EPIDEMIOLOGIC RESEARCH ON DRUG ABUSE Release Date: October 2, 1998 PA NUMBER: PA-99-002 P.T. National Institute on Drug Abuse PURPOSE This PA replaces PA-94-007, "Survey Research on Drug Use and Associated Behaviors," which was published in the NIH Guide, Vol. 22, No. 39, October 29, 1993. The purpose of the National Institute on Drug Abuse"s (NIDA) epidemiologic program is to characterize the nature and extent of drug abuse and its development, to determine trends and the factors that influence them, and to identify and measure public health problems associated with drug abuse. In order to accomplish this, NIDA funds investigator-initiated studies focusing on defining factors and patterns associated with the initiation, escalation, continuation, and cessation of drug use and on associated antisocial, health- threatening and other problematic behaviors that arise as a result of drug abuse. The findings from this research serve to guide the development of interventions that address the needs of the general population and defined subpopulations with special needs such as those at risk for infection with HIV, TB, HBV, and HCV and to inform public programs and policy. Further, the epidemiologic research findings provide future directions for all phases of NIDA research, basic, clinical, and prevention. As drug abuse is a constantly changing phenomenon, the epidemiology research program will also attempt to identify early emergent patterns of drug abuse, definition of their nature, and, where possible, the prediction of their future course. 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 is primarily related to the priority area of Alcohol and Other Drugs. Potential applicants may obtain a copy of Healthy People 200 (Full Report: Stock No. 017-001-00474-0, or Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, D.C. 20402-9325 (Telephone: 202-512-1800). ELIGIBILITY REQUIREMENTS Applications may be submitted by foreign and domestic for-profit and nonprofit organizations, public and private, such as universities, colleges, hospitals, laboratories, units of State or local governments, and eligible agencies of the Federal Government. Foreign institutions are not eligible for program project or centers (P-Series) awards. Women and minority investigators are encouraged to apply. MECHANISM OF SUPPORT The mechanisms available for support of this program announcement includes Project Grants (R01), small grant (R03), exploratory/developmental grant (R21), program project (P01), and research centers (P30, P50, and P60). Application for Research Centers must be in accordance with the NIDA guidelines for Research Center applications. More specific information about individual research mechanisms can be obtained from the NIDA home page at: http://www.nida.nih.gov/Funding.html. Because the nature and scope of the research proposed in response to this program announcement might vary, it is anticipated that the size of an award will vary also. Applications requesting direct costs of $500,000 or more in any one year must obtain agreement from the assigned institute that the application will be accepted for review and consideration of award, in accordance with NIH policy, which is available at http://www.nih.gov/grants/guide/notice-files/not98- 030.html . Applicants must identify, in the cover letter sent with the application, the specific NIH office and staff member who agreed to accept assignment of the application. Applicants seeking funding under this program announcement must contact the appropriate program official to discuss the proposal well in advance of the submission date, ideally early in the planning phase, and submit a brief (not over 5 pages) concept paper and tentative budget for NIDA internal review. RESEARCH OBJECTIVES Background and Significance Epidemiologic research has historically been the foundation for developing an understanding of the nature and extent of drug abuse, for developing strategies to prevent drug use, and for providing scientific support for other types of basic, clinical, and treatment research. The etiologies of drug abuse vary across individuals, families, age, sex, and populations with different predisposing or protective factors and co-morbid conditions. This announcement is to encourage studies which have the potential to expand and refine epidemiologic research on drug abuse in new areas, to develop innovative statistical methods, to develop diagnostic and developmental assessment protocols for use in general populations, and to explore the origins and pathways to drug use, abuse, and dependence. Key questions addressed by epidemiologic research on drug abuse include: 1. What is the extent of drug-using behaviors? How do they vary over time, across genders, across populations, for different substances, and in relation to cultural and other factors. 2. What are the patterns of drug-using behaviors (e.g., groups affected, specific drugs or drug combinations, forms of the drugs, routes of administration, contexts of use, geographic variations, etc.), and how do these develop in individuals and groups? 3. What are the characteristics of persons using drugs? What factors distinguish those whose use escalates from those who resist increased drug involvement? 4. What factors influence temporal trends in drug use in the overall population, and how do these relate to changes in subpopulation drug use patterns such as those listed in question 2? 5. What factors predispose an individual to the use of drugs and influence the onset of drug-using behaviors and continued use of drugs? 6. What factors are related to the discontinuation of drug use, including discontinuation that may occur in association with, and independent of, treatment? 