PAR-00-130: INTERDISCIPLINARY BEHAVIORAL SCIENCE CENTERS FOR MENTAL HEALTH

Department of Health
and Human Services (HHS)

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INTERDISCIPLINARY BEHAVIORAL SCIENCE CENTERS FOR MENTAL HEALTH Release Date: August 21, 2000 (see replacement PAR-04-004) PA NUMBER: PAR-00-130 National Institute of Mental Health Letter of Intent Receipt Date: November 27 each year Application Receipt Date: January 24 each year PURPOSE The National Institute of Mental Health (NIMH) invites applications for Interdisciplinary Behavioral Science Centers for Mental Health (IBSC). The purpose of these Centers is to support collaborative, hypothesis-driven basic research activities that will extend the most cutting-edge theories and approaches in basic behavioral science to incorporate current approaches in neuroscience. Center activities will be driven by a basic research question (or set of questions) that is framed at the behavioral level (e.g., cognition, emotion, personality, social interaction) and that is forging connection with neural-level processes. Ultimately, knowledge yielded by such connections will increase the explanatory power of behavioral science, and will enrich neuroscience by providing an ever-more-detailed understanding of behavioral and mental processes. The integration of knowledge that results will be in the service of the fullest understanding of the complex and reciprocal biobehavioral processes responsible for mental health and mental illness. In addition to support for Full-scale Center activities, support also will be available for Start-up Centers. The goal of Start-up Centers is to support a preparatory period of multidisciplinary research prior to the launching of integrative activities on a larger scale. Usually, this will be for those behavioral questions, topics, or domains for which there currently are few known links to neural processes. This Program Announcement expires three years from the Release Date shown directly above. HEALTHY PEOPLE 2010 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of Healthy People 2010, a PHS- led national activity for setting priority areas. This PA, Interdisciplinary Behavioral Science Centers for Mental Health, is related to the priority areas of Mental Health and Mental Disorders. Potential applicants may obtain a copy of Healthy People 2010 at http://www.health.gov/healthypeople. ELIGIBILITY REQUIREMENTS Applications may be submitted by 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. Foreign institutions are not eligible for Center Grants (P50). Racial/ethnic minority individuals, women, and persons with disabilities are encouraged to apply as IBSC Directors and Project Investigators. MECHANISM OF SUPPORT IBSCs will be supported by the Center Grant mechanism (P50), which provides funding for multidisciplinary and multi-investigator approaches to the investigation of specific and complex research problems requiring the application of diverse expertise and methodologies. There are two levels of Center support: (1) Full-scale Centers are limited to $1.5 million direct costs in any one year. This limit applies to new grants, non-competing continuations, and any subsequent competing continuations. Support is provided for five or more individual research projects as well as for core support. Support may be requested for a project period of up to five years. Each Full-Scale Center will be limited to a maximum of ten years of support in total. (2) Start-up Centers are limited to $600,000 direct costs in any one year, including non-competing continuation years. Support is provided for three or more individual research projects as well as for core support. Support may be requested for a project period of up to five years. Start-up Centers may be renewed only as Full-scale Centers, which then would be permitted a maximum of ten years of support in total. Competitive supplements will not be considered for these Center grants. It is anticipated that individual projects that are outgrowths of Center activity will seek independent funding through mechanisms such as research project grants (R01s). Since IBSCs are defined by their multidisciplinary, integrative, nature and not by departmental or geographic boundaries, projects constituting a given Center may be based at a variety of institutions. In an effort to allow for such multi-institutional involvement, for the purposes of this PA, Facility and Administrative Costs for such consortial and contractual arrangements will not be counted against the direct costs limits noted above. However, these costs should be delineated as instructed in Form PHS 398 (rev. 4/98). RESEARCH OBJECTIVES Background A broad range of substantive domains within basic behavioral science have demonstrated their critical role in elucidating fundamental mechanisms involved in mental health and mental illness. Examples are: cognitive research in attention and executive function that is fundamental to understanding deficits in both adult and childhood mental disorders, basic research in emotion that is identifying the nature and functions of both negative and positive emotion and mood, research in individual differences (including temperament) that help define both risk and protective processes, and research on interpersonal and social interaction that is demonstrating the impact of social experiences on both mental and physical health. Productive linkages of these behavioral science approaches to parallel neuroscience approaches have begun, particularly in the domains of cognition and emotion. Still, much more needs to be done in all domains to elucidate the specific paths by which behavioral processes and social experiences influence and are influenced by brain function. It is particularly important, as well, to examine the developmental course of these multi- directional influences across the lifespan. Ultimately, the full understanding of mental health and disorder critically depends on filling these gaps in our knowledge of the reciprocal mechanisms linking experience, behavior, and