This Notice of Special Interest informs current awardees that the National Cancer Institute (NCI) is providing an opportunity for supplemental funding to support exploratory research studies to expand the current understanding of cancer stigma (as defined below), assess its impact on cancer control and prevention, and develop stigma-reduction interventions to improve cancer outcomes in low- and middle-income countries (LMICs).
The goals of these administrative supplements focused on global cancer stigma research are to: 1) elucidate the etiology and perpetuation of cancer stigma; 2) measure the impact of cancer stigma on physical and mental well-being and associated health behaviors of patients; 3) identify mechanisms and pathways by which stigma is a barrier to cancer prevention, treatment, palliation, and survivorship; and 4) develop interventions to reduce cancer stigma and improve cancer outcomes.
Stigma is a powerful social process characterized by labeling and stereotyping of certain human characteristics as socially undesirable and linked with negative stereotypes, leading to loss of status and discrimination towards labeled individuals. Moreover, stigma can act as a fundamental barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally including cancer. Stigma manifests across all stages along the cancer care continuum and remains a key challenge for cancer prevention and control.
Enacted stigma, which is characterized by cancer patients being treated differently and/or being denied opportunities, and internalized stigma, which is characterized by cancer patients avoiding certain situations and/or interactions to prevent anticipated stigmatization, have both been reported to have consequential impacts on affected cancer patients’ outcomes. In low- and middle-income countries (LMICs) where access to traditional health care is limited, stigma may exacerbate the existing barriers to cancer diagnosis, treatment, and palliative care and perpetuate health inequities.
Specific Areas of Research Interest
- Studies to develop and validate measurements of cancer stigma and elucidate the mechanisms/pathways by which cancer stigma impacts health outcomes globally.
- Studies examining the impact of stigma on access to cancer prevention, treatment, care, and patient support services.
- Studies examining the intersectionality of stigma with socio-economic and cultural barriers to cancer prevention and control.
- Studies investigating the impact of media (traditional and social) in perpetuating and disseminating cancer stigma.
- Studies to understand and/or reduce cancer stigma associated with health behaviors (e.g., smoking, obesity, alcohol use, diet).
- Studies that focus on the psychological, social, and financial burden on cancer survivors and caregivers and its impact on internalized stigma in patients.
- Stigma reduction interventions to improve cancer outcomes across the care continuum.
- Studies testing feasibility of implementing cancer stigma reduction strategies/interventions.
- Studies that develop stigma reduction strategies to combat cancer stigma in healthcare facilities, improve communication between patients and diverse healthcare providers, and reduce enacted stigma which may be perpetrated by healthcare providers.
The NCI encourages collaborative research among NCI-funded domestic investigators and their foreign counterparts in LMICs who have complementary expertise and access to LMIC populations. Applicants are encouraged to leverage existing resources and partnerships, and to design projects that can reasonably be completed within the given time and budget. Where appropriately justified, supplemental funding may be applied towards attaining adequate global populations for cancer stigma research. It is not essential for the parent award to have a cancer stigma research focus. The request for supplemental funding may propose to augment the parent award by integrating cancer stigma research in global populations into the ongoing research project in a way (i.e., within its approved scope) that increases its impact.
NCI will conduct administrative reviews of submitted applications and will support the most meritorious applications based upon the programmatic priorities and availability of funds.
The following criteria will be used to assess the supplement requests:
- Does the proposed project address a knowledge and/or research gap in cancer stigma?
- Does the proposed project appropriately justify the proposed LMIC research focus?
- Does the applicant demonstrate reasonable access to the appropriate populations or datasets?
- Is the project design scientifically rigorous and serve the needs of the target population?
- Does the proposal demonstrate the feasibility of accomplishing project goals within the time and budget?
Application and Submission Information
Applications for this initiative must be submitted using the following Funding Opportunity Announcement (FOA) or its subsequent reissued equivalent:
- PA-20-272 - Administrative Supplements to Existing NIH Grants and Cooperative Agreements (Parent Admin Supp Clinical Trial Optional)
All instructions in the SF424 (R&R) Application Guide must be followed, with the following additions:
- Application Due Date: Submissions must be received by May 15, 2021, at 5:00 PM local time of applicant organization for FY 2021 funding
- Administrative supplement applications are limited to currently funded projects supported by NCI.
- PDs/PIs must hold an active eligible R01, R21, R33, R37, P01, P20, P30, P50, U19, U01, UH3, U54, or UM1 from NCI.
- The proposed project for supplemental funding is required to be within the scope of the parent award and be a logical extension of the original aims.
- The supplement application budget is limited to 1 year only.
- At least one full year on the parent grant must remain at the time of funding of the administrative supplement application/award.
- NCI grants in an extension (or needing an extension in order to be eligible) at the time the award is made in FY21 are not eligible for this supplement. In other words, requests for no-cost extensions on the parent grant to accommodate a supplement will not be permitted.
- Only one supplement application per grant will be accepted for consideration through this Notice.
- For funding consideration, applicants must include “NOT-CA-21-026” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.
- Applicants should begin the supplement application abstract by stating "This application is being submitted in response to the Notice of Special Interest (NOSI) identified as "NOT-CA-21-026”.
- Budget and Period of Support:
- The budget should not exceed $125,000 in direct costs for the entire allowable 1-year project period of the application/award.
- The Research Strategy must not exceed three (3) pages, should summarize the activities of the parent grant and describe how those activities would be augmented and/or enhanced in the supplemental request by:
- Describing the supplement's purpose, its relationship to the parent grant (proposed research must be within scope of the parent grant), and the additional value to the research in the parent grant);
- Describing the proposed global population and/or data and how the applicant will access the same; and
- Justifying the cancer stigma research question being investigated and how inclusion of the LMIC population and/or data will advance the understanding of cancer stigma and/or interventions that address it.
- NCI requires applicants to submit electronically through Grants.gov. All applications (including those for multi-project activity codes) must be submitted electronically using a single-project application form package with the Competition ID of “FORMS-E-ADMINSUPP-RESEARCH”
- The process for Streamlined Submissions using the eRA Commons cannot be used for this initiative.
Applicants are strongly encouraged to notify the program contact at the NCI that a request has been submitted in response to this NOSI to facilitate efficient processing of the application.
Applications that do not meet these requirements will be not be considered for this NOSI initiative.