Full Text HL-97-015
 
SLEEP ACADEMIC AWARD
 
NIH GUIDE, Volume 26, Number 25, August 1, 1997
 
RFA:  HL-97-015
 
P.T.


Keywords: 

 
National Heart, Lung, and Blood Institute
 
Letter of Intent Receipt Date:  November 20, 1997
Application Receipt Date: December 23, 1997
 
THIS RFA USES "JUST-IN-TIME" PROCEDURES.  THIS RFA INCLUDES DETAILED
MODIFICATIONS TO STANDARD APPLICATION INSTRUCTIONS THAT MUST BE
FOLLOWED WHEN PREPARING AN APPLICATION IN RESPONSE TO THIS RFA.
 
PURPOSE
 
The primary objective of this initiative is to encourage the
development and/or improvement of the quality of medical curricula,
physician/patient/nurse and community education, and clinical
practice for the prevention, management, and control of sleep
disorders.  A secondary objective is to promote high quality clinical
research in sleep.
 
HEALTHY PEOPLE 2000
 
The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This RFA,
Sleep Academic Award, is related to the priority areas of heart
disease and stroke, diabetes, chronic disabling conditions, mental
health and disorders, and clinical prevention services.  Potential
applicants may obtain a copy of "Healthy People 2000" (Full Report:
Stock No. 017-001-00474-0 or Summary Report:  Stock No.
017-001-00473-1) through the Superintendent of Documents, Government
Printing Office, Washington, DC 20402-9325 (telephone 202-512-1800).
 
ELIGIBILITY REQUIREMENTS
 
Institutions
 
Applications may be submitted by any domestic university or school of
medicine or osteopathy.  Institutions that have not yet developed a
curriculum in sleep medicine are especially encouraged to apply.
Eligible institutions may submit only one application in each
competition. Institutions that are already receiving support from the
Sleep Academic Award program may not apply for this competition.
 
Institutions may sponsor a candidate experienced in both medical
education and clinical sleep research or a candidate experienced in
clinical sleep research if supported by faculty with expertise in
medical education. Institutions should also be committed to
implementing the curricula development and educational research
programs proposed by candidates. In this competition, there is a
special interest in receiving applications from minority institutions
and institutions with eligible minority faculty members.
 
Candidates
 
A candidate for the Sleep Academic Award must have the following
credentials:
 
o  knowledge and skills in sleep and sleep disorders medicine and a
demonstrated commitment to one or more areas of medical education for
students, physicians, patients, nurses, or the public;
 
o  sufficient post graduate training and experience in clinical sleep
research, clinical practice, and/or medical education to develop and
implement a high quality curriculum in sleep and sleep disorders and
to provide leadership in clinical research on sleep;
 
o  established appointment on the faculty of an accredited school of
medicine or osteopathy in the United States, its territories or its
possessions;
 
o  unqualified support from the Dean and educational leadership of
the institution and;
 
o  be a citizen or non-citizen national of the United States or have
been lawfully admitted to the United States for permanent residence
at the time of application.
 
Individuals who have or have had another NIH career development award
(K series) or a regular research grant (R01) are eligible for a Sleep
Academic Award if the individual meets the requirements of the Sleep
Academic Award program.  Applications from minority individuals and
women are encouraged.
 
MECHANISM OF SUPPORT
 
This RFA is part of the Academic Award Program (K07) of the National
Heart, Lung, and Blood Institute.  Responsibility for the planning,
direction, and execution of the proposed project will be solely that
of the applicant.  The total project period may not exceed five years
and is non-renewable.  Awards will be limited to a maximum of $50,000
for the salary of the Principal Investigator, plus applicable fringe
benefits, and a maximum of $30,000 for technical support.  Facilities
and administrative (indirect) costs may not exceed 8 percent.
 
It is anticipated that support for this program will begin September
1, 1998.
 
