Full Text OD-97-001 INFORMED CONSENT IN RESEARCH INVOLVING HUMAN PARTICIPANTS NIH GUIDE, Volume 25, Number 32, September 27, 1996 RFA: OD-97-001 P.T. 34 Keywords: Human Subjects Policy National Cancer Institute National Center for Human Genome Research National Institute on Aging National Institute on Alcohol Abuse and Alcoholism National Institute of Allergy and Infectious Diseases National Institute of Child Health and Human Development National Institute on Drug Abuse National Institute of Mental Health National Institute of Nursing Research Office of Extramural Research Department of Energy Department of Veteran Affairs Application Receipt Date: March 11, 1997 PURPOSE The National Cancer Institute (NCI), the National Center for Human Genome Research (NCHGR), the National Institute on Aging (NIA), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Allergy and Infectious Diseases ((NIAID), the National Institute of Child Health and Human Development (NICHD), the National Institute on Drug Abuse (NIDA), the National Institute of Mental Health (NIMH), the National Institute of Nursing Research (NINR), the Department of Energy (DOE), and the Department of Veterans Affairs (VA) invite applications for a three year research grant program to stimulate investigations into the informed consent process in scientific research. There is an ethical as well as a legal responsibility to ensure that individuals both consent to and understand their participation in research. For consent to participate in research to be truly informed, the information imparted to potential participants must clearly explain study procedures, distinguish research from treatment, realistically portray the potential for medical or other benefits from participation and the nature of potential benefit, carefully explain the potential for discomfort, toxicity, or other risks that may accompany participation in the research, and clearly delineate the participant~s rights and limits regarding confidentiality and withdrawal from participation. The sponsoring organizations are jointly issuing this Request for Applications (RFA) because voluntary informed consent is the defining aspect of interactions between researchers and participants, and is integral to the conduct of the scientific research funded by all of these organizations. One of the goals of this RFA is to bring together perspectives of these different agencies, since their different research foci reflect a diversity of issues relating to informed consent. Of course, many facets of understanding the informed consent process are shared, and hence a combined effort is efficient for the agencies and scientists alike. Little empirical work exists to document the degree of understanding achieved by research participants regarding: (1) identity of the sponsoring federal agency or agencies; (2) purposes for which the research is being conducted; (3) comprehension of a study's methods and procedures; (4) relative risks and benefits (including financial) of deciding to consent or refuse participation; (5) confidentiality and any exceptions to confidentiality; (6) the implications of withdrawal from a study and (7) planned and other possible use of the data. Such data should be useful in designing informed consent procedures that are readily comprehended by prospective participants and impart all critical information. The goal of the present initiative is to develop and test alternative strategies for obtaining informed consent in diverse populations and determine optimal ways to obtain informed consent for research participation. ELIGIBILITY Applications may be submitted by any domestic or foreign, for-profit or non-profit organizations, public or private, such as universities, colleges, hospitals, laboratories, units of State and local governments, or eligible agencies of the Federal government. Racial/ethnic minority individuals, women, and persons with disabilities are encouraged to apply as Principal Investigators. MECHANISM OF SUPPORT This RFA will use the NIH individual research project grant (R01) mechanism of support. However, specific application instructions have been modified to reflect "MODULAR GRANT" and "JUST-IN-TIME" procedures being used under an NIH Reinvention Initiative. The modular grant concept established specific modules (increments) in which direct costs may be requested as well as a maximum level for requested budgets. Only limited budgetary information is required under the approach. The just-in-time concept allows applicants to submit certain information only when there is a possibility for an award. It is anticipated that these changes will reduce the administrative burden for the applicants, reviewers, and government staff. For this RFA, funds must be requested in $50,000 direct cost modules and a maximum of four modules ($200,000 direct costs) per year may be requested. A feature of the modular grant concept is that no escalation is provided for future years, and all anticipated expenses for all years of the project must be included within the number of modules being requested. Only limited budget information will be required and any budget adjustments recommended by the Initial Review Group will be in modules of $50,000. In accordance with JUST-IN-TIME procedures, instructions for completing the Biographical Sketch have also been modified. In addition, Other Support information and the application Checklist page