This Notice of Special Interest (NOSI) 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).
Effective immediately, this NOSI replaces NOT-CA-23-025, Notice of Special Interest (NOSI): Administrative Supplement to Support Global Cancer Stigma Research.
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.
Within the areas of cancer, the specific research priorities may include, but are not limited to, the following:
- 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 in LMICs;
- Studies that elucidate the impact of cancer stigma and other intersectional factors on resilience and treatment response in cancer patients;
- Studies to 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;
- Studies investigating the impact of the media (traditional and social) in perpetuating and disseminating cancer stigma;
- Studies supporting interventions addressing stigma related to health literacy and its impact on cancer care;
- Stigma reduction interventions to improve cancer outcomes in vulnerable populations across the care continuum;
- Studies testing the feasibility of implementing cancer stigma reduction strategies/interventions in LMIC populations;
- Studies aimed at understanding cancer stigma in immigrant populations within the United States;
- 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 diverse 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 away (i.e., within its approved scope) that increases its impact.
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 and PA-20-272 must be followed, with the following additions:
- Application Due Date: Applications can be submitted on a rolling basis between January 16, 2023 - May 21, 2023, at 5:00 PM local time of applicant organization for FY 2023 funding. The NOSI will expire May 22, 2023.
- For funding consideration, applicants must include “NOT-CA-23-036” (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-23-036”.
Eligibility and Eligible Individuals (Program Director/Principal Investigator)
- Administrative supplement applications are limited to currently funded R01, R21, R33, R37, P01, P20, P30, P50, U19, U01, UH3, or U54 projects supported by NCI. Requests for no-cost extensions on the parent grant to accommodate a supplement will not be permitted.
- PDs/PIs must hold an active award supported by NCI with sufficient time (minimum 1 year) left to complete the study proposed after the supplement has been awarded within the existing project period.
- The proposed project period cannot extend beyond the project period of the parent.
- 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.
- NCI grants in an extension (or needing an extension in order to be eligible) at the time the award is made in FY23 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.
- For supplements to parent awards that include multiple PDs/PIs, the supplement may be requested by any or all of the PDs/PIs (in accordance with the existing leadership plan) and submitted by the awardee institution of the parent award.
- The budget should not exceed $125,000 in direct costs for the entire allowable 1-year project period of the application/award.
- At least one full year on the parent grant must remain at the time of funding. The application budget is limited to 1 year only.
- If an applicant anticipates a balance of 50% or more of the current total costs for the parent grant, please contact the scientific research contact prior to submitting an application.
- Only one supplement application per grant will be accepted for consideration through this NOSI.
- Requests must reflect the actual needs of the proposed project. Administrative supplements can be used to cover cost increases that are associated with achieving certain new research objectives as long as the research objectives are within the original scope of the peer-reviewed and approved project (i.e., award), or the cost increases are for unanticipated expenses within the original scope of the project.
- Permitted for 1 year of support only; the earliest anticipated start date is September 1, 2023.
- For administrative supplements to grants and cooperative agreements, supplement requests must be submitted in accordance with the parent program announcement, PA-20-272. NOTE: Administrative supplement requests (application) for support of clinical trials will not be accepted and/or considered in response to this NOSI.
- 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-23-036.”
- Supplement requests should be submitted electronically.
- For funding consideration, applicants must include “NOT-CA-23-036” (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.
- In order to facilitate efficient processing of the request applicants are strongly encouraged to notify the assigned NCI Program Official for the parent award that a request has been submitted in response to this NOSI.
These sections have the following page limits:
- Project Summary/Abstract: 30 lines of text
- Project Narrative: 3 sentences
- Research Strategy: 5 pages
- Biographical Sketch: for Senior/Key Personnel and Significant Contributors only
Administrative Review and Selection
The following criteria will be applied for evaluation of the applications:
- Does the administrative supplement reasonably allow for the proposed project to be completed, given the time and budget requested?
- Does the proposed project for supplemental funding fill an identified gap in the scientific literature that advances cancer stigma research?
- Does the proposed project appropriately justify the proposed LMIC research focus?
- Is the project design scientifically rigorous and serve the needs of the target population?
- Does the applicant demonstrate reasonable access to the appropriate populations or datasets?
Applicants are encouraged to discuss their application with the scientific/research contact listed in this NOSI prior to submission.