NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH

Release Date:  August 24, 2001

RFA NUMBER:  RFA-GM-02-001

Indian Health Service
 (http://www.ihs.gov/)
National Institute of General Medical Sciences
 (http://www.nigms.nih.gov/)

Letter of Intent Receipt Date:  October 1, 2001
Application Receipt Date:       December 12, 2001

PURPOSE

The Indian Health Service (IHS) and the National Institute of General Medical 
Sciences (NIGMS) announce an initiative to support Native American Research 
Centers for Health (NARCH) which will develop opportunities for conducting 
research and research training responsive to the needs of Native American 
communities.  For purposes of this announcement, "American Indian" and "Native 
American" refer to American Indian and Alaska Native.

The NARCH initiative will support partnerships between American Indian or 
Alaska Native tribes or of tribal-based organizations such as the National 
Indian Health Board and Area Health Boards, and institutions that conduct 
intensive academic-level biomedical and behavioral research; these 
partnerships are called Native American Research Centers for Health.  The 
purposes of the NARCH initiative are:  to develop a cadre of American Indian 
scientists and health professionals engaged in biomedical, clinical, and 
behavioral research who will be competitive in securing NIH funding; to 
increase the capacity of both research-intensive institutions and American 
Indian organizations to work in partnership to reduce distrust by American 
Indian communities and people toward research; and to encourage competitive 
research linked to the health priorities of the American Indian organizations 
and to reducing health disparities.  These purposes will be achieved by 
supporting student development projects, faculty development projects, and 
research projects (including pilot projects) developed by each NARCH 
partnership.

HEALTHY PEOPLE 2010

The Public Health Service (PHS) is committed to achieving the health promotion 
and disease prevention objectives of "Healthy People 2010," a PHS led national 
activity for setting priority areas.  This Request for Applications (RFA), 
Native American Research Centers for Health, is related to one or more of the 
priority areas.  Potential applicants may obtain a copy of "Healthy People 
2010" at http://www.health.gov/healthypeople/.

ELIGIBILITY REQUIREMENTS

The proposed NARCH must be a working partnership of the American Indian 
organization and of the research-intensive institution.  Applicants eligible 
to receive a NARCH award are the Native American organizations of the 
partnerships.  As the grantee, the Native American organizations will define 
criteria and eligibility for participation in all aspects of the partnership, 
consistent with this announcement.  A minimum of 30% of the grant funds must 
remain with that Native American organization, that is, no more than 70% may 
be subcontracted to other institutions or organizations.

The American Indian or Alaska Native applicant must be one of the following:

o  a federally recognized Indian tribe or tribally sanctioned non-profit 
tribal organization; or

o  a non-profit national or area Indian health board; or

o  a consortium of two or more of those tribes, tribal organizations, or 
health boards.

Applicants are strongly encouraged to establish eligibility of their proposed 
applications prior to submission.  Inquiries about eligibility should be sent 
to William L. Freeman, M.D., M.P.H. at the address listed under INQUIRIES.

The Research-Intensive Partner must be:

o  an accredited public or private nonprofit university or other institution: 
 that has an established record of conducting research into the health 
problems of American Indians; that has demonstrated a commitment to enhancing 
the capability of Native American faculty, students, investigators, and 
communities to engage in biomedical, behavioral, and clinical research; and 
that has demonstrated a commitment to mentoring Native American faculty, 
students, and investigators.

The proposed NARCH must have:

o  a Community and Scientific Advisory Council with more than 50% of its 
membership being appointed by the American Indian or Alaska Native applicant.

The proposed NARCH may include additional affiliated organizations, e.g., 
tribal colleges, additional colleges or universities, additional tribes, or 
other Indian communities or organizations.  NARCH applicants are encouraged to 
have an affiliation with an applicable component of the IHS for technical and 
other in-kind support, such as linking data from IHS and others to understand 
better the health status of the involved tribes or communities.

Principal Investigator

The Principal Investigator, the individual responsible for the administration 
(including fiscal management) of the overall project, must have his/her 
primary appointment with the American Indian or Alaska Native applicant 
organization.  Special arrangements of employment, such as inter-
organizational personnel agreements, are permissible.  The Principal 
Investigator may be, but is not required to be, the NARCH Program Director or 
a Research Project Investigator.

NARCH Program Director

The NARCH Program Director is the individual responsible for the day-to-day 
leadership and management of the research and training programs within the 
proposed NARCH.  The Program Director may be, but is not required to be, the 
Student and Faculty Development Director or a Research Project Investigator.

Student and Faculty Development Director and Participants

The NARCH initiative is an institutional developmental grant mechanism that 
places an emphasis on the continual development of students and faculty.  In 
order to be included as the Student and Faculty Development Director, the 
prospective director:  must have a faculty appointment at the research-
intensive institution or equivalent appointment at the American Indian 
organization or other consortium partner; and must show that the director has 
the knowledge, skills, and capabilities to mentor students and faculty and to 
generate and direct development and mentoring programs.  The Student and 
Faculty Development Director may be the NARCH Program Director.

Faculty and students may be supported in research education activities that 
improve their skills and abilities to be successful at the next stage of their 
professional development.  To be included for faculty development in the 
proposed NARCH, the individual must have a faculty appointment at the 
research-intensive institution or equivalent appointment at the American 
Indian organization or other consortium partner.

Research Project Investigators

The NARCH initiative is an institutional developmental grant mechanism that 
places an emphasis on continual improvement of the research competitiveness of 
the research investigators.  In order to be included as a research project 
investigator in the proposed NARCH, a prospective investigator:  must have a 
faculty appointment at the research-intensive institution or equivalent 
appointment at the American Indian organization or other consortium partner; 
and must show that the investigator has the need, based on institutional, 
departmental, and professional development plans, to enhance his/her research 
knowledge, skills, and capabilities by engaging in the proposed research 
program and associated activities.

TRIBAL APPROVAL OF THE APPLICATION

It is the policy of the IHS that all research involving AI/AN tribes be 
approved by the tribal governments with jurisdiction.  The following 
documentation, therefore, is required as part of the application.

