Full Text ES-96-002

ENVIRONMENTAL JUSTICE:  PARTNERSHIPS FOR COMMUNICATION

NIH GUIDE, Volume 24, Number 33, September 22, 1995

RFA:  ES-96-002

P.T. 34

Keywords: 
  ENVIRONMENT 
  Community/Outreach Programs 


National Institute of Environmental Health Sciences

Letter of Intent Receipt Date:  October 27, 1995
Application Receipt Date:  December 22, 1995

PURPOSE

The purpose of this program is to strengthen the National Institute
of Environmental Health Sciences (NIEHS) support of research aimed at
achieving environmental justice for socioeconomically disadvantaged
and medically underserved populations in the United States.  One goal
of the NIEHS is to stimulate investigative efforts that attempt to
address questions related to the influence of economic and social
factors on the health status of individuals exposed to environmental
toxicants.

This component of the NIEHS research program in environmental justice
is designed to stimulate community outreach, training, and education
efforts that will become the catalyst for reducing exposure to
environmental pollutants in underserved populations.  The main
objective of this RFA is to establish methods for linking members of
a community, who are directly affected by adverse environmental
conditions, with researchers and health care providers.  This will
ensure that:

o  the community is aware of basic environmental health concepts,
issues, and resources;

o  the community has a role in identifying and defining problems and
risks related to environmental exposures;

o  the community is included in the dialogue shaping potential future
research approaches to the problem; and

o  the community actively participates with researchers and health
care providers in developing responses and setting priorities for
intervention strategies.

The aim of this program is to facilitate the process of developing
the trust needed for establishment of effective partnerships among
individuals who are adversely impacted by an environmental hazard in
a socioeconomically disadvantaged community, researchers in
environmental health, and health care providers.

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,
Environmental Justice:  Partnerships for Communication, is related to
the priority area of environmental health.  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 202-512-1800).

ELIGIBILITY REQUIREMENTS

Applications may be submitted by domestic for-profit and non-profit
organizations, public and private, including predominantly minority
institutions, individually or as joint efforts of minority
institutions and majority institutions.  Usually, only one award
under this RFA will be funded at an institution.  Although a single
institution must be the applicant, a multi-institutional arrangement
(consortium) is possible.  Such consortia, entailing active
participation by more than one organization, are encouraged if there
is clear evidence of close interaction and responsible partnership
among the participants.

It is important to note that, because of the wide range of
environmental health problems to be addressed and the diversity of
affected communities, applications must include at least one of each
of the following:

o  A research scientist in environmental health sciences (such as
those at NIEHS Environmental Health Sciences Centers).

o  A primary health care provider directly involved in a community
affected by an environmental pollutant.  This individual must have a
record of providing health care to the participating community.
He/she could, but need not necessarily, be affiliated with a county
or state public health department.

o  A member of a community organization in an area having an
underserved population that is adversely affected by an environmental
pollutant.  This individual must be someone who lives in or works
directly and regularly with the participating community.

At least one member of each of these three required personnel groups
must have an active and meaningful role in both development of the
application and conduct of the proposed project.  These personnel
must be listed on page 2 of the PHS 398 application, and a
biographical sketch must be provided for each.  Applications lacking
the required personnel will not be considered.

The role of each member of these three personnel groups in developing
the application and carrying out the project must be clearly
identified and fully described.  There should be an equitable
distribution of responsibilities as well as of requested financial
resources among the three personnel groups.

The NIEHS has a significant commitment to the support of programs
designed to increase the number of underrepresented minority and
female scientists participating in biomedical and behavioral
research.  Therefore, applications from minority individuals and
women are encouraged.

MECHANISM OF SUPPORT

This RFA will use the National Institutes of Health (NIH) Education
Grant (R25).  Responsibility for the planning, direction, and
execution of the proposed project will be solely that of the
applicant.  The total project period for an application submitted in
response to the present RFA may not exceed four years, and projects
are not renewable.  This RFA is a one time solicitation.