the brain. Interdisciplinary Behavioral Science Centers (IBSCs) will support interactive and collaborative research environments organized to address a cohesive, interrelated set of hypothesis-driven research questions that are stimulated by knowledge and theory in basic behavioral science and that incorporate cutting-edge methods and techniques of both behavioral science and neuroscience. In addition, Centers will be defined by diversity and cross- disciplinarity in terms of subjects (e.g., human, non-human), designs (e.g., cross-sectional, longitudinal), settings (e.g., laboratory, field), and/or substantive domains (e.g., cognition, emotion). Centers also will offer interdisciplinary research experiences for students and junior faculty. Both Full-scale and Start-up Centers share the components and goals stated above and the characteristics listed below. In Start-up Centers, however, collaborations are expected to be less differentiated and extensive, involving a more limited range of disciplinary specialties. Center Characteristics o IBSCs must address an interrelated set of hypothesis-driven research questions in basic behavioral science that are fundamental to the understanding of mental health and mental illness. o IBSCs must be conceptualized and organized according to a multidisciplinary framework that extends cutting-edge theories and approaches in basic behavioral science to incorporate current approaches in neuroscience. Expertise and technological support must be available to address the behavioral-neural linkages. o IBSCs must demonstrate synergy in their conceptualization and approach. The whole must be more than the sum of the parts. o IBSCs must address novel, innovative, and creative research questions and cross-disciplinary linkages. o The IBSC Director must be a senior scientist with substantial research and scholarly experience in basic behavioral science. S/he must have a demonstrated ability to organize, administer, and direct the Center. The Director must be the scientific leader of the Center and must also be the Principal Investigator on at least one of the individual research projects and have a minimum time commitment of 30 percent to the Center grant (including both administrative and research efforts). o Principal Investigators of individual research projects must be established scientists in basic behavioral science or neuroscience research. o An IBSC must demonstrate a high degree of collaboration and interdependence among investigators, and solid evidence of integration across the component research projects. o An IBSC must provide research apprenticeship opportunities for junior investigators to become skilled in the strategies, approaches, and techniques of cross-disciplinary behavioral science and neuroscience research. In addition, there should be close coordination between the Center and relevant predoctoral and/or postdoctoral research training programs of the institution. Special attention should be given to the recruitment and training of minority and/or disabled students and scientists. o An IBSC is conceptualized and defined by its integrative, multidisciplinary nature and need not be limited by geographical or departmental boundaries. Collaborations among different institutions are encouraged, if scientifically appropriate and feasible. o Each IBSC must have an outreach plan that makes the public aware of the importance and implications of the IBSC research for mental health and mental disorder. Research Areas Core areas of basic behavioral science that are relevant to the IBSC Program include: cognition (e.g., learning, memory, attention, language, perception, decision-making), emotion (e.g., experiential, expressive and/or physiological aspects of emotional states, emotional traits, and mood), personality processes and individual differences, motivation, social cognition (e.g., information processing, attributions, expectancies), social influences and processes, self-regulation, attitudes and persuasion, interpersonal interaction, and fundamental biobehavioral processes such as sleep, reproduction, and ingestion. The substantive relevance of the chosen topics to the understanding of mental health and mental illness must be documented and described in the application. In keeping with the integrative, multidisciplinary emphasis of the IBSC, it is encouraged that attention be given to connections across the above domains and processes, e.g., links between emotion and learning or memory, or between social experience and cognitive functioning. Developmental approaches to understanding these domains and processes also are a priority. In addition to human studies, animal models are appropriate. Also appropriate are mathematical/computational modeling approaches. In keeping with current NIH priorities related to Health Disparities, the broadest possible representation of subjects (e.g., in terms of ethnicity, sex, or age) is strongly encouraged. Where possible, power should be sufficient for testing differences within and among groups that are likely to yield information of ultimate public health importance. Neuroscience approaches relevant to the IBSC Program include examinations of neural systems, structures, circuits, or processes (e.g., development, plasticity) that are poised to inform central questions in behavioral science. Techniques may include neuroimaging (e.g., fMRI, PET, SPECT, noninvasive optical imaging), psychophysiological methods (e.g., EEG, MEG), neuroendocrine methods, and neurochemical or lesion techniques. The IBSC Program’s focus on basic behavioral science is intended to foster the specificity and depth of knowledge about fundamental psychological and neural processes likely to be involved in mental health and mental illness. In contrast, research that is primarily focused on clinical or applied issues (e.g., etiology, risk or protective factors, diagnosis, treatment, prevention, service delivery) is not appropriate for the IBSC Program. Investigators seeking avenues for the application or translation of basic