Full Text AA-94-003

ALCOHOL AND MINORITIES:  BIOMEDICAL AND BEHAVIORAL RESEARCH

NIH GUIDE, Volume 22, Number 36, October 8, 1993

RFA:  AA-94-003

P.T. 34, FF

Keywords: 
  Alcohol/Alcoholism 
  Biomedical Research, Multidiscipl 
  Behavioral/Social Studies/Service 


National Institute on Alcohol Abuse and Alcoholism

Application Receipt Date:  January 12, 1994

PURPOSE

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is
seeking research grant applications to study the medical and
behavioral consequences of alcohol consumption on minority groups and
individuals, including development of more effective treatment and
prevention programs.

The primary purpose of this Request for Applications (RFA) is to
expand the limited information available on alcohol related problems
among and within ethnic minority populations of African Americans,
Native American/Alaskans, Asian Americans, Pacific Islanders, and
Hispanic Americans.  Most of these groups are at elevated risk for
specific alcohol problems or have patterns of increased alcohol
consumption.  The NIAAA encourages innovative research on biomedical,
behavioral, clinical, socio-cultural, and epidemiological factors
associated with the use or abuse of alcohol; the prevention and
treatment of alcohol-related problems; and the consequences of these
problems in minority groups and individuals.  The NIAAA supports
alcohol relevant basic and applied research involving a wide array of
health science fields and related academic disciplines.  Research on
alcohol problems among ethnic minority groups should be directed
toward better understanding of how variations in drinking patterns
and responses to alcohol among diverse cultural and ethnic sub-groups
can serve as the basis for development of more effective treatment
and intervention strategies for specific populations, and to do
research on the implementation of such approaches.

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 RFA,
Alcohol and Minorities:  Biomedical and Behavioral Research, is
related to the priority areas of alcohol abuse reduction and
alcoholism treatment.  Potential applicants may obtain a copy of
"Healthy People 2000" (Full Report:  Stock No. 017-001-00474-0, or
Summary Report:  Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington,
DC 20402-9325 (telephone 202-783-3238).

ELIGIBILITY

Applications may be submitted by domestic and foreign, public and
private, non-profit and for-profit organizations, such as
universities, colleges, hospitals, research institutes and
organizations, units of State and local governments, and eligible
agencies of the Federal government.  Women and minority investigators
are encouraged to apply.  Foreign institutions are not eligible for
First Independent Research Support and Transition (FIRST) (R29)
awards.

MECHANISMS OF SUPPORT

Research support may be obtained through applications for a regular
research grant (R01) or FIRST (R29) award.  Applicants for R01s may
request support for up to five years.  In FY 1992, the average total
cost per year for new R01s funded by the NIAAA was approximately
$200,000.  Because the nature and scope of the research proposed in
response to this RFA may vary, it is anticipated that the size of an
award will vary also.  FIRST Award applications must be for five
years.  Total direct costs for the five-year period may not exceed
$350,000 or $100,000 in any one budget period.  FIRST Awards cannot
be renewed, but grantees may apply for R01 support to continue
research on the same topics.

Applicants for FIRST Awards may obtain copies of the FIRST program
announcement from the National Clearinghouse for Alcohol and Drug
Information, P.O. Box 2345, Rockville, MD 20852, telephone:
301-468-2600 or 1-800-729-6686.  Program project grants (P01) will
not be accepted for this RFA.

Applicants may submit Investigator-Initiated Interactive Research
Project Grants (IRPG).  Interactive Research Project Grants require
the coordinated submission of related research project grant (R01)
and, to a limited extent FIRST Award (R29) applications from
investigators who wish to collaborate on research, but do not require
extensive shared physical resources.  These applications must share a
common theme and describe the objectives and scientific importance of
the interchange of, for example, ideas, data, and materials among the
collaborating investigators.  A minimum of two independent
investigators with related research objectives may submit concurrent,
collaborative, cross-referenced individual R01 and R29 applications.
Applicants may be from one or several institutions.  Further
information on the IRPG mechanism is available in program
announcement PA-93-078, NIH Guide for Grants and Contracts, Vol. 22,
No. 16, April 23, 1993.

FUNDS AVAILABLE

It is estimated that up to two million dollars in total costs will be
available for approximately 8 to 10 grants under this RFA in FY 1994.
This level of support is dependent on the receipt of a sufficient
number of applications of high scientific merit.  Although this
program is provided for in the financial plans of the NIAAA, the
award of grants pursuant to this RFA is also contingent upon the
availability of funds for this purpose.

RESEARCH OBJECTIVES

Background

The United States encompasses a great number of minority groups.
Indeed, one out of every four Americans belongs to a racial or ethnic
minority.  Many of the alcohol-related problems that affect the
majority population also are prevalent in ethnic minority groups.
However, national surveys have found disproportionately high levels
of alcohol consumption and alcohol-related problems among some
minority groups.

