HEALTH AND EFFECTIVE FUNCTIONING IN THE MIDDLE AND LATER YEARS

NIH Guide, Volume 22, Number 15, April 16, 1993



PA NUMBER:  PA-93-076



P.T. 34



Keywords:

  Aging/Gerontology 

  Health Promotion 

  Social Psychology 

  Behavioral/Social Studies/Service 



National Institute on Aging



PURPOSE



The National Institute on Aging (NIA) invites the submission of

research and career grant applications for projects designed to specify

how psychosocial processes, interacting with biological processes,

influence health and functioning in the middle and later years of life.



This program announcement is part of the broad program of the NIA,

which was established by law in 1974 for the conduct and support of

biomedical, social, and behavioral research and training related to the

aging process and the diseases and other special problems and needs of

the aged. Under this mandate, health and well-being are viewed as the

outcome of complex psychological, social, environmental, physiological,

and medical processes.  Four principles guiding NIA research are:  (1)

the dynamic character of aging as a process, and of social and

historical changes that affect the age structure of society and the

ways in which individuals age; (2) the interrelatedness of old age with

earlier age; (3) the social, cultural, and individual variability of

aging; and (4) the continuing interplay between psychosocial and

biomedical aging processes.



This initiative is coordinated with related programs in other agencies,

including the National Institute of Child Health and Human Development,

the National Institute of Mental Health, and the National Center for

Nursing Research.



HEALTHY PEOPLE 2000



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 program

announcement, Health and Effective Functioning in the Middle and Later

Years, is related to the priority area of age-related objectives for

adults and older adults.  Potential applicants may obtain a copy of

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

"Healthy People 2000" (Summary Report:  Stock No. 017-001-00473-1)

through the Superintendent of Documents, Government Printing Office,

Washington, DC 20402-9325 (telephone 202-783-3238).



ELIGIBILITY REQUIREMENTS



Applications may be submitted by foreign and domestic, for-profit and

non-profit organizations, public and private, such as universities,

colleges, hospitals, laboratories, units of State and local

governments, and eligible agencies of the Federal Government.

Applications from minority individuals and women are encouraged.

Foreign institutions are not eligible to apply for program projects

(P01) or First Independent Research Support and Transition (FIRST)

(R29) awards and can apply for National Research Service Training

Awards (F32, F33) only if the applicant is a U.S. citizen or resident

alien.  Applicants for F32 and F33 awards must be U.S. citizens or

resident aliens.



MECHANISM OF SUPPORT



The mechanisms of support for this program are the research grant

(R01), the anticipated average award (direct costs) is $150,000 per

year; the FIRST award (R29); program projects (P01); and Fellowships

(F32, F33).



RESEARCH OBJECTIVES



The 20th century's triumph of extension of life means not only that the

numbers of old people are increasing, but that more and more

individuals can look forward to living out their lives to the full.  As

life expectancy has been extended, the proportion of adult life that

might be spent in retirement has also increased.  However, it remains

to be seen whether and how people will benefit from these added years.

How can the relatively vigorous health, effective functioning, and

productivity of the middle years be continued into the later years?

How can disability and dependency be postponed until the last years of

the extended life course?



Research findings suggest how the productive middle years might be

extended, how many disabilities of old age might be prevented or

postponed, and how the costs of health care and dependency might be

contained.  For example, intellectual decline with aging (when it

occurs) can often be slowed or reversed by relatively simple training

interventions; older people can often learn to compensate for declines

in reaction time, memory, and other age-related deficits (e.g., through

mnemonic strategies, carefulness, and persistence); for the visual

impairments suffered by many older people, particular styles and sizes

of type can facilitate reading, and training can improve the functional

field of view and reduce a significant risk factor for driving

accidents; food can be adapted to the age-related changes in taste and

smell that influence eating behaviors; health can be promoted through

changes in self-care behaviors and/or lifestyle (e.g., smoking, diet,

and exercise) across the lifespan; illness can often be alleviated

through social supports and improved coping behaviors; and many serious

disabilities (even when experienced in nursing homes) can be reduced by

regimens that reward activity and independence.