FUNDS AVAILABLE

The estimated total funds available for the first year of support for
the entire program are anticipated to be $750,000.  The maximum award
will be $150,000 in direct costs, including subcontract total (direct
plus indirect) costs, per year.  Indirect costs will be paid at the
approved indirect cost rate for the applicant organization less
appropriate exclusions.  It is anticipated that one to four  grants
will be awarded depending upon the availability of funds for this
purpose and the quality of the applications received.  Awards are not
renewable and supplements are not allowed.  Although this program is
provided for in the financial plans of the NIEHS, awards pursuant to
this RFA are contingent upon the availability of funds for this
purpose.  Funding beyond the first and subsequent years of the award
will be contingent upon satisfactory progress during the preceding
year and upon availability of funds.

RESEARCH OBJECTIVES

Background

Americans want to live long and healthy lives, and the majority of
them achieve that goal.  In general, however, people who are
economically disadvantaged and/or who live or work in areas and
occupations where conditions impart greater exposure to hazardous
substances are less likely to do so.  At every stage of life, these
persons suffer disproportionate levels of morbidity and mortality.
Evidence suggests that certain groups, especially minorities and low
income communities, bear an uneven share of hazardous environmental
exposures.  Socioeconomically disadvantaged people suffer the lowest
life expectancy and the highest adverse health consequences of
inadequate access to high quality health care.  Additionally, they
most often experience the highest degree of exposure to environmental
agents and frequently have the least information available about the
health consequences of exposure to these agents.

Environmental justice refers to the need to remedy the unequal burden
borne by socioeconomically disadvantaged persons in terms of
residential exposure to greater than acceptable levels of
environmental pollution, occupational exposure to hazardous
substances, and fewer civic benefits such as sewage and water
treatment.  Geographic location plays an important role in
environmental exposure of socioeconomically disadvantaged persons.
Inner city poor often live in homes with high lead levels.  They may
also be exposed to higher levels of air pollution.  Toxic wastes
sites are more frequent in rural, low socioeconomic counties in the
US.  Nuclear facilities and chemical plants are often located in
rural areas.  Exposure to pesticides is another example where rural,
socioeconomically disadvantaged populations are at a greater than
average risk.  Disadvantaged neighborhoods may rely on well water
which may be polluted with toxic chemicals.  In addition, medical
care is often inadequate or unavailable to a significant proportion
of the socioeconomically disadvantaged and minority people in America
today.

Lead poisoning and the cognitive and developmental damage associated
with exposure to lead occur disproportionately among minorities.
High blood pressure and prostate cancer are very common among African
Americans.  Low birth weight babies and other problems during
pregnancy are common among groups of women who do not have access to
good prenatal care.  Some of these conditions or other diseases may
have an environmental component in their etiology.  The lack of
resources for early identification of the effects of toxic agents may
lead to an increased disease burden in people who are economically
least able to cope with it.

Recent Progress and Opportunities

Some work has been done to investigate the effects of pesticides in
agricultural workers, of polychlorinated biphenyls in children in
rural areas, and of lead exposure in socioeconomically disadvantaged
urban children.  The effect of low versus high air pollutant exposure
on pulmonary function has been extensively studied.  Evidence from
the NHANES study has shown that, for comparable levels of exposure,
different racial groups have different levels of blood lead.  Some
evidence is also available that suggests the toxic effects of some
agents such as lead can be mitigated by good nutrition.

Many of these studies have engaged underserved populations, but none
have focused on such problems from the perspective of identifying
issues of highest impact on and priority to these populations.  Thus,
progress has been minimal in most areas due to the lack of well
developed studies targeting socioeconomically disadvantaged
populations.  More effort must be put into defining disadvantaged
populations having high levels of exposure to various types of
environmental hazards in residential or occupational settings.
Comprehensive outcomes to these exposures must be defined and
measured.  Prevention and treatment strategies for these effects must
also be generated.

