NIH GUIDE, Volume 21, Number 34, September 25, 1992

PA NUMBER:  PA-92-105

P.T. 34, FF, II


  Health Promotion 

  Behavioral/Social Studies/Service 


National Institute on Aging

National Institute of Child Health and Human Development

National Institute of Mental Health


The National Institute on Aging (NIA), the National Institute of Child

Health and Human Development (NIDCD), and the National Institute of

Mental Health (NIMH) invite qualified researchers to submit

applications for research to investigate social and behavioral aspects

of women's health during adulthood.  Research is needed to understand

the natural course and consequence of the aging processes of women

(e.g., healthy life expectancy) in a general population of

reproductive-aged, middle aged and older women, as well as a wide range

of special women's issues (i.e., health related behaviors, family life,

role and task demands, psychological well-being, work and productivity)

that may be related to health and/or aging.  Special emphasis on

minority women is an integral part of this solicitation.

Differences between men and women in health and illness, mortality and

social circumstances, appear across the adult lifecourse.  Women

constitute about 60 percent of the population aged 65 and over and

approximately 70 percent of those 85 and over (Lamphere-Thorpe &

Blendon, 1991).  While they live longer, women also experience more

chronic illness and disability than men, due to higher incidence of

nonfatal chronic conditions, such as rheumatoid arthritis, depression,

and osteoporosis (Ory and Warner, 1990).  More than half of women 75

and over live alone.  Of those older women who live alone, they are

five times more likely to be living in poverty as compared to men of

the same age (Aging America, 1991).

There are differences in the circumstances of younger and midlife women

from those of older women.  Women born in 1940 or later experience

later onset of childbearing, fewer children, and complete families

sooner than women born 1910-1940.  These women experience higher

divorce rates and are less likely to have children than women from

older cohorts (U.S. Bureau of the Census, 1990).  Younger and midlife

women may be particularly likely to be balancing competing demands of

differing role responsibilities.

The lifecourse of women, including the timing of family formation and

child-rearing, and aging, is affected by differences in their

experiences.  Family situations and work patterns, including labor

force participation and child-rearing, help shape the character of

other experiences of women, including reproduction, menopause and

aging.  Conversely, the order and timing of lifecourse events, in

addition to chronological age, may also determine family situations and

work experiences.  Women's situations are further influenced by

ethnicity and cultural practices, neighborhood environments, living

arrangements and socioeconomic status.  Health and illness may

influence, as well as be influenced by, these aspects of women's lives.

This Program Announcement (PA) supplements, but does not replace

earlier PAs on related topics (see NIH Guide for Grants and Contracts

Vol. 17, No. 18, May 20, 1981: Gender and Aging:  Relation To Health

and Longevity, and NIH Guide for Grants and Contracts, Vol. 20, No. 36,

September 27, 1991: Special Issues in Women's Health Over the Life


The NIA has a particular interest in supporting research on the health

and well-being of middle-aged and older women.  Earlier social and

behavioral research efforts have included studies of women's health and

functioning in mid-life, gender differences in specific chronic

conditions (e.g., arthritis), burdens of caregiving, family

relationships and widowhood, and women's perceptions and responses to

normal aging (e.g., menopause).

The NICHD is concerned with the health of women during the reproductive

years.  The timing and integration of different events such as union

formation, marriage, the establishment of households, and childbearing

during these years is of interest.  Women from different socioeconomic,

racial, ethnic, and cultural backgrounds may time events differently or

may establish different patterns of integrating work and family roles

(Zambrana, 1987).  More research is needed to identify how the

sociocultural environment and demographic factors such as race, gender

and social class shape attitudes, behaviors, and opportunities which

then influence the health and functioning of women of reproductive

(Ford Foundation, 1991) or older ages.

The NIMH supports basic, clinical, and applied services research that

examines issues relevant to mental disorders or the mental health of

older women.  The NIMH is particularly concerned with factors and

processes that contribute to mental health and adaptation or that may

lead to disorder.  This interest includes studies of gender differences

in psychological processes that may play a role in mental disorder and

interpersonal, family, societal, and cultural processes that may

constitute risk or protective factors in relation to mental health


Research has demonstrated that health and the aging process are

responsive to some degree of intervention and control.  By identifying

factors in the sociocultural environment that either positively or

negatively affect reproduction, adult women's health, and the aging

process it is possible to design specific interventions that can

improve the health and functioning of women and lead to an overall

improvement in the quality of life for women over the lifecourse.