Application instructions have been modified to reflect "just-in-time"
streamlining efforts being considered by the NIH.  The just-in-time
concept requires applicants to submit certain materials only when
there is the possibility of an award.  It is anticipated that these
changes will reduce the administrative burden for the applicants,
reviewers, and NHLBI staff. For this RFA, only limited budgetary
information is required in the application.  However, the anticipated
level of effort in all years and a brief description of
responsibilities for the Principal Investigator and key personnel
must be included in the research plan.  Instructions for completing
the Biographical Sketch have been modified.  In addition, the Other
Support information and application "Checklist" page are not required
as part of the initial application.  If the possibility of an award
exists, the Budget, Other Support, and Checklist information will be
requested by NHLBI staff following the initial review.  The
APPLICATION PROCEDURES section of this RFA provides specific details
of these modifications to the standard PHS 398 application kit.
 
FUNDS AVAILABLE
 
It is anticipated that in fiscal year 1998, support will be available
for total costs of approximately $300,000 and that approximately
three to four grants will be awarded under this program.  The actual
number of awards each year, however, will depend upon the merit and
scope of the applications received and the availability of funds.
 
RESEARCH OBJECTIVES
 
Background
 
Recent estimates suggest that as many as 40 million people may suffer
from chronic or intermittent disorders of sleep.  Many remain
undiagnosed and untreated, the consequences of which include reduced
productivity, lowered cognitive performance, increased likelihood of
accidents, higher risk of morbidity and mortality and decreased
quality of life.  It is now apparent that sleep disorders,
disturbances of sleep, and sleep deprivation are major public health
concerns.  Sleep problems occur in both genders, in all races and
socioeconomic groups, and increase with age.
 
National attention has been directed to this problem.  The National
Commission on Sleep Disorders Research submitted their report
entitled "Wake Up America: A National Sleep Alert" to the United
States Congress in January 1993.  The Commission's recommendations
include encouraging broader awareness of sleep and training in sleep
and sleep disorders, spanning the full range of health care
professions, particularly at the primary care level.  Several surveys
have documented that physician training and knowledge about sleep and
sleep disorders is minimal.  For example, in 1978 the American Sleep
Disorders Association (ASDA) conducted a survey of medical school
teaching and found about one third of the medical schools provided
between 1-4 hours of teaching in sleep.  A more recent (1990) survey
found that less than two hours were allocated to teaching about sleep
at one third of the medical schools and one third reported no formal
teaching about sleep.  It was estimated that about 30% of medical
students receive no instruction in sleep.  These results would
suggest that there actually has been a decrease in the amount of
medical school training about sleep.
 
The American Thoracic Society (ATS) surveyed pulmonary residency
training programs and found that 70% had laboratories, but only 29%
had formal training programs about sleep.  Of greater concern was
that 90% of the trainees diagnosed patients with sleep apnea, but
only 33% of the trainees had formal training on how to conduct sleep
studies.  The major obstacles cited for increasing the attention to
sleep in medical schools included low administrative priority, lack
of qualified faculty, and limited curriculum time.
 
Given the limited medical school training about sleep and sleep
disorders, it is not surprising that several surveys have reported
that health practitioners rarely diagnose sleep disorders.  In fact,
primary care physicians scored less than 50% correctly on factual
items for diagnosis and management of sleep disorders.  A 1991 Gallup
survey showed that primary care physicians failed to correctly
diagnose one in three adults with insomnia. Most narcoleptics contact
as many as five physicians before a proper diagnosis is made.
Clearly, physicians are not well trained or knowledgeable about sleep
and sleep disorders.
 
Sleep disorders cut across several medical specialties (e.g.,
neurology, psychiatry, internal medicine, pulmonary medicine, and
otolaryngology etc.), which complicates the development of effective
treatment guidelines and research.  Although most sleep disorders can
be controlled with medical treatment, many patients are not being
diagnosed or receiving state-of-the-art medical care.  This may be
because many people believe that no effective treatments exist and
therefore do not seek medical help. Multidimensional research is
clearly necessary to improve clinical practice and patient education.
 
