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National Cancer Institute (NCI)

This Notice is to inform the research community that the National Cancer Institute (NCI) intends to issue a Request for Applications (RFA) to solicit applications for the Cancer Control Research in Persistent Poverty Areas (U54 Clinical Trials Optional) program. The purpose of this RFA is to provide resources to support the time and effort of transdisciplinary teams in collaboration with communities and clinics to develop a cancer prevention and control research program, and provide training to junior investigators, that focuses on and serves populations in persistent poverty census tracts. The long-term goal of this initiative is to build capacity in persistent poverty census tracts to foster cancer prevention and control research and promote the implementation of programs and practices in communities to alleviate the effects of persistent poverty.

This Notice is being provided to allow potential applicants sufficient time to develop a responsive proposal. The RFA is expected to be published in February 2022 with an expected application due date in July 2022.

This RFA will utilize the U54 activity code requiring at least two research projects (one intervention); a training component; and two pilot studies which will be decided upon after the centers are funded. The aim of the training core is to build a cadre and network of pre- and post-doctoral scholars who are well versed in conducting cancer control and population research in underserved communities, especially in persistent poverty areas.

Potential applicants are required to propose research from the provided list of persistent poverty census tracts. To ensure that the unique social contexts and the historical and contemporary injustices are accounted for and addressed in the research, this RFA allows only within group comparisons in the primary aims of the study. Interventions should be responsive to the unique social contexts and the historical/contemporary injustices and developed, modified, and implemented to meet the needs of particular racial/ethnic and/or geographical group. For example, applicants can compare one persistent poverty census tract(s) to another within an urban area. Therefore, the following limitations are placed on potential applicants and projects. Applications not following these guidelines will be deemed nonresponsive and returned without review:

• The intervention(s) are to be developed and implemented with and for a particular racial/ethnic group. If more than one racial/ethnic group is targeted, it is expected that interventions will not be identical, but uniquely adapted to that racial/ethnic group. Outcome comparisons across racial/ethnic groups are only allowed if the researchers take this adaptation into account.
• Similarly, no comparisons are allowed between geographic areas. Applications proposing comparisons (for example, among rural, urban, and suburban areas) are not allowed, because these areas would differ markedly in social context, structural, and institutional factors.
• Proposed research sites should be in persistent poverty census tract(s) from the attached list. Inclusion of sites from non-persistent poverty areas is not allowed. Thus, comparisons between persistent and non-persistent poverty areas are not allowed.

Awardees will be expected to identify community priorities, address challenges and opportunities related to working in partnership with communities and clinics, and build on existing cancer prevention and control strategies to lessen the burden of cancer in persistent poverty census tracts. It is expected that applicants will propose centers that seek to understand the interaction among various risk factors at multiple levels associated with poor health outcomes experienced by those living in persistent poverty census tracts, including individual, neighborhood/community, structural, institutional, biological, physical, geographic, historical, social, and environmental factors. Thus, an important aspect of this RFA is to develop sustainable cancer prevention and control strategies in persistent poverty census tracts in partnership with local communities, community-based organizations, and primary/local clinics/hospitals.

Examples of specific types/areas of research that may be appropriate are provided below, which applicants are encouraged to consider:

• Identifying pathways by which the effects of place on health can be elucidated, such as the interactions of neighborhoods and people, health care or public health systems, and their social and physical environments, etc.
• Elucidating the multilevel pathways by which protective factors and mechanisms at a population level result in positive health behaviors and outcomes (e.g., ethnic enclaves) in individuals living in persistent poverty
• Characterizing differentials in income and wealth accumulation for subpopulations (e.g., elderly, racial and ethnic minorities, immigrants), and identifying the sources of these differentials and their impacts on health status
• Community-level intervention studies among populations that combine individual and community approaches to healthy lifestyles by integrating psychosocial interventions with traditional management of disease risk factors
• Design and implementation of community-based participatory prevention strategies to promote aggregate-level health by changing social, structural, institutional, and community environments (e.g., tobacco free policy -including promotion of respectful use of tobacco for American Indian and Alaska Native populations; institutional policies)
• Intervention research focusing on the prevention of cancer that incorporates risk and resilience factors such as historical trauma, immigration policies, discrimination, structural racism, housing, and criminal justice practices, etc.

• Identifying and characterizing the social factors that interact with genetic susceptibility/risk factors for cancer and factors that contribute to variation in the prevalence and incidence of cancer for example, determining whether social factors are equally involved in differential cancer prevalence and incidence in various subgroups (e.g., race/ethnicity, sexual gender minorities)
• Developing models for survivorship care, including but not limited to, mitigating treatment-related toxicity
• Research on the development of cancer treatment interventions and service delivery approaches that address historical and contemporary inequities and structural barriers to health services, such as staff training, service delivery settings, novel strategies to match availability of services to population needs, use of digital platforms, language and health literacy barriers, costs, financial toxicity, etc.

Application Guidelines

• Multi-PI applications will be encouraged to maximize the potential of team science efforts and combine capabilities that might be necessary to fulfill the need for specialized multidisciplinary research at the intersection of persistent poverty and cancer control population science research.

• Projects should delineate their partnerships with the community (including, but not limited to, patient navigators, clinicians, local/county/state departments of health) and their specific role in the projects. While it is important to form a community advisory board (CAB), it is not sufficient to merely propose the formation of such a board. The composition (i.e., areas of expertise, location, etc.) and role of the CAB in the projects should be delineated in the application.
• Applicants from NCI-Designated Cancer Centers are encouraged to develop alliances with states that do not have a P30 Cancer Center Support Grant and/or communities outside of their catchment area to build partnerships to address issues of persistent poverty.