Prominent among the goals of the NIEHS is support of research aimed
at achieving environmental justice for all populations.  It is
equally important to bring minority populations into the mainstream
of biomedical research as scientists, health care providers, and
allied health service professionals.  Both of these goals have a
clear benefit to the health of the nation and provide a means of
addressing a potential labor shortage in the twenty first century.
As one aspect of this effort, the NIEHS is requesting submission of
applications that focus on establishing new avenues of communication
among those living or working in a community impacted by an
environmentally related health problem and the researchers and health
care providers attempting to recognize and ameliorate such problems.

Objectives and Scope

One component of the mission of NIEHS is to promote research aimed at
achieving environmental justice by identifying and addressing
disproportionately high and adverse effects of environmental agents
on human health in low income and minority populations.

The main objective of this program is to establish methods for
linking members of a community, who are directly affected by adverse
environmental conditions, with researchers and health care providers.
Development of community based strategies to address environmental
health problems requires approaches that are not typically familiar
to the research and medical communities.

Customary approaches to risk assessment and management often neglect
the knowledge and experience of at risk populations and the
sociocultural context of environmental hazards.  The distinctive
needs of individual communities and their inhabitants are only rarely
considered in identifying environmental health problems and devising
appropriate disease and pollution prevention tactics.  Underserved
populations are often diverse, fragmented, and isolated, making it
difficult to obtain their input and to integrate their concerns in
decision making processes.  Assays of the health effects of
environmental pollution, as well as regulations based on such assays,
are often performed with little or no input from the affected
community.  The purpose of this program is to institute mechanisms to
bridge this communication gap.

Applicants are therefore expected to create equitable partnerships
among researchers in environmental health, health care providers, and
representatives of low income or minority communities affected by
environmental health problems.

Types of activities that may be proposed include, but are not limited
to:

o  Develop efficacious methods for risk communication in minority and
low income communities unfavorably impacted by environmental hazards.

o  Develop community based, culturally sensitive educational programs
to mitigate adverse health effects from environmental toxicants in
minority and low income communities.

o  Carry out community based training to increase environmental
health literacy, i.e., increase awareness of the public, in such
neighborhoods.

o  Train and educate neighborhood health care professionals in the
diagnosis and treatment of disorders having an etiology related to
exposure to hazardous substances, i.e., increase awareness of health
care providers.  These providers should have a direct role in
assisting a community affected by exposure to an environmental
hazard.

NIEHS wishes to encourage a broad, comprehensive approach to this
problem.  Applicants are encouraged to consider proposing some
combination of the above activities.

The following factors must be included in applications submitted in
response to this RFA:

o  A means of establishing effective input from an underserved
community affected by an environmental toxicant.  For example,
applicants may consider creating a community based advisory board or
steering committee to facilitate outreach, planning, and evaluation
efforts.  This input could be obtained directly from members of a
community affected by an environmental toxicant as well as from
representatives of such groups as community and neighborhood
associations, churches, public housing resident councils, community
health centers, local public health service departments, and minority
educational institutions.

o  An objective assessment process designed to identify priority
areas in environmental health as perceived by community members,
develop a consensus among community members about plausible
approaches, build upon existing expertise and knowledge within the
community, and detect any potential constraints in implementing the
project.

o  Development of appropriate education/communication modules.
Proposed projects must provide for dissemination of relevant
information within the community as well as a means for the community
to have a voice that reaches researchers and health care providers.
There must be an effective flow of information among all
participants.

o  Feedback and evaluation of the project's effectiveness.  A
procedure must be established to assess the usefulness of the
project's education/communication activities.

o  Recommendations for future activities, beyond the period of NIEHS
funding, to assure continued participation of community members in
research and service programs addressing environmental injustices.

Each of the above elements is essential to fulfill the education,
communication, and outreach aims of this RFA.  Applications lacking
any of the above components will not be considered.

It is important to note that award of a grant under this RFA by the
NIEHS does not imply a commitment to future funding of any programs
planned with the support of such a grant.  Separate applications must
be submitted for such programs and such applications will be
evaluated on the basis of their own merits.

SPECIAL REQUIREMENTS

To encourage applicants to share information gained via these grants,
a member of each of the three types of required personnel on each
project will be asked to attend an annual meeting at NIEHS.
Applicants should include such travel in their budget requests.

