STUDYING SPIRITUALITY AND ALCOHOL

Release Date:  February 7, 2000

RFA:  AA-00-002

National Institute on Alcohol Abuse and Alcoholism
The Fetzer Institute   

Letter of Intent Receipt Date: April 24, 2000
Application Receipt Date: May 24, 2000

THIS REQUEST FOR APPLICATIONS (RFA) 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 
RFA.

PURPOSE

The Fetzer Institute (http://www.fetzer.org) in Kalamazoo, Michigan is a non-profit 
foundation that supports scientific research and education exploring the 
relationship of the physical, mental, emotional, social, and spiritual 
dimensions of life.  It joins with the National Institute on Alcohol Abuse and 
Alcoholism (www.niaaa.nih.gov) in co-sponsoring this RFA.  This RFA is 
intended to support research to better understand the role of religiousness 
and spirituality in the prevention and treatment of and recovery from 
alcoholism and alcohol-related diseases.

There is a growing interest in the impact of religious and spiritual 
commitment and activities on health outcomes. Medical scientists, in general, 
have understudied the role and relationship of religion and spirituality in 
health and this has also been the case for alcoholism research.  Yet, the 
history of alcohol use and alcoholism is intertwined with spirituality and 
religion.  Many religious traditions express strong beliefs about alcohol use 
and some encourage specific practices with regard to the consumption of  
alcohol.  Some treatment programs insist that spirituality be at the core of 
any enduring recovery from alcohol addiction.  Further work is needed to 
better understand the role of religiousness and spirituality as protective 
and/or risk factors in the development of alcohol disorders. Studies are 
needed on the role and efficacy of spirituality in intervention programs, and 
on the effects of race, gender and ethnicity on the relationship between 
spirituality and alcohol abuse and alcoholism.   

This RFA builds upon the presentations and discussions held in a conference 
entitled Studying Spirituality and Alcohol, held February 1-2, 1999, and 
co-sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 
of the National Institutes of Health and the Fetzer Institute.  The meeting 
brought together experts from a variety of disciplines, including alcohol 
researchers, neuroscientists, treatment professionals, religion researchers, 
and general health experts to examine spirituality and alcoholism from a 
multi-disciplinary perspective.  The conference reviewed conceptual issues, 
the current state of knowledge, the best available methodologies, and 
promising avenues for future research. Copies of the conference summary are 
available and may be obtained by sending a request to Madhu Gola, Office of 
Collaborative Research Activities, National Institute on Alcohol Abuse and 
Alcoholism at mgola@willco.niaaa.nih.gov or (301) 443-7043 (fax).

This RFA follows the conference and is designed to stimulate research on the 
influence of spirituality on the prevention of alcohol abuse, the development 
and treatment of alcohol dependence and alcoholism, and on the maintenance of 
long-term recovery from alcohol dependence. Applications will be submitted to 
the NIH and will be reviewed according to normal NIH peer review procedures. 
Applications judged meritorious, but not funded by the NIAAA, will be eligible 
for funding by the Fetzer Institute. Applicants eligible for funding 
consideration by the Fetzer Institute will be notified following completion of 
the NIH peer review process. At that time it will be the applicant’s 
responsibility (following the application guidelines of the Fetzer Institute) 
to submit the application, along with the NIH prepared summary statement, to 
the Fetzer Institute to be eligible for Fetzer Institute funding.

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 Request for Applications (RFA), 
Studying Spirituality and Alcohol, is related to the priority areas of alcohol 
abuse and alcoholism. Potential applicants may obtain a copy of "Healthy 
People 2000" at http://odphp.osophs.dhhs.gov/pubs/hp2000.