If the applicant is a federally recognized Indian tribe, a resolution of 
support from the tribal government must be part of the application.  
Applications that affect more than one Indian tribe must include resolutions 
of support from all affected tribes.  If the applicant is an eligible 
consortium of tribes, a resolution of support from each tribe of the 
consortium must be included.  If the applicant is a tribally sanctioned non-
profit tribal organization, specific tribal resolution(s) of support will not 
be required if the current tribal resolution(s) under which the organization 
operates encompasses the proposed application.  (A copy of the current 
operational resolution(s) must be submitted with the application.)  The 
official final signed resolution must be received by the Grants Management 
Branch, IHS, no later than April 30, 2002.  A grant will not be awarded unless 
the final signed resolution is received by this date.

If the applicant is a non-profit national or area Indian health board, or is 
an eligible consortium of those Indian health boards, it is not required to 
submit a resolution.  However, the applicant organization must submit a letter 
of support signed by the executive director of each health board involved, 
specifically citing the research project proposed.  Each AI/AN organization 
that derives benefit from the grant must also submit such a letter.

MECHANISM OF SUPPORT

Awards under this initiative will be administered using the competing 
institutional grant mechanism of the IHS, and will be reviewed using the NIH 
S06 mechanism.  The responsibility for planning, directing, and executing the 
program, as well as data acquisition and analysis and evaluation of the 
proposed program, lies solely with the applicant organization.  The maximum 
grant period may not exceed four years, with the opportunity for competing 
renewal at the end of that period.

FUNDS AVAILABLE

The estimated funds (total costs) available for the first year of support for 
the entire initiative is expected to be $1.5 million in Fiscal Year 2002.  The 
actual amount may vary, depending on the response to the RFA and availability 
of funds.  Three to five awards are anticipated.

An application may request a project period not to exceed four years of 
support, and direct costs not to exceed $700,000 in the first year.  Direct 
costs to the applicant include the entire cost of each subcontract--that is, 
each subcontract's direct cost plus the subcontract's appropriate facilities 
and administration (F&A) cost.  Because it is anticipated that all budget 
requests will exceed $250,000, the modular grant requirements would not apply 
to this RFA.  A minimum of 30% of the grant funds must remain with the 
applicant organization.

TECHNICAL ASSISTANCE WORKSHOP

The IHS and NIGMS together will conduct a technical assistance and information 
sharing workshop about this grant initiative.  It will be held Thursday, 
September 20, 2001, in Denver, CO.  People planning to attend are asked to 
notify either Ms. Patricia Gregory or Mr. Pallop Chareonvootitam, telephone 
(301) 443-5204, FAX (301) 443-9602, Email PGregory@HQE.ihs.gov or 
PChareon@HQE.ihs.gov, of the name of each person and of the organization each 
represents, no later than Wednesday Thursday, September 13, 2001, to help 
insure that IHS and NIGMS bring enough copies of materials to the workshop.  
The details of the location of the workshop can be obtained from Ms. Gregory 
or Mr. Chareonvootitam.

BACKGROUND

The American Indian and Alaska Native tribal nations and communities have long 
experienced poorer health status than other Americans.  Although major gains 
of reducing health disparities were made in the last half of the twentieth 
century, most gains stopped by the mid 1980s (Trends in Indian Health 1998-
99).  A few diseases, e.g., diabetes, got worse.  "All Indian" rates contain 
marked variation among the "IHS Areas" or regions (Regional Differences in 
Indian Health 1998-99); variation by tribe exists within Areas as well.  
Although the "All Indian" mortality rates for all cancers are about 20% lower 
than the US rates for all races, there is variation among IHS Areas for 
specific cancers; moreover, the favorable American Indian mortality rates for 
some cancers may be due to markedly lower incidence rates partly offset by 
higher case-fatality rates (NIH Publication 98-4247).  Unfamiliarity with 
modern health care may adversely influence health status among the elderly, 
the low-income elderly, and tribes, and also may reduce the acceptability of 
health research among them.  The daunting tasks confronting tribes, 
researchers, and health care and public health programs in the beginning of 
the twenty-first century are to resume the reduction of health disparities 
that had occurred up to the 1980s, to reverse the worsening in a few diseases, 
to maintain and strengthen the favorable status, and to reduce the disparities 
among and within Areas and tribes.

Factors known to contribute to health status and disparities are complex, and 
include underlying biology, physiology, and genetics, as well as ethnicity, 
culture, socioeconomic status, gender/sex, age, geographical access to care, 
and levels of insurance.  Additional factors known to contribute to health 
status and disparities include:  family, home, and work environments; health 
practices; social support systems; lack of access to culturally-appropriate 
health care; and attitudes toward health.  Yet none of these alone or in 
combination accounts for all documented differences.

Health disparities of American Indians may also reflect a lack of research 
relevant to improve their health status.  Many Native Americans distrust 
research for historical reasons.  One approach that combats this distrust is 
to ensure that tribes are senior partners in training and research that 
involves them, as for example in community-based participatory research.  This 
approach is especially helpful to design both training relevant to researchers 
from tribal communities, and research relevant to the health needs of the 
communities.

The mission of NIH is to acquire new knowledge that will lead to better health 
by understanding the processes underlying health and disease, that in turn 
will help prevent, detect, diagnose, and treat disease and disability.  The 
NARCH initiative works toward the NIH mission by supporting research that 
discovers the interrelationships among the many factors that contribute to 
health and disease, and by helping train and promote researchers concerned 
with American Indian health.  In addition, the NARCH initiative is based on 
tribes as senior partners in training and research.

OBJECTIVES

Due to the complexity of factors contributing to the health and disease of 
American Indians, and to their health disparities compared with other 
Americans, the collaborative efforts of the agencies of the Department of 
Health and Human Services, and the collaboration of researchers and Native 
American communities, are needed to achieve significant improvements in the 
health status of American Indian people.

