The purpose of this Notice is to encourage currently funded NCI extramural investigators to apply for administrative supplements to support cancer-related policy research including empirical evaluation of policy or evaluation of policy implementation or dissemination methods.
The goals of these administrative supplements on cancer-related health policy are to: 1) generate new or utilize secondary data that operationalize policies hypothesized to affect cancer control at the geographic, provider, patient, and/or temporal level; 2) examine the effects of existing policies and/or simulate the potential effects of new policies, with an emphasis on understanding health disparities by examining differential impacts on disadvantaged groups; 3) identify effective community-engaged strategies for dissemination or implementation of evidence to inform policymaking.
Policy plays a central role in shaping health and healthcare, including cancer prevention and control. For the purposes of this Notice we are including formal public policies (e.g., legislation and regulations) at local, state, and federal levels of government, and private/organizational level policies and practice guidelines, such as those implemented by school districts, large organizations, worksites, health systems, and health insurance or managed care companies. The research enterprise has a vital role in generating evidence to enable evidence-based policymaking, and in evaluating the impact of various policies and their implementation on health-related outcomes.
Health policy research may employ a range of data, or methods and approaches. To understand how policies can advance or detract from health equity, health policy evidence should include data generated in diverse populations and communities, especially groups that have been economically or socially marginalized.
For purposes of this NOSI, we have identified two areas of focus.
Option 1: Empirical analysis of associations between cancer-related health policies and outcomes.
Projects can propose to generate and analyze data on federal or state policies that impact cancer control including, but not limited to, broad legislation or regulations that impact eligibility for publicly subsidized health insurance, premium cost of private insurance, health insurance benefit design, provider reimbursement, cost sharing, or healthcare financing. Outcomes of interest include, but are not limited to, cancer-related healthcare access, utilization, quality, total or out-of-pocket expenditure, financial hardship, quality of life, patient care experience, and survival.
Option 2: Community-engaged dissemination or implementation (D&I) research.
Projects can leverage community partnerships (e.g., with cancer control coalitions, community-based organizations, state health departments, etc.) to advance the dissemination of scientific evidence to inform the development of policies that will positively impact health, to disseminate evidence on health policies known to be effective in promoting cancer control, or to study implementation of an evidence-based cancer control policy in a new context relevant to community needs.
Within these areas of cancer-related health policy, the specific research priorities may include, but are not limited to, the following:
Option 1: Research priorities for empirical analysis include (but are not limited to):
- Studies that examine the effects of public or private insurance provider payment policies for various types of cancer treatments, surveillance, survivorship care, palliative and end-of-life care on access, quality, total and out-of-pocket cost of cancer-related services.
- Studies that examine the effects of benefit design in public or private pharmacy benefit plans on receipt of guideline recommended cancer therapy, adherence, duration, and out-of-pocket cost. Applications focusing solely on the effects of the Medicare Part D Low Income Subsidy will not be considered.
- Studies that examine the effect of policies directed at strengthening provider networks within managed care organizations on access to specialty cancer care.
- Studies that examine the effects of provisions of the Patient Protection and Affordable Care Act (ACA) on cancer-related healthcare utilization, total and out-of-pocket spending, and clinical trial participation. Applications that focus primarily on the effects of the ACA Medicaid expansions on insurance coverage or diagnosis stage will be given low priority.
- Studies that examine the effects of high-deductible health insurance plans on initiation, completion, and out-of-pocket costs of recommended cancer treatments, as well as other cancer-related care.
Option 2: Community-engaged D&I research priorities include (but are not limited to):
- Studies that examine dissemination strategies for cancer control-focused data sharing with community partners and/or policymakers to inform evidence-based policymaking.
- Studies that evaluate dissemination strategies, including but not limited to tailored communications, for cancer control-related guidelines (e.g., on genetic risk assessment, cancer-related vaccination (HPV, Hep B), cancer screening and early detection) to underserved communities to advance health equity.
- Studies that evaluate the dissemination or implementation of an evidence-based cancer control policy in a new context in partnership with community partner(s).
- Studies that evaluate the effectiveness of strategies to build capacity among public health professionals to communicate scientific evidence packaged appropriately for various policy audiences including policymakers and advocacy groups (e.g., how to construct an effective policy brief).
- Projects that involve community partners to identify community-driven, health equity-focused policy research or dissemination science opportunities to establish a foundation for future research studies or collect pilot data.
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:
- 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-23-044 (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-23-044.
- Applicants are strongly encouraged to discuss their application with the scientific contacts listed below prior to submission to ensure responsiveness and facilitate processing of the application.
- Applicants are also strongly encouraged to notify the assigned NCI Program Official for the parent award that a request has been submitted in response to this NOSI.
Eligibility and Eligible Individuals (Program Director/Principal Investigator)
- Administrative supplement applications are limited to currently funded R01, R21, R33, R37, P01, P20, P30, P50, U01, UH3, U19, UM1, U54, and UG1 projects supported by NCI.
- 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 period for the supplement 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 a no-cost extension (or needing a no-cost 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.
- Foreign grants are excluded.
- The budget can not exceed $125,000 in total costs for the entire allowable 1-year project period of the application/award.
- The application budget is limited to 1 year only. The earliest anticipated start date is September 1, 2023.
- 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. Applicants must choose either Option 1 or Option 2; applications may NOT address both options.
- 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); supplements designed to meet cost increases for unanticipated expenses within the original scope of the project will not be considered.
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?
- Are the proposed activities relevant to the parent grant and original work scope?
- 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 new evidence related to 1) the role of health policy on cancer-related healthcare delivery or outcomes or 2) the dissemination and implementation of scientific evidence for evidence-based policymaking?