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, 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 RFA will use the National Institutes of Health (NIH) 
Exploratory/Developmental Research  Grant (R21) award mechanism.  Normally 
Exploratory/Developmental Research Grants supported under this RFA will be for 
$50,000 or $75,000 per year (direct costs) for up to two years, but maybe for 
up to $100,000, if well-justified.   Responsibility for the planning, 
direction, and execution of the proposed project will be solely that of the 
applicant. The total project period for an Exploratory/Development Research 
Grant application submitted in response to this RFA may not exceed two years, 
although requests for no-cost extensions may be considered.  R21 awards are 
not renewable, however, it is the expectation that successful 
exploratory/developmental projects supported through this RFA will lead to the 
subsequent submission of regular research project grant (R01) applications. 

Applications for competitive supplements to existing R01 research grants for 
$100,000 (direct costs) or less a year for up to two years will also be 
accepted. In planning to submit an application for a supplement to an existing 
grant, the investigator should assure that the grant meets the requirements to 
be supplemented.  Competing supplements cannot exceed the parent grant project 
period.  The program administrator should be consulted before submission of a 
competing supplement application. 

This RFA is a one-time solicitation.  The anticipated award date is September 
29, 2000.

FUNDS AVAILABLE

The National Institute on Alcohol Abuse and Alcoholism and the Fetzer 
Institute intend to commit up to $1 million  in FY 2000 to fund 7 to 10 new 
grants in response to this RFA. An applicant may request a project period of 
up to two years and a budget for direct costs of up to    $100,000 per year 
for an R21 or a competitive supplement to an existing grant.  Because the 
nature and scope of the research proposed may vary, it is anticipated that the 
size of each award will also vary. Although the financial plans of the 
Institute provide support for this program, awards pursuant to this RFA are 
contingent upon the availability of funds and the receipt of a sufficient 
number of applications of outstanding scientific and technical merit.

BACKGROUND

Alcoholism and alcohol-related problems have an enormous impact on our 
society. Most adults can drink alcohol moderately and responsibly without 
complications. However, nearly 14 million Americans meet the medical criteria 
for a diagnosis of alcohol abuse or alcoholism.  In addition, it is estimated 
that about 40 percent of Americans have direct family experience with this 
issue.  Although a dollar figure cannot adequately reflect the social and 
human devastation caused by these illnesses, it is estimated that the economic 
and health care costs to society from alcoholism and alcohol abuse are nearly 
$167 billion annually.  Much of this cost is related to lost productivity, 
motor vehicle crashes, alcohol-related medical expenses and crime. Cirrhosis 
is the tenth leading cause of death in the United States and a significant 
portion of this incidence is related to alcohol dependence. Only a fraction of 
the total cost, around $10.5 billion, is attributable to treating alcohol 
dependence and its medical consequences. 

Alcoholism is a disease associated with alcohol seeking and the increasing 
dominance of alcohol in a person"s life, a dominance that essentially 
displaces other concerns and responsibilities.   Why some people who drink get 
into trouble from alcohol use, while many others do not has been a central 
question in alcohol research.  It is clear that there are genetic influences 
on an individual"s risk for alcoholism, but environmental influences are also 
key factors.  Religiousness and spirituality are a part of the internal and 
external environment which should be considered when dealing with individuals 
facing the risk of  alcoholism and in dealing with and treating people with 
alcohol problems.

Religiousness and spirituality form interlocking pieces of a multidimensional 
construct.  Looking at various aspects some features have emerged. 
Spirituality may be found within or outside of specific religious traditions. 
It can be related to attitudes about life"s meaning and purpose, fundamental 
connections among people, or the value people give to themselves and others.  
These can be crucial for coping with difficulties and motivating behavior.

Studies have typically found less alcohol abuse among people claiming to be 
very religious than among less religious people.  Recovery from alcoholism is 
often associated with corresponding increases in spiritual measures, although 
the causal direction is not clear.  It is also unclear to what extent some 
aspects of religion/ spirituality may be risk factors for alcoholism and 
alcohol-related diseases.  As a foundation for the development of rigorous 
research on these issues, the Fetzer Institute supported the development of an 
annotated bibliography on spirituality and substance use. The bibliography was 
developed by Drs. William Miller and Melanie Bennett of the University of New 
Mexico and is available on the website:
http://casaa-0031.unm.edu/bib/fetzer.html. It is the result of a series of 
literature searches that cross spirituality terms with alcohol terms with the 
citations entered into a structured database. 

