Full Text AG-93-04


NIH GUIDE, Volume 22, Number 7, February 19, 1993

RFA:  AG-93-04

P.T. 34, FF

  Health Promotion 

National Institute on Aging

Letter of Intent Receipt Date:  March 10, 1993
Application Receipt Date:  April 19, 1993


This Request for Applications (RFA) aims to establish Exploratory
Centers for Research on Health Promotion in Older Minority
Populations.  The Exploratory Centers will conduct pilot research and
plan for a program of medical, behavioral and social research,
medical and psychosocial interventions, and programs of health
education and community outreach aimed at improving the health status
of older ethnic minority populations.  It is anticipated that support
of exploratory centers will lead to the development of applications
for Research Centers in Health Promotion in Older Minority
Populations.  The purpose of the Research Centers in Health Promotion
will be to provide an environment for a coordinated program,
including research related to diseases, conditions and other factors
that lead to ill health and disability in older minority populations,
research on health behaviors and their relationship to health status,
the development and testing of interventions to improve health and
functioning, and the development of programs of health education and
outreach.  The future Centers should provide an environment in which
experienced and junior investigators, and non-minority and minority
investigators can interact and direct research efforts focused on
health and aging of ethnic minority populations.  For the purpose of
this solicitation ethnic minority populations include Asian
Americans/Pacific Islanders, African Americans, Hispanics and
American Indians/Alaskan Natives.

This RFA aims to assist institutions in building upon existing
strengths and programs.  Thus, those institutions which have programs
of research, interventions and/or health promotion in older minority
populations are encouraged to build upon those existing programs.
Prior experience in health-related research on minority populations
as demonstrated by receipt of federal or major private organizational
funding is a requirement for this RFA.


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,
Exploratory Center Grants for Research on Health Promotion in Older
Minority Populations, is related to the priority areas of diabetes
and chronic disabling conditions, cancer, heart disease and stroke,
physical activity, and educational and community-based programs.
Potential applicants may obtain a copy of "Healthy People 2000" (Full
Report:  Stock NO. 017-001-00474-0) or "Healthy People 2000" (Summary
Report:  Stock NO. 017-001-00473-1) through the Superintendent of
Documents, Government Printing Office, Washington, DC 20402-9325
(telephone number 202-783-3238).


Applications may be submitted by domestic for-profit and non-profit
organizations, public and private institutions, such as universities,
colleges, hospitals, laboratories, units of State and local
governments, and eligible agencies of the Federal government.
Applicants must demonstrate access to and ability to work with the
selected minority populations.  Applications from minority
investigators and institutions, and/or collaborations involving
predominantly minority institutions are encouraged, especially those
minority institutions with medical and/or clinical components, or
programs of medical research oriented to minority populations.
Awards will not be made to foreign institutions.  Questions about
eligibility may be referred to the staff contacts listed at the end
of this announcement.


The support mechanism for this RFA is the exploratory center grant
(P20).  Such awards cover a variety of research and related
activities focused around a common theme or specific area of
interest.  The Exploratory Center resulting from this RFA should
consist of small scale studies of factors influencing health of older
minorities, including development and evaluation of interventions
based on knowledge of risk factors for ill health, and development of
programs of health education aimed at communities of older
minorities.  In addition, the Exploratory Center will include an
administrative and planning core that provides administrative,
coordination, research planning, logistical and methodological

A maximum of three years support may be requested.  The award may be
renewed for an additional two years based on competitive application
and review.  The Exploratory Centers award is expected to lead to a
competing continuation application for a P50 Center Grant award.  All
current policies and requirements that govern the research grant
programs of the NIH will apply to grants awarded in connection with
this RFA.

Small-scale studies consist of pilot, feasibility or preliminary
research relevant to the common theme and involve either a single
discipline or multidisciplinary approach.  Collaborations among
institutions are encouraged to facilitate the planning and
establishment of various components of the Exploratory Center
program.  Such collaborations may be necessary in order to encompass
basic research, applied research in the form of interventions, and
programs of health education, all aimed at minority populations.
Collaboration may thus provide for research expertise, expertise in
minority health, or dealing with minority populations.  If consortium
arrangements are planned, the applicant should refer to the NIH Guide
for Grants and Contracts, Vol. 14, No. 7, June 21, 1985.