are not required as part of the initial application. If the initial review suggests that there is a possibility for an award, the necessary budget, Other Support, and Checklist information will be requested by NIH staff. The APPLICATION PROCEDURES section of this RFA provides specific details of modifications to standard PHS 398 application kit instructions. FUNDS AVAILABLE It is anticipated that for fiscal year 1997, $2,250,000 total funds (direct and indirect costs) will be available. Award of grants pursuant to this RFA is contingent upon receipt of such funds for this purpose. Between 8 to 11 awards are anticipated. The exact amount of funding awarded will depend on the quality of applications and the availability of funds. Applicants are requested to furnish estimates of the time required to achieve the objective of the proposed research project. Applicants may request support for up to three years. The usual PHS policies governing grants administration and management will apply. Annual awards will be made, subject to continued availability of funds and progress achieved. This RFA is a one-time solicitation. At the end of the official award period, competitive renewal applications may be submitted for peer review and competition for support through the regular grant programs of the NIH. It is anticipated that awards resulting from RFA OD-97-001 will begin October 1, 1997. Administrative adjustments in project period of amount of support may be required at the time of the award. Since a variety of approaches would represent valid responses to this RFA, it is anticipated that there will be a range of costs among the grants awarded. All current policies and requirements that govern the research grant programs of the NIH will apply to grants awarded in connection with this RFA. RESEARCH OBJECTIVES Background This RFA is a joint effort of the Department of Health and Human Services, the Department of Energy, and the Department of Veterans Affairs. The co-sponsoring organizations share a common vision of how research should be conducted, as indicated by their support of the common rule (45 CFR Part 46, Subpart A: June 18, 1991). This program is being coordinated under the auspices of the Office of Extramural Research (OER) Office of the Director, of the National Institutes of Health. The OER is responsible for developing regulations, policies, and procedures concerning the NIH extramural program, including the oversight of the protection of human subjects for the entire Department of Health and Human Services. Several of NIH's Institutes and Centers have joined together in the support of this project, and each seeks to encourage research related to its own mission. The NCHGR supports research activities that address the ethical, legal, and social issues that may arise from human genetics research, and is especially interested in research on informed consent as it pertains to participation in genetics research, the role of IRBs in dealing with genetics research, the involvement of individuals and families in genetics research, policies related to maintaining privacy and confidentiality of genetic information obtained through genetics research participation, issues raised by the commercialization of products from genetics research, and issues surrounding the development and use of experimental gene-based diagnostic tools and therapies. The National Cancer Institute seeks to advance understanding of the informed consent process by supporting research to simplify the process, improve comprehension, and to identify methods to provide study-specific information to diverse populations in cancer prevention and treatment trials. The National Institute on Aging conducts and supports biomedical, social, and behavioral research and training related to the special needs and capacities of elderly participants in research, and is particularly interested in the role of cognitive function in aging, and the ability of the elderly to understand and remember so that information related to the consent process is meaningful. The National Institute on Alcohol Abuse and Alcoholism is interested in research designed to improve the informed consent process for clinical research, especially with regard to special populations such as women of child bearing age, alcohol dependent individuals, and individuals with a family history of alcohol problems. The National Institute of Allergy and Infectious Diseases supports research to prevent and treat allergic and immunologic diseases and disorders, and is interested in research to enhance the process of informed consent for participation in a variety of clinical trials, including asthma, transplantation, sexually transmitted disease, and HIV therapies, vaccines and other preventative measures. The National Institute of Child Health and Human Development supports research on biological and behavioral human development, including reproduction and population studies, perinatal biology, maternal and infant well-being, congenital defects, developmental biology and nutrition, human learning and behavior, mental retardation and developmental disabilities, and medical rehabilitation. The National Institute of Drug Abuse supports research on the causes and consequences, prevention, and treatment of drug abuse and addiction, and is interested in research to understand and improve the informed consent process for participation in clinical