Notice of Intent to Publish a Funding Opportunity Announcement for Firearm Injury Prevention in Community Healthcare Settings (R01 Clinical Trial Optional)

Key Dates

None

National Institute of Nursing Research (NINR)

All applications to this funding opportunity announcement should fall within the mission of the Institutes/Centers. The following NIH Offices may co-fund applications assigned to those Institutes/Centers.

Division of Program Coordination, Planning and Strategic Initiatives, Office of Disease Prevention (ODP)

Office of Behavioral and Social Sciences Research (OBSSR)

Office of Research on Women's Health (ORWH)

The purpose of this notice is to inform the research community that the National Institute of Nursing Research (NINR) intends to promote a new initiative by publishing a Request for Applications (RFA) to advance research that reduces firearm injury and disparities through the development and evaluation of firearm injury primary prevention interventions leveraging community healthcare settings.

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

This RFA will utilize the R01 activity code. Details of the planned RFA are provided below.

The purpose of this initiative is to advance research that reduces firearm injury and disparities through the development and evaluation of firearm injury primary prevention interventions leveraging community healthcare settings. Projects that include translation into routine practice are also invited. Following the public health model from the 2019 Medical Summit on Firearm Injury Prevention, primary prevention refers to events happening prior to discharge of a firearm, such as safe firearm storage and handling, safety training, screening, community-building and investment, and programs addressing social determinants of health or unmet social needs. Prevention interventions at multiple levels are needed to address firearm morbidity and mortality due to both intentional injury (including suicide) and unintentional injury. Under this initiative, NINR is interested in novel and creative approaches to firearm injury prevention that capitalize on community healthcare settings, to identify risk factors; reduce exposure risk in individuals, families, and populations; prevent injury or reoccurrence of injury; and mitigate disparities. 

In alignment with its mission and focus on a holistic, contextualized approach to optimizing health for all people, NINR prioritizes research that meaningfully incorporates social determinants of health (SDOH) as primary drivers of health and health disparities. Effective and sustainable solutions to the challenge of firearm injury prevention demand the integration of an SDOH perspective. Firearm injury is a complex problem that requires attention to the context in which individuals live, learn, work, play, worship, and age, and how these factors intersect, including how those factors contribute to risk, exposure, and injury. Meaningful engagement of the community in the research is necessary to develop sustainable solutions. Nursing’s contributions to injury prevention in the varied community healthcare settings where nurses practice will be emphasized. 

For this funding opportunity, community healthcare settings include locations where individuals interact with health care personnel outside of acute care settings. These community healthcare settings include, but are not limited to, schools; primary care centers including Federally Qualified Health Centers; non-hospital-based locations where walk-in and same-day services are available including pharmacies, pharmacy-based clinics, vaccination clinics, and mobile health units; home health care; workplaces; faith-based clinics; and other local community settings where healthcare is provided (e.g., WIC centers, Senior Centers, Health Fairs, etc.). Acute healthcare settings, including but not limited to hospitals and emergency departments are excluded.

Scope and Objectives

This funding opportunity will solicit applications that focus on primary prevention of firearm injury leveraging community healthcare settings. Applications may propose intervention studies with a rigorous design including but not limited to policy implementation studies, natural experiments and other studies with a quasi-experimental design, as well as those meeting the NIH definition of a clinical trial. Aims may focus on efficacy, effectiveness, or hybrid effectiveness/implementation research. Health or behavioral outcomes for this funding opportunity should be appropriate to the aims and should include, but are not limited to, changes in behavior related to firearm injury prevention and firearm safety procedures, and implementation outcomes. Change in knowledge of firearm injury prevention measures may be a secondary outcome (e.g., as a mechanism of action) but should not be the focus of the project. Multi-level, multi-disciplinary interventions and outcomes are encouraged, including individual, interpersonal, organizational, and community levels. Individual level outcomes should be one of the outcome levels included. Rigorous methods that address potential sources of bias that are appropriate to the study design are expected. Intervention studies are expected to include a theory-informed examination of the mechanisms of intervention effects.

