NIH

Transformative Research to Address Health Disparities and Advance Health Equity (U01 Clinical Trial Optional)

https://grants.nih.gov/grants/guide/rfa-files/RFA-NR-24-004.html

Purpose

This funding opportunity supports unusually innovative intervention research which, if successful, would have a major impact on preventing, reducing, or eliminating health disparities and advancing health equity. Interventions addressing research questions that target social determinants of health (SDOH), which include structural factors and conditions of daily life, are required for this initiative (See NIH SDOH conceptualization here https://www.ninr.nih.gov/researchandfunding/nih-sdohrcc#tabs2). SDOH can be addressed alone or in combination with other determinants of health and as part of a single or multilevel intervention approach. Although a formative research phase may be necessary for some projects, an intervention research component is required for each proposed project. Applicants may propose interventions addressing disparities in any health condition, disease, or health behavior that align with the priority research areas of listed NIH Institutes, Centers, and Offices.

This initiative invites intervention research focused on transformative research ideas. To be considered transformative, projects should reflect ideas substantially different from traditional concepts and have high potential to lead to major improvements in health through the development, implementation, or dissemination of innovative interventions to address health disparities and health inequities. To accelerate progress in reducing health disparities, this funding opportunity seeks to support interventions that advance or solidify strategies, policies, programs, and environmental changes to address the Nation’s most pressing health challenges. Innovative interventions could take many forms depending on the population of interest and health disparity being addressed. Note that "innovation" can include development and testing of an innovative intervention, new implementation and/or dissemination strategies for evidence-based interventions, and/or creative evaluation of a novel or unusual policy, program, or environmental change to provide insight into their health impacts.

Several key features of this funding opportunity are designed to emphasize that Transformative Research to Address Health Disparities and Advance Health Equity applications are different from conventional, investigator-initiated research applications. These applications focus on the significance of the problem, the novelty of the hypothesis and/or the proposed methodology, and the magnitude of the potential impact rather than on preliminary data or experimental details. No preliminary data are required for applications submitted in response to this funding opportunity, but could be included if available. Applicants should keep the goal of the Transformative Research to Address Health Disparities and Advance Health Equity initiative in mind throughout the process – to develop, implement, disseminate, and/or evaluate innovative interventions and strategies that address health disparities and that seek to advance health equity.

To support the most innovative and impactful research, the NIH recognizes the need to promote a diverse research workforce (see NOT-OD-20-031 for NIH Interest in Diversity). Applications to this award program should reflect the full diversity of potential applicants and applicant institutions. Applications from researchers with diverse backgrounds underrepresented across roles and positions in research, including underrepresented racial and ethnic groups, persons with disabilities, and women are strongly encouraged to apply. Outstanding research is conducted at a broad spectrum of institutions. To support the highest quality research, this funding opportunity encourages applications from the full range of eligible institutions, including those that may serve primarily underrepresented groups, those that may be less research-intensive, and from all domestic geographic locations.

Background

Despite scientific and technological discoveries that improved the health of the U.S. population overall, racial and ethnic minority populations and other populations marginalized by society continue to bear a disproportionate burden of disease and premature death. The life expectancy at birth for Black/African American and American Indian/Alaska Native populations is 6 and 11 years lower than for the non-Hispanic White population. Across diseases and conditions, these disparities deepen with a large variance attributed to historical injustices and present social inequities that limit the opportunity of communities and populations to live and maintain lives that are health-promoting. These factors are known as SDOH which shape individual, community, and population health across the life span.

Research Objectives

Projects are expected to propose exceptionally innovative and transformative activities that are urgently needed to prevent, reduce, or eliminate health disparities and advance health equity. Projects may prospectively test new or adapted interventions (referred to as prospective interventions), evaluate existing or upcoming novel or unusual policy, programmatic, or environmental changes to generate significantly novel insights, or conduct innovative dissemination and implementation research. Research projects must address one or more SDOH as conceptualized by the NIH (https://www.ninr.nih.gov/researchandfunding/nih-sdohrcc#tabs2). SDOH can be addressed alone or in combination with other determinants of health and as part of a single or multilevel intervention approach. Studies should be guided by a conceptual framework identifying hypothesized pathways between the intervention or program and outcome(s). All projects should examine the mechanisms by which the intervention alters health and health disparities.