research. The National Institute of Mental Health conducts and supports research on mental illness and mental health, including studies of the brain, behavior, and mental health services, and is interested in research to understand and enhance the informed consent process for participation in clinical mental health research. Finally, the National Institute of Nursing Research is interested in establishing better approaches to promoting health and preventing disease; and to improving clinical environments by testing interventions that influence patient health outcomes and participation in clinical research. Joining the NIH in funding this RFA is the Department of Energy (DOE), Office of Health and Environmental Research (OHER) which supports fundamental science to identify, understand, and anticipate the long-term health and environmental consequences of energy production, development, and use. With respect to this RFA, the DOE is particularly interested in consent issues arising in research related to mapping the structure of the human genome, developing advanced medical technologies and radiopharmaceutical. and determining biological structure and function at the molecular and cellular level. Also co-sponsoring this RFA is the Department of Veterans Affairs (VA), which conducts biomedical, health services, and rehabilitation research related to the special needs of veterans. The VA seeks to ensure that clinical research in its medical centers is conducted in full compliance with the spirit and letter of the common rule, and is interested in research relevant to any component of informed consent or other requirements for the protection of human subjects. Full consideration of the components of informed consent is an essential part of every research project involving human subjects. Indeed, the Code of Federal Regulations (45 CFR Part 46, Subpart A: June 18, 1991) requires that "...no investigator may involve a human being as a subject in research...unless the investigator has obtained the legally effective informed consent of the subject or the subject's legally authorized representative." As stated in 45 CFR Part 46: (a) ...in seeking informed consent, the following information shall be provided to each subject: 1) A statement that the study involves research, an explanation of the purposes of the research and the expected duration of the subject's participation, a description of the procedures to be followed, and identification of any procedures which are experimental; 2) A description of any reasonably foreseeable risks or discomforts to the subject; 3) A description of any benefits to the subject or to others which may reasonably be expected from the research; 4) A disclosure of appropriate alternative procedures or courses of treatment, if any, that might be advantageous to the subject; 5) A statement describing the extent, if any, to which confidentiality of records identifying the subject will be maintained; 6) For research involving more than minimal risk, an explanation as to whether any compensation and any medical treatments are available if injury occurs and, if so, what they consist of or where further information may be obtained; 7) An explanation of whom to contact for answers to pertinent questions about the research and research subjects' rights, and whom to contact in the event of a research-related injury to the subject; 8) A statement that participation is voluntary, refusal to participate will involve no penalty or loss of benefits to which the subject is otherwise entitled, and the subject may discontinue participation at any time without penalty or loss of benefits to which the subject is otherwise entitled. (b) Additional elements of informed consent. When appropriate, one or more of the following elements of information shall be provided to each subject: 1) A statement that the particular treatment or procedure may involve risks to the subject (or to the embryo or fetus, if the subject is or may become pregnant) which are currently unforeseeable; 2) Anticipated circumstances under which the subject's participation may be terminated by the investigator without regard to the subject's consent; 3) Any additional costs to the subject that may result from participation in the research; 4) The consequences of a subject's decision to withdraw from the research and procedures for orderly termination of participation by the subject; 5) A statement that significant new findings developed during the course of the research which may relate to the subject's willingness to continue participation will be provided to the subject; and 6) The approximate number of subjects involved in the study. While 45 CFR Part 46 is quite specific about the content of informed consent, the responsibility for ensuring that this information is presented and understood is left to the researcher and his or her Institutional Review Board. It is clear that informed consent involves much more than a signature on a consent form. Willingness to participate in research may wax and wane depending on a participant~s expectations and satisfaction. This may be further complicated by changes in cognitive abilities and judgment over time. In some instances, obtaining consent from a legally authorized representative may be a requirement, as with research on children, comatose patients, or older participants with advanced dementias. The issues of substituted judgment can be germane