In the United States, about 100,000 deaths per year are attributed to
alcohol-related causes, and alcohol-related problems affect
approximately 1 in 10 adults and several million adolescents and
children.  These problems have been found to be more extensive among
some groups of African Americans, Hispanic Americans, Native
Americans and Alaska Natives than in the general U.S. population.
Although it tends to be lower for Asian Americans/Pacific Islanders,
recent evidence indicates that alcohol consumption may be increasing
among these two groups.

African Americans account for 12 percent of the total population and
are the largest minority group in the United States.  African
Americans are at high risk for alcohol related diseases such as
cirrhosis, alcoholic fatty liver, hepatitis, heart disease, and
certain cancers.  Although overall rates of alcohol consumption are
similar among Caucasian and African American males, they differ with
respect to age of onset of heavy drinking (later in African
American), economic status of heavy drinkers, and other factors.
Although African-American women tend to drink less on the average
than Caucasian women, those who are heavy drinkers may be more prone
to develop alcohol-related problems, including having children with
fetal alcohol syndrome.

The Hispanic population comprises nine percent of the U.S. population
and consists of several distinct groups; Mexican Americans, Puerto
Ricans, Cuban Americans, and persons from other countries in South
and Central America and the Caribbean.  Studies suggest that Hispanic
males have higher rates of alcohol dependence and other alcohol-
related problems that continue throughout adulthood than Caucasian
males.  Hispanic women abstain or drink infrequently, however,
Hispanic women born in the U.S. have rising consumption rates.

The Native American/Alaskan population is approximately two million
people representing over 300 distinct tribal and ethnic groupings.
It is a young, diverse, rapidly growing population living in urban,
rural, and reservation settings.  Alcohol abuse is a contributing
factor in death from accidents, chronic liver disease and cirrhosis,
homicide and suicide.  Alcohol use patterns vary markedly among
tribes, regions and communities.  In general, women drink less than
men, however, prevalence of drinking among women is growing rapidly
in some groups, and the incidence of fetal alcohol syndrome is high
in some populations.  Death from alcohol related causes are
particularly prevalent in the 25 to 44 age group.

The size of the Asian/Pacific Islander American population has more
than doubled during the last decade, growing to approximately 2.9
percent of the U.S. population.  There is increasing diversity among
Asian American groups as well.  Research on Asian American alcohol
use and abuse indicates that they have low rates of alcohol-related
problems even among those identified as heavy drinkers.  This has
been attributed to ethnic differences in physiological reactions
(i.e., the "flushing response") as well as socio-cultural and
environmental factors.  Nevertheless, recent findings suggest an
increase in drinking problems among recent Asian immigrants as they
assimilate into the American value system.

The NIAAA has supported studies of variations in drinking patterns
and problems among the different racial and ethnic groups.  In the
past decade attention has become more focused on understanding why
these patterns differ and how this information may be used to design
and conduct culturally relevant, methodologically sound research.
Further information is needed on how these patterns relate to
differential biological and behavioral responses to alcohol and how
specific responses may explain adverse outcomes of alcohol use.
Knowledge of the causes and consequences of alcohol consumption is
critical to achievement of the ultimate goal:  development and
implementation of effective prevention and treatment strategies for
specific ethnic populations.

Areas of Research Interest

The following list of topics is intended only to illustrate NIAAA
interests; topics not mentioned are not necessarily excluded from
consideration.

Variations in drinking patterns and drinking problems have been noted
among different racial and ethnic groups for over 20 years.  Many
reports provide evidence that the frequency of alcohol problems is
distinctly high in some groups.  Much of the information regarding
alcohol-related problems is based on ethnographic and community
studies.  Baseline longitudinal studies are needed to better
understand consumption patterns and their relationship to chronic
alcohol-related diseases.  These studies include, but are not limited
to:

o  Studies to identify genetic and environmental factors associated
with excessive alcoholic cirrhosis mortality among Native Americans
and African Americans.

o  Studies to identify the factors, either genetic or environmental,
associated with increased risk for fetal alcohol syndrome among some
Native Americans and African Americans.

o  Epidemiologic studies of alcohol consumption and alcohol related
problems that focus on subgroups of each of the ethnic and racial
minority groups.

o  Studies to identify and assess age, ethnicity and gender
associated with the onset of alcohol consumption and development of
alcohol-related problems.

