This Program Announcement expires three years from the release date, 
unless reissued.

RESEARCH ON SOCIAL NETWORKS AND HIV RISK PREVENTION

Release Date:  March 15, 2001
  
PA NUMBER:  PAS-01-068

National Institute of Child Health and Human Development
 (http://www.nichd.nih.gov)
National Institute on Alcohol Abuse and Alcoholism
 (http://www.niaaa.nih.gov)
National Institute of Mental Health
 (http://www.nimh.nih.gov)

THIS PA USES THE “MODULAR GRANT” AND “JUST IN TIME” CONCEPTS.  IT INCLUDES 
DETAILED MODIFICATIONS TO STANDARD APPLICATION INSTRUCTIONS THAT MUST BE USED 
WHEN PREPARING APPLICATIONS IN RESPONSE TO THIS PA.

PURPOSE

This Program Announcement calls for basic, applied, and methodological 
research that can advance knowledge about the influence of social networks on 
HIV risk and the application of that knowledge to HIV prevention and 
treatment efforts.  It invites applications for research that will extend 
existing knowledge of how the structure, function, and content of social and 
sexual networks influence HIV risk and transmission, and advance the 
development of prevention and treatment approaches based in social network 
theory and methods.  Through this announcement, the National Institute of 
Child Health and Human Development (NICHD) seeks to advance scientific 
knowledge and strategies directed at the sexual transmission of HIV in 
vulnerable populations, especially including adolescents, young adults, and 
minority populations, as does the National Institute of Mental Health (NIMH).  
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) seeks to 
expand prior work on the role of social environmental influences on alcohol 
consumption and sexual risk behaviors by systematically examining the 
relationships among social environmental factors, alcohol use, sexual risk 
behaviors, and sexually transmitted infections (STI) for groups at high risk 
of acquiring and transmitting STIs. 

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 Program Announcement 
(PA) is related to one or more of the priority areas.  Potential applicants 
may obtain “Healthy People 2010” at http://www.health.gov/healthypeople.

ELIGIBILITY REQUIREMENTS

Applications may be submitted by domestic and foreign for-profit and non-
profit organizations, public and private, such as universities, colleges, 
hospitals, laboratories, and units of State and local governments, and 
eligible agencies of the Federal government.  Racial/ethnic minority 
individuals, women, and persons with disabilities are encouraged to apply as 
Principal Investigators.

MECHANISM OF SUPPORT

This PA will use the National Institutes of Health (NIH) Research Project 
Grant (R01) award mechanism.  Responsibility for the planning, direction, and 
execution of the proposed project will be solely that of the applicant. 

For all competing R01 applications requesting up to $250,000 per year in 
direct costs, specific application instructions have been modified to reflect 
“MODULAR GRANT” and “JUST-IN-TIME” streamlining efforts being examined by the 
NIH.  Applications that request more than $250,000 in any year must use the 
standard PHS 398 (rev. 4/98) application instructions.  Complete and detailed 
instructions and information on Modular Grant applications can be found at 
http://grants.nih.gov/grants/funding/modular/modular.htm. 

FUNDS AVAILABLE

The NICHD intends to commit approximately $1.3 million, the NIAAA intends to 
commit approximately $795,000 and the NIMH intends to commit approximately 
$350,000 in total costs [direct plus Facilities and Administrative (F&A) 
costs] in FY 2002 to support new and/or competing continuation applications 
submitted in response to this PA.  Although not participating in this PA, the 
National Institute on Drug Abuse (NIDA) states their continuing interest in 
this area of research.

An applicant may request a project period of up to five years.  Because the 
nature and scope of the research proposed may vary, it is anticipated that 
the size of awards also will vary.  Although the financial plans of NICHD, 
NIAAA and NIMH provide support for this program, awards pursuant to this PA 
are contingent upon the availability of funds and the receipt of a sufficient 
number of meritorious applications. 