STUDY POPULATIONS

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 new policy results
from the NIH Revitalization Act of 1993 (Section 492B of Public Law
103 43) and supersedes and strengthens the previous policies
(Concerning the Inclusion of Women in Study populations, and
Concerning the Inclusion of Minorities in Study Populations), which
have been in effect since 1990.  The new policy contains some
provisions that are substantially different from the 1990 policies.

All investigators proposing research involving human subjects should
read the "NIH Guidelines for Inclusion of Women and Minorities as
Subjects in Clinical Research," which have been published in the
Federal Register of March 28, 1994 (FR 59 14508-14513) and reprinted
in the NIH Guide for Grants and Contracts, Volume 23, Number 11,
March 18, 1994.

Investigators also may obtain copies of the policy from the program
staff listed under INQUIRIES.  Program staff may also provide
additional relevant information concerning the policy.

LETTER OF INTENT

Prospective applicants are requested to submit, by October 27, 1995,
a letter of intent that includes a descriptive title of the proposed
project, 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.  The letter of intent
influences neither review nor funding decisions, but it is helpful to
NIEHS staff in planning the review process, e.g., in estimating
workload and avoiding conflict of interest.

Letters of intent are to be directed to:

Allen Dearry, Ph.D.
Division of Extramural Research and Training
National Institute of Environmental Health Sciences
P.O. Box 12233, MD 3-04
111 T.W. Alexander Drive
Research Triangle Park, NC  27709

APPLICATION PROCEDURES

The research grant application form PHS 398 (rev. 5/95) is to be used
in applying for these grants.  These forms are available at most
institutional offices of sponsored research and from the Office of
Grants Information, Division of Research Grants, National Institutes
of Health, 6701 Rockledge Drive, Suite 3032, MSC 7762, Bethesda, MD
20892-7762, telephone (301) 435-0714.  The RFA label available in the
PHS 398 (rev. 5/95) 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 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:

DIVISION OF RESEARCH GRANTS
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:

Ethel Jackson, D.D.S.
Division of Extramural Research and Training
National Institute of Environmental Health Sciences
P.O. Box 12233, MD 17-09
111 T.W. Alexander Drive
Research Triangle Park, NC  27709

Applications must be received by December 22, 1995.  If an
application is received after that date, it will be returned to the
applicant without review.  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.

Applicants who are submitting revised applications based on
criticisms in summary statements received in response to previous
announcements of this RFA (ES-94-005 or ES-95-002) are urged to read
the appropriate instructions on page 15 of the PHS 398 and to contact
program staff listed under INQUIRIES.

All human and animal welfare as well as misconduct assurances must be
complete for a application to be reviewed.  All follow up assurances
and approvals submitted as pending must be received within 60 days of
the application receipt deadline or the application will not be
reviewed.

The following is the schedule planned for this initiative.  It should
be noted that this schedule may be changed without notification due
to factors that were unanticipated at the time of the announcement.
Please contact the program official listed below regarding any
changes in the schedule.

Letter of Intent Receipt Date:  October 27, 1995
Application Receipt Date:       December 22, 1995
Initial Scientific Review:      March 1996
Advisory Council Review:        May 1996
Anticipated Date of Funding:    July 1, 1996

REVIEW CONSIDERATIONS

Review will be carried out by the Scientific Review Branch, Division
of Extramural Research and Training (NIEHS).  Applications will be
screened by staff for completeness and responsiveness to the RFA.
Those that are incomplete or nonresponsive will be returned to the
applicant without review.  Complete and responsive applications will
be reviewed by either the Environmental Health Sciences Review
Committee or a special review committee impaneled by the Scientific
Review Branch.

Applications that are complete and responsive to the program
announcement will be evaluated for scientific and technical merit by
an appropriate peer 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 National Advisory Environmental Health
Sciences Council.