as well, if an individual's competency to consent is in question. Finally, the research setting may play a role in the informed consent process. For instance, the degree of risk is affected by whether a study involves inpatients or outpatients, how closely these participants are monitored, and by different legal requirements in community, clinical, and institutional research settings. Since these and other complex issues have an impact on informed consent, there is much to be learned and understood about this process. Research Goals and Topics Through this RFA, the NIH, DOE, and VA seek to encourage research designed to gather empirical data on the informed consent process, particularly with respect to studies involving research populations. Possible research topics are listed below. This list should not be considered exhaustive; it is expected that applicants will identify other topics as well. This RFA encourages research with a focus on: o Evaluating the degree of comprehension and reasoning ability required to understand and consent to specific experimental procedures and risks (e.g., placebo controls, stored tissue), differentiate between research and standard treatment, and distinguish between discretionary and obligatory activities o Applying existing knowledge in basic behavioral, cognitive neuroscience, social, and educational research to develop methods for efficiently assessing comprehension and reasoning ability in a research setting o Identifying the cognitive processes underlying complex decisions, and evaluating methods for enhancing the decision making process o Identifying the determinants for participation, retention, and satisfaction in research (e.g., altruism, remuneration, hopes for new or better treatment, closer follow up, free care, interest in science, risk-taking behavior) o Developing and assessing innovative methods for clearly and efficiently conveying consent information that 1) meets basic requirements, and 2) offers extra material for the active information seeker (e.g., audio-visual aids, computer-assisted instruction) o Developing and evaluating outcome measures to monitor progress in improving the consent process (e.g., resource use, number and type of procedural reviews, incidence of injuries, exposure to unwarranted risk, educational outcomes) o Assessing whether a participant understands experimental procedures over time, including assessment throughout the full duration of participation in a study; developing methods to inform patients of new relevant information during participation In a trial o Determining if appropriate inclusion of a participant's relatives or friends in the consent process changes participation and retention rates within a study or alters the reported satisfaction with participation in research o Determining the impact of families, communities of interest, limited -English proficiency, durable powers of attorney, or advance directives on participation and outcomes o Identifying and developing ways to address special issues related to records (e.g., protection of confidentiality while providing a mechanism for future patient notification of unanticipated benefits or risks resulting from study participation) o quantifying and defining comprehension of social harms, and improving participant understanding of the risk of social harms associated with research participation (e.g., discrimination by insurance companies or in employment resulting from participation in HIV treatment or vaccine research, genetics research) o Identifying and determining the impact of special age-related issues related to informed consent in research involving: 1) children and adolescents (e.g., parental responsibilities and consent, autonomy issues in adolescents, emancipated or institutionalized minors, additional protections from risk and meaning of minimal risk, young children~s ability to understand in relation to giving assent, sense of altruism in children volunteering for research to help others), and 2) older individuals whose cognitive states may affect their abilities to fully comprehend the conditions of the experiment o Examining the role of cultural and educational differences, ethnicity, and gender on the informed consent process and participation in research o Identifying and determining the impact of special issues related to informed consent in specialized populations such as women of child bearing potential, drug abusers, HIV positive, mentally ill, institutionalized, alcohol dependent, terminally ill, or comatose individuals, individual with genetic disorders, and individuals with questionable competence (e.g., worsening of cognitive impairment over the course of a study, durable power of attorney) o Assessing the impact of special informed consent issues in research involving individuals in specialized settings such as emergency care, the workplace, the military, prisons, and outer space (e.g., potential for confusion resulting from similarity of the research project to routine duties and procedures; effect of generalized deference to authority; effect of presence or absence during recruitment of unit officers, prison guards or other official personnel) o Examining how the research setting, timing, presence of an ombudsman, and qualities of the individual obtaining informed consent (e.g., cultural similarity, gender) affect the process. ANNUAL MEETINGS AND COLLABORATION Successful applicants