7. What factors protect individuals who may be at risk from abusing drugs? How do predisposing and protective factors interact? Program Objectives Drug abuse epidemiology derives concepts and methods from a wide range of disciplines including statistics, psychology, biology, sociology, and anthropology. Use of multidisciplinary perspectives to investigate key questions is encouraged. Investigators should also consider a wide range of statistical methods and study designs appropriate to the research question and consider cost efficiency in research design. Where appropriate, secondary analysis of existing data is encouraged. Theory-driven, longitudinal studies that focus on the origins of drug abuse and dependence, and natural history studies of populations at risk for drug abuse or who have already initiated drug-abusing behaviors, will help clarify the impact of the many complex factors found to be associated with drug abuse and its outcomes. Of particular importance is the examination of the cumulative impact of multiple interacting risk and protective factors affecting different stages of human development, indicating factors that appear to exert the greatest influence. Research following drug abusers over time to determine the natural trajectories of their lives is also encouraged, such research may yield information valuable in intervention planning. Natural history studies comparing drug abusers and non-drug abusers are needed to assess the increased risk of medical/health, behavioral, social, psychological, and psychiatric problems due to drug abuse, and similar studies are needed to compare subgroups of drug abusers to determine factors associated with differential risks. Finally, methodological research will be encouraged to improve response rates, validity, precision, and efficiency of epidemiologic studies. Development and application of innovative sampling, surveillance, ethnographic, and data collection methods, and refinement of statistical tools to analyze epidemiologic data will also be encouraged. This program announcement invites research proposals within the broad spectrum of epidemiologic research on drug use and abuse: 1. Studies of the incidence (i.e., onset), prevalence, trends, and patterns of drug use, associated beliefs and attitudes, and related affective, cognitive, and behavioral characteristics among children, adolescents, young adults, and older populations. 2. Studies that document and attempt to account for phenomena such as the resurgence of drug use in the 1990s, emergence of new substances of abuse, influences of new trafficking patterns, shifts in routes of administration, and use of drugs in combination, particularly at the community or local area level. These studies should assess the nature and extent of newly identified drug problems, characteristics of affected populations and individuals, impact on the individual and the community, and factors which affect the spread of the problem. 3. Studies of the natural history of substance use and abuse, multivariate etiologic studies that examine the direct and mediating factors contributing to or protecting against the initiation and/or escalation of drug use to dependence, and studies examining patterns of drug use initiation, maintenance, escalation, and discontinuation in general or defined populations. 4. Studies that assess prevalence of drug abuse and dependence using specified nosologic systems such as the DSM-III-R or DSM-IV, studies that examine the comorbidity of drug-using behaviors and drug abuse disorders with psychiatric disorders, and studies that examine risk and protective factors and co-factors associated with these disorders and comorbid conditions. 5. Multivariate studies that relate drug-using behaviors to factors representing a variety of domains, including, but not limited to: genetic, social (e.g., family, peer group, community) and cultural, environmental, personality, perinatal, developmental, psychopathological, cognitive, behavioral, affective, and dispositional factors, as well as interactions among these factors. 6. Studies focusing on the prevalence of drug use and associated impairment in behaviors such as driving, parenting, job performance, etc. 7. Studies focusing on drug use and associated behaviors and factors among special populations such as runaways, abused and neglected children, teenage mothers, pregnant women, ethnic minorities, school dropouts, institutionalized persons, rural populations, juvenile and adult offenders, gays and lesbians, veterans, the elderly, children of alcoholics/substance abusers, homeless individuals and families, etc., especially when particular characteristics of these groups are assessed to determine their specific association with drug use patterns. 8. Methodological studies of several types, including development and evaluation of new data collection techniques and instruments, development and testing of enhanced sampling strategies, refinement of imputation procedures, development of more efficient estimators, development of innovative analytic procedures and statistical models, and development and evaluation of procedures to determine and reduce risk of disclosure of identifiable data in public use files. 9. Studies to examine the validity of self-report based on the use of biological markers, external records, or statistical models. 10. Studies that address nonresponse in household and nonhousehold populations, including usefulness of incentives and development of improved nonresponse adjustment procedures using state-of-the-art statistical methods. 11. Studies addressing other related substantive or methodological issues using secondary analysis of existing data. International studies on similarities and variations in drug abuse behaviors, factors influencing the initiation, progression, and cessation of drug abuse, and social and health consequences of drug abuse including HIV transmission. Studies on the role of environmental factors including social, cultural, political and economic factors on drug use behaviors in different national and regional contexts. Additional information about the epidemiologic research program will be posted on the homepage of the Division of Epidemiology and Prevention Research, NIDA located at: http://www.drugabuse.gov/about/organization/DESPR/DESPRHome.html. