier Avenue W., 9th Floor
Address Locator 4209A
Ottawa, ON K1A 0W9
Telephone: 613-941-4643
Fax: 613-941-1040
Email: aeberhart@cihr.ca
UNITED STATES:
HEALTH RESOURCES AND SERVICES ADMINISTRATION
Laura Cheever, M.D., Sc.M.
Chief, HIV Education Branch
Health Resources and Services Administration
Parklawn Building, Room 7-29
5600 Fishers Lane
Rockville, MD 20857
Telephone: 301-443-3067
Fax: 301-443-9887
Email: LCheever@HRSA.gov
NATIONAL INSTITUTES OF HEALTH:
FOGARTY INTERNATIONAL CENTER
Kathleen Michels, Ph.D.
Program Director
Division of International Training and Research
Fogarty International Center
Building 31, Room B2C39
31 Center Drive, MSC 2220
Bethesda, MD 20892
Telephone: 301-435-6031
Fax: 301-402-0779
Email: Michelsk@nih.gov
NATIONAL HUMAN GENOME RESEARCH INSTITUTE
Jean E. McEwen, J.D., Ph.D.
Program Director
Ethical, Legal, and Social Implications Program
National Human Genome Research Institute
National Institutes of Health
Building 31, Room B2B07
31 Center Drive, MSC 4997
Bethesda, MD 20892-2033
Telephone: 301-402-4997
Fax: 301-402-1950
Email: jm522n@nih.gov
NATIONAL INSTITUTE OF ALCOHOL ABUSE AND ALCOHOLISM
Margaret M. Murray, M.S.W.
Chief, International and Health Education Programs Branch
National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
6000 Executive Boulevard, Suite 302
Rockville, MD 20852
Telephone: 301-443-2594
Email: pmurray@mail.nih.gov
NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES
Rodney Hoff, D.Sc., MPH
Vaccine and Prevention Research Program
Division of AIDS, NIAID/NIH
6700B Rockledge, Room 4157, MSC 7620
Bethesda, MD 20892-7620
Telephone: 301 496 6179
Email: rh25v@nih.gov
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Patricia S. Bryant, Ph.D.
Director, Behavioral and Social Science Research
Division of Population and Health Promotion Sciences
National Institute of Dental and Craniofacial Research
National Institutes of Health
Building 45, Room 4AN24E, MSC 6402
Bethesda, MD 20892-6402
Telephone: 301-594-2095
Fax: 301-480-8318
Email: BryantP@de45.nidr.nih.gov
NATIONAL INSTITUTE ON DRUG ABUSE
Minda R. Lynch, Ph.D.
Branch Chief
Behavioral and Cognitive Sciences Research Branch
Division of Neuroscience and Behavioral Research
National Institute on Drug Abuse
National Institutes of Health
6001 Executive Boulevard, Room 4282, MSC 9555
Bethesda, MD 20892
Telephone: 301-435-1322
Fax: 301-594-6043
Email: mlynch1@nida.nih.gov
Leslie C. Cooper, Ph.D., M.P.H.,B.S.N.,R.N.
Research Program Director for the Epidemiology, Etiology and
Consequences of
Drug Abuse in Special Populations and Health Disparities.
Captain/USPHSCC
Nurse Epidemiologist
NIH/NIDA/DESPR
6001 Executive Boulevard, Room 5167, MSV 9589
Bethesda, MD 20892-9589
Telephone: 301-402-1906
Fax: 301-480-2543
Email: lc58q@nih.gov
NATIONAL INSTITUTE OF MENTAL HEALTH
Emeline Otey, Ph.D.
Division of Mental Disorders, Behavioral Research and AIDS
National Institute of Mental Health
6001 Executive Boulevard, Room 6186, MSC 9625
Bethesda, MD 20892-9625
Telephone: 301-443-1636
Fax: 301-443-4611
Email: eotey@nih.gov
Christopher M. Gordon, Ph.D.
Division of Mental Disorders, Behavioral Research, and AIDS
National Institute of Mental Health
6001 Executive Boulevard, Room 6204, MSC 9619
Bethesda, MD 20892-9619
Telephone: 301-443-1613
Email: cgordon1@mail.nih.gov
NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE
Margaret P. Jacobs
Program Director, Epilepsy Research
National Institute of Neurological Disorders and Stroke, NIH
Neuroscience Center
6001 Executive Boulevard, Room 2138, MSC 9523
Bethesda, MD 20892-9523
Telephone: 301-496-1917
Fax: 301-480-2424
Email: mj22o@nih.gov
OFFICE OF THE DIRECTOR, NIH:
OFFICE OF AIDS RESEARCH
Paul A. Gaist, Ph.D., M.P.H.