Develop a Cadre of American Indian Scientists and Health Professionals Engaged 
in Research

The NARCH initiative offers opportunities to develop more Native American 
scientists and health professionals engaged in research, and to conduct 
biomedical, clinical, and behavioral research that is responsive to the needs 
of the Native American community and the goals of this initiative.  Faculty 
and students at each proposed NARCH will be supported through science 
education projects designed to increase the numbers of, and to improve the 
research skills of investigators involved with Native Americans, and through 
investigator-initiated, scientifically meritorious research projects, 
including pilot research projects.

Enhance Partnerships

Recent community-based participatory research suggests that Native American 
communities can work collaboratively in partnership with health researchers to 
further the research needs of American Indians.  Fully utilizing all cultural 
and scientific knowledge, strengths, and competencies in such partnerships can 
lead to better understanding of the biological, genetic, behavioral, 
psychological, cultural, social, and economic factors either promoting or 
hindering improved health status of American Indians, and generate the 
development and evaluation of interventions to improve their health status.

Reduce Health Disparities

In the Indian Health Care Improvement Act, Public Law (P.L.) 94-437, as 
amended, IHS was legislatively mandated to improve the delivery of effective 
health care to Native Americans.  In the NIH Revitalization Act of 1993, NIH 
was encouraged to increase the number of underrepresented minorities 
participating in biomedical, clinical, and behavioral research, including 
studies on drug abuse and alcoholism, and the examination of the role of 
resiliency in the prevention and treatment of those conditions.  Also, the 
"Initiative to Eliminate Racial and Ethnic Disparities in Health" by HHS 
(http://raceandhealth.hhs.gov/) encouraged NIH to help reduce health 
disparities.  NIH published a draft "Strategic Research Plan to Reduce and 
Ultimately Eliminate Health Disparities" 
(http://www.nih.gov/about/hd/strategicplan.pdf).  Finally, the "NIGMS 
Strategic Plan for Reducing Health Disparities" 
(http://www.nigms.nih.gov/news/reports/health_disparities.html) presents an 
NIGMS role in health disparity reduction through its focussed programs on 
research infrastructure to increase the number and capabilities of 
underrepresented minority health researchers.  In response to these 
priorities, the IHS and NIGMS have established a collaboration to support 
Native American Research Centers for Health.

Reducing health disparities among Native American communities and individuals 
may be fostered by greater understanding of how to enhance their strengths and 
resiliencies.  While American Indian communities have relied on health 
research and medical science to reduce health disparities, they also have 
relied on their own psychological, organizational, and cultural, assets and 
strengths to survive major harms and disruptions over the centuries, and to 
rebound from insults to health.  (For research about resiliencies, see 
http://www.nida.nih.gov/ResilandRiskWG/ResilandRiskWG.html.)

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, 
clinical, 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 P.L. 103-43).  Because the NARCH initiative targets American 
Indian and Alaska Native people and communities, a minority population, only 
the policy of inclusion of women applies to this RFA.

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

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of NIH that children (i.e., individuals under the age of 21) 
must be included in all human subjects' research, conducted or supported by 
the NIH, unless there are scientific 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 initiative 
staff listed under INQUIRIES.  Initiative staff may also provide additional 
relevant information concerning the policy.

URLS IN NIH GRANT APPLICATIONS OR APPENDICES

All applications and proposals for NIH funding must be self-contained within 
specified page limitations.  Unless otherwise specified in an NIH 
solicitation, internet addresses (URLs) should not be used to provide 
information necessary to the review because reviewers are under no obligation 
to view the Internet sites.  Reviewers are cautioned that their anonymity may 
be compromised when they directly access an Internet site.

REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS

NIH policy requires education on the protection of human subject participants 
for all investigators submitting NIH proposals for research involving human 
subjects.  This policy announcement is found in the NIH Guide for Grants and 
Contracts Announcement dated June 5, 2000, at the following website:  
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT

The Office of Management and Budget (OMB) Circular A-110 has been revised to 
provide public access to research data through the Freedom of Information Act 
(FOIA) under some circumstances.  Data that are (1) first produced in a 
project that is supported in whole or in part with Federal funds and (2) cited 
publicly and officially by a Federal agency in support of an action that has 
the force and effect of law (i.e., a regulation) may be accessed through FOIA. 
 It is important for applicants to understand the basic scope of this 
amendment.  NIH has provided guidance at:  
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.

Applicants may wish to place data collected under this RFA in a public 
archive, which can provide protections for the data and manage the 
distribution for an indefinite period of time.  If so, the application should 
include a description of the archiving plan in the study design and include 
information about this in the budget justification section of the application. 
In addition, applicants should think about how to structure informed consent 
statements and other human subjects procedures given the potential for wider 
use of data collected under this award.

LETTER OF INTENT

Prospective applicants are asked to submit a letter of intent that includes 
the title of the proposed NARCH, the name, address, and telephone number of 
the Principal Investigator and its Program Director, the identities of the 
partners and of key personnel, and the number and title of this RFA.  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 the IHS and NIH Center for Scientific Review (CSR) staffs to estimate 
the potential review workload and to plan the review.

The letter of intent is to be sent to the initiative staff listed under 
INQUIRIES by the letter of intent receipt date listed in the heading of this 
RFA.

APPLICATION PROCEDURES

The PHS 398 research grant application instructions and forms (rev. 5/2001) at 
http://grants.nih.gov/grants/funding/phs398/phs398.html are to be used in 
applying for these grants.  This version of the PHS 398 is available in an 
interactive, searchable, PDF format.  Although applicants are strongly urged 
to begin using the 5/2001 revision of the PHS 398 as soon as possible, NIH 
will continue to accept applications prepared using the 4/1998 revision until 
January 9, 2002.  Beginning January 10, 2002, however the NIH will return 
applications that are not submitted on the 5/2001 version.  For further 
assistance contact GrantsInfo, telephone (301) 435-0714, Email:  
GrantsInfo@nih.gov.

Applicants are strongly urged to contact NARCH initiative staff at an early 
stage to request the specific supplementary instructions for the PHS 398 for 
the NARCH grants.  Application kits and supplementary instructions may be 
obtained from the initiative contacts listed under INQUIRIES.