In line with increasing calls for additional research on traditionally

ignored women's health issues (Society for the Advancement of Women's

Health Research, 1991; Institute of Medicine, 1991; Ory and Warner,

1990; Rodin and Ickovics, 1990), the NIA, the NICHD and the NIMH are

targeting the following areas of social and behavioral aspects of

women's health and aging for more in-depth examination:

o  Improved healthy life expectancy, psychological adjustment, and

quality of life

o  Women's health behaviors, especially in the context of family, work,

and community

o  Labor force participation over the lifespan and its relationship to

women's well-being, health, and mortality

o  Multiple roles, stress, stress buffers (such as social support), and

physical, psychological, and social consequences for women

o  Minorities, special populations and cross-national research

This PA encourages two basic types of research:  (1) research on

women's special life circumstances and health needs and (2) comparative

research of women and men at differing points in the lifecourse,

examining antecedents and consequences of gender differences in health

status, health behaviors, social role, and life circumstances.  The

nature of a woman's aging experience and her health across the

lifecourse is influenced by a variety of factors, therefore, research

is also encouraged on ethnic, socioeconomic, and racial differences;

changing gender and economic roles; and the special needs of

reproductive aged, middle aged, and older women.


The Public Health Service (PHS) is committed to achieving the health

promotion and disease prevention objectives of "Healthy People 2000,"

a PHS-led national activity for setting priority areas.  This PA,

Women's Health Over the Lifecourse:  Social and Behavioral Aspects, is

related to the priority areas of age-related objectives for adults and

older adults and objectives for special populations, including people

in minority groups.  Potential applicants may obtain a copy of "Healthy

People 2000" (Full Report:  Stock No. 017-001-00474-0 or Summary

Report:  Stock No. 017-001-004730-1) through the Superintendent of

Documents, Government Printing Office, Washington, DC 20402-9325

(telephone 202-783-3238).


Applications for research grants may be made by public and private,

for-profit and non-profit organizations, such as universities,

colleges, hospitals, and laboratories.  Women and minority

investigators, in particular, are encouraged to apply.  Foreign

institutions are not eligible for all mechanisms.  Foreign applicants

are advised to contact NIA staff to determine eligibility.


Applicants funded under this announcement will be supported through the

PHS grant award in accordance with PHS policies applicable to research

project grants.  All research, career development, and research

training mechanisms are applicable.


Examples of relevant research topics include, but are not limited to,

the following:

Improved Healthy Life Expectancy, Psychological Adjustment, and Quality

of Life

o  comparisons of healthy life expectancy or mortality rates for men

and women, and social and behavioral factors which account for reported


o  determination of the impact of co-morbidities (e.g., heart disease,

cancer, arthritis, HIV/AIDS) on Activities of Daily Living

(ADLs)/Instrumental Activities of Daily Living (IADLs); how various

combinations of diseases/illnesses/injuries affect older women's health

and functioning

o  identification of precursors (i.e., changing health, social, housing

and environment factors, and prior lifecourse experiences) to the high

rates of poverty among the oldest-old

o  identification of gender-related factors (i.e., gender-specific

tasks and activities) that affect women's coping with physical and/or

cognitive problems

Women's Health Behaviors

o  understanding why older women have lower rates of preventive health

behaviors than younger women for breast cancer and other conditions to

which they are particularly vulnerable

o  clarification of the role of socioeconomic and demographic factors,

health perceptions, social supports, attitudes about health and aging,

and current medical practices in health behaviors and attitudes of


o  identification of behavioral and social interventions which are

effective in motivating women to make greater use of preventive health

services across the lifespan

o  identification and examination of social and behavioral components

of biological aging, such as menopause

o  examination of underlying psychosocial and physiological processes

linking health and behavior in women vs. those operating in men

Labor Force Participation

o  studies of the impacts of differences in employment patterns on

physical and mental health and quality of life, as well as other


o  examination of work patterns of women over the life course and their

relation to employment opportunities, income levels and related

benefits (e.g., health insurance coverage, private pensions, social


o  studies of the economic, social and health determinants and

consequences for women who do not participate in the labor force,

participate intermittently, or who retire early vs. late

o  studies of changing work experience and opportunities in different

cohorts of women and the effects on health

o  examination of women's perceptions of job adequacy and perceived

control and their relation to physical and mental health

o  examination of changes in labor force participation (e.g., voluntary

leaves for child rearing, forced unemployment, part-time employment,

retirement) and their relation to changes in health outcomes

Multiple Roles of Women, Stress, Stress Buffers and Physical,

Psychological and Social Consequences For Women

o  understanding how level of support from spouse or other household

members in the presence of multiple roles relates to perceptions of

burden and health

o  studies of community and family services that are designed to

prevent or alleviate strain associated with caregiving and/or multiple

roles (e.g., work/family demands)