Biological, psychological, and social processes of growing old are to

a considerable extent malleable.  However, the mechanisms and

conditions that influence health and functioning during the middle and

later years remain to be specified.  NIA's goal in issuing this program

announcement is to encourage basic research studies of these mechanisms

and conditions that can extend the productive middle years of life by

preventing, postponing, or reversing disabilities of old age.



Specific Objectives



Many research issues fall within the realm of health and effective

functioning in the middle and later years. The following are offered as

illustrations of appropriate topics.  Applications need not, however,

be limited to these issues.  The PHS referral guidelines will be

followed in assigning applications to the NIA or to other Institutes.

The NIA will support research that extends the knowledge base

underlying the provision of health services for the aging and the aged.

However, the NIA does not support demonstration, control, and

evaluation projects nor the provision of services per se.  Services may

be one of the "experimental" variables in a proposed study.



1.  Work and Retirement (See Program Announcements on Economics of

Aging, Health, and Retirement; on Cognitive Functioning and Aging; and

Human Factors Research on Older People)



o  Aspects of work situations that stimulate intellectual competence,

provide incentives and opportunities for sustained or enhanced

performance.



o  Factors influencing vigor, intellectual functioning, memory, and

other physical and psychological capacities, and motivations for

continuing productivity and creativity.



o  Processes and conditions associated with retirement that influence

physical and mental functioning.



o  Age-related disabilities specific to particular occupations;

organizational and technological (human factors) innovations to remedy

or compensate for these deficits.



2.  Health Institutions (See Program Announcements on Aging and Formal

Health Care; Home Health Care and Aging)



o  Psychological and social factors that reduce the need for long-term

care of older people; alternatives to institutionalization.



o  Influence of institutionalization on health and functioning of the

institutionalized elderly and of their significant others (spouse,

children, other relatives, friends).



o  Psychosocial factors in the diagnosis and treatment of elderly by

health-care practitioners, including clinical decision-making and

treatment outcomes.



o  The influence of the organization of health care and related social

institutions on health outcomes and quality of life for older people.



3.  Social Support



o  Changes and stabilities in social networks as protections against

disabilities in the middle and later years.



o  Positive and negative consequences of social relationships for

health and functioning.



4.  Health Behaviors and Attitudes (See Program Announcement on Health

Behaviors and Aging: Psychosocial Geriatrics Research; Women's Health

over the Life Course)



o  Biopsychosocial linkages between health and behavior and interacting

influences of aging processes.



o  Age and/or cohort differences in health behaviors, attitudes, and

beliefs (e.g., symptom recognition and care-seeking).



o  Factors influencing initiating and maintaining health behaviors

associated with promoting health and preventing disease and disability.



o  Factors affecting adherence to prescribed therapies.



o  Ways of coping with stress, ranging from "daily hassles" to

life-threatening events.



5.  Personality and Self Concept (See Program Announcement on Sense of

Control throughout the Life Course)



o  Etiology and developmental course of disease-prone personality

configurations over the life course.



o  Nature, antecedents, and consequences of "sense of control"

throughout the life course.



o  Individual differences in psychological and physiological response

to chronic or persistent stressful situations.



6.  Family and Household



o  Changes in household composition and resources and their interaction

with health and functioning.



o  Family and household decision-making, and patterns of

intergenerational exchanges of material and emotional support.



7.  Cultural, Demographic, and Socioeconomic Variation



o  The processes or variables through which socioeconomic status affect

health and effective functioning over the life course.



o  Health and effective functioning in special populations such as the

very elderly, retarded, or rural older people.  (See Program

Announcements on the Oldest Old; Older Rural Populations; and Aging of

Retarded Adults.)



o  Ethnic group and minority population variations in the processes

affecting health and effective functioning.



8.  Methodological Studies



In addition to substantive topics, applications are sought for

methodological projects that promise improved understanding of the

complex processes that influence health and effective functioning in

the middle and later years. (See, for example, Program Announcement on

Forecasting Life and Health Expectancy in Older Populations.)



o  Improved longitudinal designs for examining the linkages between

psychosocial and biomedical aging processes.



o  Development of cohort-comparative, cross-cultural, and

historical-comparative designs for examining the interrelationship

between societal changes and variations in the individual aging

process.



o  Development of statistical and mathematical models of age-related

behavioral changes that are suitable for the analysis of longitudinal

and cohort-comparative data.



o  Improved measures of health, productivity, and functioning, suitable

for use in the field or in the laboratory.



o  Development and improvement of measures of human performance and

functioning suitable for tracing changes over the full life course.



o  Development of innovative qualitative or ethnographic methodologies,

especially as related to studies of older special populations.