A supplemental application to an existing NARCH program may be submitted if 
the supplemental application is within the first 12-month period of a four-
year NARCH grant, if the total number of projects in the parent grant plus the 
supplemental application does not exceed five (5) research projects and five 
(5) pilot research projects, and if the direct costs (including all 
subcontract costs) of the parent grant plus the supplemental application do 
not exceed $700,000 in the first year of supplement.  A supplemental 
application may not extend beyond the project period of the parent NARCH 
grant.  Supplemental applications are to use the grant application form PHS 
398 (rev. 5/2001), and should also follow the supplementary instructions for 
Form PHS 398 for NARCH grants.  The receipt dates for the Letter of Intent and 
Application, the instructions about the original and photocopies, and all 
requirements for and limitations on original NARCH applications apply to 
supplemental applications.   Because the reviewers will not have the original 
application, the supplemental application should be self-contained and 
complete in itself.

The RFA label available in the PHS 398 (rev. 5/2001) application form must be 
affixed to the bottom of the face page of the application.  Type the RFA 
number on the label.  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. The RFA label is also available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf.

Submit a signed, typewritten original of the application, including the 
Checklist, and one (1) single-sided photocopy of the entire signed application 
(including Appendices and supporting documents) in one package to:

Grants Management Branch
Indian Health Service
Twinbrook Metro Plaza, Suite 100
12300 Twinbrook Parkway
Rockville, MD  20852-1750
Telephone:  (301) 443-5204
(for express or courier service, the zipcode is unchanged).

At the time of submission, four (4) additional single-sided photocopies of the 
complete signed original application, including the Checklist, Appendices, and 
supporting documentation, must also be sent to:

Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 2030 - MSC 7720
Bethesda, MD  20892-7720
Telephone:  (301) 435-0715
or Bethesda, MD  20817 (for express or 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.

APPLICATION CONTENT

The purposes of the NARCH initiative are:  to develop a cadre of American 
Indian scientists and health professionals engaged in biomedical, clinical, 
and behavioral research that is competitive to NIH funding; to increase the 
capacity of both research-intensive institutions and American Indian 
organizations to work in partnership to reduce distrust by American Indian 
communities and people toward research; and to encourage competitive research 
linked to the health priorities of the American Indian partner and to reducing 
health disparities.  A proposed NARCH, therefore, may include any or all of 
the following components:  student development projects; faculty development 
projects; research projects (including pilot projects); or "core" 
administrative facility.

The content of the application should explain the components of the 
application, and how they help meet the purposes of the NARCH initiative.

o  A description should be provided of the current state of the research and 
research training enterprise at the proposed NARCH and its institutional and 
community partners, including faculty and student profiles.

o  A clear statement should be presented of the overall goals, specific 
measurable objectives, and anticipated milestones; these elements should be 
presented in the context of needed improvements in the partners' 
organizational infrastructure and environment for research.

o  Documentation should be given that the research-intensive partner is an 
institution with an established record of conducting research into the health 
of American Indians, and that it has a demonstrated commitment to the special 
encouragement of, and assistance to, Native American faculty, students, 
investigators, and communities for enhancing their capacity to engage in 
biomedical research.

o  Documentation about the nature of the partnership itself should be 
included, such as:  the process to develop the application and proposed NARCH 
itself; and the past and future efforts to increase the capacity of the 
partners, to improve their partnership, and to contribute to the success of 
the NARCH.

o  A plan for assessment of the benefits of the activities by the proposed 
NARCH on specific, measurable outcomes identified in the application should be 
provided.  IHS and NIGMS recognize that tribes, tribal-based organizations, 
and research-intensive institutions are diverse in their mission, their health 
and economic statuses, and their cultures.  Such an assessment could include a 
self-study by the proposed NARCH and its partners, which focuses on fact-
finding, program evaluation, and recommendations for improvement in key areas.

o  Strategies for determining the initial and ongoing success of their efforts 
for organizational development should also be presented.  It is expected that 
each proposed NARCH will develop its own set of strategies that best match its 
circumstances.

Guidance and suggestions for program evaluation of a proposed NARCH can be 
obtained from http://www.the-aps.org/education/promote/promote.html.

Student Development Projects

If student development projects are proposed, the NARCH application should 
describe new programs, modifications, or additions to existing programs of the 
partners, that encourage and facilitate American Indian students to enter, 
advance, and remain in research careers.  Such projects might include, but are 
not limited to, providing employment as research assistants in research 
projects of research-active mentors with an explicit mentoring plan, providing 
other mentoring with an explicit mentoring plan, providing workshops to 
improve technical or communication skills, providing motivating seminars or 
journal clubs highlighting problems of interest to students, providing contact 
with role models, and providing opportunities to travel to present results at 
national scientific meetings.

If research mentorships or apprenticeships are proposed, the application 
should clearly document the experience, proposed commitment, and quality of 
the mentors in providing guidance and advice to students (including 
responsible conduct of research and research integrity, teaching, and 
protection of human subjects), and in fostering the development of academic 
and community-based American Indian researchers.

The application must clearly describe how the development plans for students 
will meet both the individual's professional development goals, and one 
purpose of the NARCH initiative:  to develop a cadre of American Indian 
scientists and health professionals.

The application must have an evaluation plan for the project(s) that indicates 
the anticipated outcomes relative to the current baseline data.  For example, 
one outcome might be the improved retention of students in science majors.  
The application should indicate the anticipated (quantitative) improvement 
relative to the current retention rate.

A student in a NARCH Student Development Project must be a full-time or part-
time student officially enrolled in an educational program leading to an 
undergraduate or graduate degree, or in a post-doctoral educational program, 
or (if well justified) in late high school.

A helpful book about mentoring science students is found at 
http://books.nap.edu/catalog/5789.html.

Faculty Development Projects

If faculty development projects are proposed, the NARCH application should 
describe the need, proposed activity, and anticipated outcomes.  Faculty 
development projects might include, but are not limited to, short-term 
mentored research experiences in the lab of an active NIH-extramurally-funded 
researcher with an explicit mentoring plan, long-term general mentoring under 
an explicit mentoring plan, or attendance at workshops or courses or national 
meetings needed for acquiring specific skills or methodologies needed for 
prospective research.

