Infectious Agents in the Origins of Chronic Lung Disease

RFA Number: RFA-HL-05-005

Part I Overview Information

• The NHLBI invites applications for research projects that will investigate the contribution of known or unknown infectious agents, or infectious agents-derived bioproducts, to the early origin of chronic lung diseases in humans. Novel, high risk studies that employ state of the art technologies in the areas of molecular biology, genomics and proteomics are encouraged.
• The NHLBI intends to commit approximately $4 million in FY 06.
• The NHLBI anticipates 10-12 awards.
• This RFA will use the NIH R01 grant mechanisms.
• Eligible organizations include: For-profit or non-profit organizations, public or private institutions, such as universities, colleges, hospitals, and laboratories, units of State and local governments, eligible agencies of the Federal government, domestic institutions/organizations, and foreign institutions that offer unusual talent, resources, populations, or environmental conditions that are not readily available in the United States or that augment existing U.S. resources.
• Eligible principal investigators include any individual with the skills, knowledge, and resources necessary to carry out the proposed research. Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH programs.
• Each applicant may submit one application.
• The PHS 398 document is available at http://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive format. For further assistance contact GrantsInfo, Telephone (301) 710-0267, Email: GrantsInfo@nih.gov.

Telecommunications for the hearing impaired: TTY 301-451-5936

Table of Contents

Part II - Full Text of Announcement

1. Research Objectives

• Nature of the research opportunity
• Pertinent background information that establishes the need for the research
• Scientific knowledge to be achieved through research supported by the special program
• Objective of this research program
• Identify the types of research and experimental approaches that are being sought to achieve the objectives

The purpose of this RFA is to solicit applications to investigate the contribution of known or unknown infectious agents, or infectious agents-derived bioproducts, to the early origin of chronic lung diseases in humans.

Chronic pulmonary diseases cause substantial morbidity and mortality among people of all ages and represent a huge public health burden with an estimated cost of 50 billion dollars a year in the United State. Some studies suggest that the chronic inflammation, tissue remodeling, and progressive loss of function that are observed in these conditions could result from incompletely resolved lung infections. Also, while infection may not be the single explanation or cause of chronic lung diseases, infectious agents may serve as co-factors or triggers of inflammation or abnormal cell growth and proliferation in genetically susceptible individuals. Examples of relevant findings that may lead to insight into the pathogenesis of some chronic lung diseases are: detection of human herpesvirus-8 (HHV-8), which is linked to the development of Kaposi's sarcoma and Castleman's disease, in tissues of individuals affected by primary pulmonary hypertension (PPH). Multiple herpes viruses, including Epstein Barr virus, Cytomegalovirus, and herpes viruses 7 and 8, in a majority of interstitial pulmonary fibrosis (IPF) tissues. Viral infections have been implicated in the etiology of sarcoidosis, and latent adenovirus infections may enhance the inflammatory reactions in COPD.

Also, Chlamydia pneumoniae has been linked to interstitial pneumonia, sarcoidosis, hypersensitivity pneumonitis and other chronic lung diseases. The search for an infectious agent in the pathogenesis of the non-caseating granuloma that is the hallmark of sarcoidosis has been so far unsuccessful. There have been reports of identification of genetic material belonging to various infectious agents in patients' lesions, but the epidemiological criteria for establishing an infectious agent as the cause of the disease, such as consistent isolation of the agent from cases, have not been satisfied. The identification of a contributing infectious agent in a lung disease could have a tremendous impact on public health strategies for prevention and control. For some of these diseases, the establishment of an infectious agent as the cause or a contributor to morbidity could revolutionize our approaches to therapy and improve long term survival for many affected individuals.

The NHLBI strongly encourages investigators with expertise in infectious diseases (especially virology, bacteriology, and mycology) to participate in this program in collaboration with pulmonologists, pulmonary pathologists, immunologists, and molecular biologists. An important goal of this program is to move the research on infectious agents and chronic lung diseases beyond associative or correlative studies, by supporting projects designed to yield definitive proof-of-principle information also through use of appropriate animal models. It is expected that investigators will capitalize

on and include research advances and state-of-the-art and/or cutting-edge techniques from the fields of cell biology, genomics, proteomics, and genetics (e.g., real-time analyses of gene expression) in their proposed research programs. Multidisciplinary approaches are encouraged.