Methodology



While research applications need not be limited to any particular

methodology of data collection or analysis, the use of objective,

reliable, and valid measures of psychosocial, or biological health and

performance is essential.  Consideration should be given to the

relative advantages and disadvantages of cross-sectional vs.

longitudinal or cohort designs, or to the use of experimental and

quasi-experimental designs in a variety of settings (including the

laboratory, health-care institutions, the residence, the community, and

the workplace).  Given the expense associated with collecting original

data, the secondary analysis of pre-existing data sets is encouraged.

(The NIA sponsors the National Archive for Computerized Data on Aging

at the Inter-university Consortium for Political and Social Research,

University of Michigan, Ann Arbor, MI 48106-1248.)  In many instances,

however, the collection of new data may be required to meet particular

objectives.



STUDY POPULATIONS



SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING IMPLEMENTATION OF NIH

POLICIES CONCERNING INCLUSION OF WOMEN AND MINORITIES IN CLINICAL

RESEARCH STUDY POPULATIONS



NIH policy is that applicants for NIH clinical research grants and

cooperative agreements are 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 must be placed on the need for inclusion of minorities

and women in studies of diseases, disorders, and conditions that

disproportionately affect them.  This policy is intended to apply to

males and females of all ages.  If women or minorities are excluded or

inadequately represented in clinical research, particularly in proposed

population-based studies, a clear compelling rationale must be

provided.



The composition of the proposed study population must be described in

terms of gender and racial/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 must 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, 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 population groups must be provided.



For the purpose of this policy, clinical research is defined as 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

minorities.



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

women or minorities 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.



APPLICATION PROCEDURES



Receipt dates for applications are as follows:



F-series grants:                  Apr 5, Aug 5, and Dec 5

New P01 and R-series:             Feb 1, Jun 1, and Oct 1

Competing renewal and revisions:  Mar 1, Jul 1, and Nov 1



Applications are to be submitted on grant application form PHS 398

(rev. 9/91) for research project and program project grants, PHS 416-1

(rev. 10/91) for Individual Fellowships, Applications will be accepted

at the standard receipt dates as indicated in the application kit.  The

title and number of this announcement must be typed in Section 2a on

the face page of the application.



Application kits are available at most institutional offices of

sponsored research and may be obtained from the Office of Grants

Inquiries, Division of Research Grants, National Institutes of Health,

Westwood Building, Room 449, Bethesda, MD 20892, telephone

301/710-0267.



The original application and five copies of PHS 398 or two copies of

PHS 416-1 must be sent to:



Division of Research Grants

National Institutes of Health

Westwood Building, Room 240

Bethesda, MD  20892**



REVIEW PROCEDURES



Applications will be assigned on the basis of established PHS referral

guidelines.  Applications will be reviewed for scientific and technical

merit in accordance with the standard NIH peer review procedures.

Following scientific-technical review, the applications will receive a

second-level review by the appropriate national advisory council.



AWARD CRITERIA



Applications recommended for further consideration by an appropriate

Advisory Council will be considered for funding on the basis of overall

scientific, clinical, and technical merit of the proposal as determined

by peer review, appropriateness of budget estimates, program needs and

balance, policy considerations, adequacy of provisions for the

protection of human subjects, and availability of funds.



INQUIRIES



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:



Ronald P. Abeles, Ph.D.

Behavioral and Social Research

National Institute on Aging

Gateway Building, Room 2C234

Bethesda, MD  20892

Telephone:  (301) 496-3136



Direct inquiries regarding fiscal matters to:



Ms. Linda Whipp

Office of Grants and Contracts

National Institute on Aging

Gateway Building, Room 2N212

Bethesda, MD  20892

Telephone:  (301) 496-1472



AUTHORITY AND REGULATIONS



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.



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