The administrative core manages the overall activities of the Center
and should include a discrete administrative structure with a Center
Director.  The core may also include the administration of shared
resources, such as datasets, community or clinical research
facilities, or provide research design and data analysis services.
The core may include an advisory committee consisting of community
leaders and those knowledgeable about research in minority
communities.  The general make-up of the Advisory Committee should be
described, as well as criteria for selection of members, but
prospective members should not be named.  It is expected that up to
three awards will be made at a maximum of $500,000 direct costs for
the first year excluding all indirect costs requested within the
consortium budgets.  Requests that exceed this amount will be
returned without review.


An estimated $2,000,000 will be made available in fiscal year 1993
for support of awards made under this RFA.  This level of support is
dependent on the receipt of a sufficient number of applications of
high scientific merit.  Small increases in budget, not to exceed 4
percent of the direct cost request for the proceeding year, are
allowed in years two and three, excluding large or one time purchases
such as equipment. Awards pursuant to the RFA are contingent upon the
availability of funds for the purpose.



Numerous studies and reports continue to document the less healthy
status of ethnic minorities in comparison with white populations.
This disadvantaged health status of minorities continues into older
ages and is reflected in the increased prevalence of disease and
chronic conditions among older minorities, and in reduced life
expectancy.  The age-adjusted death rates for common diseases overall
indicate that the health status of minorities is worse than that of
whites, with major diseases being heart disease, cerebrovascular
disease, malignant neoplasms, and diabetes.  However, it is
recognized that mortality rates after age 80 are lower for Blacks
than for Whites.

It has also been projected that the numbers of ethnic minority aged
will grow much more rapidly than the number of white elderly over the
next fifty years.  The percentage of non-white elderly will increase
from 10.1 in 1990 to 15.3 in 2020 and 21.3 in 2050.  This growth has
implications for increased health care costs for older minority
individuals in the coming years.  Research and health promoting
activities directed toward alleviating conditions of disability and
ill-health in older minority populations will assist in reducing
health care costs and in improving quality of life for this segment
of the population.  Greater understanding of the nature and extent of
morbidity and disability in older minority individuals enhances our
ability to deal with the disability and thereby improve quality of
life among older minority populations.

A program of research and related activities is needed for examining
those physical, behavioral, social and environmental factors that
affect health status of minority older persons, test interventions to
improve health status and utilization of health services, and develop
better means of providing health-related information to older
minority populations.

The goal of this RFA is to support the establishment of Exploratory
Centers that conduct medical, behavioral and social research and
related activities necessary to understanding and improving the
health status of minority aging populations.  Each center should be
organized around a central theme.  Such centers should be based on
integrated research and related activities relevant to the proposed
theme of the research of the center.  The application should include
an introduction that does not exceed five pages that describes the
overall research focus and how the individual projects, including
interventions and projects of community education and outreach are
linked to the central focus, and how the projects support each other.

Individual models will vary, but the centers overall should focus on
descriptive as well as hypothesis testing research, pilot/feasibility
studies, methodological development, clinical and behavioral
interventions, and community outreach and education.  Each center
must demonstrate strong intellectual leadership and the availability
of researchers knowledgeable about health and aging among ethnic
minority populations, especially members of the minority group of
focus.  Through its activities the center should demonstrate the
potential to become a major national scientific research resource on
health of ethnic/minority older populations.  It is anticipated that
the future major national research center will be supported through
the P50 grant mechanism.

Each exploratory center must include an administrative core, small
scale research and an intervention component, including evaluation of
the interventions(s).  It is optional that the health education and
community outreach component be part of the application package.


Annual Meeting

Investigators are encouraged to request funds to travel to NIH once
each year to meet with other investigators funded through this RFA.

Examples of possible research relevant to the RFA include, but are
not limited to:

Research on Health Status

o  Research focusing on factors related to incidence, prevalence, and
control of specific diseases and chronic conditions prevalent in
older minority populations.  Both individual-level or small group
level analyses, as well as macro-level approaches (e.g. economic or
demographic analyses)  are encouraged.  Applicants may select the
ethnic minority population of study and disease(s) or chronic
condition(s) to receive focus.  Justification for selection of
particular conditions and ethnic groups must be provided.

o  Research on presentation of disease symptoms and opportunities for
early diagnosis.

o  Behavioral and psychosocial factors that influence treatment of
the disease or condition, and means of prevention.

o  Relationships between disease/condition and cognitive status;
especially cognitive loss and its influences on self-care and care
seeking behavior.

o  Studies aimed at identification of the interrelationship between
and among diseases/conditions and relationships between disease,
ethnicity and socioeconomic factors.

o  Studies aimed at improvement of health behaviors and lifestyle and
the maintenance of such behaviors over time.

