Notice of Special Interest (NOSI): Research on Drowning Prevention
Notice Number:
NOT-HD-21-048

Key Dates

Release Date:

February 16, 2022

First Available Due Date:
June 05, 2022
Expiration Date:
May 08, 2024

Related Announcements

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-20-194- NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required)

PA-20-195 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed)

PA-20-185- Research Project Grant (Parent R01 Clinical Trial Not Allowed)

PA-20-183 – Research Project Grant (Parent R01 Clinical Trial Required)

PA-20-202 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Required)

PA-20-203 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Not Allowed)

PA-20-187 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Required)

PA-20-188 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Not Allowed)

PA-20-206 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Required)

PA-20-205 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Not Allowed)

Issued by

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

National Institute on Minority Health and Health Disparities (NIMHD)

Purpose

Background

Drowning is a foremost cause of child death. In the United States (US), drowning is the leading cause of injury death in children ages 1-4 years and a leading cause of unintentional injury death in children ages 5-19 years. Globally, nearly 300,000 annual drowning deaths occur; 90% of which are in low- and middle-income countries (LMIC) and young children have the highest death rates. Morbidity from drowning is also high with more than 50% of US drowning victims who receive emergency department care requiring hospitalization or higher-level care. When drowning victims survive, they can suffer severe organ damage, including long-term neurologic impairment and disability.

Drowning is also a pressing health equity issue. In addition to age, drowning rates vary by a multitude of individual and contextual factors such as sex or gender, race, ethnicity, underlying medical or developmental disorders, access to and type of water sources, and high-risk behaviors.

In the US, males are more likely to drown than females at every age after the first year of life. Non-Hispanic Black, American Indian, and Alaskan native children drown more frequently than children of other ethnicities. Underlying medical conditions, such as seizures and autism, increase risk of drowning, whereas swimming can trigger cardiac arrythmias in children with underlying cardiac conditions. Other intellectual and physical disabilities may make one more susceptible to drowning.

Infants in the US are more likely to drown in bathtubs; children aged 1-4 years drown more frequently in home swimming pools. As children age, the percentage of drowning events in natural water sources increases. By comparison, LMIC victims commonly drown in watering holes, wells, and natural surface waters regardless of age.

Alcohol use around water (by caregivers and older victims themselves) increases the risk of drowning in the US and globally, as does lack of adequate supervision of children in aquatic settings

The US and global burden of drowning, and the need for research prioritization, was highlighted in two recent American Academy of Pediatrics reports (2019 and 2021) and several World Health Organization documents. Moreover, on April 28, 2021, governments worldwide adopted the first ever United Nations General Assembly Resolution focused on global drowning prevention.

Research Objectives

Though epidemiologic research has helped identify drowning risk factors, little is known about what intervention strategies have the greatest efficacy to prevent drowning and/or improve outcomes after a drowning event. Thus, the goal of this NOSI is to encourage and facilitate scientific discovery for drowning prevention, specifically aimed at reducing drowning risk and improving outcomes in three primary domains.

Domain 1: Understanding drowning disparities and developing drowning interventions to address these disparities.

Rates of drowning vary significantly. Reasons contributing to drowning risks among certain populations are multifaceted and likely related to access and exposure to water, knowledge and skills around water, and behaviors and beliefs. Research evaluating both structural and/or systemic forces which contribute to disparities in drowning risk among children, parents and communities is needed. Development of effective interventions aimed at addressing these factors as they pertain to drowning prevention is critical.

Domain 2: Studying the effects of swim instruction on swim skills to prevent drowning.

Swim skills, which are often obtained through swim instruction, can decrease drowning risk; however tremendous variability among types and techniques of swim instruction exists. Validated measures which consistently assess swim skill efficacy to prevent drowning at differing ages and developmental abilities are lacking. Metrics which help to identify effective, quality swim instruction to prevent drowning are needed. The development of evidence-based best practices as to when and how to instruct populations most at risk for drowning (such as children of young age, of certain races/ethnicities, with intellectual or developmental disabilities, or those with linguistic or cultural differences), is essential.

Domain 3: The adoption, integration and sustainable scale-up of the drowning chain of survival.

The five steps of drowning chain of survival can reduce drowning mortality. These steps include: (1) preventing drowning, (2) recognizing distress, (3) providing flotation, (4) removal from water and (5) providing care as needed. Depending on the water source, interventions which constitute these layers of drowning protection exist. Research to advance the adoption, integration and sustainable scale-up of evidence-based drowning prevention interventions and the drowning chain of survival across families and communities is needed.