o  identification of the impact of employment on health in the presence

of multiple family roles and women's perceptions of work in relation to

these roles

o  examination of different roles of men and women and how they

contribute to gender differences in cognitive functioning, in everyday

functioning (e.g., cooking, shopping, and driving), and in the relation

between cognitive functioning and everyday functioning

o  examination of how caregiving responsibilities, marital status

(divorce, widowhood, single parenthood, cohabitation), and household

structure affect health

Minorities, Special Populations and Cross-National Research

o  examination of how patterns of family structure, immigration and

migration, age and sex ratio, and opportunity for employment affect

specific populations of minority women at different points in the


o  studies of attitudes toward and the availability, utilization, and

quality of health care and other services for women in rural or

under-served areas

o  comparative studies of health care, work, family, and economic

policies affecting women in different countries

o  studies of differences in abilities of particular women at risk

(e.g., low income, immigrant) to adapt to multiple roles and

identification of other specific needs





NIH and ADAMHA policy is that applicants for NIH/ADAMHA clinical

research grants and cooperative agreements will be required to include

minorities and women in study populations so that research findings can

be of benefit to all persons at risk of the disease, disorder or

condition under study; special emphasis should be placed on the need

for inclusion of minorities and women in studies of diseases, disorders

and conditions which disproportionately affect them.  This policy is

intended to apply to males and females of all ages.  If minorities and

women are excluded or inadequately represented in clinical research,

particularly in proposed population-based studies, a clear compelling

rationale should be provided.

The composition of the proposed study population must be described in

terms of gender and race/ethnic group.  In addition, gender and

racial/ethnic issues should be addressed in developing a research

design and sample size appropriate for the scientific objectives of the

study.  This information should be included in the form PHS 398 in

Sections 1-4 of the Research Plan AND summarized in Section 5, Human

Subjects.  Applicants are urged to assess carefully the feasibility of

including the broadest possible representation of minority groups.

However, the NIH recognizes that it may not be feasible or appropriate

in all research projects to include representation of the full array of

United States racial/ethnic minority populations (i.e., Native

Americans (including American Indians or Alaskan Natives),

Asian/Pacific Islanders, Blacks, Hispanics). The rationale for studies

on single minority populations groups should be provided.

For the purpose of this policy, clinical research includes human

biomedical and behavioral studies of etiology, epidemiology, prevention

(and preventive strategies), diagnosis, or treatment of diseases,

disorders or conditions, including but not limited to clinical trials.

The usual NIH policies concerning research on human subjects also

apply.  Basic research or clinical studies in which human tissues

cannot be identified or linked to individuals are excluded.  However,

every effort should be made to include human tissues from women and

racial/ethnic minorities when it is important to apply the results of

the study broadly, and this should be addressed by applicants.

For foreign awards, the policy on inclusion of women applies fully;

since the definition of minority differs in other countries, the

applicant must discuss the relevance of research involving foreign

population groups to the United States' populations, including


If the required information is not contained within the application,

the review will be deferred until the information is provided.

Peer reviewers will address specifically whether the research plan in

the application conforms to these policies.  If the representation of

minorities or women in a study design is inadequate to answer the

scientific question(s) addressed AND the justification for the selected

study population is inadequate, it will be considered a scientific

weakness or deficiency in the study design and will be reflected in

assigning the priority score to the application.

All applications for clinical research submitted to NIH are required to

address these policies.  NIH funding components will not award grants

or cooperative agreements that do not comply with these policies.


Researchers considering an application in response to this announcement

are strongly encouraged to discuss their project, and the range of

grant mechanisms available, with NIA, NICHD, or NIMH staff in advance

of formal submission.  This can be done either through a telephone

conversation or through a brief letter of intent giving the descriptive

title of the proposed project and identifying the Principal

Investigator and, when known, other key participants.

Applicants are to use the research grant application form PHS 398 (rev.

9/91) and PHS 416-1 (rev. 10/91) for Individual Fellowships, available

at the applicant's institutional business office and from the Office of

Grants Inquiries, Division of Research Grants, National Institutes of

Health, Westwood Building, Room 240, Bethesda, MD 20892, telephone:

301-496-7441.  Complete item 2a on the face page of the applications

indicating that the applications is in response to this announcement

and print (next to the checked box) WOMEN'S HEALTH OVER THE LIFECOURSE:


The PHS 398 application and five legible copies must be mailed to:

Division of Research Grants

National Institutes of Health

Westwood Building, Room 240

Bethesda, MD  20892**


Applications will be assigned to the appropriate group for initial

review in accordance with the usual PHS peer review procedures.  The

review criteria are the traditional considerations underlying

scientific merit.  Applications will be reviewed for scientific and

technical merit by an appropriate initial review group; second-level

review will be by the appropriate National Advisory Council.

Second-level review of individual fellowship applications will be

conducted by the appropriate Institute Executive Group.  Applications

compete on the basis of scientific merit.