o  Studies of attitudes toward health and health care, especially
long term care.

o  Studies of social support and the influence of these relationships
on health and utilization of health care services, including studies
of barriers to utilization of health services.


o  Development and evaluation of interventions for prevention and/or
lessening the impact and associated disabilities/impairments of
specific diseases or chronic conditions.

o  Recruitment of older minorities to specific types of intervention
programs (e.g., exercise, nutrition) and the retention of recruits in
such programs.

o  Interventions of innovative means of providing health care to
older ethnic minority populations (e.g., home health care).

o  Research leading to the development of means of advantageous
utilization of cultural preferences and norms to promote wider
utilization of health services.

o  Integration of community roles and services utilizing community
institutions, such as churches and other organized religious,
fraternal, and social groups in overcoming barriers of access to
health care.

o  Innovative means of combining social and health services in order
to provide increased access to services and improved quality of life.

o  Replication of long-term interventions in specific ethnic groups
in other ethnic groups to determine effectiveness of the intervention
across ethnic groups.

o  Examination of health care provider behavior impact on health care
utilization and compliance, and opportunities for behavior change.

Research on Health Education and Community Outreach

o  Identification of specific types of information most useful and
the most effective ways to provide health information to older
minority individuals.

o  Use of community sites and institutions, such as senior centers,
organizations of older people, minority educational institutions, and
churches in specific types of health education programs for older
ethnic minorities.

o  Use of various media in providing health education.



It is NIH policy that applicants for NIH clinical research grants
will be required to include minorities and women in study populations
so that research findings can be of benefit to all persons at risk of
the disease, disorder or condition under study; special emphasis
should be placed on the need for inclusion of minorities and women in
studies of diseases, disorders and conditions which
disproportionately affect them.  This RFA is directed specifically at
studies of older minority populations, and includes studies of both
males and females.  The rationale for focusing on particular ethnic
or racial groups must be included.

The composition of the proposed study population must be described in
terms of gender and racial/ethnic issues should be addressed in
developing a research design and sample size appropriate for the
scientific objectives of the study.  This information should be
included in form PHS 398 (rev. 9/91) in items 1-4 of the Research
Plan for each component involving the study population and summarized
in item 5, Human Subjects.  In addition, a statement summarizing the
composition of the proposed study population should be included in
the introduction to the proposed program.  For the purpose of this
policy, clinical research includes human biomedical and behavioral
studies of etiology, epidemiology, prevention (and preventive
strategies), diagnosis, or treatment of diseases, disorders or
conditions, including but not limited to clinical trials.

The usual NIH policies concerning research on human subjects also
apply. Basic research or clinical studies in which human tissues
cannot be identified or linked to individuals are excluded.  Peer
reviewers will address specifically whether the research plan in the
application conforms to these policies.  If the representation of
women and minorities in a study design is inadequate to answer the
scientific question(s) addressed and the justification for the
selected study population is inadequate, it will be considered a
scientific weakness or deficiency in the study design and will be
reflected in assigning the priority score to the application.


Prospective applicants are asked to submit a letter of intent that
includes identification of other participating investigators and
institutions, and a descriptive title.  The NIA requests such letters
only for the purpose of providing an indication of the number and
scope of applications to be received and, therefore, usually does not
acknowledge their receipt.  A letter of intent is not binding, and it
will not enter into the review of any application subsequently
submitted, nor is it a necessary requirement for application.

The letter of intent is to be received no later than March 10, 1993
and is to be sent to:

Shirley P. Bagley, M.S.
National Institute on Aging
Building 31, Room 5C35
Bethesda, MD  20892


Prospective applicants are advised to communicate with indicated
contacts listed in the RFA as early as possible in the planning phase
of application preparation.  NIA staff are available to assist
applicants to ensure that the objectives, structure, and the budget
format for the proposed Exploratory Center are acceptable.

The research grant application form PHS 398 (rev. 9/91) is to be used
in applying for these grants.  This form is available in the
applicant institution's office of sponsored research or business
office and from the Office of Grants Inquires, National Institutes of
Health, Westwood Building, Room 449, Bethesda, MD 20892-9912,
telephone (301) 496-7441.  The page limitations apply separately to
the administrative core and each individual research project.
Complete information, including a fully-justified budget, must be
provided for each component project, and the administrative core.
The application should include an introduction that clearly describes
the major theme and rationale for the exploratory center, the
organization of the administrative core and its relationship to the
individual projects.