Projects must include a focus on one or more NIH-designated populations that experience health disparities in the US, which includes racial and ethnic minority populations, people with lower socioeconomic status, underserved rural populations, sexual and gender minority populations, people with disabilities, and any subpopulations that can be characterized by the intersection of two or more of these descriptors. As appropriate, studies are encouraged to explicitly examine whether the intervention mitigates differences in health outcomes between health disparity and non-health disparity populations. Given the heterogeneity within health disparity populations, within-group comparisons of intervention effects that allow for discovery of health risk and resilience factors are also encouraged.

Innovative approaches to identifying, understanding, and developing strategies for overcoming barriers to the adoption, adaptation, integration, scale-up and sustainability of evidence-based interventions, tools, policies, and guidelines are of interest. Projects that focus on elimination of interventions that are ineffective, unproven, low-value, or harmful in advancing health equity are also invited. Implementation research aims should be guided by equity-oriented theoretical models and frameworks. Modeling studies that evaluate the impact of specific interventions and implementation strategies to identify leverage points on costs and prioritizing strategies, particularly across the broad multi-sector nature of SDOH to inform scale up of interventions across communities and contexts, would also be responsive. Research that directly tests the effectiveness of SDOH interventions in narrowing health gaps between health disparity and non-health disparity populations is also strongly encouraged.

Community Partnerships: Projects must document or demonstrate throughout the research process meaningful community partnerships to foster the development of feasible and acceptable approaches as well as acceptance, uptake, and sustainability of proposed interventions and strategies. Community partners can include, but are not limited to, those in the housing, transportation, food system, economic development, education, social services, and criminal legal system sectors. Applicants should provide details on the nature and extent of the partnerships by clearly describing the roles of partners and providing evidence of support from partners.

Prospective Interventions to Address SDOH may develop and test the effectiveness of new or adapted interventions in a variety of settings in the U.S., such as neighborhoods, community-based organizations, child welfare and human service settings, workplaces, businesses, stores and restaurants, schools, criminal justice settings, faith-based organizations, public works and facilities, healthcare systems, and recreational settings. Approaches may include group or cluster randomized controlled trial (RCT), stepped wedge RCT, stepped wedge group or cluster RCT, pragmatic RCT, pragmatic trials, adaptive designs (e.g., multiphase optimization strategy [MOST], sequential multiple assignment randomized trials [SMART]), implementation trials (including hybrid effectiveness/implementation designs), and rigorous quasi-experimental designs.

Examples of projects supported in this category include, but are not limited to, studies that develop and evaluate the effectiveness of interventions to improve health or reduce health disparities by:

• Improving community conditions through community revitalization investment projects
• Improving economic stability, such as through increased job opportunities or quality employment
• Improving housing access, quality, or affordability
• Improving education quality
• Reducing community-level violence, including firearm violence
• Improving the availability or quality of green spaces or recreational spaces
• Improving community childcare availability together with providing access to parental support groups
• Improving nutritious food availability in the community in addition to providing primary care-based nutritional counseling to individuals

Study Designs: Randomization may not be possible for all intervention studies, e.g., where it is not possible to assign participants to high versus low discrimination conditions or in small sample sizes where cross intervention contamination is likely to occur or be a problem. Alternative rigorous research designs that provide robust evidence of intervention effectiveness include quasi-experimental designs, such as multiple baseline or repeated measures design or interrupted time series design. Also, hybrid effectiveness-implementation designs allow observational investigation of implementation processes while also testing intervention effectiveness. Investigators should justify their research and analytic design selection and provide adequate evidence of their ability to execute a rigorous and appropriate analysis of randomized or non-randomized study data.