RESEARCH OBJECTIVES

Background

Social networks refer to sets of linkages or relations between people, 
generally defined in terms of a type of relation.  For example, networks may 
comprise individuals who are connected to each other through kinship, 
friendship, sexual contact, or the exchange of information or services.  
Research on social networks encompasses a diverse set of approaches, ranging 
from ethnographic studies of people interacting within a cultural context to 
formal mathematical modeling of contact structures.  A significant body of 
theory and research has developed identifying different ways of 
conceptualizing and measuring networks (e.g., egocentric vs. sociometric 
networks); various dimensions of network structure (e.g., size and range, 
boundedness, density, homogeneity); and the characteristics of relations 
within networks (e.g., intimacy, duration, reciprocity, and the types and 
variety of activities and resources that flow between and among actors).  
Critical distinctions have been made between "strong" and "weak" network ties 
and the functions these ties can assume.  Research has also documented the 
influence of the larger social, cultural, and physical environment on network 
structure and function.  

Social networks are believed to affect health through a variety of 
mechanisms.  They influence the creation and enforcement of behavioral norms; 
they channel the flow of resources, including social support, information, 
and material goods and services; and they influence the social engagement and 
integration of network members.  Their influence on the health of individual 
network members can potentially be seen at the behavioral, psychological, and 
physiological levels. These mechanisms may influence health in both positive 
and negative ways.  For example, the norms that develop within networks may 
encourage healthy or risky behaviors; the "resources" exchanged may include 
positive tools for health promotion or dangerous pathogens.

Application of social network research to HIV risk and prevention can take 
many forms.  Many analysts have studied the characteristics of "risk 
networks," composed of individuals who engage in HIV risk behaviors together.  
These include drug injection networks and sexual networks, and are relevant 
because they define the potential for disease transmission and the 
opportunities for interrupting transmission. Researchers have modeled the 
transmission of HIV within and across social networks based on varying 
assumptions of partnership choice, duration, and concurrency.  They have 
demonstrated that individuals’ probability of infection depends on their 
location within a network, and that the spread of HIV depends on its point of 
introduction within a risk network.  They have developed the concept of “core 
transmitters” and applied it in contact tracing and in interventions to 
interrupt the spread of disease and to improve the dissemination of 
treatment.  They have documented the role of bridge populations, such as 
heterosexually active injection drug users and men who have sex with both men 
and women, in transmitting HIV between infected and uninfected population 
groups.  They have studied the relationship between sexual and drug-using 
networks and the geographic locations (shooting galleries, bathhouses, bars, 
workplaces, schools, etc.) that help to tie networks together.  They have 
introduced the concept of a "sexual marketplace" within which a network or 
networks may operate. 

Social networks that are unrelated to HIV-risk behaviors also may play an 
important role in influencing HIV risk.  Social networks based on kinship, 
friendship, employment in a common firm or occupation, membership in a 
religious or community organization, or other basis can influence an 
individual's HIV risk through affecting behaviors, channeling resources, and 
affecting social integration and psychological well-being. The social 
influence and social learning that occur in such networks are accomplished 
through a variety of mechanisms, including persuasion, modeling of behavior, 
sanctioning of behavior, and the creation of normative environments that 
encourage some behaviors and discourage others.  Networks play a powerful 
role in mediating transmission of information about HIV risk and protective 
behaviors, at both general (how does one avoid risk?) and specific (who is 
engaging in risky behavior?) levels.  Network characteristics affect how 
quickly and effectively information is transmitted, and how information is 
interpreted and transformed as it is communicated.  They also influence the 
ability of network members to  monitor and influence the behaviors of other 
members.

Social networks based on kinship, friendship, and other "non-risk" attributes 
also may influence the composition and characteristics of risk networks.  For 
example, family and friends often have influence over the selection of sexual 
partners and the course of sexual relationships. The extent to which risk 
networks overlap "non-risk" social networks may influence behavior. Research 
has found that personal network characteristics are associated with risky 
sexual behaviors among injection drug users; that network members' self-
reported alcohol use predicted individuals' alcohol consumption, and network 
members' substance use predicted individuals' risky sexual behaviors.  
Overlap between risk and non-risk networks also may affect the extent to 
which sexual and drug-using behaviors are subject to effective monitoring and 
social control.  On the one hand, an individual surrounded by caring friends 
and family members may be better able to avoid involvement in risky 
behaviors; on the other hand, norms emphasizing mutual support among friends 
and kin may make it more difficult to sanction individuals who engage in 
risky sexual behaviors.  Norms governing how and to whom individuals 
communicate about their sexual behaviors also matter.  Networks in which 
frank and open communication is the norm will be better able to identify and 
react to unsafe individual behavior than networks in which the norms support 
exaggeration, denial, or silence about sexual matters. 