There are different therapies for alcoholism that may have a spiritual base.  
Alcoholics Anonymous (AA) is a worldwide organization that advocates a 
spiritual approach to recovery.  AA is a major social movement that has grown 
in size and significance in shaping public opinion, yet the mechanisms by 
which members are helped and the nature and degree of that help remain 
inadequately understood.  AA and groups that use this approach can provide 
solid ground for exploring the relationship between spirituality and 
treatment.   Studies are needed to elucidate the spiritual aspects of AA 
affiliation, the relationship of spirituality and possible differences in 
attendance and involvement in AA, and the role of spirituality in mechanisms 
of change.   

In addition, there is a need for further study of other programs based on 
religious and spirituality precepts. A recent multi-site trial found that a 
12-step facilitation treatment was at least as effective, and on some outcome 
measures more effective, than two other treatment approaches, previously well 
supported by outcome research (Project MATCH Research Group, l997).  However, 
little is understood about 12-step programs from a cross-cultural perspective, 
and the efficacy of culturally developed programs addressing the spiritual 
needs and alcohol problems of specific cultural groups, (e.g., American 
Indians) have been inadequately studied. 

It is customary to assess drinking behavior together with a broad range of 
dimensions of functioning to understand the process of recovery. Physical 
health, psychological adjustment, legal status, employment, emotional 
stability, and cognitive functioning are typically studied. However, greater 
attention to spirituality may also lead to a better understanding of the 
process, prevention, and treatment of alcoholism. 

Reliable findings will emerge from studies that utilize strong measures, 
define constructs carefully, and propose clear hypotheses which are tested 
using rigorous methodology. 

KEY CONCEPTS, MEASURES, AND METHODS

While some may regard religiousness and spirituality as indistinguishable, 
others see the terms as distinct but intertwined.  Generally, religiousness 
has specific behavioral, social, doctrinal, and denominational characteristics 
because it involves a system of worship and doctrine that is shared within a 
group.  Spirituality can be characterized as concerning the transcendent (that 
which is addressing ultimate questions about life"s meaning with the 
assumption that there is more to life than what we see or fully understand).  
Spirituality can call one beyond oneself to concern and compassion for others. 
There is no need to polarize the two constructs.  Religions aim to foster and 
nourish the spiritual life, and spirituality is often a salient aspect of 
religious participation, but it is possible to adopt the outward forms of 
religious worship and doctrine without having a strong relationship to the 
transcendent.  Researchers should be clear in the operationalization of these 
multidimensional constructs within their specific research programs so it is 
clear what is being measured.

Religiousness and spirituality, like personality and health, are complex, 
multi-dimensional constructs. In an earlier effort, the National Institute on 
Aging (NIA) and the Fetzer Institute developed a working document that 
identified different domains of religiousness and spirituality that may be 
relevant for studies involving health and health outcomes (see reference 
below).  Domains identified by NIA and Fetzer working group include: meaning, 
values, beliefs, forgiveness, private religious practices, coping, history, 
commitment, organizational religiousness, and daily spiritual experience.  The 
working group also concluded that domains to be used in studies for specific 
populations or disease processes need further refinement. A multi-dimensional 
approach to the characterization of religiousness and spirituality is a 
reasonable starting point for conducting research on alcohol and 
religiousness/spirituality.  The multi-dimensional approach can help by 
focusing on specific aspects or a combination of aspects of religiousness and 
spirituality that are most relevant to the topic studied. 

In addition to the NIA/Fetzer supported report on measurement issues, there 
are a large number of measures of spirituality and religiousness in use in 
various research.  Dr. Peter Hill, a presenter at the conference, and Ralph 
Hood recently published a book examining many of these measures (see reference 
below).  There is room too, for further development of dimensions of the 
construct that might have particular relevance for populations suffering from 
alcohol use disorders.