Research projects supported through this RFA may employ a variety of experimental approaches, including studies of biological (tissues, cells, fluids) specimens from affected individuals, animal model systems and research on the potential role of novel pathogens. Diseases for which evidence already exists for possible involvement of an infectious agent are good candidates for this initiative. Applicants are encouraged to use existing populations as appropriate to address the question in humans and to establish collaborations with existing clinical research networks and clinical studies that have experience in phenotyping the lung diseases of interest. Utilization of existing human tissue repositories obtained from well characterized populations as well as the resources of the recently established NHLBI Lung Tissue Research Consortium are also encouraged as a source of tissues.

All grant applications submitted in response to this RFA should include sample size and statistical power calculations appropriate to the proposed study design.

Areas of research that are encouraged include the following:

• Well controlled studies to detect foreign genetic materials in specific chronic lung diseases (e.g. sarcoidosis, IPF, primary pulmonary hypertension etc.) and establish the role of this agent in the pathogenesis of the disease;
• Identification and characterization of infected cells through use of state-of-the-art and/or cutting-edge techniques involving the use of laser confocal microscopy, laser microdissection analysis, and/or conventional immunohistochemistry and molecular biology are encouraged as are methods to isolate, characterize, and propagate infectious agents from human specimens with the goal of determining their role(s) in the disease-associated pathological process(es);
• Characterization of direct, specific molecular interactions between genomes/gene products of infectious agents and infected cells, and the resulting altered cell phenotype and functions; study of indirect or systemic effects of infectious agents harbored in lung cells and inflammatory cells present at the site, such as macrophages and lymphocytes; studies of specific mechanisms by which infectious agents might modify the lung microenvironment at both the genetic and phenotypic levels;
• Identification of foreign proteins or altered human proteins and explore the functions of these proteins in biological pathways involved in a disease through use of state-of-the-art proteomic techniques that allow analyses of the protein contents of disease-associated pathological lesions;
• Mechanistic studies of infectious agents as co-factors in the etiology of chronic lung disease(s) and as triggers of inflammation or abnormal cell growth in genetically susceptible individuals;
• Establishment of an animal model to reproduce or mimic a chronic lung disease in humans for which there is already sufficient associative/correlative data to implicate as etiologic role for a specific microbial agent; specific aims should include studies elucidating the underlying pathogenetic mechanism. In addition, plans to disseminate the animal models and willingness to share them with the scientific community are expected to be part of these proposals;
• Utilization of non-linear mathematical and computerized modeling techniques coupled with bench studies to elucidate interactions between host(s) and microbe(s), and also for the purposes of generating new hypotheses, analyzing large data sets, and identifying potential therapeutic targets along pathways critical for the development of chronic lung disease(s).

Certain types of investigations, although potentially of scientific interest, will not be considered for support by this program. It is particularly recommended that prospective applicants make inquiries, especially regarding scientific/research issues, as soon as possible (i.e., considerably in advance of submitting the application). Doing so it will allow a preliminary evaluation of responsiveness to be made at an early stage and will help to prevent the preparation and/or submission of an unresponsive application.

Applications proposing the following types of studies will be considered non-responsive to the RFA:

• Applications that propose development of animal models without plans to study the underlying molecular mechanisms
• Applications that explore mechanisms of exacerbation or reactivation of chronic lung diseases
• Applications that involve investigations of the role(s) of HIV infection(s) in lung disease(s)
• Applications that propose large clinical epidemiological studies
• Applications that do not involve studies of human subjects or of materials (e.g., tissues, cells, or bodily fluids) obtained from participating human subjects

Section II. Award Information

2. Funds Available

The NHLBI intends to commit approximately $4,000,000 in FY 2006 to fund 10 to 12 new grants in response to this RFA. An applicant may request a project period of up to 4 years and a budget for direct costs of up to $250,000. Since the total costs for a subcontract or consortium are included in the direct cost request, one additional module of $25,000 above the $250,000 cap may be requested for the facilities and administrative costs associated with third party agreements. A module requested for this purpose must be clearly identified in the budget justification section of the application, and will be restricted for this purpose only at the time of award. Because the nature and scope of the proposed research will vary from application to application, it is anticipated that the size and duration of each award will also vary. Although the financial plans of the NHLBI provide support for this program, awards pursuant to this RFA are contingent upon the availability of funds and the receipt of a sufficient number of meritorious applications.

Section III. Eligibility Information

• For-profit organizations
• Non-profit organizations
• Public or private institutions, such as universities, colleges, hospitals, and laboratories
• Units of State government
• Units of local government
• Eligible agencies of the Federal government
• Domestic institutions/organizations
• Foreign institutions that offer unusual talent, resources, populations, or environmental conditions that are not readily available in the United States or that augment existing U.S. resources.