will be asked to participate in yearly meetings to report progress, discuss problems, and share information related to the conduct of their grants. It is recommended that costs associated with attendance at these meetings, to be held in the Washington DC area, be included as a part of the budget proposal. Previous experience with meetings of this kind has shown that they can provide an opportunity to work collaboratively with other Investigators on various issues, which might include common core instruments, joint publication, sharing of protocols and data, or other avenues of collaboration that may arise. INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH-supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This new policy results from the NIH Revitalization Act of 1993 (Section 492B of the Public Service Act, added by Public Law 103-43) and supersedes and strengthens the previous policies (Concerning the Inclusion of Women in Study Populations, and Concerning the Inclusion of Minorities in Study Populations) which have been in effect since 1990. The new policy contains some new 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 has been published in the Federal Register of March 28, 1994 (FR 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 from these sources of from the program staff or contact the person listed below. Program staff may also provide additional relevant information concerning the policy. LETTER OF INTENT Prospective applicants are asked to submit by January 30, 1997, a letter of intent that includes a descriptive title of the proposed research and identification of any other participating institutions. Such letters are requested only for the purpose of providing an indication of the number and scope of applications to be received: Therefore, their receipt is usually not acknowledged. A letter of intent is not binding, and it will not enter into the review of any application subsequently submitted, nor is it necessary to have sent a letter of intent to submit an application. The letter of intent is to be sent to: Referral Office Division of Research Grants National Institutes of Health MSC 7720 6701 Rockledge Drive Bethesda MD 20892-7720 APPLICATION PROCEDURES The research grant application form PHS 398 (rev. 5/95) is to be used in applying for these grants. These forms are available at most institutional offices of sponsored research and may be obtained from the Office of Grants Information, Division of Research Grants, National Institutes of Health, 6701 Rockledge Drive, Room 3034--MSC 7762, Bethesda, MD 20892-7910, telephone 301/710-0267, E-mail: [email protected]. This RFA use the Just-in-Time" concept. The following modifications must be made to the standard PHS 398 application instructions (applications not conforming to these Guidelines will be considered unresponsive to this RFA and will be returned without further review): o INITIAL BUDGET PERIOD - Only the names of personnel and level of effort must be itemized in the Personnel section of the "Detailed Budget for the Initial Period" (Form Page 4). In addition, list consultants, equipment, supplies, travel, patient care activities, alterations and renovations, and other needs, as appropriate. Costs are not to be indicated for these individual items or categories. If subcontracts are involved, state the name(s) of collaborating institutions in the "Consortium/Contractual Costs" section and provide individual budgets as detailed in the "SUBCONTRACTS section below. The "Total Direct Costs" line at the bottom of the page must be completed based on the number of $50,000 modules being requested. Applicants may not request a change in the amount of each module. A maximum of four modules ($200,000 direct costs) per year may be requested. Any large one-time purchases, such as large equipment requests, must be accommodated within these limits. o FUTURE BUDGET PERIODS - It is anticipated that direct cost budgets will remain the same for each year of the period of award (i.e., the same number of modules requested for each and every budget period). Any necessary escalation must be considered when determining the number of modules to be requested. However, in the event that the number of modules requested must change in any future year, appropriate justification must be provided. The "Budget for Entire Proposed Project Period" (top section of Form Page 5) must include Total Direct Costs requested for each year and the Total Direct Costs for the Entire Proposed Project Period. The Justification section must be completed based on instructions provided on Form Page 5. o SUBCONTRACTS - If collaborations or subcontracts are involved that require transfer of funds from the grantee to other institutions, it is necessary to establish formal subcontract agreements with each collaborating institution. A letter of agreement from each collaborating institution must be submitted with the application. Initial and future year budgets for subcontracts must be prepared using the same guidelines as for the main grant except that total subcontract costs need not be in $50,000 modules. Requested amounts must be based on individual needs of the subcontract and must reflect both direct and indirect costs. The subcontract costs are included in the total budget request, which must conform with the number of $50,000 modules requested. o BIOGRAPHICAL SKETCH - In addition to the standard information