Studies are needed to examine the effects of policies and practices
that alter the physical, social, or economic availability of alcohol
and reduce demand for it among minority ethnic populations.  Such
studies might investigate the effects of:

o  The impacts of existing alcohol beverage control (ABC) regulations
as they pertain to minorities; impacts of price on alcoholic beverage
consumption among minorities; and the effects of other culturally
appropriate interventions designed to alter social or physical
environment in bars.

o  Advertising and counter advertising focused on particular ethnic
groups and on age, gender, and socioeconomic subpopulations within
them.

o  Prevention programs operated through key social institutions in
ethnic minority communities, such as churches, schools, recreational
organizations, and business organizations.

o  Minority group appropriate:  school-based programs focused on
reaching children of alcoholics; family-based interventions designed
for adolescent and young women to facilitate abstinence during
pregnancy; special programs to reach "not in school" young people.

Pre-intervention studies are needed to expand knowledge regarding
sociocultural, economic, behavioral, and biological factors related
to alcohol use.  Such studies include:

o  Studies of the coping resources and protective factors that have
been shown to reduce alcohol problems among minority individuals who
are exposed to "high-risk" environments.

o  Studies of the effects of immigration, urbanization, assimilation,
and acculturation, or the phenomenon of bicultural membership and
stresses associated with it, as mediators of problematic drinking
practices.

o  Studies to establish the validity of standard tests and
instruments for measuring consumption among relevant ethnic
populations.

o  Research on the norms and values related to alcohol use and risk-
taking behavior identified with specific age and generational cohorts
in specific ethnic minority populations, (e.g., the role of cultural
values in the definition of "heavy drinking" and "alcohol abuse"
among Hispanic youth) or more broadly applied to cultural definitions
of "inappropriate" alcohol use.

o  Studies of the role of the family in socializing youth to drinking
norms and behaviors in different groups.

o  Studies to examine the influences of the family, peer group, and
gender role (particularly the relationship of "machismo" or
masculinity) on alcohol consumption among various sub-groups and its
contributions to alcohol-related violence.

o  Studies to identify and characterize biological factors, including
cellular and molecular mechanisms, that may account for differences
in metabolism and elimination of alcohol among racial groups.

o  Studies to determine the biological, genetic, behavioral, and
environmental effects that specifically relate to a minority
population that may interact in contributing to alcoholism and
related pathologies such as organ damage.

o  Research to determine the extent to which alcohol consumption
contributes to prevalence of hypertension in African Americans.

o  Controlled, randomized treatment studies that match on various
dimensions related to culture, age, and gender are needed to
demonstrate if outcomes for minority populations receiving
culture/age/gender-specific treatments differ from outcomes obtained
through treatments not specific to culture, age, or gender.

STUDY POPULATIONS

SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING
IMPLEMENTATION OF NIH POLICIES CONCERNING
INCLUSION OF WOMEN AND MINORITIES IN CLINICAL
RESEARCH STUDY POPULATIONS

Applications for NIH grants and cooperative agreements are required
to include both women and minorities in study populations for
clinical research, unless compelling scientific or other
justification for not including either women or minorities is
provided.  This requirement is intended to ensure that research
findings will be of benefit to all persons at risk of the disease,
disorder, or condition under study.  For the purpose of these
policies, clinical research involves human studies of etiology,
treatment, diagnosis, prevention, or epidemiology of diseases,
disorders or conditions, including but not limited to clinical
trials; and minorities include U.S. racial/ethnic minority
populations (specifically:  American Indians or Alaskan Natives,
Asian/Pacific Islanders, Blacks, and Hispanics).

NIH recognizes that it may not be feasible or appropriate in all
clinical research projects to include representation of the full
array of U.S. racial/ethnic minority populations.  However,
applicants are urged to assess carefully the feasibility of including
the broadest possible representation of minority groups.

Applications must include a description of the composition of the
proposed study population by gender and racial/ethnic group, and the
rationale for the numbers and kinds of people selected to
participate.  This information should be included in the form PHS 398
in Sections 1-4 of the Research Plan and summarized in Section 5,
Human Subjects.

Applications must incorporate in their study design gender and/or
minority representation appropriate to the scientific objectives of
the work proposed.  If representation of women or minorities in
sufficient numbers to permit assessment of differential effects is
not feasible or is not appropriate, the reasons for this must be
explained and justified.  The rationale may relate to the purpose of
the research, the health of the subjects, or other compelling
circumstances (e.g., if in the only study population available, there
is a disproportionate representation in terms of age distribution,
risk factors, incidence/prevalence, etc., of one gender or
minority/majority group).

If the required information is not contained within the application,
the review will be deferred until it is complete.  Peer reviewers
will address specifically whether the research plan in the
application conforms to these policies.  If gender and/or minority
representation/ justification are judged to be inadequate, reviewers
will consider this as a deficiency in assigning the priority score to
the application.

All applications for clinical research submitted to NIH are required
to address these policies.  NIH funding components will not award
grants that do not comply with these policies.

