Department of Health
and Human Services (HHS)
and Human Services (HHS)
April 27, 2021
PA-20-185 – NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)
PA-20-183 – NIH Research Project Grant (Parent R01 Clinical Trial Required)
PA-20-200 – NIH Small Research Grant Program (Parent R03 Clinical Trial Not Allowed)
PA-21-221 – NICHD Small Research Grant Program (R03 Clinical Trial Required)
PA-21-231 – NICHD Small Research Grant Program (R03 Basic Experimental Studies with Humans Required)
PA-20-195 – NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed)
PA-21-194 – NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required)
PA-21-196 – NIH Exploratory/Developmental Research Grant Program (Parent R21 Basic Experimental Studies with Humans Required)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
All applications to this funding opportunity announcement should fall within the mission of the Institutes/Centers. The following NIH Offices may co-fund applications assigned to those Institutes/Centers.
Sexual and Gender Minority Research Office (SGMRO)
Initiative Background:
Treating injured and traumatized children and efforts to implement preventive interventions have become increasingly challenging in the context of the current pandemic. Children are notably at greater risk of injury, morbidity and mortality due to the social isolation, economic stressors, and other challenges related to policies and practices designed to mitigate the spread of the coronavirus. Given the limitations of traditional contexts for identifying and reporting abuse due to these mitigation strategies, research on treatment and care in diverse (e.g. primary, emergency and acute care) settings is essential to identify effective ways of screening, diagnosing and assessing trends in abuse and abuse related injuries in this current context.
This is important because, for example, approximately 10 percent of pediatric emergency department visits are due to various forms of physical child abuse. However, the diagnosis of abuse may be missed due to challenges in distinguishing between inflicted and unintentional injuries, both of which may present with bruising, fractures, and other non-specific signs. This challenge may be further exacerbated by the current context of this pandemic. Additional research is needed to develop and refine tools and technologies to improve diagnostic accuracy of abuse and abuse related injuries as potentially more children may be admitted during the pandemic due to such injuries. The need to study ways to strengthen and/or develop new channels of communication between and among reporting systems and systems of care for children at risk of abuse and/or neglect is paramount.
Additionally, there are important disparities in injury burden, including those by race, ethnicity, gender, socioeconomic status, and urbanicity. National pre-COVID data show that in 2018, the child abuse rate in the United States is highest among American Indian or Alaska Native victims with a rate of 15.2 cases per 1,000 children. It is most common among children between two to five years of age, with about 166,400 cases reported in 2017. Child abuse cases are fairly evenly distributed between girls and boys. However, more boys than girls were victims of abuse resulting in death. Notably, studies have shown that LGBT youth may experience maltreatment at higher rates than other children and youth, however, little research has been done on the ways in which the intersection of sexual and gender minority (SGM) status, race/ethnicity, and socioeconomic status may impact rates, and severity of childhood abuse. These child abuse rates are likely to be exacerbated in the context of current pandemic in light of the fact that disparity populations appear to be disproportionately affected by the coronovirus.
While child abuse is prevalent across both rural and urban settings, hospitals may have widely divergent abilities and resources to address abuse. Although there is little published information characterizing the needs of rural EDs, they likely have fewer resources for managing abuse and less access to community abuse assessment centers for consultation and follow-up than do many urban hospitals. This may be further impacted by the need for resources for treatment and care in the context of the pandemic.
Thus, these pre-existing disparities and apparent challenges in resources for treatment and care of children experiencing abuse call for more data and research resources to identify, substantiate and improve care and ultimately outcomes for vulnerable children and youth during and following the current crisis.
It is anticipated that research stemming from this NOSI will help to provide greater recognition of the need for better resources and support for vulnerable children. More touchpoints for communication, identification and screening for risks of child trauma, and injury will help inform processes for screening, identification, treatment and care in new and emerging disaster related contexts in the future.
Scope/Work to be Performed:
The COVID pandemic has resulted in unprecedented health, social and economic conditions significantly changing the ecological context for children and families. Rates of multiple risk factors including unemployment, poverty, and social isolation have increased placing families, especially those with pre-existing vulnerabilities in jeopardy of experiencing severe psychosocial impacts. For children and youth in these contexts, the specter of experiencing various forms of child abuse, sustaining abuse related injuries, as well as the deleterious effects of child neglect and related mental and physical health consequences is alarming.
Exacerbating these concerns is the notion that the pandemic has rendered traditional non-medical data sources such as school-based personnel, social workers, or child welfare professionals inaccessible for screening, assessing trends or reporting suspected cases of abuse and neglect. Thus, the impact of these ecological changes on child abuse rates and severity of injury and illness is a significant and immediate public health concern and calls for reliable data, expanding sources of data and strengthening linkages within and among trauma informed systems of care.
Revision applications and new research studies are encouraged to address such questions and topics as the following:
1. To what extent have rates and patterns of child abuse and abuse related injuries been affected by current pandemic? What is the impact on treatment and care?
2. What psychosocial issues compound the experience of abuse or neglect in children and youth in the context of the pandemic? What are the short- and long- term sequelae of experiencing abuse and/or neglect in the context of the pandemic?
3. To what extent have disparities in child abuse identification, screening and care deepened or become more pronounced as a result of the pandemic? What are the short- and long- term implications for disparity populations?
4. What data sources, tools and resources are needed to strengthen reporting and communication among systems of care during and after the current pandemic?
5. Novel projects designed to improve short and long-term health outcomes for pediatric trauma patients including such complementary issues as family functioning and systems engagement (e.g. school, health, child protection, legal).
6. Research resources and innovative approaches to improve screening, evaluation, and diagnosis of abuse or neglect related injury and illness in children during and after the pandemic including the use of biomarkers, imaging, and biomechanics.
7. Studies identifying lessons learned to address gaps and challenges in treatment and care of vulnerable children and youth for new and emerging disasters/crises.
Application and Submission Information
This notice applies to due dates on or after June 5, 2019 and subsequent receipt dates through May 31, 2024.
Submit applications for this initiative using one of the following funding opportunity announcements (FOAs) or any reissues of these announcement through the expiration date of this notice.
All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:
Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.
Scientific/Research Contact(s)
Valerie Maholmes, Ph.D., CAS
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-496-1514
Email: maholmev@mail.nih.gov