1.B. Eligible Individuals

Any individual with the skills, knowledge, and resources necessary to carry out the proposed research is invited to work with his/her institution to develop an application for support. Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH programs.

2. Cost Sharing
Not Applicable

3. Other-Special Eligibility Criteria

Investigators applying for funding through this RFA should provide proof of access to the human biological samples of interest from patients and subjects who have given appropriate informed consents and who have been appropriately studied in terms of clinical and biological markers. This proof in form of a letter of collaboration should indicate the number of samples available and their status (i.e., formalin/frozen).

In order to be considered for funding applications conducting molecular epidemiological studies should select a sample size that will allow for the results to be statistically valid.

Grantees will meet annually at or near the NIH in Bethesda, MD, to share results, to ensure that NHLBI has a coherent view of the advances in the field, and to have opportunities for collective problem solving among investigators. Every applicant should include a budget request for travel in his/her requested budget that covers the travel-related expenses of the principal investigator and one additional young investigator for attendance at these annual meetings.

Section IV. Application and Submission Information

3.A.1. Letter of Intent

Prospective applicants are asked to submit a letter of intent that includes the following information:

• Descriptive title of proposed research
• Name, address, and telephone number of the Principal Investigator
• Names of other key personnel
• Participating institutions
• Number and title of this funding opportunity

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 IC staff to estimate the potential review workload and plan the review.

The letter of intent is to be sent by the date listed at the beginning of this document.

The letter of intent should be sent to:

Valerie Prenger, Ph.D.
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
Rockledge II, Room 7194
6701 Rockledge Drive
Bethesda, MD 20892-7924
Telephone: (301) 435-0288
FAX: (301) 480-4755
Email: prengerv@nhlbi.nih.gov

3.B. Sending an Application to the NIH

Applications must be prepared using the PHS 398 research grant application instructions and forms as described above. Submit a signed, typewritten original of the application, including the checklist, and three signed photocopies in one package to:

Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD 20892-7710 (U.S. Postal Service Express or regular mail)
Bethesda, MD 20817 (for express/courier service; non-USPS service)

At the time of submission, two additional copies of the application and all copies of the appendix material must be sent to:

Valerie Prenger, Ph.D.
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
Rockledge II, Room 7194
6701 Rockledge Drive
Bethesda, MD 20892-7924
Telephone: (301) 435-0288
FAX: (301) 480-4755
Email: prengerv@nhlbi.nih.gov

Using the RFA Label: The RFA label available in the PHS 398 application instructions 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.

3.C. Application Processing

Applications must be received on or before the application receipt date listed in the heading of this funding opportunity. If an application is received after that date, it will be returned to the applicant without review. Applications will be evaluated for completeness by CSR.

The NIH will not accept any application in response to this funding opportunity that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. However, when a previously unfunded application, originally submitted as an investigator-initiated application, is to be submitted in response to a funding opportunity, it is to be prepared as a NEW application. That is, the application for the funding opportunity must not include an Introduction describing the changes and improvements made, and the text must not be marked to indicate the changes from the previous unfunded version of the application.

Although there is no immediate acknowledgement of the receipt of an application, applicants are generally notified of the review and funding assignment within eight (8) weeks.

4. Intergovernmental Review

This initiative is not subject to intergovernmental review

5. Funding Restrictions

All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement. The Grants Policy Statement can be found at http://grants.nih.gov/grants/policy/policy.htm (See also Section VI.3. Award Criteria)

6. Other Submission Requirements

Specific Instructions for Modular Grant applications.

Applications requesting up to $250,000 per year in direct costs must be submitted in a modular budget format. The modular budget format simplifies the preparation of the budget in these applications by limiting the level of budgetary detail. Applicants request direct costs in $25,000 modules. Section C of the research grant application instructions for the PHS 398 (rev. 5/2001) at http://grants.nih.gov/grants/funding/phs398/phs398.html includes step-by-step guidance for preparing modular budgets. Additional information on modular budgets is available at http://grants.nih.gov/grants/funding/modular/modular.htm.

Plan for Sharing Research Data
Not applicable.

Sharing Research Resources
Not applicable.

Section V. Application Review Information

1. Criteria
Not applicable.

2. Review and Selection Process

Upon receipt, applications will be reviewed for completeness by the CSR and responsiveness by the NHLBI . Incomplete and/or nonresponsive applications will not be reviewed.

Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened by NHLBI in accordance with the review criteria stated below.