RESEARCH ISSUES
 
The following areas illustrate suitable topics for research. While applicants 
are not limited to these themes, they are advised to consult with program 
staff on the relevance of their proposed subject to the RFA.

Prevention/Intervention Issues

Studies to determine the role of religiousness/spirituality as a protective 
factor and/or vulnerability influence for alcoholism. Research to explore the 
aspects of religiousness/spirituality that are most relevant as protective 
and/or risk factors.

Studies to determine the aspects of religious traditions that influence the 
risk of alcohol abuse. 

Studies of the role of spirituality in adolescent development and how this 
relates to alcohol use among adolescents.

Research on the role of individual spiritual practices (prayer, meditation, 
readings, etc.) in intervention programs that are not spirituality based.

An exploration of the effectiveness of spiritually focused interventions.

An examination of spirituality in the different stages of substance abuse: 
from initial use, to continued use, to dependence, and in primary prevention 
vs. secondary prevention.

Treatment and Recovery Issues
12-Step Programs

Studies of the role of spiritual or religious ingredients in 12-step 
treatment programs. 
This might include studies on the association of 
spirituality/religiousness and personality factors in individuals in 
spirituality based intervention programs. 
 
Determine the relationship of spirituality/religion and cohesiveness of 
spirituality-based 12 step programs including the relationship of 
spirituality/religion and attendance vs. engagement in the process of 12 
step groups.  

Examine the effectiveness of spirituality-based 12-step programs in 
cross cultural contexts.

Research to determine whether consideration of a patient"s spirituality might 
lead to more efficacious assignment to type of treatment.

Research in spirituality/religiousness and Alcoholics Anonymous: This might 
include how spirituality is understood, differences with other treatment 
adjuncts and behavior associated with core spiritual beliefs.

An exploration of the influence of spirituality and religious beliefs in 
non-spirituality-based treatment programs

Encouraged are well thought out qualitative studies which explore the role of 
religious and spiritual factors on the experience of treatment and recovery.

Studies of the effectiveness of treatment programs that incorporate a 
traditional or cultural spiritual focus.

The relationship of spirituality/religion to known personal traits and 
cognitive and affective variables associated with recovery (e.g., 
regret/remorse, self responsibility).

Examine how an individual’s spirituality changes as the person progresses into 
dependence and then through treatment and recovery.

Evaluate whether clergy trained in therapies, e.g. motivational enhancement 
techniques, are more effective in supporting those in recovery to maintain 
sobriety than clergy who are not trained.

Studies of the role of religious institutional support, (e.g., African 
American inner city churches) in the community matrix of care and other 
integrated approaches to alcoholism treatment.

Studies of the possible role of spirituality in natural recovery.

Health Services Research

Research to determine effective models of formal and informal linkages between 
organized religion and alcohol services.

Studies to determine the effect of religion-based services (e.g., pastoral 
counseling) on access to alcohol treatment services - the effectiveness of 
clergy as gatekeepers?

An exploration of whether reimbursement for spirituality-based alcohol 
services affects access, quality and outcomes of those services.

Physiological Relationships

Research on the use of neuroimaging techniques and electrophysiological 
assessments to better understand mechanisms involved in spirituality and 
alcoholism.

Multi-disciplinary approaches that include physiological, psychological, and 
spiritual aspects of prevention, treatment, and recovery from alcoholism.  

Other Research Areas

Research on the relationship of spirituality and spiritual resources of the 
family of an alcoholic and the family’s ability to cope.

Studies of the moderating effects of gender, race, and ethnicity on the 
relationship between religiousness/spirituality and alcoholism.  

An examination of the domains and qualities of spirituality and religion often 
neglected in research (perceptions of guilt, one"s religious history, 
non-religious spiritual practices, and qualities such as hope and joy) in 
relationship to treatment outcome.