To identify the application as a response to this RFA, check "YES" in
item 2a on page 1 of the application and enter the title "Exploratory
Center Grant on Health Promotion in Older Minority Populations" and
the RFA number.

The RFA label enclosed with the PHS 398 form must be affixed to the
bottom of the face page of the original application.  Failure to us
this label could result in delayed processing of the application.

Send or deliver the completed application and three signed, exact
photocopies in a single package, making sure that the original
application with the RFA label attached is on top, to:

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

Send two additional copies of the application to:

Michael Oxman, Ph.D.
Chief, Scientific Review Office
National Institute on Aging
Gateway Building, Suite 2C212
7201 Wisconsin Avenue
Bethesda, MD  20892

It is important to send these copies at the same time as the original
and the three copies are sent to the Division of Research Grants.
The NIA needs copies for early review.


Upon receipt, NIA staff will review applications for completeness and
responsiveness.  Applications that do not conform to instructions,
that are incomplete or nonresponsive to this RFA, or exceed the
maximum first year direct cost limit of $500,000 excluding direct
costs within consortium budgets will be returned to the applicant
without further consideration.  Applications may be subjected to
triage by a peer review group to determine the scientific merit
relative to other applications in response to this RFA.  The NIA will
withdraw from further competition those applications judged by triage
to be noncompetitive for award and notify the applicant and
institutional official.  Applications judged to be competitive will
undergo further scientific merit review by an initial review group
(IRG) within the NIA.  The second level of review will be provided by
the National Advisory Council on Aging.

Criteria to be considered in evaluating applications for
scientific/technical merit include:

1.  Overall Program

a.  The scientific merit of the program as a whole.  The significance
of the overall program goals and the development of a well-defined
central theme related to improvement of health status of older
minority populations as relevant to the goals and mission of the NIA.

b.  Appropriateness and adequacy of the research approach and
methodology proposed.

c.  The potential of the identified participants to develop research
programs of high merit as evidenced by previous accomplishments;
especially health-related research accomplishments in older minority
populations.  Applicants should provide information which enables
review of the involvement of ethnic minority investigators and
institutions in the research.

d.  The likelihood that the planned activities will result in
development of a Research Center for Health Promotion in Older
Minority Populations.

e.  Evaluation plans for measuring the effectiveness of proposed

f.  Strategies for community outreach and means of providing health
education to older minority populations.

2.  Administration and Planning Core

a.  The scientific and administrative leadership ability and
experience of the Center Director and his/her commitment and ability
to devote adequate time to the effective management of the Center.

b.  The adequacy of the proposed administrative organization to
conduct the following:

o  Maintenance of communication and cooperation among the
investigators involved in the Center.

o  Fiscal administration, personnel management, budget planning and
monitoring, and the ability to manage collaboration between

c.  The appropriateness of the Center budgets for the various
components of the Center.

d.  The institutional commitment to the program, including lines of
responsibility for the Center, and institution's contribution to the
management capabilities of the Center.

e.  The academic environment and resources in which the activities
will be conducted, including the availability of space, equipment,
and facilities, and the potential for interaction with scientists
from other departments and schools.


Inquiries concerning this RFA are encouraged in order to clarify
issues or questions.  Such inquires from prospective applicants are

Direct inquires regarding programmatic issues to:

Shirley P. Bagley, M.S.
National Institute on Aging
Building 31, Room 5C35
Bethesda, MD  20892
Telephone:  (301) 496-0765
FAX:  (301) 496-2525

Direct inquires regarding fiscal matters to:

Joseph Ellis
National Institute on Aging
Gateway Building, Suite 2N212
7201 Wisconsin Avenue
Bethesda, MD  20892
Telephone:  (301) 496-1472
FAX:  (301) 402-3672


This program is described in the Catalog of Federal Domestic
Assistance, Number 93.866.  Awards are made under the authority of
the Public Health Service Act, Section 301 (42 USC 241) and
administered under PHS grant policies and Federal Regulations, most
specifically at 42 CFR Part 52 and 45 CFR Part 74.   Special Terms of
Awards applying to projects funded in response to this RFA are in
addition to, and not in lieu of, otherwise applicable OMB
administration guidelines, HHS grant administrative regulations at 45
CFR Part 74, and other HHS,  PHS, and NIH grant administration
policies.  Awardees will maintain custody of and primary rights to
their data developed under their awards, subject to Government rights
of access, consistent with current HHS, PHS, and NIH policies. This
program is not subject to the intergovernmental review requirements
of Executive Order 12372 or Health Systems agency review.


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