As part of the initial merit review, all applications will:

• Undergo a selection process in which only those applications deemed to have the highest scientific merit, generally the top half of applications under review, will be discussed and assigned a priority score.
• Receive a written critique
• Receive a second level of review by the National Heart, Lung, and Blood Advisory Council.

3. Merit Review Criteria

The goals of NIH supported research are to advance our understanding of biological systems, to improve the control of disease, and to enhance health. In their written critiques, reviewers will be asked to comment on each of the following criteria in order to judge the likelihood that the proposed research will have a substantial impact on the pursuit of these goals. Each of these criteria will be addressed and considered in assigning the overall score, weighting them as appropriate for each application. Note that an application does not need to be strong in all categories to be judged likely to have major scientific impact and thus deserve a high priority score. For example, an investigator may propose to carry out important work that by its nature is not innovative but is essential to move a field forward.

1. Significance . Does this study address an important problem? If the aims of the application are achieved, how will scientific knowledge or clinical practice be advanced? What will be the effect of these studies on the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?

2. Approach . Are the conceptual or clinical framework, design, methods, and analyses adequately developed, well integrated, well reasoned, and appropriate to the aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics?

3. Innovation . Is the project original and innovative? For example: Does the project challenge existing paradigms or clinical practice; address an innovative hypothesis or critical barrier to progress in the field? Does the project develop or employ novel concepts, approaches, methodologies, tools, or technologies for this area?

4. Investigators . Are the investigators 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? Does the investigative team bring complementary and integrated expertise to the project (if applicable)?

5 . Environment . Does the scientific environment in which the work will be done contribute to the probability of success? Do the proposed studies benefit from unique features of the scientific environment, or subject populations, or employ useful collaborative arrangements? Is there evidence of institutional support?

3.A. Additional Review Criteria:

In addition to the above criteria, the following items will be considered in the determination of scientific merit and the priority score:

Protection of Human Subjects from Research Risk : The involvement of human subjects and protections from research risk relating to their participation in the proposed research will be assessed (see the Research Plan, Section E on Human Subjects in the PHS Form 398).

Inclusion of Women, Minorities and Children in Research: The adequacy of plans to include subjects from both genders, all racial and ethnic groups (and subgroups), and children as appropriate for the scientific goals of the research will be assessed. Plans for the recruitment and retention of subjects will also be evaluated (see the Research Plan, Section E on Human Subjects in the PHS Form 398).

Care and Use of Vertebrate Animals in Research: If vertebrate animals are to be used in the project, the five items described under Section F of the PHS Form 398 research grant application instructions will be assessed.

3.B. Additional Review Considerations

Budget: The reasonableness of the proposed budget and the requested period of support in relation to the proposed research. The priority score should not be affected by the evaluation of the budget.

3.C. Sharing Research Data
Not applicable.

3.D. Sharing Research Resources
Not applicable.

Section VI. Award Administration Information

• Scientific merit of the proposed project as determined by peer review
• Availability of funds
• Relevance of program priorities

4. Reporting

Awardees will be required to submit the PHS Non-Competing Grant Progress Report, Form 2590 annually:
http://grants.nih.gov/grants/funding/2590/2590.htm and financial statements as required in the NIH Grants Policy Statement.

Section VII. Agency Contacts

Required Federal Citations

Use of Animals in Research:
Recipients of PHS support for activities involving live, vertebrate animals must comply with PHS Policy on Humane Care and Use of Laboratory Animals (http://grants.nih.gov/grants/olaw/references/PHSPolicyLabAnimals.pdf), as mandated by the Health Research Extension Act of 1985 (http://grants.nih.gov/grants/olaw/references/hrea1985.htm), and the USDA Animal Welfare Regulations (http://www.nal.usda.gov/awic/legislat/usdaleg1.htm), as applicable.

Human Subjects Protection:
Federal regulations (45CFR46) require that applications and proposals involving human subjects must be evaluated with reference to the risks to the subjects, the adequacy of protection against these risks, the potential benefits of the research to the subjects and others, and the importance of the knowledge gained or to be gained. http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm.

Data and Safety Monitoring Plan:
Data and safety monitoring is required for all types of clinical trials, including physiologic toxicity, and dose-finding studies (phase I); efficacy studies (Phase II) efficacy, effectiveness and comparative trials (Phase III). Monitoring should be commensurate with risk. The establishment of data and safety monitoring boards (DSMBs) is required for multi-site clinical trials involving interventions that entail potential risks to the participants. (NIH Policy for Data and Safety Monitoring, NIH Guide for Grants and Contracts, June 12, 1998: http://grants.nih.gov/grants/guide/notice-files/not98-084.html).