Social networks provide a natural frame for interventions designed to 
interrupt the transmission of HIV infection and to change values, beliefs, 
and behaviors that increase or reduce HIV risk. Some interventions that make 
explicit use of social networks have already proven effective, including 
programs designed to change adolescent peer norms and the norms of networks 
of drug injectors.  However, much more could be learned about the development 
and effective implementation of network-based interventions.  Interventions 
may target risk reduction through changing network structures or dynamics, 
changing the culture or norms of networks, or influencing individuals 
occupying strategic locations within or between networks.  Interventions may 
target networks at varying levels of specificity:  risk networks, social 
networks of risk-taking individuals, or social networks within schools, 
neighborhoods or communities.  Different approaches and strategies may be 
appropriate to different intervention goals. 

Research Scope

This announcement invites basic, applied, and methodological research that 
can advance knowledge about the influence of social networks on HIV risk and 
the application of that knowledge to HIV prevention and treatment efforts.  
Successful applicants will articulate a theory specifying the role of social 
and/or sexual networks in HIV risk and demonstrate how the proposed work will 
advance strategies for HIV prevention and intervention approaches. 
Applications to design, implement, and evaluate interventions are 
appropriate.  Applicants may address any population, but are strongly 
encouraged to address populations and locations where the risk of HIV is high 
or increasing.  International as well as domestic studies are encouraged. 

Questions may include, but are not limited to, the following:

o  Basic Research

How do the structure and content of egocentric and sociometric networks 
affect social norms, HIV-related risk-taking behaviors, and HIV transmission?  
What types of networks (sexual, friendship, kin, etc.) are most influential 
in influencing HIV risk and transmission and in what ways?  Does this vary 
among different populations or groups?

What are the social network influences on alcohol consumption and sexual risk 
behaviors among groups at risk for HIV and other sexually transmitted 
infections (STIs)?

What influences the overlap between sexual and other types of social 
networks, and how does this overlap influence HIV-related risk behavior?  How 
do social and sexual networks interact and influence each other?

How does the larger physical, social, economic, and cultural environment 
influence the structure and characteristics of networks, and the ways in 
which networks affect HIV risk?   What is the role of institutions, 
commercial establishments, features of the physical environment, social and 
economic stratification, and other factors? 

What influences change within networks over time, and how does permanence or 
change affect the dynamics of HIV transmission and/or the influence of 
networks on HIV risk through norms and behavior? 

o  Applied research

How can intervention strategies grounded in social network theory and methods 
be developed, extended, and evaluated?

What types of networks can provide effective mechanisms for stimulating 
behavioral change to reduce HIV risk, under what circumstances?

What approaches work best in implementing network-based interventions?  
Should one target key individuals (e.g., core members, opinion leaders, or 
individuals who bridge between networks) or attempt to engage a network as a 
whole unit, perhaps through geographic or institutional focal points that 
help to bring network members together?  How can the larger social contexts, 
such as faith communities, schools or worksites, within which networks exist, 
be used as leverage points for intervention work?

How can the culture of networks be changed, and how can that change be 
measured? 

How do networks differ systematically across groups differing with respect to 
age, race, culture, sexual orientation, and geography, and what are the 
implications of these differences for intervention approaches? 

While “peer education” has been widely utilized in a variety of settings, are 
there other techniques utilizing the more “hidden” properties of social 
networks, which might be used in intervention designs? 

o  Methodological Questions

Can the techniques for measuring social and sexual networks associated with 
HIV transmission be refined and, if so, how?

What are the implications of error in the measurement of social networks 
(e.g., failure to report ties, incomplete measurement of network ties) for 
analyses related to HIV risk and transmission?

What are optimum sampling methodologies for network studies?    