behavioral science to such clinical issues should consult updates on the NIMH website (http://www.nimh.nih.gov) or e-mail Dr. Bruce Cuthbert (bcuthber@mail.nih.gov). Basic neuroscience research that does not have an overriding emphasis on behavioral processes and research questions also is not appropriate for an IBSC. Information on center mechanisms for neuroscience research may be found on the NIMH website (http://www.nimh.nih.gov). Genetics research that incorporates behavioral measures in order to reveal the action of specific genes (e.g., random mutagenesis, QTL analysis, linkage studies for psychopathology) is not appropriate for an IBSC. However, applications with behavioral genetic components (e.g., twin or adoption designs) may be considered if the primary goal is the understanding of experiential as well as heritable contributions to behavioral or mental function. Activities Supported To provide a suitable structure for achieving the objectives of this program, IBSCs may request funds for the following: o Individual Research Projects: Funds should be requested to support five or more individual research projects in Full-scale Centers (three or more in Start-up Centers). Each project should have the characteristics of a traditional research grant (R01), as well as demonstrate a significant integrative contribution to the other projects in the IBSC and to the Center as a whole. If the number of projects judged to be meritorious is smaller than the specified minimum, this may preclude funding of the entire Center. o Cores: Funds may be requested for core support. Each Core must provide essential services to three or more approved individual research projects in Full-scale Centers (two or more in Start-up Centers). Possible Cores include those focused on administrative, subject recruitment, measurement, technological, and/or data management/analysis issues. Core support may involve salaries, research resources to be shared across projects, equipment needed to conduct the research, and incidental alteration and renovation of facilities consistent with Public Health Service policy. o Research Apprenticeships: Funds should be requested to support the supervised cross-disciplinary research activities of junior faculty, postdoctoral staff, and/or advanced graduate students. These individuals should have a high potential for a research career but require further supervised research experience. These experiences should be designed in a way that takes advantage of the cross-disciplinary, integrative character of the IBSC. Salary support, tuition, travel and research support may be provided. At least five research apprenticeships must be made available per year in Full-scale Centers (at least three in Start-up Centers). These Research Apprentice positions may not be provided to individuals receiving National Research Service Award support. o Essential Scientific Expertise: To provide the most effective combination of scientific knowledge and skills, applicants may request funds to support scientists to augment or strengthen the skills, expertise, and capabilities of existing Center staff. Although recruitment of such scientists may take place after the award has been made, the expertise required, the role in Center activities, and the time to be devoted to the Center should be provided in the application. It should be emphasized, however, that such individuals may not serve as a substitute for a Project Principal Investigator after the award is made. o Advisory Board: An external advisory board should serve as an important source of guidance from experts in the field who do not have a vested interest in the Center or in the research to be conducted by the Center. Funds may be requested to support travel of board members for meetings in the beginning of the second and fourth years of funding. To avoid reducing the pool of potential reviewers, applicants should NOT identify prospective board members in the application or contact them before a funding decision is made. 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 have been 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 available on the web at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not94-100.html 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 URL address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html Investigators also may obtain copies of these policies from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. LETTER OF INTENT Prospective applicants are asked to submit, by November 27, a letter of intent that includes: a descriptive title of the proposed Center, the scale of the Center (Start-up or Full-scale), the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number and title of this program announcement. Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows NIMH staff to estimate the potential review workload and avoid conflict of interest in review. The letter of intent should be sent to Dr. Mary Ellen Oliveri, at the address listed in INQUIRIES, below. URLS IN NIH GRANT APPLICATIONS OR APPENDICES All applications and proposals for NIH funding must be self-contained within specified page limitations. Unless otherwise specified in an NIH solicitation, internet addresses (URLs) should not be used to provide information necessary to the review because reviewers are under no obligation to view the internet sites. Reviewers are cautioned that their anonymity may be compromised when they directly access an internet site. APPLICATION PROCEDURES Applications are to be submitted on the grant application form PHS 398 (rev. 4/98) and will be accepted on January 24. Application kits are available at most institutional offices of sponsored research and from the Division of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, telephone (301) 435- 0714, Email: GrantsInfo@nih.gov. Applications are also available on the World Wide Web at: http://grants.nih.gov/grants/forms.htm. The title and number of this Program Announcement must be typed in section 2 of the face page of the application form and the