Therefore, the aim of this program is to improve the quality of
medical education and to stimulate the development of patient and
community education, high quality clinical research programs, and
clinical practice focused on the control of sleep disorders.
Applicants are encouraged to submit program plans in sleep education
and applied research that complement each other.
 
Objectives
 
The objectives of the Sleep Academic Award program include the
following:
 
o  develop high quality curricula in schools of medicine that will
significantly increase the knowledge and skills of students, house
staff, practicing physicians, and others needed to apply
state-of-the-art principles and practice to the prevention,
management, and control of sleep disorders;
 
o  evaluate the impact of the proposed program and assemble
curricular materials that can be adapted and used by other
Institutions;
 
o improve communication among specialists in primary care and other
specialties to ensure appropriate strategies for the treatment of
sleep disorders in patients of various ages and ethnic groups;
 
o foster development of institutional environments facilitating the
interchange of information on advances in sleep research and the
implementation of improved interdepartmental programs with
standardized diagnostic and therapeutic approaches to sleep medicine;
 
o educate community health practitioners and the public about sleep
and sleep disorders through the development of outreach programs,
especially through the enhancement of sleep education programs in
minority medical schools and the communities they serve;
 
o develop the sleep medicine skills of faculty to provide high
quality instruction in the diagnosis and management of sleep
disorders, with special emphasis on minority faculties;
 
o  establish channels of communication between medical educators,
institutions, sleep researchers, and community agencies to enhance
the transfer of knowledge and ideas on educational requirements and
optimal approaches to the prevention and management of sleep
disorders;
 
o contribute to public health efforts to address sleep disorders in
the United States;
 
o  encourage the development of high quality clinical and applied
research in the treatment and control of sleep disorders.
 
In this competition, programs targeted to inner city populations and
to rural areas needing education about sleep and sleep disorders and
to community physicians, nurses, and other health care workers caring
for medically undeserved populations are of particular interest.
 
SPECIAL REQUIREMENTS
 
Applicants should develop a comprehensive program that effectively
addresses the needs in their area and the objectives of this RFA.
The primary focus must be on plans to improve the quality of medical
school education on sleep and sleep disorders for students and
physicians.  Plans and educational materials for curricular
improvements must be of a design that facilitates replication at
other sites.  All applications must also include plans to evaluate
the outcome of educational and research initiatives.  The
responsibilities of the Principal Investigator and key personnel must
be specifically stated at the beginning of the research plan and
placed in the context of other institutional and research
commitments.  Since the Sleep Academic Award primarily provides
support for the salary of the Principal Investigator, applications
that are contingent on receiving support from other agencies and
institutions must specifically identify these resources in
relationship to the program plan.  For revised applications, the
comments of the previous review committee should be specifically
addressed in a
preface to the program plan.
 
INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN
SUBJECTS
 
It is the policy of the NIH that women and members of minority groups
and their subpopulations must be included in all NIH supported
biomedical and behavioral research projects involving human subjects,
unless a clear and compelling rationale and justification is provided
that inclusion is inappropriate with respect to the health of the
subjects or the purpose of the research.  This policy results from
the NIH Revitalization Act of 1993 (Section 492B of Public Law
103-43) and supersedes and strengthens the previous policies
(Concerning the Inclusion of Women in Study Populations, and
Concerning the Inclusion of Minorities in Study Populations), which
have been in effect since 1990. The policy contains some provisions
that are substantially different from the 1990 policies.  All
investigators proposing research involving human subjects should read
the "NIH Guidelines for Inclusion of Women and Minorities as Subjects
in Clinical Research," which have been published in the Federal
Register of March 28, 1994, (F 59 14508-14513), and reprinted in the
NIH GUIDE FOR GRANTS AND CONTRACTS of March 18, 1994, Volume 23,
Number 11.
 
Investigators may obtain copies of the policy from these sources or
from the program staff listed under INQUIRIES.  Program staff may
also provide additional relevant information concerning the policy.
 
Although the Sleep Academic Award is not primarily a mechanism to
support research, it is likely that human subjects will be involved.
Therefore, protection for human subjects must be addressed, and the
approximate percent of women and each minority group that you expect
in the total population must be included.
 