As with student development projects, the application should document the 
experience, proposed commitment, and quality of the mentors, teachers, or 
experience in providing guidance and advice to faculty, and in fostering the 
development of academic and community-based American Indian research.

The application must also describe the evaluation plan for the faculty 
development project.  Release time for preparing proposals or mini-research 
projects, not reviewed as pilot projects, is not allowed.

The application must clearly describe how the development plans for faculty 
will meet both the individual's professional development goals, and two 
purposes of the NARCH initiative:  to develop a cadre of American Indian 
scientists and health professionals, and to enhance the partnership of the 
proposed NARCH.

Research Projects

NARCH applications may include a maximum of five (5) research projects and a 
maximum of five (5) pilot research projects.  Unlike regular research 
projects, a pilot research project is limited in scope and is not expected to 
have preliminary data.  It is also limited to a budget of no more than $35,000 
direct costs per year for four years.  The pilot research project is intended 
for faculty without current research support.  Support for faculty 
participating in pilot research projects is preparatory to seeking more 
substantial funding from NIH research grant programs (e.g., Academic Research 
Enhancement Award [AREA], K, and R01 awards), as well as funding from other 
agencies and private sources.  Funds received from the proposed NARCH to 
support pilot research projects may not be used to supplement ongoing research 
projects.  A NARCH application need not include both research projects and 
pilot research projects.  Applications for only pilot research projects or for 
only research projects may be submitted.  Individual project investigators may 
propose either a research project or a pilot research project, but not both.  
In addition, the NARCH application must show that each participating 
investigator has the need, based on institutional, departmental, and 
professional development plans, to develop or enhance his/her research 
knowledge, skills, and capabilities by engaging in the proposed research 
program and associated activities.

Research projects (including pilot research projects) proposed under this 
initiative must be in research areas normally funded by any of the National 
Institutes of Health.  Research projects addressing health disparities and the 
health priorities of the American Indian partner are especially encouraged.

A listing of grants recently funded by NIH may be found at CRISP (Computer 
Retrieval of Information on Scientific Projects), a searchable database of 
federally funded biomedical research projects conducted at universities, 
hospitals, and other research institutions.  It may be accessed at 
http://crisp.cit.nih.gov/.

Each research project or pilot research project should follow the instructions 
provided in PHS 398 (rev. 5/2001) for preparing research grant applications.  
The application must clearly describe how the proposed research plan will meet 
both the individual's professional development goals, and the three purposes 
of the NARCH initiative:  to develop a cadre of American Indian scientists and 
health professionals; to enhance the partnership of the proposed NARCH; and to 
conduct competitive research linked to the health priorities of the American 
Indian partner and to reducing health disparities.  The professional 
development goals must clearly describe specific objectives and milestones.  
The goals should include, but are not limited to, improving competitiveness in 
winning grant support, and should describe how successful completion of the 
proposed research project will improve the research skills of, and will help 
develop, the students and faculty, thus contributing to the overall goals and 
specific measurable objectives of the proposed NARCH.

Each research project or pilot research project must follow the IHS policy 
concerning tribal approval, that all research involving American Indian tribes 
be approved by the tribal governments with jurisdiction.  That is, each 
project that involves people or community[ies] of an American Indian or Alaska 
Native tribe, or an eligible non-profit organization, must include a 
resolution of approval from the tribal government[s], or (if applicable) a 
letter of support signed by the director of the eligible Native American 
organization, or both (if applicable).

Administration of the overall NARCH

The administrative personnel, facilities, and programs of the overall NARCH 
should be described.  It is permissible but not necessary to have a set of 
core support programs, that provide common scientific services to two or more 
NARCH projects.

Supplemental Applications

A supplemental application must include an Introduction.  The Introduction to 
the supplemental application should contain an overall description of the 
nature of the supplement and how it will enhance the current NARCH program.  
All revised subproject applications in a supplemental application must include 
an Introduction that summarizes the substantial additions, deletions, and 
changes, as well as responses to the criticisms and issues raised in the 
scientific review summary statement of the original subproject.  The changes 
in each subproject must be clearly marked by appropriate bracketing, 
indenting, or changing of typography.  If changes are so extensive they 
include most of the text, explain this in the subproject's Introduction.  All 
requirements for and limitations on original applications apply to 
supplemental applications.  Because the reviewers will not have the original 
application, the supplemental application should be self-contained and 
complete.

ALLOWABLE COSTS

Administrative Costs

Certain administrative costs for managing a comprehensive program are 
allowable and may vary, depending upon the size and complexity of the 
program's activities.  The costs budgeted for NARCH grants and subcontracts 
may not duplicate items already budgeted in other cost centers of the Native 
American, research-intensive, and subcontracted organizations and 
institutions, such as accounts which make up the Facilities and Administration 
(F&A) cost pool.  The grantee organization receiving the award must be 
prepared to provide documentation showing the direct relationship of proposed 
costs to the program and that costs of this type are charged in a uniform 
manner to all other grants at all institutions and organizations participating 
in the award.

Salary (up to 25 percent effort, although it should generally be less) for the 
NARCH Program Director is allowable for that portion of time or effort 
specifically employed in directing the proposed NARCH.  (The 25% limit does 
not include salary for being a research investigator.)  Limited salary support 
for secretarial or clerical help is allowable only when in direct support of 
the proposed NARCH.  For guidance, applicants should refer to the OMB Circular 
appropriate for them, A-87 (Cost Principles for State, Local, and Indian 
Tribal Governments, 
http://www.whitehouse.gov/OMB/circulars/a087/a087-all.html) 
or A-122 (Cost Principles for Non-Profit Organizations, 
http://www.whitehouse.gov/OMB/circulars/a122/a122.html), or should contact the 
grants management officer under INQUIRIES.

Costs for evaluation activities are allowable, as are costs for the Community 
and Scientific Advisory Council.  All applications must include costs 
associated with one annual meeting per year in Rockville, MD, of NARCH 
directors and their key scientific personnel.