Health Scientist Administrator
Office of AIDS Research
Office of the Director
National Institutes of Health
Building 31, Room 4C06
31 Center Drive
Bethesda,MD 20892
Telephone: 301-402-3555
Fax: 301-496-4843
E-mail: gaistp@nih.gov
OFFICE OF RESEARCH ON WOMEN'S HEALTH
Joyce Rudick
Director, Programs and Management
Building 1, Room 201
9000 Rockville Pike, MSC 0161
Bethesda, MD 20892-0161
Telephone: 301-402-1770
Fax: 301-402-1798
Email: Joyce_Rudick@nih.gov
o Direct your questions about peer review issues to:
Mariela C. Shirley, Ph.D.
Risk, Prevention, and Health Behavior IRG
Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1102, MSC 7848
Bethesda, MD 20892-7848
Bethesda, MD 20817 (For express/courier service)
Telephone: 301-435-3554
Fax: 301-480-3962
Email: Shirleym@csr.nih.gov
o Direct your questions about financial or grants management
matters to:
FOGARTY INTERNATIONAL CENTER
Bruce Butrum
Grants Management Officer
Grants Office
Fogarty International Center
Building 31, Room B2C29
31 Center Drive,MSC 2220
Bethesda, MD 20892-2220
Telephone: 301-496-1670
Fax: 301-402-0779
Email: butrumb@mail.nih.gov
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
H. George Hausch, Ph.D.
Division of Extramural Activities
National Institute of Dental and Craniofacial Research
National Institutes of Health
Building 45, Room 4AN-44K, MSC 6402
Bethesda, MD 20892-6402
Telephone: 301-594-2904
Fax: 301-480-8303
Email: George.Hausch@nih.gov
LETTER OF INTENT
Prospective applicants are asked to submit a letter of intent that
includes the following information:
o Descriptive title of the proposed research
o Name, address, and telephone number, of the Principal Investigator
o Names of other key personnel
o Participating institutions
o Number and title of this RFA
Although a letter of intent is not required, is not binding, and does
not enter into the review of a subsequent application, the information
that it contains allows IC staff to estimate the potential review workload
and plan the review.
The letter of intent is to be sent by the date listed at the beginning
of this document. The letter of intent should be sent to:
Kathleen Michels, Ph.D.
Program Director
Division of International Training and Research
Fogarty International Center
Building 31, Room B2C39
31 Center Drive, MSC 2220
Bethesda, MD 20892-2220
Telephone: 301-435-6031
Fax: 301-402-0779
Email: Michelsk@nih.gov
SUBMITTING AN APPLICATION
Applications must be prepared using the PHS 398 research grant
application instructions and forms (rev. 5/2001). 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.
SUPPLEMENTAL INSTRUCTIONS:
Description section: If a country other than the home country of the
applicant institution is involved in the application, please include the
name of the other country or countries in your description.
Canadian Applicants: Applicants who wish to have their projects considered
for funding by CIHR and IDRC must include with their application a letter
stating that their application and summary statement should be shared with
CIHR and IDRC.
R21 applications: limit of 20 pages for the Research Plan (sections a-d).
SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS: Applications
requesting up to $250,000 per year in direct costs must be submitted in a
modular grant format. The modular 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.
USING THE RFA LABEL: The RFA label available in the PHS 398 (rev. 5/2001)
application form must be affixed to the bottom of the face page of the
application. Type the RFA number on the label. Failure to use this label
could result in delayed processing of the application such that it may not
reach the review committee in time for review. In addition, the RFA title
and number must be typed on line 2 of the face page of the application form
and the YES box must be marked. The RFA label is also available at:
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf.
SENDING AN APPLICATION TO THE NIH: Submit a signed, typewritten original of
the application, including the Checklist, and four 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)
At the time of submission, one additional copy of the application must be
sent to:
Kathleen Michels, Ph.D.
Program Director
Division of International Training and Research
Fogarty International Center
Building 31, Room B2C39
31 Center Drive, MSC 2220
Bethesda, MD 20892-2220
Phone: 301-435-6031
Fax: 301-402-0779
Email: Michelsk@nih.gov
APPLICATION PROCESSING: Applications must be received by the application
receipt date listed in the heading of this RFA. If an application is
received after that date, it will be returned to the applicant without review.
The Center for Scientific Review (CSR) will not accept any application in
response to this RFA 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 substantial
revisions of applications already reviewed, but such applications must
include an Introduction addressing the previous critique.
PEER REVIEW PROCESS
Upon receipt, applications will be reviewed for completeness by the CSR and
responsiveness by the participating Institutes and Centers. Incomplete
applications will be returned to the applicant without further consideration.