requested on Form Page 6, the applicant has the option of providing the title and source of any sponsored support relevant to the proposed research. o OTHER SUPPORT - No other support information is required on "Other Support" pages (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 NIH 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 NIH staff if there is a possibility for an award. o The applicant must provide the name and phone number of the individual to contact concerning fiscal and administrative issues if additional information is necessary following the initial review. Applicants from institutions that have a General Clinical Research Center (GCRC) funded by the NIH National Center for Research Resources may wish to identify the GCRC as a resource for conducting the proposed research. If so, a letter of agreement from either the GCRC program director or principal investigator could be included with the application. To identify the application as a response to this RFA, the RFA title "Informed consent in research involving human participants," and number "OD-97-001," must be typed under item 2 of the face page of the application form, and YES box must be checked. The RFA label available in the PHS 398 application kit must be affixed to the bottom of the face page of the original copy of the application. Failure to use this label could result in delayed processing the application such that it may not reach the review committee in time for review. Submit a signed, typewritten original of the application and four signed, exact 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 time of submission, an additional copy of the application must also be sent under separate cover to: Susan D. Solomon, Ph.D. Office of Extramural Research National Institutes of Health Building One, Room 156 One Center Drive, MSC 0155 Bethesda, MD 20892 All applicants must provide a Protection of Human Subjects Assurance Identification/Certification/Declaration as specified in the policy described on the Optional Form 310. If there is a question regarding the applicability of this assurance, contact the Office for Protection from Research Risks of the National Institutes of Health at (301) 496-7041. Applications must be received by March 11, 1997. If an application is received after that date, it will be returned to the applicant. The Division of Research Grants (DRG) will not accept any application in response to this RFA that is essentially the same as one currently pending initial review, unless the applicant withdraws the pending application. The DRG will not accept any application that is essentially the same as one already reviewed. This does not preclude the submission of substantial revisions of applications previously reviewed, but such applications must include an introduction addressing the previous critique. REVIEW CONSIDERATIONS Upon receipt, applications will be reviewed for completeness by DRG, and for responsiveness by the NIH, DOE, and/or VA program staff. Incomplete applications will be returned to the applicant without further consideration. In addition, if program staff find that the application is not responsive to the RFA, it will be returned to the applicant without review. Applications that are complete and responsive to the RFA will be evaluated for scientific and technical merit by an appropriate peer review group convened in accordance with NIH peer review procedures. As part of the initial merit review, all applications will receive a written critique and undergo a process in which only those applications deemed to have the highest scientific merit, generally the top half of applications under review, will be discussed, and assigned a priority score; those with the potential for funding will receive a second level review by the National Advisory Council of the relevant NIH institute. Applications will be judged on the following criteria: o scientific, technical, or medical significance and originality of proposed research; o appropriateness and adequacy of the experimental approach and methodology proposed to carry out the research; o qualifications and research experience of the Principal Investigator and staff, particularly, but not exclusively, in the area of the proposed research; o availability of the resources necessary to perform the research; o appropriateness of the proposed budget and duration in relation to the proposed research; o adequacy of plans to include both genders and minorities and their subgroups as appropriate for the scientific goals of the research. Plans for the recruitment and retention of subjects will also be evaluated. The initial review group will also examine the provisions for the protection of human participants and the safety of the research environment. Receipt and Review Schedule Application Receipt Date: March 11, 1997 Initial Review: June/July Advisory Council Review: September Earliest Start Date: October 1, 1997 AWARD CRITERIA Funding decisions will be made on the basis of scientific and technical merit as determined by peer review, program priorities and balance, potential policy and practice relevance, and the availability of funds. INQUIRIES Inquiries concerning this RFA are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Program staff of the NIH, DOE, and VA are available for consultation concerning application development before or during the process of preparing an application. Potential