LETTER OF INTENT
 
Prospective applicants are asked to submit, by November 20, 1997, a
letter of intent that includes a descriptive title of the proposed
program plan, the name, address, and telephone number of the
Principal Investigator, the identities of other key personnel,
participating institutions, and the number and title of the RFA in
response to which the application may be submitted. Although a letter
of intent is not required, is not binding, and does not enter into
the review of subsequent applications, the information that it
contains allows NHLBI staff to estimate the potential review workload
and to avoid conflict of interest in the review.  The letter of
intent is to be faxed or sent to Dr. C. James Scheirer, at the
address listed under INQUIRIES.
 
APPLICATION PROCEDURES
 
Applications are to be submitted on the grant application form PHS
398 (rev. 5/95).  These forms are available at most institutional
offices of sponsored research and from the Grants Information Office,
Office of Extramural Outreach and Information Resources, National
Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD
20892-7910, telephone (301) 435-0714, Email:
asknih@odrockm1.od.nih.gov.
 
The RFA label available in the PHS 398 application form must be
affixed to the bottom of the face page of the application.  Failure
to use this label could result in delayed processing of the
application such that it may not reach the review committee in time
for review.  In addition, to identify the application as a response
to this RFA, check "YES" in item 2 of application page 1 and enter
the title "Sleep Academic Award NIH HL-97-015".
 
Use the following modifications in completing the standard PHS 398
application instructions:
 
o  BUDGET INFORMATION - No current/future year budgets or
justifications (Form Pages 4 and 5) are required in the application.
However, the anticipated level of effort in all years and a brief
description of responsibilities for the Principal Investigator and
all key personnel must be specifically stated at the beginning of the
research plan.  Necessary budget information will be requested by
NHLBI staff if there is a possibility for an award.
 
o  BIOGRAPHICAL SKETCH - In addition to the standard information
requested on Form Page 6, the applicant should provide the title and
source of any sponsored support relevant to the proposed research.
 
o  OTHER SUPPORT - No other support information is required on the
"Other Support" page (Form Page 7).  Selected other support
information relevant to the proposed research may be included in the
Biographical Sketch as indicated above.  Complete other support
information will be requested by NHLBI staff if there is a
possibility for an award.
 
o  CHECKLIST - No "Checklist" page is required as part of the initial
application.  A completed Checklist will be requested by NHLBI staff
if there is a possibility for an award.
 
o  FACE PAGE - Currently, the Division of Research Grants requires
that requested costs be reflected on the face page for computer
system tracking purposes.  Because no budgetary information is
required as part of the "streamlined" application, we are requesting
that the following amounts be entered on the face page: 7a. Direct
Costs for Initial Budget Period - $80,000; 7b. Total Costs for
Initial Budget Period - $86,400; 8a. Direct Costs for Proposed Period
of Support - $400,000 and; 8b. Total Costs for Proposed Period of
Support - $432,000.
 
It is understood that these levels are strictly for administrative
purposes and that actual award levels are subject to negotiation,
prior to award.
 
The applicant should provide the name, phone number, and facsimile
phone number of the individual to contact concerning fiscal and
administrative issues if additional information is necessary
following the initial review.
 
Applications not conforming to these guidelines will be considered
unresponsive to this RFA and will be returned without further review.
 
Submit a signed, typewritten original of the application and three
signed, photocopies, in one package to:
 
DIVISION OF RESEARCH GRANTS
NATIONAL INSTITUTES OF HEALTH
6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express courier service)
 
At the time of submission, two additional copies of the application
must be sent to Dr. C. James Scheirer, at the address listed under
INQUIRIES.
 
Applications must be received by December 23, 1997.  If an
application is received after this date, it will be returned to the
applicant without review.  The Division of Research Grants (DRG) will
not accept any application in response to this RFA that is
essentially the same as one currently pending initial review, unless
the applicant withdraws the pending application.  The DRG will also
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.
 
o  If an application is determined to be unresponsive to the RFA, the
principal investigator will be notified and the application returned.
 