Projects that will be responsive to this funding opportunity include R01 studies of all size, from small, single-site, three-year projects such as to adapt an intervention to the community or to test efficacy of an intervention, to large multi-site trials to test effectiveness and implementation strategies. Years requested and project budgets should reflect the scope of the project. A description of plans for community engagement, including clear justification of the planned approach, is required. Projects that focus on populations that experience health disparities are highly encouraged.

Research Objectives

Research questions that might be addressed through this funding opportunity include, but are not limited to:

• What are effective interventions, systems, and models of care that leverage community healthcare settings to reduce risk, exposure, and firearm injury?
• What are effective interventions, systems, and models of care that leverage community healthcare settings to mitigate disparities in risk, exposure, and firearm injury? 
• How do social determinants of health (perspective using the NIH-wide Social Determinants of Health conceptualization) and individual or family social needs affect risk, exposure, or injury, and alter effectiveness of firearm injury prevention programs, their implementation in routine practice, and their sustainability? 
• How can effective interventions for screening, directed assessments, and brief education interventions be customized or tailored for use, implemented into a specific community setting, and sustained? 
• What are effective strategies to support equitable access to effective firearm injury prevention programs within the context of an encounter with a nurse? 
• What models of care leveraging nurses' unique perspectives, skills, and relationships with people and organizations with whom they interact are effective in integrating firearm injury prevention activities in community healthcare settings? 
• What are the best approaches to integrate effective interventions for firearm injury prevention into community healthcare settings, reduce health disparities, and promote health equity?
• What strategies close the gap in access to equitable firearm injury prevention programs among diverse and disadvantaged individuals, families, populations defined by intersecting identities, and communities, and which interventions are most effective?
• How do changes in local, state, and federal health care and non-health care policies (e.g., laws/policies regarding insurance coverage, eligibility for services, workplace safety) influence the effectiveness of firearm injury prevention?

Examples of projects supported by this funding opportunity can include, but are not limited to: 

• Studies testing effectiveness of a universal screening approach in community healthcare settings to identify at-risk individuals, families, and populations where they live, learn, work, play, worship, and age.
• Studies that adapt and test prevention approaches found to be effective in addressing other public health challenges and that have been successfully integrated into practice, such as those addressing seat belt use, smoking cessation, risk factors for alcohol abuse, breast cancer screenings, and others, in a way that normalizes primary prevention of firearm injury.
• Studies that intervene on social determinants of health or social needs to prevent firearm injuries and reduce disparities.
• Studies that test how social determinants of health or social needs modify the effectiveness of interventions, their implementation in routine practice, or their sustainability. 
• Implementation/effectiveness and/or pragmatic trials focusing on multi-level interventions, and sustainability of the intervention.
• Studies developing and testing integrated models of preventive care that span healthcare to community settings.
• Implementation of firearm safety screening in mental health, alcohol- and/or substance-use disorder clinics.
• A natural experiment studying the effects of a firearm injury prevention program implemented in a school district.
   

Funding Information

Public/State Controlled Institution of Higher Education
Private Institution of Higher Education
Nonprofit with 501(c)(3) IRS Status (Other than Institution of Higher Education)
Small Business
For-Profit Organization (Other than Small Business)
State Government
Indian/Native American Tribal Government (Federally Recognized)
County governments
Independent school districts
Public housing authorities/Indian housing authorities
Indian/Native American Tribally Designated Organization (Native American tribal organizations (other than Federally recognized tribal governments)
U.S. Territory or Possession
Indian/Native American Tribal Government (Other than Federally Recognized)
Regional Organization
Eligible Agencies of the Federal Government

Applications are not being solicited at this time. 

Inquiries

Please direct all inquiries to:

Karen Huss, PhD, RN, ANP-BC, FAAN, FAAAAI, FAHA
National Institute of Nursing Research (NINR)
Telephone: 301-594-5970
Email: hussk@mail.nih.gov