Studies of alcohol problems and spirituality/religiousness over different 
stages of the life-course.  

SPECIAL REQUIREMENTS

An annual meeting will be held in the Washington, D.C., area to facilitate the 
exchange of information and coordination among investigators. Applicants must 
include support for these required meetings in the budget request.

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 was 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: 
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 a letter of intent that includes a 
descriptive title of the proposed research, 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 the RFA in 
response to which the application may be submitted. 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 Institute 
staff to estimate the potential review workload and avoid conflict of interest 
in the review.

The letter of intent is to be sent to the following address by the letter of 
intent receipt date listed in the heading of this RFA.

RFA: AA-00-002
Extramural Project Review Branch
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard, Suite 409,MSC 7003
Bethesda, Maryland 20892-7003
Rockville, Maryland 20852 (for express/courier service)

APPLICATION PROCEDURES

The research grant application form PHS 398 (rev. 4/98) is to be used in 
applying for these grants. These forms 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, E-mail: 
GrantsInfo@nih.gov.

SPECIFIC APPLICATION INSTRUCTIONS FOR MODULAR GRANTS

The modular grant concept establishes specific modules in which direct costs 
may be requested. 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 Institute staff.  The research grant application form PHS 398 
(rev. 4/98) is to be used in applying for these grants, with the modifications 
noted below.

BUDGET INSTRUCTIONS

Modular Grant applications will request direct costs in $25,000 modules, up to 
a total direct cost request of $100,000 per year for R21 applications. 
Applications for competitive supplements to existing research grants for less 
than $100,000 (direct costs) a year for two years will also be accepted. The 
total project period for an application submitted in response to this RFA may 
not exceed two years. 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:

PHS 398

FACE PAGE - Items 7a and 7b should be completed, indicating Direct Costs (in 
$25,000 increments up to a maximum of $100,000) 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.

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.

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.

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 key 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 key 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.

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, and
- List selected peer-reviewed publications, with full citations.

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

The RFA label available in the PHS 398 (rev. 4/98) application form must be 
affixed to the bottom of the face page of the application. Be sure to type the 
RFA number on the label.  The sample RFA label available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf has been modified to 
allow for this change.  Failure to use this label could result in delayed 
processing of the application such that it may not reach the review committee 
in time for review.  In addition, the RFA title and number 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 three 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)

At the time of submission, two additional copies of the application must be 
sent to:

RFA :AA-00-002
Extramural Project Review Branch
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard, Suite 409, MSC 7003
Bethesda, MD  20892-7003
Rockville, MD 20852 (for express/courier service)

Applications must be received by the application receipt date listed in the 
heading of this RFA. If an application is received after that date, it will be 
returned to the applicant without review.

The Center for Scientific Review (CSR) will not accept any application in 
response to this RFA that is essentially the same as one currently pending 
initial review, unless the applicant withdraws the pending application. The 
CSR will not accept any application that is essentially the same as one 
already reviewed. This does not preclude the submission of substantial 
revisions of applications already reviewed, but such applications must include 
an introduction addressing the previous critique.

REVIEW CONSIDERATIONS

Upon receipt, applications will be reviewed for completeness by the CSR and 
responsiveness by the NIAAA.  If the application is not responsive to the RFA, 
CSR staff may contact the applicant to determine whether to return the 
application to the applicant or submit it for review in competition with 
unsolicited applications at the next review cycle.
Applications that are complete and responsive to the RFA will be evaluated for 
scientific and technical merit by an appropriate peer review group convened by 
the NIAAA in accordance with the review criteria stated below. As part of the 
initial merit review, a process will be used by the initial review group in 
which applications 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 the applications under review, will be discussed, assigned a 
priority score, and receive a second level review by the National Advisory 
Council on Alcohol Abuse and Alcoholism.

