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National Institute of Nursing Research (NINR)

Tribal Health Research Office (THRO)

The purpose of this notice is to inform the research community of the National Institute of Nursing Research (NINR) and above participating NIH Institutes, Centers, and Offices (ICOs) intent to publish a funding opportunity announcement, advancing integrated models (AIM) of care, intended to stimulate research to inform the development and implementation of interventions focused on the provision of supportive care, throughout the pregnancy continuum, among populations who bear a disproportionate burden of severe maternal morbidity and mortality (i.e., Black/African American, American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, Hispanic/Latina, and Asian women).

This Notice is being provided to allow potential applicants sufficient time to develop meaningful collaborations and responsive projects. 

This FOA will utilize the R21 activity code. Details of the planned FOA are provided below.

Research Objectives
Persistent disparities in maternal health outcomes is a public health crisis that requires new insights and solutions, especially in disproportionately impacted populations such as American Indian, Alaska Native, Native Hawaiian, and Pacific Islander women where little is known about root causes and potential solutions to addressing them. This initiative will support original qualitative, quantitative, and mixed-methods research to inform development of integrated models of supportive care, as well as pilot or feasibility studies of new or adapted interventions as an initial step in implementing a larger intervention trial. Studies can focus on any maternal care timepoint, the antepartum, intrapartum, or postpartum period. Projects must involve the priority population of pregnant/postpartum women in the research process and use a conceptual framework to guide efforts.

For this initiative, integrated supportive care is defined as care that addresses healthcare access, healthcare quality, and the social conditions in which people live, work, worship, and play through use of supportive care persons and services. Supportive care can include but is not limited to care provided by or through: doulas, certified nurse midwives, community health workers, care navigators, social workers or social service providers, mental health specialists, childbirth educators, traditional healers, group-based prenatal care, or a maternity care home.. Specific focus within each domain of interest can include, but is not limited to:

• Healthcare access related to appointment scheduling, care coordination, availability of care, and health insurance status;
• Healthcare quality related to timeliness of care, comorbid diagnoses, provision of general and specialty care, labor and delivery support, patient-provider communication, and education; and
• Social conditions related to food access, transportation, and housing.

Studies must involve the priority population of pregnant/postpartum women in the research process. This can be accomplished through multisectoral partnerships with, but not limited to, patient advocacy groups, community-based organizations, obstetric clinics, hospital systems, social service organizations, birthing centers, and tribal communities and organizations.

TBD