Notice of NCI's participation on PA-18-499, End-of-Life and Palliative Care Health Literacy: Improving Outcomes in Serious, Advanced Illness (R21 Clinical Trial Optional)

Notice Number: NOT-CA-18-033

Key Dates
Release Date: March 19, 2018

Related Announcements

Issued by
National Cancer Institute (NCI)


The purpose of this Notice is to inform potential applicants that the National Cancer Institute (NCI) is participating in PA-18-499, "End-of-Life and Palliative Care Health Literacy: Improving Outcomes in Serious, Advanced Illness (R21 Clinical Trial Optional)."

The following changes have been made to reflect NCI's participation in this FOA:

Part 1. Overview Information

Components of Participating Organizations
National Institute of Nursing Research (NINR)
National Cancer Institute (NCI)

Catalog of Federal Domestic Assistance (CFDA) Number(s) 

93.361, 93.399

Part 2. Full Text of Announcement

Section I. Funding Opportunity Description

The text that follows this sentence is hereby to be considered as information inserted at the end of the original Funding Opportunity Description in Part 2, Section I, of PA-18-499 .

In addition to research areas already listed in the Funding Opportunity Description, NCI is interested in applications that address important gaps in this area, including applications that:

  • Address barriers to access and utilization of end-of-life and palliative care services for patients diagnosed with advanced cancer, particularly among those with limited health literacy. Some of the identified barriers include, but are not limited to: lack of knowledge about end-of-life and palliative care (EOLPC) services, financial concerns, poor communication between care providers and patients/caregivers, and stigma associated with the end of life.
  • Develop and test health literacy tools for advanced cancer patients and caregivers, training programs for providers, and multi-level or multi-component interventions or care delivery models that promote discussions of prognosis and goals of care, including decision-making about advanced care planning actions (e.g., Do-Not-Resuscitate [DNR] orders, transition to supportive care and hospice) between patients, caregivers, and the healthcare provider team.
  • Develop, test, and evaluate patient-centered cancer care delivery models and interventions that enable the provision of palliation simultaneously with active treatment, including in the context of cancer clinical trial participation.
  • Develop and test approaches to effectively ascertain patient values, preferences, goals, and priorities, as well as models to deliver value-concordant care for patients diagnosed with advanced cancer.
  • Conduct mixed methods research on the communication of prognosis, goals of care, and uncertainty in cancer. Such research projects should extend beyond patient-provider dyads to include cancer care teams and informal cancer caregivers.
  • Develop feasible, precise, and interpretable approaches to collecting patient-generated health data, including approaches that utilize patient-reported outcomes (PROs) and data from symptom monitoring devices, from patients with advanced cancers (particularly those patients who are identified as having limited health literacy).
  • Develop and test communication interventions in EOLPC that utilize emerging technology and media, including mobile technology, in-home monitoring devices, wearable technologies, personal health data portals, and social media to enhance usability and improve palliative care communication.
  • Conduct research to facilitate and improve symptom management and medical care outside of the clinical/hospital setting, particularly for patients with limited health literacy.
  • Develop and test interventions to improve skills and capacity for cancer patients and caregivers in the day-to-day management of complex tasks and cancer care needs at home.
  • Implement existing evidence-based health literacy interventions for limited health literacy advanced cancer populations receiving EOLPC services, and, in that context, evaluate the dissemination and implementation strategies and processes (e.g., changes in attitudes, awareness, feasibility, fidelity and sustainability) in clinical and community settings.
  • Large, multi-site trials based in cancer care delivery systems are encouraged.

Section VII. Agency Contacts

The following contacts have been added:

Scientific/Research Contact(s)

Wen-Ying Sylvia Chou, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-6954

Financial/Grants Management Contact(s)
Carol Perry
National Cancer Institute (NCI)
Telephone: 240-276-6282

All other aspects of this FOA remain unchanged.


Please direct all inquiries to:

Wen-Ying Sylvia Chou, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-6954