What are the ethical and intervention implications for data collected via 
local, partial or complete network designs?  

Since data reported from individuals in local or ego-centric networks cannot 
be viewed as statistically independent, what methods for modeling are 
appropriate?
  
What methods are appropriate for measuring and analyzing dynamic change in 
the composition, structure, and other characteristics of networks over time?

How can we improve the ability of network studies to differentiate the 
influence of network structures and processes on individuals from the 
propensity of individuals to associate in networks that reflect their values, 
norms, and behaviors?

How can network studies effectively integrate qualitative and quantitative 
methods to advance our understanding of network structure and function, and 
their implications for HIV risk?

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 sub-populations must be included in all NIH-supported biomedical and 
behavioral research projects involving human subjects, unless a clear and 
compelling rationale and justification are provided indicating 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 
UPDATED "NIH Guidelines for Inclusion of Women and Minorities as Subjects in 
Clinical Research," published in the NIH Guide for Grants and Contracts on 
August 2, 2000  
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html); a 
complete copy of the updated Guidelines are available at  
http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm.  The 
revisions relate to NIH-defined Phase III clinical trials and require: a) all 
applications or proposals and/or protocols to provide a description of plans 
to conduct analyses, as appropriate, to address differences by sex/gender 
and/or racial/ethnic groups, including subgroups if applicable; and b) all 
investigators to report accrual, and to conduct and report analyses, as 
appropriate, by sex/gender and/or racial/ethnic group differences.

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 or 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,” published in the NIH Guide for Grants and 
Contracts, March 6, 1998, and available at:
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 also may provide additional relevant 
information concerning the policy.

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 
(revised 4/98) and will be accepted at the standard application deadlines for 
AIDS and AIDS-related applications, as indicated in the application kit.  
These forms are available at most institutional offices of sponsored 
research, on the Internet at 
http://grants.nih.gov/grants/funding/phs398/phs398.html, 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, E-mail:  grantsinfo@nih.gov. 

Applicants planning to submit an investigator-initiated new (Type 1), 
competing continuation (Type 2), competing supplement (Type 3), or any 
amended/revised version of the preceding grant application types requesting 
$500,000 or more in direct costs for any year are advised that they must 
contact the NIH program staff before submitting the application, i.e., as 
plans for the study are being developed.  Furthermore, the applicant must 
obtain agreement from NIH staff that the institute will accept the 
application for consideration for award.  Finally, the applicant must 
identify, in a cover letter sent with the application, the staff member who 
agreed to accept assignment of the application. 

This policy requires an applicant to obtain agreement for acceptance of both 
any such application and any such subsequent amendment.  Refer to the NIH 
Guide for Grants and Contracts, March 20, 1998, at 
http://grants.nih.gov/grants/guide/notice-files/not98-030.html.

Any application subject to this policy that does not contain the required 
information in a cover letter sent with the application will be returned to 
the applicant without review.

Modular Grant Application Instructions 

The modular grant concept establishes specific modules in which direct costs 
may be requested as well as a maximum level for requested budgets.  Only 
limited budgetary information is required under this approach. The just-in-
time concept allows applicants to submit certain information only when there 
is a possibility for an award.  It is anticipated that these changes will 
reduce the administrative burden for the applicants, reviewers, and NIH 
staff.  The research grant application form PHS 398 (revised 4/98) is to be 
used in applying for these grants, with the modifications noted below.

Applications will request direct costs in $25,000 modules, up to a total 
direct cost request of $250,000 per year. (Applications that request more 
than $250,000 direct costs in any year must follow the traditional PHS 398 
application instructions.)  The total direct costs must be requested in 
accordance with the program guidelines and the modifications made to the 
standard PHS 398 application instructions described below:

o  FACE PAGE:  Items 7a and 7b should be completed, indicating Direct Costs 
(in $25,000 increments up to a maximum of $250,000) and Total Costs [Modular 
Total Direct plus Facilities and Administrative (F&A) costs] for the initial 
budget period.  Items 8a and 8b should be completed indicating the Direct and 
Total Costs for the entire proposed period of support.