The following sections are specific cost guidelines that will apply
to those applications selected for award consideration.
 
1. Principal Investigator's Salary
 
The salary for the Principal Investigator must not exceed the actual
institutional salary rates for the effort being devoted to the
Academic Award.  In addition, salary rates must not exceed an annual
salary level of $125,000 plus fringe benefits (a maximum of $50,000
plus fringe benefits for 40 percent effort).  A candidate must devote
at least 30 percent effort and no greater than 40 percent effort to
this award.
 
The combined efforts of any individual, Principal Investigator or key
personnel, on the Sleep Academic Award and any other non-NIH or
NIH-supported grant(s) or contract(s) must not exceed 100 percent.
 
2.  Program Support
 
Technical support will be provided up to a maximum of $30,000 per
year for the following:
 
o  personnel, other than the Principal Investigator, if requested for
the development, implementation, and evaluation of the program.
Collaborations with consultants possessing medical, educational, or
evaluative expertise complementary to that of the principal
investigator are strongly encouraged.  Salaries and the associated
costs for any personnel other than the Principal Investigator are
limited to the $30,000 per year allowed for technical support.
 
o  consumable supplies essential to the proposed program are
allowable, but equipment costs are not allowable;
 
o  funds for educational development to enable the awardee to develop
educational skills;
 
o  funds for the Principal Investigator to travel and meet with other
investigators and NHLBI staff to exchange ideas, to develop
collaborative projects, and to provide for some needed technical
support.  (Investigators may be requested to meet as a group up to
two times a year; $2,000 should be allocated for this purpose.)
 
3.  Facilities and Administrative Costs
 
Facilities and administrative costs will be provided at eight percent
of the total direct costs of each award excluding equipment.
 
4. Conditions of the Award
 
Institutions must provide documentation that the applicant would have
the necessary time and resources to implement the proposed plan.  In
some cases, it may be necessary for the applicant to be relieved of
some responsibilities for the five years of the grant award in order
to implement the proposed plan.
 
An institution is expected to apply on behalf of a named individual
meeting the criteria for this award. Only one application may be
submitted from each eligible institution in each competition. Awards
will be limited to one from each eligible school over the life of the
award.  After the first year, grants will be renewed for a maximum of
four years on a noncompetitive basis depending upon progress in
meeting the program's objectives and the availability of funds. An
annual report that summarizes curriculum development at the
institution, other elements of the program plan, and the outline of
future plans will be required.  This report will serve as the
principal basis for renewal of the grant.
 
Awards may not be transferred from one institution to another.  If a
principal investigator moves to another institution, the award will
continue at the original institution only upon acceptance by the
National Heart, Lung and Blood Institute of a suitable replacement
proposed by the grantee institution.  Such a replacement will not
lengthen the overall term of the award.
 
REVIEW CONSIDERATIONS
 
Upon receipt, applications will be reviewed for completeness by the
DRG and responsiveness to this RFA by NHLBI.  Incomplete or
non-responsive applications will be returned to the applicant without
further consideration. Applications will be evaluated for scientific
and technical merit by an appropriate peer review group convened by
the Division of Extramural Affairs, NHLBI.  The roster of the review
panel may be found on the NHLBI home page
(gopher://fido.nhlbi.nih.gov:70/11/nhlbi/about/meet/sep/irsep)
approximately one month prior to the review date.
 
As part of the initial merit review, all applications will receive a
written critique and undergo a review in which only those
applications deemed to have the highest scientific merit of the
applications under review (usually two to three times the number of
applications that the NHLBI and participating Institutes anticipate
funding under the program) will be discussed, assigned a priority
score, and receive a second level review by the National Heart, Lung,
and Blood Advisory Council.
 