Non-Responsive Applications

The following studies will be considered non-responsive for this announcement:

• Projects that do not address one or more SDOH as conceptualized as structural factors and conditions of daily life
• Projects that intervene solely at the individual/family level and not on SDOH as conceptualized by the NIH
• Intervention projects that do not include a community partnership
• Projects that do not focus on a population at higher risk of morbidity or mortality based on race, ethnicity, socioeconomic status, rurality, sexual orientation, and/or ability status
• Projects focusing on populations outside of the United States
• Projects that do not include a Plan for Enhancing Diverse Perspectives
• Construction and major renovations costs are unallowable through this RFA. Applications that propose to use grant funds to support construction or major alteration and renovation projects will be considered non-responsive.

NIH Institute Interest

https://obssr.od.nih.gov/about/violence-research-initiatives

Violence Research Initiatives

Violence—defined by the World Health Organization as “the intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation”—is a significant public health problem that has profound impacts on lifelong health, opportunity, and well-being.

The National Institutes of Health (NIH) supports scientific research to increase our understanding of public health interventions to prevent different forms of violence and the trauma, injuries, and mortality resulting from them. Given that violence research cuts across many NIH institutes and centers and the central role of behavioral and social science research in violence related research, the NIH Office of Behavioral and Social Sciences Research (OBSSR) has increasingly played a coordinating role for this research at NIH. These efforts build off and complement existing NIH Institute, Center, and Office (ICO) priorities and of effective initiatives focused on specific types of violence such as child or elder maltreatment, youth violence, bullying, online harassment and abuse, community violence, intimate partner violence, and sexual violence.

The FY2020 Further Consolidated Appropriations Act, FY21 Consolidated Appropriations Act, FY22 Consolidated Appropriations Act, and FY23 Consolidated Appropriations Act provided $12.5 million dollars of funding for each of the past 4 years to NIH to conduct research on firearm injury and mortality prevention by taking a comprehensive approach to studying the underlying causes and evidence-based methods of prevention of firearm injury, including crime prevention. Congressional language noted that the research must be ideologically and politically unbiased, that no funds could be used to advocate or promote gun control, and that grantees were required to fulfill NIH requirements around open data, open code, pre-registration of research projects, and open access to research articles.

Firearms Focused Notices of Funding Opportunities (NOFO) Funded Projects FY2020 FY2021 FY2022 FY2023

FY2020 and FY2021 OBSSR, along with IC partners, developed Notice of Funding Opportunity (NOFOs) PAR-20-143, NOT-OD-20-089, PAR-21-191 and PAR-21-192, that were intended to build upon the existing NIH research portfolio and address emerging opportunities. The NOFOs took a broad public health approach to firearm injury and mortality prevention, encouraging research on interventions delivered in healthcare and community settings, integration of individual, family, interpersonal, community, and structural or system (e.g., legal, child welfare) approaches and included focusing on both victimization and perpetration of firearm violence across the life course and across populations.

FY2022 OBSSR worked with other ICs to coordinate two NOFOs, PAR 22-115 and PAR 22-120, that solicited applications for a coordinating center and a network of research projects to develop and test community/organization level interventions to prevent firearm and related violence, injury and mortality. The goal of the network is to support research projects to develop, implement, and evaluate innovative interventions that seek to modify characteristics of organizations, environments and/or settings to target higher order, “root” causes of firearm mortality and injury. The Coordinating Center will provide cross-network coordination, communication, analytics, engagement, and dissemination efforts to enhance the impact and generalizability of the study findings.

FY2023 OBSSR coordinated with other ICOs to publish a NOFO (PAR-23-066) that was a re-issue of PAR-22-115 to add additional network sites. In addition, NIH published two NOFOs (PAR-23-107 and PAR-23-108) focused on advanced training and career development for established NIH investigators in related fields to obtain the necessary skills and expertise to integrate firearm injury prevention work into their research. These awards will be a critical first step into expanding the field of qualified researchers and building capacity for the future. OBSSR issued a Notice of Intent to Publish a Funding Opportunity Announcement for Career Enhancement Awards to Advance Research on Firearm Injury and Mortality Prevention (NOT-OD-23-192) on September 29, 2023. This NOFO is expected to be published in Winter 2023/2024 with an expected application due date in Spring 2024.