YES box must be checked. Application Format A major requirement for an IBSC is the conduct of collaborative, multidisciplinary research on a set of cohesive, interrelated basic science research questions that are linked in a fundamental, substantive way to mental health and mental illness, the nature of these substantive links to mental health and illness must be stated clearly in the application. The application also must describe the overall goals of the IBSC, the hypotheses to be tested, and the methods to be used. The application should clearly articulate the reasons a Center approach is needed for the proposed activities, as well as the unique benefits that will accrue from a Center. Utilizing the PHS Form 398, the application should include the following components in the designated order. Information for the entire Center: o Face Page, pertaining to the entire Center o Description, Performance Sites, and Key Personnel (Form Page 2), pertaining to the entire Center o Table of Contents (Form Page 3) for the entire application o Budget (Form Pages 4 and 5). Categorical figures should be provided to describe the budget of the overall Center. Since detailed budget justifications will be provided separately for each project and core (as described below), only items for which justification is not provided elsewhere should be presented in narrative here. o Biographical Sketches of Key Personnel (Form Page 6). These should be provided for key personnel of the entire Center, and should be arranged alphabetically based on the individual’s surname. o Other Support (Form Page 7) of key personnel for the entire Center, presented alphabetically by surname. o Resources (Form Page 8). These should be restricted to those not described separately for the individual projects and cores. o General Description of the Overall Center (not to exceed 10 pages, for amended applications, provide a one-page introduction describing changes from the previously submitted version). Provide an overview of the entire proposed Center, describing the Center goals and how they will be achieved. Explain the proposed contribution of each of the individual projects and cores to achieving the Center’s objectives, and how these components relate to each other scientifically. o Evidence of Feasibility and Preliminary Findings (for new--Type 1-- applications and amended Type 1 applications only, not to exceed 10 pages, for amended applications, provide a one-page introduction describing changes from the previously submitted version). Present evidence that the research team will be able to work together to achieve the research goals of the Center, preliminary results, evidence of competence in the areas proposed, and any other information that speaks to feasibility. o Progress Report (for competing continuation--Type 2--applications and amended Type 2 applications only, not to exceed 3 pages for each project supported in the previous Center grant, for amended applications, provide a one-page introduction to the entire Progress Report describing changes from the previously submitted version). Describe the research progress of the previously supported Center and the manner in which the results relate to the current application. Describe the manner in which the Center mechanism provided synergy to the previously funded Center. o Operational Plan for the Overall Center (not to exceed 10 pages, for amended applications, provide a one-page introduction describing changes from the previously submitted version). Describe the working administrative and logistical arrangements, as well as resource support necessary to implement the research. When multiple institutional sites are involved, a detailed description of the cooperative administrative arrangements should be included (and documented in the Letters of Support section). Also include in this section a description of the manner in which an external advisory board will relate to the Center. Prospective board members should NOT be chosen or contacted prior to a funding decision and, therefore, should not be named in the application. Finally, describe a plan for providing access to data, research tools and biological material generated by the Center. o Research Career Development and Outreach Plans (not to exceed 2 pages). Describe how the Center will provide opportunities for junior investigators, including the Research Apprentice positions as well as relationships with training programs of participating institutions. Also, describe plans for disseminating information to the public regarding the activities of the Center. Information for each Project or Core: Provide, in the order indicated: o Title page for the project or core. If this component is to be conducted under a consortial or contractual arrangement, this title page must bear the signature of the responsible official at the collaborating organization. o Description, Performance Sites, and Key Personnel (Form Page 2), referring specifically to the project or core. o Budget (Form Pages 4 and 5). Detailed budgetary information for each project or core, including narrative justification. o Resources (Form Page 8), referring specifically to the project or core. o Research Plan for Individual Projects (not to exceed 10 pages for any one project, for amended applications, provide a one-page introduction describing changes from the previously submitted version). Describe the specific aims, background, and significance, the research questions to be addressed, and the hypotheses to be tested. Address the status of current research efforts on the topic, the limitations of these, why the particular research question lends itself to a multidisciplinary, integrative approach, and how the proposed project will be linked to and integrated with other proposed Center projects. Describe the research design and methods in as much detail as possible, and address issues of feasibility, potential pitfalls, alternative approaches, and relevance to Center goals. o Descriptions of Individual Cores (Not to exceed 8 pages for any one core, for amended applications, provide an extra one-page introduction describing changes from the previously submitted version). Describe how the core will contribute to the overall goals of the Center, including the facilities, resources, services, and professional skills that it will provide. Describe which projects will be supported by the core and the manner in which support will be rendered. o Literature Cited, compiled across all sections of the application. o Letters of Support from Collaborating Institutions, compiled across all sections of the application. o Checklist o Personal Data on Center Director The completed original application and three 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 OR COURIER SERVICE) At the same time, two additional copies of the application must be sent to Dr. Mary Ellen Oliveri, listed under INQUIRIES, below. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by the CSR and responsiveness by NIMH. Applications that are incomplete or unresponsive will be returned to the applicant. Applications that are complete and responsive will be evaluated for scientific and technical merit by an appropriate peer review group convened by the NIMH in accordance with the standard NIH 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 will be discussed, assigned a priority score, and receive a second level review by the National Advisory Mental Health Council. Although primary assessments of scientific merit will be based on the Center as a whole, one or more individual projects or cores could receive lower priority in some instances, possibly resulting in the funding of a Center smaller than proposed. Review Criteria Criteria for review of scientific and technical merit will include the following: o Intrinsic Merit: The overall quality, scientific merit, substantive relevance to mental health/illness, and innovation of the research to be conducted, the likelihood that the Center will lead to fundamental advances, to new discoveries, and/or to new technological developments. o Appropriateness of the Center Approach: The need for and suitability of a Center approach, whether a Center approach will add significantly to what could be accomplished through other modes of research support, demonstration of synergy in the Center’s conceptualization and approach. In this respect, the integration and interdependence of component projects and cores is of utmost significance and should be described explicitly. o Research Competence: The qualifications and scientific credentials of the Center Director and constituent project directors, these individuals should be regarded by their peers as leaders in, and at the forefront of, their respective fields. o Center Director Credentials: Demonstrated ability of the Center Director to organize, direct, and administer the Center and, in addition, be the Principal Investigator on at least one of the individual projects. It is expected that this individual will devote a minimum of 30 percent time to the Center grant. Thus, the Director must by necessity be the scientific leader of the Center. o Institutional Commitment: The nature and level of resource commitments and resources available from the home institution and from other participant institutions, and plans for interactions with the rest of the sponsoring institution. o Appropriateness of Management Plans and Arrangements: The feasibility and adequacy of the organizational and administrative plans, the appropriateness of the budget, and the mechanisms to evaluate the Center’s progress. o Quality of Plans for Research Apprenticeships: The effectiveness of approaches used to attract and involve junior investigators and students who show potential for significant contributions and independent research careers. o Quality of linkages between the proposed Center and ongoing training programs in the institutional environment. o Outreach: Quality of approaches used to disseminate information regarding the Center’s activities as they relate to public understanding of science and mental health and illness. Peer reviewers also will examine the provisions for the protection of human and animal subjects, the safety of the research environment, and conformance with NIH guidelines for the inclusion of women, minorities, and children in research involving human subjects. AWARD CRITERIA o Potential to advance the field o Scientific merit as determined by peer review o Responsiveness to the purposes and objectives outlined in this PA o Availability of funds The P50 grant supporting an IBSC is not transferable to another institution. RECEIPT AND REVIEW SCHEDULE Letter of Intent Receipt Date: November 27 Application Receipt Date: January 24 Administrative Review: February Scientific Review: May/June Advisory Council Review: September Earliest Start Date: September INQUIRIES Inquiries are encouraged at the earliest possible stage in application development. Direct inquiries regarding programmatic issues to: Mary Ellen Oliveri, Ph.D. Chief, Behavioral Science Research Branch Division of Neuroscience and Basic Behavioral Science National Institute of Mental Health 6001 Executive Blvd., Room 7220, MSC 9651 Bethesda, MD 20892-9651 (Express/courier service: Rockville, MD 20852) Telephone: (301) 443-3942 FAX: (301) 443-9876 Email: moliveri@nih.gov Direct inquiries regarding fiscal matters to: Diana S. Trunnell Grants Management Branch National Institute of Mental Health 6001 Executive Blvd., Room 6115, MSC 9605 Bethesda, MD 20892-9605 Telephone: (301) 443-2805 FAX: (301) 443-6885 Email: Diana_Trunnell@nih.gov AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance No. 93.242. 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. The PHS strongly encourages all grant and contract recipients to provide a smoke-free workplace and promote the non-use 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, and portion of a facility) in which regular or routine education, library, day care, health care or 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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