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 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:

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 will also 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 or the environment, to 
the extent they may be adversely affected by the project proposed in the 
application.
Additional consideration pertinent to the review of Exploratory/Developmental 
Grant (R21) applications:

o   Pilot/feasibility studies may contain little or no preliminary data. 
Review should focus on whether the rationale for the study is well developed 
and whether the proposed research is likely to generate data that will lead to 
a regular research project grant or full-scale clinical trial. Adequate 
justification for the proposed work may be provided through literature 
citations, data from other sources, or investigator-generated data. 
Schedule

Letter of Intent Receipt Date:    April 24, 2000 
Application Receipt Date:         May 24, 2000
Peer Review Date:                 July/August, 2000
Council Review:                   September 13, 2000
Earliest Anticipated Start Date:  September 29, 2000

AWARD CRITERIA

Award criteria that will be used to make award decisions include:

o  scientific merit (as determined by peer review)

o  availability of funds

o programmatic priorities.

As indicated above under the Purpose of the RFA, applications will be 
submitted to the NIH and will be reviewed according to normal NIH peer review 
procedures. Applications judged meritorious, but not funded by the NIAAA, will 
be eligible for funding by the Fetzer Institute. Applicants eligible for 
consideration by the Fetzer Institute will be notified following completion of 
the NIH peer review process. At that time it will be the applicant’s 
responsibility to submit the application, along with the NIH prepared summary 
statement, to the Fetzer Institute (following the application guidelines of 
the Fetzer Institute) to be eligible for Fetzer Institute funding.

INQUIRIES

Inquiries concerning this RFA are encouraged. The opportunity to clarify any 
issues or questions from potential applicants is welcome. Inquiries should be 
limited to the persons identified below as NIH administrators.
Direct inquiries regarding programmatic issues to:

Raye Litten, III, Ph.D.
Division of Clinical and Prevention Research
National Institute on Alcohol Abuse and Alcoholism
Willco Building, Room 505
6000 Executive Boulevard
Bethesda, MD 20892-7003
Telephone: (301) 443-0636
FAX: (301) 443-8774
E-mail: rlitten@willco.niaaa.nih.gov

Vivian Faden, Ph.D.
Division of Biometry and Epidemiology
National Institute on Alcohol Abuse and Alcoholism
Willco Building, Room 514
6000 Executive Boulevard
Bethesda, Maryland 20892-7003
Telephone: (301) 594-6232
FAX: (301) 443-8614
E-mail: vfaden@willco.niaaa.nih.gov

Antonio Noronha, Ph.D.
Chief,  Neuroscience and Behavioral Research Branch
Division of Basic Research
National Institute on Alcohol Abuse and Alcoholism
Willco Building, Room 402
6000 Executive Boulevard
Bethesda, Maryland 20892-7003
Telephone: (301) 443-7722
FAX: (301) 594-0673
E-mail: anoronha@willco.niaaa.nih.gov

Direct inquiries regarding fiscal matters to:
Ms. Judy Simon
Grants Management Branch
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard, MSC 7003
Bethesda, MD 20892-7003
Telephone: (301) 443-2434
FAX: (301) 443-3891
E-mail: js182a@nih.gov

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance No. 
93.273. 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 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 
Health Systems Agency review.

The PHS strongly encourages all grant 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.

REFERENCES:

Multidimensional Measurement of Religiousness/Spirituality for Use in Health 
Research, January, l999, John E. Fetzer Institute (info@fetzer.org or 
http://www.fetzer.org))

Hill, P.C. and Hood, R.W., Jr. (1999) Measures of Religiosity. Birmingham, AL: 
Religious Education Press.
 
Miller, William R. Spiritual Aspects of Addictions Treatment and Research. 
Mind/Body Medicine. (1997) 2:37-43.

Project Match Group. Matching Alcoholism Treatments to client Heterogeneity. 
Project MATCH Three Year Drinking Outcomes. Alcoholism: Clinical and 
Experimental Research (1998) 22 (6):1300-1311.



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and Human Services (HHS)
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