The major review factors listed below will be used in evaluation of
applications for this RFA:

o  Scientific, technical, and/or medical significance and merit of
the proposed project as determined by such factors as its content,
originality, and feasibility.

o  Evidence of access to, interaction with, and input from a
minority, low income, or underserved community, whose members' health
is adversely impacted by an environmental toxicant.  There should be
evidence of effective involvement of such a community in development
of the application as well as in conduct of the project.

o  Capacity of the project to:

a.  Identify key environmental hazards that affect the health and
quality of life of people who live in or around communities thought
to be at risk.

b.  Establish a focus and appropriate strategies and procedures for
information exchange related to environmental health problems in
socioeconomically disadvantaged communities.

c.  Enhance awareness of environmental health problems among members
of the public and/or health care providers living or working in
minority or low income communities.

d.  Have a direct impact on the health or quality of life of
individuals in affected communities, e.g., by diminishing exposure to
environmental toxicants.

o  Appropriateness and adequacy of the approach and methodology
proposed to accomplish the project's objectives.  Effectiveness of
the proposed plan in reaching the target audience.  For example, many
socioeconomically disadvantaged persons tend not to obtain
information from the written word.  Low or no literacy, as well as
bilingual, materials may need to be generated.

o  Plans for evaluation of factors contributing to the project's
effectiveness.  Evaluations should include a measure of the impact of
the project on community members' knowledge and awareness of issues
and resources related to environmental health sciences.

o  Qualifications and experience of the principal investigator and
staff, particularly but not exclusively in areas relevant to the
mission of NIEHS.  Personnel should demonstrate knowledge of the
needs of their target audience.  There should be evidence of
effective cooperation and interaction in development of the
application as well as in execution of the project among the three
types of required personnel: a researcher in environmental health
sciences, a health care provider, and a member of a community
organization in an area having an underserved population that is
adversely affected by an environmental pollutant.  There should be an
equitable distribution of responsibilities among the three types of
required personnel.

o  Strength of institutional commitment as evidenced by provision of
appropriate resources, services, technical support, and allocation of
space.

o  Availability of resources necessary to carry out the project.

o  Appropriateness of the proposed budget and duration in relation to
the project's objectives.  Consistent with an equitable distribution
of responsibilities, there should likewise be an equitable
distribution of requested financial support among the three types of
required personnel.

o  Adequacy of plans to include both genders and minorities and their
subgroups as appropriate for the scientific goals of the research
when human subjects are used.  Plans for the recruitment and
retention of subjects will also be evaluated.

AWARD CRITERIA

The anticipated date of award is July 1, 1996.  The following will be
considered in making funding decisions:

o  Quality of the proposed application as determined by peer review.
o  Significance with respect to the goals of this RFA and the
priorities of the NIEHS.
o  Availability of funds.

INQUIRIES

Inquiries concerning this RFA are encouraged.  The opportunity to
clarify any issues or questions from potential applicants is welcome.

Direct inquiries regarding programmatic issues to:

Allen Dearry, Ph.D.
Division of Extramural Research and Training
National Institute of Environmental Health Sciences
P.O. Box 12233, MD 3 04
Research Triangle Park, NC  27709
Telephone:  (919) 541 4500
FAX:  (919) 541 2843
E mail:  DEARRY@NIEHS.NIH.GOV

Direct inquiries regarding fiscal matters to:

Ms. Carolyn Winters
Division of Extramural Research and Training
National Institute of Environmental Health Sciences
P.O. Box 12233, MD 2 01
Research Triangle Park, NC  27709
Telephone:  (919) 541 7823
FAX:  (919) 541 2860
Email:  WINTERS@NIEHS.NIH.GOV

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic
Assistance Number 93.113, 93.114 and 93.115.  Awards are made under
authorization of the Public Health Service Act, Title IV, Part A
(Public Law 100 607) and administered under PHS grant policies and
Federal Regulations 42 CFR Part 52 and 45 CFR Part 74.  The program
is not subject to the intergovernmental review requirements of
Executive Order 12372 or Health Systems Agency review.

The PHS strongly encourages all grant and contract recipients to
provide a smoke-free workplace and promote the non-use of all tobacco
products.  In addition, Public Law 103-227, the Pro-Children Act of
1994, prohibits smoking in certain facilities (or in some cases, 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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