Sharing Research Data:
Investigators submitting an NIH application seeking $500,000 or more in direct costs in any single year are expected to include a plan for data sharing or state why this is not possible. http://grants.nih.gov/grants/policy/data_sharing

Investigators should seek guidance from their institutions, on issues related to institutional policies, local IRB rules, as well as local, State and Federal laws and regulations, including the Privacy Rule. Reviewers will consider the data sharing plan but will not factor the plan into the determination of the scientific merit or the priority score.

Sharing of Model Organisms:
NIH is committed to support efforts that encourage sharing of important research resources including the sharing of model organisms for biomedical research (see http://grants1.nih.gov/grants/guide/notice-files/NOT-OD-04-042.html). At the same time the NIH recognizes the rights of grantees and contractors to elect and retain title to subject inventions developed with Federal funding pursuant to the Bayh Dole Act (see the NIH Grants Policy Statement http://grants.nih.gov/grants/policy/nihgps_2003/index.htm). All investigators submitting an NIH application or contract proposal beginning with the October 1, 2004 receipt date, are expected to include in the application/proposal a description of a specific plan for sharing and distributing unique model organism research resources generated using NIH funding or state why such sharing is restricted or not possible. This will permit other researchers to benefit from the resources developed with public funding. The inclusion of a model organism sharing plan is not subject to a cost threshold in any year and is expected to be included in all applications where the development of model organisms is anticipated.

Inclusion of Women And Minorities in Clinical Research:
It is the policy of the NIH that women and members of minority groups and their sub-populations must be included in all NIH-supported clinical research projects unless a clear and compelling justification is provided indicating that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43). All investigators proposing clinical research should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html); a complete copy of the updated Guidelines is available at http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm. The amended policy incorporates: the use of an NIH definition of clinical research; updated racial and ethnic categories in compliance with the new OMB standards; clarification of language governing NIH-defined Phase III clinical trials consistent with the new PHS Form 398; and updated roles and responsibilities of NIH staff and the extramural community. The policy continues to require for all NIH-defined Phase III clinical trials that: a) all applications or proposals and/or protocols must 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) investigators must report annual accrual and progress in conducting analyses, as appropriate, by sex/gender and/or racial/ethnic group differences.

Inclusion of Children as Participants in Clinical Research:
The NIH maintains a policy that children (i.e., individuals under the age of 21) must be included in all clinical research, conducted or supported by the NIH, unless there are scientific and ethical reasons not to include them.

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 is available at http://grants.nih.gov/grants/funding/children/children.htm.

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 applications for research involving human subjects and individuals designated as key personnel. The policy is available at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

Human Embryonic Stem Cells (hESC):
Criteria for federal funding of research on hESCs can be found at http://stemcells.nih.gov/index.asp and at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html. Only research using hESC lines that are registered in the NIH Human Embryonic Stem Cell Registry will be eligible for Federal funding (see http://escr.nih.gov/ ) It is the responsibility of the applicant to provide in the project description and elsewhere in the application as appropriate, the official NIH identifier(s) for the hESC line(s)to be used in the proposed research. Applications that do not provide this information will be returned without review.

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 PA 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.

Standards for Privacy of Individually Identifiable Health Information:
The Department of Health and Human Services (DHHS) issued final modification to the "Standards for Privacy of Individually Identifiable Health Information", the "Privacy Rule", on August 14, 2002 . The Privacy Rule is a federal regulation under the Health Insurance Portability and Accountability Act (HIPAA) of 1996 that governs the protection of individually identifiable health information, and is administered and enforced by the DHHS Office for Civil Rights (OCR).

Decisions about applicability and implementation of the Privacy Rule reside with the researcher and his/her institution. The OCR website (http://www.hhs.gov/ocr/) provides information on the Privacy Rule, including a complete Regulation Text and a set of decision tools on "Am I a covered entity?" Information on the impact of the HIPAA Privacy Rule on NIH processes involving the review, funding, and progress monitoring of grants, cooperative agreements, and research contracts can be found at http://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-025.html.

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. Furthermore, we caution reviewers that their anonymity may be compromised when they directly access an Internet site.

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 PA 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.

Authority and Regulations:
This program is described in the Catalog of Federal Domestic Assistance at http://www.cfda.gov/ and is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement. The NIH Grants Policy Statement can be found at http://grants.nih.gov/grants/policy/policy.htm.

The PHS strongly encourages all grant recipients to provide a smoke-free workplace and discourage the 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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