APPLICATION PROCEDURES

The research grant application form PHS 398 (rev. 9/91) is to be used
in applying for these grants.  These forms are available at most
institutional offices of sponsored research; from the Office of
Grants Information, Division of Research Grants, National Institutes
of Health, 5333 Westbard Avenue, Room 449, Bethesda, MD 20892,
telephone 301-435-0714; and from the NIAAA program administrator
listed under INQUIRIES.

The RFA label available in the PHS 398 (rev. 9/91) application form
must be affixed to the bottom of the face page of the application.
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 2a of the face page of the application form and the YES box must
be marked.  Page limits and limits on size of type are strictly
enforced.  Applicants for FIRST Awards (R29) are reminded that such
applications must include three letters of reference.  Non-conforming
applications will be returned without being reviewed.

Applicants from institutions that have a General Clinical Research
Center (GCRC), funded by the NIH National Center for Research
Resources, may wish to identify the Center as a resource for
conducting the proposed research.  If so, a letter of agreement from
either the GCRC program director or Principal Investigator should be
included in the application material.

The signed original, including the checklist, and three signed,
legible copies of the completed application must be sent to:

Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**

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

Mark Green, Ph.D.
Extramural Project Review Branch
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Boulevard
Rockville, MD  20892
Telephone:  (301) 443-4375
FAX:  (301) 443-6077

Applications must be received by January 12, 1994.  If an application
is received after that date, it will be assigned to the next review
cycle and will compete with all investigator-initiated research grant
applications.  The Division of Research Grants (DRG) 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 DRG 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

The Division of Research Grants, NIH, serves as a central point for
receipt of applications for most discretionary PHS grant programs.
Upon receipt, applications will be reviewed for completeness by DRG
and responsiveness by the NIAAA.  Incomplete applications will be
returned to the applicant without further consideration.  If the
application is not responsive to the RFA, NIAAA staff will 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 may be triaged by an NIAAA peer review group on the
basis of relative competitiveness.  The NIH will withdraw from
further competition those applications judged to be non-competitive
for award and notify the applicant Principal Investigator and
institutional official.  Those applications judged to be competitive
will undergo further scientific merit review.  Those applications
that are complete and responsive will be evaluated in accordance with
the criteria stated below for scientific/technical merit by an
appropriate peer review group convened by the NIAAA.  The second
level of review will be provided by the National Advisory Council on
Alcohol Abuse and Alcoholism.

Review Criteria

Criteria to be used in the scientific and technical merit review of
alcohol research grant applications will include the following:

1.  The scientific, technical, or medical significance and
originality of the proposed research.

2.  The appropriateness and adequacy of the experimental approach and
methodology proposed to carry out the research.

3.  The adequacy of the qualifications (including level of education
and training) and relevant research experience of the Principal
Investigator and key research personnel.

4.  The availability of adequate facilities, general environment for
the conduct of the proposed research, other resources, and
collaborative arrangements necessary for the research.

5.  The reasonableness of budget estimates and duration for the
proposed research.

6.  Where applicable, the adequacy of procedures to protect or
minimize effects on animal and human subjects and the environment.

7.  Conformance of the application to the NIH policy on inclusion of
women and minorities in study populations.

Research grant applications will be reviewed based on standard
criteria for scientific and technical merit for regular research
grants (R01).  The review criteria for FIRST Awards (R29) are
contained in the FIRST program announcement.

AWARD CRITERIA

Applications recommended for approval by the National Advisory
Council on Alcohol Abuse and Alcoholism will be considered for
funding on the basis of the overall scientific and technical merit of
the proposal as determined by peer review, NIAAA programmatic needs
and balance, and the availability of funds.

INQUIRIES

Written and telephone inquiries concerning this RFA are encouraged.
Potential applicants are encouraged to seek preapplication
consultation.  The opportunity to clarity any issues or questions
from potential applicants is welcome.

Direct inquiries regarding programmatic issues to:

Ernestine Vanderveen, Ph.D.
Division of Basic Research
National Institute on Alcohol Abuse and Alcoholism
5600 Fishers Lane, Room 16C-06
Rockville, MD  20857
Telephone:  (301) 443-1273
FAX:  (301) 594-0673

Direct inquiries regarding fiscal matters to:

Elsie Fleming
Office of Planning and Resource Management
National Institute on Alcohol Abuse and Alcoholism
5600 Fishers Lane, Room 16-86
Rockville, MD  20857
Telephone:  (301) 443-4703
FAX:  (301) 443-3891

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic
Assistance, No. 93.273.  Awards are made under the authorization of
the Public Health Service Act, Sections 301 and 464H, and
administered under the PHS policies and Federal Regulations at Title
42 CFR Part 52, "Grants for Research Projects," and Title 45 CFR
Parts 74 and 92, "Administration of Grants and 45 CFR Part 46,
"Protections of Human Subjects."  This program is not subject to the
intergovernmental review requirements of Executive Order 12372 or
Health Systems Agency review.

.

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