Key Dates

Related Announcements

PA-20-272 - Administrative Supplements to Existing NIH Grants and Cooperative Agreements (Parent Admin Supp Clinical Trial Optional)

Issued by

National Cancer Institute (NCI)

Purpose

The goal of this Notice of Special interest (NOSI) from the National Cancer Institute (NCI) is to encourage currently funded NCI extramural investigators to apply for administrative supplements to better understand the effects of digital health tools and interventions on patient-provider communication across the cancer control continuum, with the aim of developing an evidence base to inform future development, modification, and delivery of digital tools/interventions for effective cancer prevention and control. 

This administrative supplement would provide  currently funded NCI extramural investigators with funding for one year to analyze existing data collected under the parent grant related to (1) the effects of digital health tools/interventions on patient-provider communication and (2) how patient-provider communication influences the relationships between digital health tools/interventions and cancer prevention and control outcomes assessed in the parent grant. Knowledge gained from this administrative supplement is intended to inform future development, modification, and delivery of digital tools/interventions to improve cancer outcomes, including patient safety and care quality, healthy behavior, health equity, and health outcomes.

For this Notice, digital health refers to a wide range of tools and technologies that can be used to support cancer prevention and control, including online and web-based interventions, mobile health, wearables, voice assistants and virtual agents, electronic health records, patient portals, and telehealth, as well as the infrastructure that enables integration, and analysis, and interpretation of data from these technologies. Digital tools/interventions may be intended for clinical, public health, home, or community settings and span the cancer control continuum. Healthcare providers are broadly defined as any health professionals providing cancer-related care; examples include, but are not limited to, physicians, physician assistants, registered nurses, pharmacists, clinical social workers, behavioral health care providers, and patient navigators. Patient-provider communication includes the frequency and quality of communication and associated aspects of the patient-provider relationship, such as trust, satisfaction, patient-centeredness, rapport, language accessibility, affective processes, information processing, shared decision-making, stigma, and empowerment. The cancer control continuum describes the various stages of cancer care including cancer etiology, prevention, screening, detection, diagnosis, treatment, survivorship, and end of life.

Background

Effective patient-provider communication remains a critical component of cancer prevention and control efforts, with high quality communication associated with better care quality and delivery, patient safety, and adherence to provider treatment and medication recommendations, among other cancer outcomes. The use of digital health has far-reaching implications for individual and population health, including fundamental changes to how, when, and where patients and providers interact. Many digital tools have the potential to facilitate patient-provider communication. For example, telehealth and secure messaging through patient portals have been shown to increase cancer patients’ access to healthcare providers, and wearable technologies may facilitate real-time monitoring and information-sharing about cancer-related health behaviors, symptoms, and treatment effects. However, digital tools and interventions may also have unintended negative consequences such as shortened appointments, missed non-verbal cues, widened digital divide, financial burden, provider burnout, or interference in relationship building. Without attention to the overall impact of digital health for patient-provider communication, these tools/interventions may fail to achieve their cancer control and prevention objectives or result in unintended harm. 

The relationships between digital health tools/interventions, patient-provider communication, and subsequent cancer outcomes are especially understudied among historically underserved populations, which include minoritized racial and ethnic groups, socioeconomically disadvantaged populations, rural populations, LGBTQ+ individuals, older adults, and individuals living with behavioral health conditions or physical disabilities. Members of many of these groups have lower access to and engagement with digital tools compared with the general U.S. population, and also tend to experience poorer quality communication with their healthcare providers. In this context, digital health tools risk exacerbating existing cancer disparities if they further degrade the quality of communication and relationships. Yet, digital tools also have the potential to ameliorate access to care and service disparities and improve patient-provider communication if developed and deployed with equity in mind. 

To maximize benefits and minimize risks of digital health, research must explicitly consider how digital tools/interventions affect patient-provider communication, and how patient-provider communication in turn influences the relationships between digital health interventions and the cancer outcomes they intend to improve.

Research Objectives

This administrative supplement allows currently funded NCI extramural investigators to examine the effects of digital tools/interventions on patient-provider communication and/or how patient-provider communication influences the relationships between digital tools/interventions and cancer-related outcomes of interest to the parent study. Applicants may propose to supplement parent awards that are focused on the development, testing, or delivery of digital health tools/interventions or to explore digital health-related barriers or opportunities in their patient-provider communication focused research.