applicants should contact program staff as early as possible for information and assistance in initiating the application process and developing an application. Inquiries regarding programmatic issues may be directed to: Eric Meslin, Ph.D. National Center for Human Genome Research 38 Library Drive, Room 617, MSC 6050 Bethesda, MD 20892-6050 Telephone: (301) 402-4997 FAX: (301) 402-1950 Email: [email protected] Leslie G. Ford, M.D. National Cancer Institute 6130 Executive Boulevard, Room 300 Rockville, MD 20852-7343 Telephone: (301) 496-0265 FAX: (301) 496-8667 Email: [email protected] Andrew A. Monjan, Ph.D., M.P.H. Neuroscience and Neuropsychology of Aging Program National Institute on Aging 7201 Wisconsin Avenue, Suite 3C307 - MSC 9205 Bethesda, MD 20892-9205 Telephone: (301) 496-9350 FAX: (301) 496-1494 Email: [email protected] Theodore Pinkert, M.D. Division of Clinical and Prevention Research National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard, Suite 505 - MSC 7003 Bethesda, MD 20892-7003 Telephone: (301) 443-1206 FAX: (301) 443-8774 Email: [email protected] Amy R. Sheon, PhD, MPH Division of AIDS National Institute of Allergy and Infectious Diseases 6003 Executive Boulevard, MSC 7620 Bethesda, MD 20892-7620 Telephone: (301) 496-6177 FAX: (301) 402-3684 Email: [email protected] Sarah L. Friedman National Institute of Child Health and Human Development Building 61E, Room 4B05 Bethesda, MD 20892 Telephone: (301) 496-6591 FAX: (301) 402-2085 Email: SF2@NIHCU(BITNET) Dorynne Czechowicz, M.D. Division of Clinical and Services Research National Institute on Drug Abuse 5600 Fishers Lane, Room 10A-08 Rockville, MD 20857 Telephone: (301) 443-0107 FAX: (301) 443-2317 Email: [email protected] John K. Hsiao, M.D. Division of Clinical and Treatment Research National Institute of Mental Health Parklawn Building, Room 18C-14 Rockville, MD 20857 Telephone: (301) 443-3524 FAX: (301) 443-6000 Email: [email protected] June Lunney, Ph.D., RN Division of Extramural Programs National Institute of Nursing Research Building 45, Room 3AN-12 Bethesda, MD 20892-6300 Telephone: (301) 594-6908 FAX: (301) 480-8260 Email: [email protected] Susan L. Rose, Ph.D. U.S. Department of Energy ER-72/OHER 19901 Germantown Road Germantown, MD 20874-1290 Telephone: (301) 903-5468 FAX: (301) 903-8521 Email: [email protected] Dennis Roth Department of Veterans Affairs Office of Research and Development (12) 810 Vermont Avenue, N.W., Room 775J Washington, DC 20420 Telephone: (202) 273-8284 FAX: (202) 273-6526 Email: [email protected] Direct inquiries regarding fiscal matters to: Jean M. Cahill Grants and Contracts Management Branch National Center for Human Genome Research 38 Library Drive, Room 613 - MSC 6050 Bethesda, MD 20892-6050 Telephone: (301) 402-0733 FAX: (301) 402-1951 Email: [email protected] Eileen Natoli Grants Administration Branch National Cancer Institute Executive Plaza South, Room 243 Bethesda, MD 20892 Telephone: (301) 496 7800 ext 256 FAX: (301) 496 8601 Email: [email protected] David Reiter National Institute on Aging 7201 Wisconsin Avenue, Room 2N212 Bethesda, MD 20892-9205 Telephone: (301) 466-1472 FAX: (301) 402-3672 Email: [email protected] Linda Hilley Grants Management Branch National Institute on Alcohol Abuse and Alcoholism 6000 Executive Boulevard, Suite 505, MSC 7003 Bethesda, MD 20892-7003 Telephone: (301) 443-4703 FAX: (301) 443-3891 Email: [email protected] Jane Unsworth Division of Extramural Activities National Institute of Allergy and Infectious Diseases 6003 Executive Boulevard, Room 4B22 Bethesda, MD 20892-7610 Telephone: (301) 496-7075 FAX: (301) 480-3780 Email: [email protected] Douglas E. Shawver Grants Management Branch National Institute of Child Health and Human Development Building 61 E, Room 8A 17F Bethesda, MD 20982 Telephone: (301) 496-1303 FAX: (301) 496 0915 Email: [email protected] Gary Fleming, J.D., M.A. Office of Planning and Resource Management National Institute on Drug Abuse 5600 Fishers Lane, Room 8A-54 Rockville, MD 20857 Telephone: (301) 443-6710 FAX: (301) 594-6847 Email: [email protected] Diana Trunnell Grants Management Branch National Institute of Mental Health 5600 Fishers Lane, Room 7C-08 Rockville, MD 20857 Telephone: (301) 443-3056 FAX: (301) 443-6885 Email: [email protected] Jeff Carow Grants and Contracts Management Branch National Institute of Nursing Research Building 45, Room 3AN-32 Bethesda, MD 20892-6301 Telephone: (301) 594-5074 FAX: (301) 480-8256 Email: [email protected] AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance Nos. 93.172 (NCHGR), 93.242 (NIMH), 93.273 (NIAAA), 93.279 (NIDA), 93.361 (NINR), 93.395 (NCI), 93.856, 93.855 (NIAID), 93.865 (NICHD), and 93.886 (NIA). Awards are made under authorization of section 301 and Title IV (42 USC 241 and 281) of the Public Health Service Act, and are administered under PHS grants policies and Federal Regulations 42 CFR Part 52, and 45 CFR Part 74. This program is not subject to the intergovernmental review requirements of Executive order 12372, or Health Systems Agency Review. Awards by PHS agencies will be administered under PHS grants policy as stated in the Public Health Service Grants Policy Statement (April 1, 1994). The PHS strongly encourages all grant and contract recipients to provide a smoke-free workplace and promote the nonuse 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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