Review Criteria
 
Applications for this Sleep Academic Award will be evaluated in terms
of the following criteria:
 
o  qualifications and effort level of the candidate and key
personnel, including pertinent experience in teaching, curriculum
development, program evaluation, administration, and clinical
research program planning and conduct;
 
o  plans to develop, improve, and integrate an interdepartmental
curricula in sleep medicine with existing institutional training
programs for medical students, graduates, and post-graduates;
 
o  plans to evaluate all proposed educational interventions,
including strategies for both process and impact evaluation;
 
o  plans for communication and interdepartmental collaboration
between medical specialists in appropriate disciplines to ensure the
development, implementation, and evaluation of optimal treatment and
educational programs;
 
o  plans and ability to work cooperatively with other investigators
developing innovative and portable curricular materials in sleep
medicine for replication at other sites;
 
o  the potential impact of the program on the degree of sleep
medicine training and on the prevention, management, and control of
sleep disorders within the population to be served;
 
o  plans for community outreach or collaborative projects with
organizations having responsibility for or interest in sleep
disorders, such as community centers, health departments, medical and
nursing associations, voluntary health agencies, and home care
agencies;
 
o  description of the need for this program and the magnitude of
sleep disorders within the population to be served;
 
o  overall merit and feasibility of the proposed five year plan;
 
o  institutional commitment to implement the proposed curriculum and
to maintain a program in education about sleep and sleep disorders
after the termination of the award.
 
AWARD CRITERIA
 
The anticipated date of award is September 1, 1998.  Factors that
will be taken into consideration in making awards include the
scientific merit of the proposed program as evidenced by the priority
score and the availability of funds. Subject to the availability of
necessary funds and consonant with the objectives of the Sleep
Academic Award, the NHLBI will provide funds for a project period up
to five years.
 
INQUIRIES
 
Inquiries concerning this RFA are encouraged. The opportunity to
clarify issues or answer questions from potential applicants is also
welcomed.
 
Direct inquiries regarding programmatic issues to:
 
Michael J. Twery, Ph.D.
Division of Lung Diseases
National Heart, Lung, Blood Institute
6701 Rockledge Drive, Suite 10018, MSC-7952
Bethesda, MD  20892-7952
Telephone:  (301) 435-0202
FAX:  (301) 480-3557
Email:  TweryM@gwgate.nhlbi.nih.gov
 
James P. Kiley, Ph.D.
National Center on Sleep Disorders Research
6701 Rockledge Drive, Suite 7024, MSC-7920
Bethesda, MD  20892-7920
Telephone:  (301) 435-0199
FAX:  (301) 480-3451
Email:  KileyJ@nih.gov
 
Direct inquiries regarding review matters to:
 
C. James Scheirer, Ph.D.
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
6701 Rockledge Drive, Room 7220, MSC 7924
Bethesda, MD  20892-7924
Telephone:  (301) 435-0266
FAX:  (301) 480-3541
Email:  ScheireJ@NIH.GOV
 
Direct inquiries regarding fiscal matters to:
 
Raymond L. Zimmerman
Grants Operations Branch
National Heart, Lung, and Blood Institute
6701 Rockledge Drive, Room 7154
Bethesda, MD  20892-7926
Telephone:  (301) 435-0171
FAX:  (301) 480-3310
Email:  ZimmermR@NIH.GOV
 
AUTHORITY AND REGULATIONS
 
This program is described in the Catalog of Federal Domestic
Assistance No. 93.838.  Grants are made under the authorization of
the Public Health Service Act, Title III, Section 301 (Public Law
78-410, as amended by Public Law 99-158, 42 US 241 and 285) and
administered under PHS grants policies and Federal Regulations 42 CFR
52 and 45 CFR Part 74. This program is not subject to the
intergovernmental review requirements of Executive Order 12372 or to
a review by a Health Systems Agency.
 
The PHS strongly encourages all grant recipients to provide a
smoke-free workplace and promote the non-use of all tobacco products.
In addition, Public Law 103-227, the Pro-Children Act of 1994,
prohibits smoking in certain facilities (or in some cases, any
portion of a facility) in which regular or routine education,
library, day care, health care or early childhood development
services are provided to children.  This is consistent with the PHS
mission to protect and advance the physical and mental health of the
American people.
 
.

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