o  DETAILED BUDGET FOR THE INITIAL BUDGET PERIOD:  Do not complete Form Page 
4 of the PHS 398.  It is not required and will not be accepted with the 
application.

o  BUDGET FOR THE ENTIRE PROPOSED PERIOD OF SUPPORT:  Do not complete the 
categorical budget table on Form Page 5 of the PHS 398.  It is not required 
and will not be accepted with the application.

o  NARRATIVE BUDGET JUSTIFICATION:  Prepare a Modular Grant Budget Narrative 
page.  (See http://grants.nih.gov/grants/funding/modular/modular.htm for 
sample pages.)  At the top of the page, enter the Total Direct Costs 
requested for each year.  This is not a Form Page.

Under Personnel, list all project personnel, including their names, percent 
of effort, and roles on the project.  No individual salary information should 
be provided.  However, the applicant should use the NIH appropriation 
language salary cap and the NIH policy for graduate student compensation in 
developing the budget request.

For Consortium/Contractual costs, provide an estimate of Total Costs (Direct 
plus F & A) for each year, each rounded to the nearest $1,000.  List the 
individuals/organizations with whom consortium or contractual arrangements 
have been made, the percent effort of all personnel, and the role on the 
project.  Indicate whether the collaborating institution is foreign or 
domestic.  The total cost for a consortium/contractual arrangement is 
included in the overall requested modular direct cost amount.  Include the 
Letter of Intent to establish a consortium.

Provide an additional narrative budget justification for any variation in the 
number of modules requested.

o  BIOGRAPHICAL SKETCH:  The Biographical Sketch provides information used by 
reviewers in the assessment of each individual’s qualifications for a 
specific role in the proposed project, as well as to evaluate the overall 
qualifications of the research team.  A biographical sketch is required for 
all key personnel, following the instructions below.  No more than three 
pages may be used for each person.  A sample biographical sketch may be 
viewed at: http://grants.nih.gov/grants/funding/modular/modular.htm.

- Complete the educational block at the top of the Form Page;
- List position(s) and any honors;
- Provide information, including overall goals and responsibilities, on 
research projects ongoing or completed during the last three years;
- List selected peer-reviewed publications, with full citations.

o  CHECKLIST:  This page should be completed and submitted with the 
application.  If the F&A rate agreement has been established, indicate the 
type of agreement and the date.  All appropriate exclusions must be applied 
in the calculation of the F&A costs for the initial budget period and all 
future budget years.

o  The applicant should provide the name and telephone number of the 
individual to contact concerning fiscal and administrative issues if 
additional information is necessary following the initial review.

Submission Instructions

The title and number of the program announcement must be typed on line 2 of 
the face page of the application form and the YES box must be marked.

Submit a signed, typewritten original of the application including the 
Checklist, and five signed photocopies, in one package, 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

Upon receipt, applications will be reviewed for completeness by the NIH 
Center for Scientific Review (CSR). Applications will be assigned on the 
basis of established PHS referral guidelines.  Applications will be evaluated 
for scientific and technical merit by an appropriate scientific review group 
convened 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, 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 our 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 
methods?  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 also will be reviewed with respect to the following:

 o 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 also will be 
evaluated.

o  The reasonableness of the proposed budget and duration in relation to the 
proposed research.

o  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 recommended 
applications. The following will be considered in making funding decisions:  
Merit of the proposed project as determined by peer review, availability of 
funds, and program priorities.

INQUIRIES

Inquiries are encouraged.  The opportunity to clarify any issues or questions 
from potential applicants is welcome.  A complete listing of contacts for 
both programmatic and fiscal/administrative inquiries may be found at:  
http://www.nichd.nih.gov/PA/Social_Networks.htm.

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance Nos. 
93.864 (NICHD Population Research), 93.273 (NIAAA) and  93.121 and 93.242 
(NIMH).  Awards are made under authorization of Sections 301 and 405 of the 
Public Health Service Act as amended (42 USC 241 and 284) and administered 
under NIH grants policies and Federal Regulations 42 CFR 52 and 45 CFR Parts 
74 and 92.  This program is not subject to the intergovernmental review 
requirements of Executive Order 12372, or to 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, any 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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