Student Development Costs

Student (graduate, undergraduate, and high school if well justified) 
remuneration through salary/wages for participation in research experiences 
may be requested, provided all the following conditions are met.
o  The student is performing necessary work involved in the research.
o  There is employer-employee relationship between the student and the 
proposed NARCH or its partners.
o  The total compensation is reasonable for the work performed.
o  It is the practice of the proposed NARCH or its partners to provide 
compensation for all students in similar circumstances, regardless of the 
source of support for the activity.

Graduate students are allowed tuition costs as part of a compensation package. 
 When requesting support for a graduate student, the NARCH application should 
provide, in the budget justification section of the application, the basis for 
the compensation level.  The IHS staff will review the requested compensation 
level and, if it is reasonable and justified, will provide compensation up to 
a maximum of $26,000 
(http://grants.nih.gov/grants/guide/notice-files/not98-168.html).  
Post-doctoral students should be compensated at a rate 
commensurate with that of other post-doctoral employees with similar degrees 
and experience at the research-intensive institution.

It is the expectation of the IHS and NIGMS that students who are enrolled in a 
Ph.D. program, as part of a proposed NARCH, will not be excluded from support 
from other non-federal or federal graduate training sources (such as loans and 
assistance under the Veterans' Adjustment Benefit Act or Pell Grants) for 
which they are eligible.  Graduate and post-doctoral students cannot 
concurrently hold another federally-sponsored stipend or fellowship or any 
other federal award that duplicates the NARCH support.

Faculty Development Costs

Costs to support various activities such as workshops or courses, national 
meetings, or short-term research experiences in the laboratory of an active 
NIH-extramurally-funded researcher needed for acquiring specific skills or 
methodologies needed for prospective research are allowable.  Such costs might 
include tuition, travel and per diem costs, as well as salary support 
appropriate to the percent effort needed for the activity.  Also, allowable 
are costs such as travel and per diem associated with short-term research 
experiences in the laboratory of an active extramurally funded researcher.

Research Project Costs

Direct costs associated with research and pilot research projects are 
allowable when adequate justification is provided.  These include faculty 
salaries, reimbursed according to percent effort.  Summer salary support can 
be paid provided the institution's academic schedule permits such release and 
when the institution approves.  The maximum summer-salary support provided by 
the program can not exceed the equivalent of two months at 100 percent effort, 
or time specified by the institution as its policy.  Grant funds may not be 
used to increase or supplement faculty academic year salaries.  Salary support 
for technical assistance and costs for consultants, if justified, are 
allowable.  Costs for equipment to be used to carry out the proposed research 
are allowable.

Costs for core scientific services to support two or more projects are 
allowable.  Costs for multi-user research equipment are also allowable.  A 
plan for access to the multi-user equipment, its maintenance, management and 
use must be included.  To aid in the review, it is suggested that a tabular 
summary show the estimated or actual proportional use of this equipment by 
each project, and other investigators and students.  Justify this core 
component by discussing ways in which these centralized services improve 
quality, bring about an economy of effort, and/or save overall costs as 
compared to their inclusion as part of each research project.  Personnel costs 
to maintain and service the equipment are an allowable cost.  Support for very 
large pieces of equipment, however, may be restricted by the NARCH budget.  
Plans to maintain the shared core scientific services and facility beyond the 
grant period should be discussed.

Costs for supplies, including costs for animals, necessary to carry out the 
proposed research may be included.  Travel costs for the investigator(s) are 
permitted when direct benefits to the program are expected, and when adequate 
justification is provided.  Alterations and Renovations costs (up to $40,000) 
are allowable only when essential for conduct of the proposed research.  Other 
permitted costs include animal maintenance (unit care costs and number of care 
days), donor fees, publication costs, computer charges, rentals and leases, 
equipment maintenance, and service contracts.

Also allowable, when fully justified, are consortium arrangements that may 
involve personnel costs, supplies, and other allowable costs, including F&A 
costs.  Contractual costs for support services, such as the laboratory testing 
of biological materials, clinical services, data processing, or core 
administrative services, are allowable expenses.

The intent of pilot research projects is to lead to regular research projects 
funded as part of the center grant or as freestanding grants.  For pilot 
research projects, applications may request support for up to $35,000 (direct 
costs) per year.  This support is non-renewable.

Subcontracts

The grant recipient may issue subcontracts to other organizations (such as the 
research-intensive institution of the partnership), as long as at least 30% of 
the grant remains with the Native American organization; that is, no more than 
70% may be subcontracted.

Unallowable Costs

Unallowable costs for research projects (including for pilots projects) 
include costs for student development, textbooks, journals, memberships, and 
Internet subscription costs, as well as other costs prohibited by OMB 
Circulars A-87 or A-122 as applicable.  Employees of the applicant 
organization may not serve as paid consultants.

The pilot research project is intended for faculty without current research 
support.  Therefore, investigators with significant current support from other 
mechanisms such as the R01 and research funding from other extramural sources 
are not eligible, and the costs therefore are not allowable.

Undergraduate tuition, housing, food, or recruitment expenses of any kind are 
not allowable under the NARCH initiative.  Support for textbooks, incentives, 
memberships, and Internet subscriptions are not allowable.

QUALIFICATIONS OF THE NARCH PROGRAM DIRECTOR AND KEY PERSONNEL

As leader of the research and research training for the proposed NARCH, the 
NARCH Program Director is expected to possess certain essential 
qualifications:  1. strong leadership skills, including scientific leadership 
experience and a strong academic and scientific background, as exemplified, 
ideally, by scientific publications and a record of peer-reviewed scientific 
support;  2. the knowledge of and personal working relationship with the 
Native American tribes or communities involved in the NARCH research, and with 
the partners of the proposed NARCH;  3. strong mentoring and supervision 
skills, to exercise responsibility for mentoring activities, organization of 
communicating skills programs, special methods workshops, tracking of student 
career plans, etc.;  4. knowledge of IHS and NIH policies, including those 
concerning human participants in research, human biological material, animals, 
hazardous materials, and tribal review and approval of research.

The names and qualifications of the NARCH Program Director, the Student and 
Faculty Development Director and directors of individual projects within the 
program (where appropriate), and any other key personnel, shall be listed in 
the application under Key Personnel, and their Biographical Sketches, 
including other support, should be included.