If the application is not responsive to the RFA, CSR staff may contact the
applicant to determine whether to return the application to the applicant or
submit it for review in competition with unsolicited applications at the next
appropriate NIH review cycle.
Applications that are complete and responsive to the RFA will be evaluated
for scientific and technical merit by an appropriate peer review group
convened by the CSR in accordance with the review criteria stated below.
As part of the initial merit review, all applications will:
o Receive a written critique
o May undergo a process in which only those applications deemed to have the
highest scientific merit, generally the top half of the applications under
review, will be discussed and assigned a priority score
o Receive a second level review by the National Advisory Council of the
relevant participating IC 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 discuss the following
aspects of your application in order to judge the likelihood that the
proposed research will have a substantial impact on the pursuit of these
goals:
o Significance
o Approach
o Innovation
o Investigator
o Environment
The scientific review group will address and consider each of these criteria
in assigning your application's overall score, weighting them as appropriate
for each application. Your 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, you may propose to carry out
important work that by its nature is not innovative but is essential to move
a field forward.
(1) SIGNIFICANCE: Does your study address an important problem related to
stigma and health? If the aims of your application are achieved, how do they
advance scientific knowledge? What will be the effect of these studies on the
concepts or methods that drive this field?
(2) APPROACH: Are the conceptual framework, design, methods, and analyses
adequately developed, well integrated, and appropriate to the aims of the
project? Do you acknowledge potential problem areas and consider alternative
tactics? Do your project use multidisciplinary tools, techniques and
expertise to address stigma and health at various levels?
(3) INNOVATION: Does your project employ novel concepts, approaches or
methods? Are the aims original and innovative? Does your project challenge
existing paradigms or develop new methodologies or technologies?
(4) INVESTIGATOR: Are you appropriately trained and well suited to carry out
this work? Is the work proposed appropriate to your experience level as
the principal investigator and to that of other researchers (if any)?
(5) ENVIRONMENT: Does the scientific environment in which your 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, your
application will also be reviewed with respect to the following:
o SPECIFIC R21 REVIEW CRITERIA:
Innovation of the project and potential significance of the proposed
research will be the major considerations in the evaluation of the R21
exploratory grant mechanism. Because the R21 is designed to support
innovative ideas, preliminary data as evidence of feasibility of the
project are not required. However, the applicant is also responsible for
presenting the background literature that provides some basis for the
approach and for developing a rigorous research plan. Relevant pilot data
should be cited when available.
o PROTECTIONS: The adequacy of the proposed protection for humans, animals,
or the environment, to the extent they may be adversely affected by the
project proposed in the application.
o INCLUSION: 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. Plans for the recruitment and
retention of subjects will also be evaluated. (See Inclusion Criteria
included in the section on Federal Citations, below)
o DATA SHARING: The adequacy of the proposed plan to share data.
o BUDGET: The reasonableness of the proposed budget and the requested
period of support in relation to the proposed research.
RECEIPT AND REVIEW SCHEDULE
Letter of Intent Receipt Date: October 14, 2002
Application Receipt Date: November 14, 2002
Peer Review Date: February 2003
Council Review: May 2003
Earliest Anticipated Start Date: July 1, 2003
AWARD CRITERIA
Award criteria that will be used to make award decisions include:
o Scientific merit (as determined by peer review)
o Availability of funds
o Programmatic priorities
REQUIRED FEDERAL CITATIONS
MONITORING PLAN AND DATA SAFETY AND MONITORING BOARD:
Research components involving Phase I and II clinical trials must include
provisions for assessment of patient eligibility and status, rigorous data
management, quality assurance, and auditing procedures. In addition, it is
NIH policy that all clinical trials require data and safety monitoring, with
the method and degree of monitoring being commensurate with the risks (NIH
Policy for Data Safety and Monitoring, NIH Guide for Grants and Contracts,
June 12, 1998: http://grants.nih.gov/grants/guide/notice-files/not98-084.html).
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 AMENDMENT "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.
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 RFA in a public
archive, which can provide protections for the data and manage the
istribution 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.
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 RFA is related to
one or more of the priority areas. Potential applicants may obtain
a copy of "Healthy People 2010" at http://www.health.gov/healthypeople.
AUTHORITY AND REGULATIONS: This program is described in the Catalog of Federal
Domestic Assistance No. 93.989. Awards are made under authorization of sections
301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and
administered under NIH grants policies and Federal Regulations 42 CFR 52 and 45
CFR Parts 74 and 92. This program is not subject to the intergovernmental review
requirements of Executive Order 12372 or Health Systems Agency review.
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.
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