Applications will compete for available funds with all other

applications.  The following will be considered in making funding


o  Quality of the proposed project as determined by peer review

o  Availability of funds

o  Program balance among research areas of the announcement


Written and telephone inquiries are encouraged.  The opportunity to

clarify any issues or questions from potential applicants is welcome.

Direct inquiries regarding programmatic issues to:

Marcia G. Ory, Ph.D.

Behavioral and Social Research Program

National Institute on Aging

Gateway Building, Room 2C234

Bethesda, MD  20892

Telephone:  (301) 496-3136


Nancy Moss, Ph.D.

Demographic and Behavioral Sciences Branch

National Institute of Child Health and Human Development

6100 Executive Boulevard, Room 8B13

Bethesda, MD  20892

Telephone:  (301) 496-1174


Mary Ellen Oliveri, Ph.D.

Personality and Social Processes Research Branch

Division of Basic Brain and Behavioral Sciences

National Institute of Mental Health

Parklawn Building, Room 11C-10

5600 Fishers Lane

Rockville, MD  20857

Telephone:  (301) 443-3942

Direct inquiries regarding fiscal matters to:

Ms. Linda Whipp

Grants and Contracts Management Office

National Institute on Aging

Gateway Building, Room 2N212

Bethesda, MD  20892

Telephone:  (301) 496-1472


Ms. Melinda B. Nelson

Office of Grants and Contracts

National Institute of Child Health and Human Development

Executive Plaza North, Room 505

6130 Executive Boulevard

Bethesda, MD  20892

Telephone:  (301) 496-5481


Mr. Bruce L. Ringler

Chief, Grants Management Branch

National Institute of Mental Health

Parklawn Building, Room 7C-15

5600 Fishers Lane

Rockville, MD  20857

Telephone:  (301) 443-3065

Other Interests in This Research Area

Other PHS institutes and agencies are also interested in research

dealing with social and behavioral factors affecting women over the

lifecourse, including:

The General Clinical Research Centers (GCRC) Program of the National

Institutes of Health (NIH) provides inpatient and outpatient research

facilities, along with specially trained research nurses, research

dietitians and other paraprofessionals to host medical research,

including research on behavioral aspects of aging.  Additionally, most

GCRCs are equipped with computerized data management capabilities, as

well as with biostatisticians.  Applicants from institutions which have

a GCRC funded by the NIH National Center for Research Resources may

wish to identify the GCRC as a resource for conducting the proposed

research.  In such a case, a letter of agreement from either the GCRC

program director or Principal Investigator must be included with the



This program is described in the Catalog of Federal Domestic Assistance

No. 93.866.  Awards are made under authorization of the Public Health

Service Act, Title IV, Part A (Public Law 78-410, as amended by Public

Law 99-158, 42 USC 241 and 285) and administered under PHS grants

policies and Federal Regulations 42 CFR 52 and 45 CFR Part 74.  This

program is not subject to the intergovernmental review requirements of

Executive Order 12372 or Health Systems Agency review.


Aging America:  Trends and Projections. (1991).  Prepared by the U.S.

Senate Special Committee on Aging, the American Association of Retired

Persons, the Federal Council on the Aging, and the U.S. Administration

on Aging.

The Society for the Advancement of Women's Health Research.  Towards a

Women's Health Research Agenda: Findings of the Scientific Advisory

Meeting. 1991.

Ford Foundation.  Reproductive Health:  A Strategy for the 1990s.  New

York, NY:  1991.

Institute of Medicine.  Committee on a National Research Agenda.

Extending Life, Enhancing Life:  A National Research Agenda on Aging.

Washington D.C.:  National Academy of Sciences, 1991.

Lamphere-Thorpe, Jo-Ann & Robert J. Blendon.  Years Gained and

Opportunities Lost:  Women and Health Care in an Aging America.

Project on Women and Population Aging. Southport, Ct.:  Southport

Institute for Policy Analysis. May, 1991.

National Institute on Aging.  Research on Older Women: Highlights from

the Baltimore Longitudinal Study of Aging. May, 1991.

Office of Research on Women's Health.  ORWH Research Agenda on Women's

Health.  Bethesda, MD:  National Institutes of Health.  March, 1992.

Ory, Marcia G. and Huber R. Warner. Eds.  GENDER, HEALTH, AND


Publishing Company. 1990.

Rodin, Judith and Jeannette R. Ickovics.  Review and Research Agenda as

We Approach the 21st Century.  American Psychologist 45 (9):

1018-1034, 1990.

U.S. Bureau of the Census, Current Population Reports, Series P-23, No.

165, Work and Family Patterns of American Women.  U.S. Government

Printing Office, Washington, DC: 1990.

Zambrana, Ruth E.  A Research Agenda on Issues Affecting Poor and

Minority Women:  A Model for Understanding Their Health Needs.  Women

& Health.  Winter, 1987:137-160.


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