REVIEW CONSIDERATIONS

Upon receipt, IHS and NIH staff will administratively review applications for 
completeness and responsiveness.  Applications that are incomplete, non-
responsive to this RFA, or do not follow the guidelines of the PHS form 398 
(Rev. 5/2001) or of the supplementary instructions for NARCH grants, will be 
returned to the applicant without further consideration.

Applications will be evaluated in accordance with the criteria stated below 
for scientific and technical merit by appropriate peer review groups convened 
by the CSR.  The National Advisory General Medical Sciences Council will 
provide the second level of review.

Overall Review of the NARCH

In reviewing the overall Center, the initial scientific review group will 
examine evidence of the partners' commitment to the purposes of the NARCH 
initiative:  to develop a cadre of American Indian scientists and health 
professionals engaged in biomedical, clinical, and behavioral research that is 
competitive for NIH funding; to increase the capacity of both research-
intensive institutions and American Indian organizations to work in 
partnership to reduce distrust by American Indian communities and people 
toward research; and to encourage competitive research linked to the health 
priorities of the American Indian partner and to reducing health disparities. 
 The evidence will include:

o   the quality of the partnership of the institutional and community 
partners, and the quality of the involvement of the Community and Scientific 
Advisory Council, as demonstrated by documentation of (for instance):  the 
intellectual and tangible contributions and activities of the partners, and of 
the Council, in developing the application and the proposed NARCH; the 
interactions of the partners, and of the members of the Council, in meetings 
(such as those to develop the application and proposed NARCH); the past 
activities and future plans to increase the capacity of the partners and of 
the Council; the plans for future contributions and activities by the 
partners, and by the Council, in furthering the goals of the proposed NARCH; 
and the plans for future development of the partnership itself;

o    the experience and commitment of the institutional and community partners 
to recruit, retain, and advance Native American faculty and students, to 
support faculty and student research efforts, and to increase the role of the 
involved American Indian communities in the plans of the proposed NARCH;

o   the appropriateness of the plan for evaluating the impact of the proposed 
NARCH, including the quality of baseline data and milestones for 
accomplishments, and a system to track the future course of program 
participants; and

o   the potential of the proposed NARCH to be a regional and national 
resource, including:  capacity to provide quality research training and 
mentoring for integrated promotion and development of American Indian research 
careers from undergraduate (or if well justified, high school) through post-
doctoral levels; attainment of quality research linked to health priorities of 
the American Indian partner and to reducing health disparities; plans for 
research information dissemination and education activities; and plans for the 
development of research networks to support the scientific aims of the 
proposed NARCH.

Review of Student and Faculty Development Plans

The anticipated effectiveness of the proposed NARCH in making a difference 
relative to the current base-line data (based in part on previous experience 
of the partners) will be assessed.  Factors to be considered include:

o   the appropriateness of the content, phasing, quality, and duration of the 
student or faculty development plans in the NARCH application to achieve the 
scientific development of the faculty, post-doctoral, pre-doctoral, 
undergraduate, and (if well justified) high school students; and

o   the experience, proposed commitment, and quality of the mentoring plan and 
of individual mentors of the partners in providing mentoring, guidance, and 
advice to candidates (including training in responsible conduct of research 
and research integrity, teaching, and protection of human subjects), and in 
fostering the development of academic and community-based American Indian 
researchers.

Review of Research Projects

The NIH has announced procedures to be used for the review of research grant 
applications (NIH GUIDE, Volume 26, Number 22, June 27, 1997 or see 
http://grants.nih.gov/grants/guide/notice-files/not97-010.html).  For NARCH 
applications, the five criteria listed in this announcement will be used for 
the scientific review of research projects and pilot research projects.  The 
review of research projects and pilot research projects will be the same 
except that applications for pilot studies may be smaller in scope and would 
not be expected to have preliminary data.

The purposes of the NARCH initiative are:  to develop a cadre of American 
Indian scientists and health professionals engaged in biomedical and 
behavioral research; to increase the formation of partnerships between 
American Indian and research-intensive institutions; and to encourage 
competitive research that address the health priorities and health disparities 
in the American Indian population.  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 purposes.  Each of these criteria will be addressed and 
considered in assigning the overall score, weighting them as appropriate for 
each application.

(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 application acknowledge potential problem areas and 
consider alternative tactics?  For pilot research projects, are the proposed 
aims reasonable, and is there potential to lead to more substantial funding?

(3)  Innovation:  Does the project employ novel concepts, approaches, or 
methods?  Are the aims original and innovative?  Does the project challenge 
existing paradigms or develop new methodologies or technologies?

(4)  Investigator:  Is the investigator appropriately trained and well suited 
to carry out this work?  Is the work proposed appropriate to the experience 
level of the principal investigator and other researchers (if any)?

(5)  Environment:  Does the scientific environment in which the work will be 
done contribute to the probability of success?  Do the proposed experiments 
take advantage of unique features of the scientific environment or employ 
useful collaborative arrangements?  Is there evidence of institutional 
support?

In addition to the above criteria, in accordance with NIH policy, all 
applications will also be reviewed with respect to the following:

o   The adequacy of plans, if research on human subjects is involved, to 
include both genders 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, animals or the 
environment, to the extent they may be adversely affected by the project 
proposed in the application.

o   The adequacy of the proposed plan to share data, if appropriate.

Schedule

Letter of Intent Receipt Date:    October 1, 2001
Application Receipt Date:         December 12, 2001
Peer Review Date:                 February/March 2002
Council Review:                   May 2002
Earliest Anticipated Start Date:  July 1, 2002

AWARD CRITERIA

Priorities for funding will be based on the scientific and technical merit of 
the application, the assessed potential of investigators in the developmental 
stages of their careers, and the likelihood that the proposed NARCH can 
further the purposes of the NARCH initiative.  Awards will be made only to 
organizations with financial management systems and management capabilities 
that are acceptable under PHS policy.  Awards will be administered under the 
PHS Grants Policy Statement.