Meet the Community Firearm Violence Prevention Network The Community Firearm Violence Prevention Network (CFVP) was seeded in September 2022 with three sites and a coordinating center at the University of Michigan. Three additional sites were added in September 2023. To meet the network and learn more about its projects, people, and activities,

NIH-Wide Firearms Mortality Prevention NOFO: On December 16, 2022, OBSSR and NIH ICOs (National Institute on Aging (NIA), National Institute on Alcohol and Alcoholism (NIAAA), National Institute of Child Health and Human Development (NICHD), National Institute on Drug Abuse (NIDA), National Institute of Mental Health (NIMH), National Institute of Nursing Research (NINR), National Institute on Minority Health and Health Disparities (NIMHD), The National Center for Complementary and Integrative Health (NCCIH), The Sexual & Gender Minority Research Office (SGMRO), Office of Disease Prevention (ODP) and Office of Research on Women's Health (ORWH)) released a Notice of Special Interest (NOSI): Firearm Injury and Mortality Prevention Research (NOT-OD-23-039). The purpose of this Notice is to highlight interest in research to improve understanding of the determinants of firearm injury, the identification of those at risk of firearm injury (including self- and other-directed, victims and perpetrators, accidental injury), the development, piloting, and testing of innovative interventions to prevent firearm injury and mortality, and the examination of approaches to improve the implementation of existing, evidence-based interventions to prevent firearm injury and mortality. This Notice will expire on February 5, 2026.

Active NOFOs On July 8, 2022, OBSSR and NIH ICOs (National Institute on Aging (NIA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Dental and Craniofacial Research (NIDCR), National Institute on Drug Abuse (NIDA), National Institute Of Mental Health (NIMH), National Institute of Nursing Research (NINR), National Institute on Minority Health and Health Disparities (NIMHD), Sexual & Gender Minority Research Office (SGMRO), Office of Disease Prevention (ODP) and Office of Research on Women's Health (ORWH)) released a Notice of Special Interest (NOSI): Research on Addressing Violence to Improve Health Outcomes (NOT-OD-22-167). The purpose of this Notice is to highlight interest in addressing the role of violence in health outcomes and integrating violence-related screening and interventions into health care settings. This Notice is to encourage intervention research focused on addressing exposure to violence - including but not limited to child maltreatment, intimate partner violence/teen dating violence, elder mistreatment, peer violence/bullying, and community violence – to improve individual-level health processes and outcomes. This Notice will expire on October 5, 2025.

On October 4, 2023, OBSSR and NIH ICOs (Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institute of Nursing Research (NINR), Sexual & Gender Minority Research Office (SGMRO), Office of Disease Prevention (ODP) and Office of Research on Women's Health (ORWH)) released:

RFA-OD-24-001: Career Enhancement Award to Advance the Study of Intimate Partner Violence (IPV) in the Context of Maternal Morbidity and Mortality Research (K18 Clinical Trial Not Allowed). This Notice of Funding Opportunity (NOFO) is designed specifically to support investigators proposing research that does not involve leading an independent clinical trial, a clinical trial feasibility study, or an ancillary clinical trial. Under this NOFO candidates are permitted to propose a research experience in a clinical trial led by a mentor or co-mentor. Those proposing a clinical trial or an ancillary clinical trial as lead investigator, should apply to the companion NOFO (RFA-OD-24-002). This funding opportunity will expire on December 2, 2023. RFA-OD-24-002: R25 for Short Courses on Techniques for Measuring Intimate Partner Violence (IPV) in Different Populations (R25 Clinical Trial Not Allowed). The NIH Research Education Program (R25) supports research education activities in the mission areas of the NIH. The overarching goal of this R25 program is to support educational activities that foster a better understanding of biomedical, behavioral and clinical research and its implications. This funding opportunity will expire on December 2, 2023.

Phillisafe

• what is teh current state
• what is teh specific plan
• who are community leaders engaed? Is there a spercific organization? Is there a city or state support to thios organizations
• Is violent crime a serious problem
• Has recent standrad measures being effective
• Greening measures, plan, steps, stages etc.

https://www.publichealth.columbia.edu/profile/charles-branas-phd#related-news