Specific research priorities may include, but are not limited to, the following: 

• Analyzing existing quantitative or qualitative data from the parent grant focused on evaluating patient-provider communication as an outcome of digital health tools/interventions (e.g., telehealth use, secure messages available through patient portals, patient-generated data, patient/clinician dashboards, patient and/or provider interviews);
• Test the mediating or moderating role of patient-provider communication on the effects of digital health tools/interventions on cancer outcomes using existing data from the parent grant;
• Using quantitative or qualitative data from the parent grant, examining how factors at the individual, interpersonal, community, and/or societal levels influence the effects of digital tools/interventions on patient-provider communication and resulting cancer outcomes. Examples of these multilevel factors include technology access, digital literacy, implicit bias, healthcare and community infrastructure, and technology policies, among others;
• Engaging parent study research participants in mixed methods and participatory approaches to elicit preferences and expectations for patient-provider communication depending on where (i.e., clinic, home, community), when, how, and how often the tool/intervention is delivered;
• In the context of the parent study, developing implementation strategies and communication tools that optimize communication and related cancer outcomes resulting from digital tools/interventions;
• In the context of the parent study, evaluating the effects of digital health policy (e.g., Centers for Medicare and Medicaid Services Interoperability and Patient Access Final Rule, organizational privacy policies) on patient-provider communication and resulting cancer outcomes in diverse populations;
• In the context of the parent study, evaluating consequences of non-use of digital tools for patient-provider communication and resulting cancer outcomes, particularly non-use as related to the digital divides in technology access, health literacy, and other resources needed to use and benefit from digital tools/interventions;
• In the context of the parent study, elucidating the role of digital tools/interventions in integrating informal care providers into cancer care and/or the role of informal care providers in communication processes resulting from use of digital tools

Administrative supplement applications focusing on under-resourced settings and underserved populations served by the parent award, which include Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asian Americans, Native Hawaiians and other Pacific Islanders, socioeconomically disadvantaged populations, rural populations, LGBTQ+ individuals, individuals living with behavioral health conditions or physical disabilities, and older adult populations, are of particular interest. 

Application and Submission Information

Applications for this initiative must be submitted using the following opportunity 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:

Eligibility. 

• Only current awardees of an active NCI-funded R01, R37, R21, P01, P20, P30, P50, U01, UH3, U19, or U54 are eligible to apply. 
• PDs/PIs must hold an active award supported through NCI with sufficient time (minimum 1 year) left to complete the proposed project after the supplement has been awarded within the existing project period. 
• The proposed project must be within the scope of the parent award and be a logical extension of the parent award aims.  
• Requests for no-cost extensions on the parent grant to accommodate a supplement will not be permitted. 
• 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 parent award will be accepted for consideration. 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.

Budget. 

• The budget should not exceed $100,000 in total costs for the entire allowable 1-year project period of the application/award. 
• The administrative supplement application budget is limited to 1 year only. 
• Administrative supplements may only be used to meet increased costs that are within the scope of the approved award, but were unforeseen when the new or renewal application or grant progress report for non-competing continuation support was submitted; supplements designed to meet cost increases for unanticipated expenses within the original scope of the project will not be considered.

Submitting Applications. 

• Application Due Date: Submissions must be received by April 21, 2023 at 5:00 PM local time of applicant organization for FY 2023 funding. The NOSI will expire April 22, 2023 .
• For funding consideration, applicants must include “NOT-CA-23-041” (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-23-041.”
• 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.

The application must include the following sections and adhere to the following 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 Process

NCI will conduct administrative reviews of applications and will support the most meritorious applications submitted for consideration, based upon availability of funds. Additionally, NCI program staff will evaluate applications using the following selection factors:

• Does the administrative supplement reasonably allow for the proposed project to be completed, given the time and budget requested?
• Are the proposed activities relevant to the parent grant and original work scope?
• Will the proposed activities meet increased costs that are within the scope of the approved award, but were unforeseen when the new or renewal application or grant progress report for non-competing continuation support was submitted?
• Does the applicant demonstrate satisfactory progress towards achieving the aims of the parent grant, as appropriate to the current stage of the project?
• Does the proposed project for supplemental funding fill an identified gap in the scientific literature that advances cancer research?
• Do the results from the proposed project have the potential to provide evidence related to the effects of digital tools/interventions on patient-provider communication and/or how patient-provider communication influences the relationships between digital tools/interventions and cancer-related outcomes?

Inquiries

Please direct all inquiries to:

Scientific/Research Contact(s)

Robin C. Vanderpool, DrPH
National Cancer Institute (NCI)
Telephone: 240-276-6558
Email: robin.vanderpool@nih.gov

Nicole Senft Everson, PhD
National Cancer Institute (NCI)
Telephone: 240-234-0773
Email: nicole.everson@nih.gov 

Financial/Grants Management Contact(s)

Crystal Wolfrey
National Cancer Institute (NCI)
Telephone: 240-276-6277
Email: crystal.wolfrey@nih.gov