INQUIRIES

Written and telephone inquiries are encouraged.  The opportunity to clarify 
any issues or questions from potential applicants is welcome.

Questions on the initiative, especially regarding IHS issues and policies, may 
be directed to:

William L. Freeman, M.D., M.P.H.
Research Program, Indian Health Service
Twinbrook Metro Plaza, Suite 450
12300 Twinbrook Parkway
Rockville, MD  20852-1750
Telephone:  (301) 443-0578
FAX:  (301) 443-1522
Email:  WFreeman@HQE.ihs.gov

Questions on the initiative, especially regarding NIGMS issues and policies, 
may be directed to:

Clifton A. Poodry, Ph.D.
Minority Opportunities in Research Division
National Institute of General Medical Sciences
45 Center Drive, Suite 2AS.37, MSC 6200
Bethesda, MD  20892-6200
Telephone:  (301) 594-3900
FAX:  (301) 480-2753
Email:  poodryc@nigms.nih.gov

Questions on the review of applications may be directed to:

Michael R. Martin, Ph.D.
Director, Division of Physiological Systems
Center for Scientific Review
6701 Rockledge Drive, Room 6160, MSC 7892
Bethesda, MD  20892-7892
Telephone:  (301) 594-7945
FAX:  (301) 480-2065
Email:  mm72k@nih.gov

Questions on grants management and fiscal matters may be directed to:

Patricia Spotted Horse
Grants Management Branch
Indian Health Service
Twinbrook Metro Plaza, Suite 100
12300 Twinbrook Parkway
Rockville, MD  20852-1750
Telephone:  (301) 443-5204
FAX:  (301) 443-9602
Email:  PSpotted@HQE.ihs.gov

AUTHORITY AND REGULATIONS

This initiative is described in the Catalog of Federal Domestic Assistance 
Nos. 93.933 and 93-375.  Sections 301(a) and 405 of the Public Health Service 
Act, as amended authorize these awards, and these are administered under PHS 
grants policies and Federal Regulations 42 CFR part 52c, 45 CFR part 74, and 
45 CFR part 92, and other applicable Departmental, IHS, and NIH policies and 
procedures such as the regulations governing protection of human subjects at 
45 CFR 46.  See also Senate Appropriations Committee Report, No. 92-316, July 
29, 1971, Executive Order 12900 , Educational Excellence for Hispanic 
Americans February 22, 1994, Executive Order 12876, Historically Black 
Colleges and Universities, November 1, 1993, and Executive Order 13021, 
October 21, 1996, and Outline of Work Plan, August 18, 1998, White House 
Initiative on Tribal Colleges and Universities.  Applications are 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, P.L. 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 FOR BACKGROUND INFORMATION

Anderson, N.B.  Levels of analysis in health science:  A framework for 
integrating sociobehavioral and biomedical research.  Annals of the New York 
Academy of Sciences, 1998, 840, 563-576.

Ballantine, B., Ballantine, I. (Eds.), Thomas, D.H., Miller, J., White, R., 
Nabokov, P., Deloria, P.J. (Text by), Josephy, A.M. (Intro.)  The Native 
Americans:  An Illustrated History.  Turner Publishing, Inc.  Atlanta, GA, 
1993.

Gazmararian, J.A., Baker, D.W., Williams, M.V., Parker, R.M., Scott, T.L., 
Green, D.C., Fehrenbach, S.N., Ren, J. & Koplan, J.P.  Health literacy among 
Medicare enrollees in a managed care organization.  Journal of the American 
Medical Association, 1999, 281, 545-551.

Freeman, W.L.  The role of community in research with stored tissue samples.  
Weir R (Ed.)  Stored tissue samples:  Ethical, legal, and public policy 
implications.  University Iowa Press.  Iowa City, IA, 1998, 267-301.

Haynes, M.A. & Smedley, B.D. (Eds.)  The Unequal Burden of Cancer:  An 
Assessment of NIH Programs for Ethnic Minorities and the Medically 
Underserved.  Institute of Medicine.  National Academy Press.  Washington, DC, 
1999.

Macaulay, A.C., Commanda, L.E., Freeman, W.L., Gibson, N., McCabe, M.L., 
Robbins, C.M., & Twohig, P.L., (for the) North American Primary Care Research 
Group.  Participatory research maximises community and lay involvement.  
British Medical Journal, 1999, 319, 774-778.

Minority Economic Profiles.  U.S. Bureau of the Census, Population Division.  
Issued July 24, 1992.  (Tables 1990 CPH -L- 92, 93, 94 and 95).

NIH Publication 98-4247.  Women of Color Health Data Book.  Office of Research 
On Women's Health, Office of the Director, National Institutes of Health, 
1998.

Trends in Indian Health 1998-99.  Program Statistics Team, Office of Public 
Health, Indian Health Service, 2001.

Regional Differences in Indian Health 1998-99.  Program Statistics Team, 
Office of Public Health, Indian Health Service, 2000.

Weiss, B.D., Reed, R.L., & Kligman, E.W.  Literary skills and communication 
methods of low-income older persons.  Patient Education and Counseling, 1995, 
25, 109-119.

Williams, D.R. & Collins, C.  US Socioeconomic and Racial Differences in 
Health:  Patterns and Explanations.  Annual Review of Sociology, 1995, 21:349-
386.

Williams, M.V., Parker, R.M., Baker, D.W., Parikh, N.S., Pitkin, K., Coates, 
W.C., & Nurss, J.R.  Inadequate functional health literacy among patients at 
two public hospitals.  Journal of the American Medical Association, 1995, 274, 
1677-1682.


Weekly TOC for this Announcement
NIH Funding Opportunities and Notices


Office of Extramural Research (OER) - Home Page Office of Extramural
Research (OER)
  National Institutes of Health (NIH) - Home Page National Institutes of Health (NIH)
9000 Rockville Pike
Bethesda, Maryland 20892
  Department of Health and Human Services (HHS) - Home Page Department of Health
and Human Services (HHS)
  USA.gov - Government Made Easy


Note: For help accessing PDF, RTF, MS Word, Excel, PowerPoint, Audio or Video files, see Help Downloading Files.