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing research involving human subjects should read the "NIH Guidelines For Inclusion of Women and Minorities as Subjects in Clinical Research," which were published in the Federal Register of March 28, 1994 (FR 59 14508-14513) and in the NIH Guide for Grants and Contracts, Vol. 23, No. 11, March 18, 1994. NIH POLICY AND GUIDELINES ON THE INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of NIH that children (i.e., individuals under the age of 21) must be included in all human subjects research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them. This policy applies to all initial (Type 1) applications submitted for receipt dates after October 1, 1998. All investigators proposing research involving human subjects should read the "NIH Policy and Guidelines on the Inclusion of Children as Participants in Research Involving Human Subjects" that was published in the NIH Guide for Grants and Contracts, March 6, 1998, and is available at the following website: http://www.nih.gov/grants/guide/notice-files/not98-024.html NATIONAL ADVISORY COUNCIL ON DRUG ABUSE RECOMMENDED GUIDELINES FOR THE ADMINISTRATION OF DRUGS TO HUMAN SUBJECTS The National Advisory Council on Drug Abuse recognizes the importance of research involving the administration of drugs to human subjects and has developed guidelines relevant to such research. Potential applicants are encouraged to obtain and review these recommendations before submitting an application that will administer compounds to human subjects. The guidelines are available on the NIDA Home Page at http://www.nida.nih.gov/, or may be obtained by calling 301-443-2755. APPLICATION PROCEDURES Applications are to be submitted on the grant application form PHS 398 (rev. 5/95) and will be accepted at the standard application deadlines as indicated in the application kit. Application kits are available at most institutional offices of sponsored research and may be obtained from the Division of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301-710-0267, Email: GrantsInfo@nih.gov. The title and number of the program announcement must be typed in Section 2 on the face page of the application. The completed original application and five legible copies must be sent or delivered to: CENTER FOR SCIENTIFIC REVIEW NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040 -MSC 7710 BETHESDA, MD 20892-7710 BETHESDA, MD 20817 (for express/courier service) REVIEW CONSIDERATIONS Applications that are complete will be evaluated for scientific and technical merit by an appropriate peer review group convened in accordance with the standard peer review procedures. As part of the initial merit review, all applications will receive a written critique and undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of applications under review, will be discussed, assigned a priority score, and receive a second level review by the appropriate national advisory council or board. Review Criteria The goals of NIH-supported research are to advance the understanding of biological systems, improve the control of disease, and enhance health. In the written comments, reviewers will be asked to discuss the following aspects of the application in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. Each of these criteria will be addressed and considered in assigning the overall score, weighting them as appropriate for each application. Note that the application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward. (1) Significance: Does this study address an important problem? If the aims of the application are achieved, how will scientific knowledge be advanced? What will be the effect of these studies on the concepts or methods that drive this field? (2) Approach: Are the conceptual framework, design, methods, and analyses adequately developed, well integrated, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics? (3) Innovation: Does the project employ novel concepts, approaches, or method? Are the aims original and innovative? Does the project challenge existing paradigms or develop new methodologies or technologies? (4) Investigator: Is the investigator appropriately trained and well suited to carry out this work? Is the work proposed appropriate to the experience level of the principal investigator and other researchers (if any)? (5) Environment: Does the scientific environment in which the work will be done contribute to the probability of success? Do the proposed experiments take advantage of unique features of the scientific environment or employ useful collaborative arrangements? Is there evidence of institutional support? In addition to the above criteria, in accordance with NIH policy, all applications will also be reviewed with respect to the following: - The adequacy of plans to include both genders, minorities and their subgroups, and children as appropriate for the scientific goals of the research. Plans for the recruitment and retention of subjects will also be evaluated. - The reasonableness of the proposed budget and duration in relation to the proposed research. - The adequacy of the proposed protection for humans, animals, or the environment, to the extent they may be adversely affected by the project proposed in the application. AWARD CRITERIA Applications will compete for available funds with all other approved applications. The following will be considered in making funding decisions: quality of the proposed project as determined by peer review, availability of funds, and program priority. INQUIRIES Inquiries are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding the programmatic issues to: Arthur Hughes and James Colliver, Ph.D. Division of Epidemiology and Prevention Research National Institute on Drug Abuse 5600 Fishers Lane, Room 9A-53 Rockville, MD 20857 Telephone: (301) 443-6637 Email: ah62b@nih.gov and jc163b@nih.gov Direct inquires regarding fiscal issues to: Gary Fleming, J.D., M.A. Grants Management Branch National Institute on Drug Abuse 5600 Fishers Lane, Room 8A-54 Rockville, MD 20857 Telephone: (301) 443-6710 Email: gfleming@nih.gov AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance No. 93.279. Awards are made under authorization of the Public Health Service Act, Title IV, Part A (Public Law 78410), as amended by Public Law 99-158, 42 USC 241 and 285), and administered under PHS grant 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. The Public Health Service strongly encourages all grant recipients to provide a smoke-free workplace and promote the nonuse of all tobacco products. In addition, Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain facilities (or in some cases, any portion of a facility) in which regular or routine education, library, day care, health care of early childhood development services are provided to children. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people.
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