High priority applications could include, but are not limited to:

  • Studies aimed at understanding structural and systemic inequities of drowning risk
  • Research developing and evaluating culturally appropriate drowning interventions to decrease drowning inequities
  • Discovery of validated measures to consistently assess the efficacy of swim skills and other components of water competency to prevent drowning across different ages, and physical and intellectual capabilities
  • Development and testing of metrics which can identify effective, quality swim instruction to prevent drowning among differing sociodemographic groups, physical and intellectual abilities, cultures, and languages
  • Trials rigorously evaluating types of swim instruction techniques and swim skills, and their related effect on drowning prevention and drowning outcomes
  • Development and evaluation of evidence-based best practices as to when and how to instruct populations most at risk for drowning
  • Testing and delivery of novel, scalable interventions to address components of water competency, including swim skills, and the chain of survival in families and communities
  • Analysis of school-based or other community interventions which promote adoption and integration of swim instruction, water competency and the drowning chain of survival into programs
  • Dissemination research to improve scale-up and reach of evidence-based drowning interventions locally, nationally, and globally
  • Implementation research to increase fidelity and sustainability of evidence-based drowning interventions
  • Evaluation of policy and standards as they relate to decreasing drowning risk and increase equity of drowning interventions and outcomes

The following Institutes, Offices and Centers are participating in this NOSI. Applications must be relevant to the objectives and responsive to funding opportunities announcements listed below each specific entity. The Health Resources and Services Administration (HRSA) is also supportive of this funding opportunity announcement as its research and programmatic interests intersect with child injury prevention.

National Institute on Minority Health and Health Disparities (NIMHD)

The mission of the NIMHD is to lead scientific research to improve minority health and reduce health disparities. NIMHD focuses on the full continuum of causes of health disparities and the interrelation of these causes. NIMHD Projects must include a focus on one or more of the following populations that NIH-designates as experiencing health disparities in the United States: African Americans, Latinos/Hispanics, American Indians and Alaska Natives, Asian Americans, Native Hawaiians and other Pacific Islanders, less privileged socioeconomic groups, underserved rural populations, and sexual and gender minorities (SGMs). Comparison groups/populations may also be included as appropriate for the research questions posed. NIMHD encourages projects that use approaches encompassing multiple domains of influence (e.g., biological, behavioral, sociocultural, environmental, physical environment, health system) and multiple levels of influence (e.g., individual, interpersonal, family, peer group, community, societal) to understand and address health disparities (see the NIMHD Research Framework, https://www.nimhd.nih.gov/about/overview/research-framework.html, for more information). NIMHD will participate only in the following related announcements:

  • PA-20-185 - Research Project Grant (Parent R01 Clinical Trial Not Allowed)
  • PA-20-183 – Research Project Grant (Parent R01 Clinical Trial Required)
  • PA-20-187 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Required)
  • PA-20-188 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Not Allowed)
  • PA-20-206 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Required)
  • PA-20-205 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Not Allowed)

Office of Disease Prevention (ODP)

The ODP is the lead office at the NIH responsible for assessing, facilitating, and stimulating research in disease prevention. In partnership with the 27 NIH Institutes and Centers, the ODP strives to increase the scope, quality, dissemination, and impact of NIH-supported prevention research. The ODP is interested in providing co-funding support for research that has strong implications for disease and injury prevention and health equity, and that include innovative and appropriate design, measurement, and analysis methods. Furthermore, the ODP has a specific interest in projects that develop and/or test interventions. For additional information about ODP’s research priorities and interests, please refer to the ODP Strategic Plan for Fiscal Years 2019–2023.

The ODP does not award grants; therefore, applications must be relevant to the objectives of at least one of the participating NIH Institutes and Centers (IC) listed in this announcement. Please contact the relevant IC Scientific/Research Contact(s) listed for questions regarding IC research priorities and funding.

Application and Submission Information

This notice applies to due dates on or after June 5, 2022 and subsequent receipt dates through May 8, 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.

 

  • 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-20-194- NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required)
  • PA-20-195 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed)
  • PA-20-185- Research Project Grant (Parent R01 Clinical Trial Not Allowed)
  • PA-20-183 – Research Project Grant (Parent R01 Clinical Trial Required)
  • PA-20-202 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Required)
  • PA-20-203 - Mentored Clinical Scientist Research Career Development Award (Parent K08 Independent Clinical Trial Not Allowed)
  • PA-20-187 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Required
  • PA-20-188 - NIH Pathway to Independence Award (Parent K99/R00 Independent Clinical Trial Not Allowed)
  • PA-20-206 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Required)
  • PA-20-205 - Mentored Patient-Oriented Research Career Development Award (Parent K23 Independent Clinical Trial Not Allowed)

 

All instructions in the SF424 (R&R) Application Guide and the funding opportunity announcement used for submission must be followed, with the following additions:

  • For funding consideration, applicants must include “NOT-HD-21-048” (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.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.

Inquiries

Please direct all inquiries to the contacts in Section VII of the listed funding opportunity announcements with the following additions/substitutions:

Scientific/Research Contact(s)

Cinnamon A. Dixon, DO, MPH
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Telephone: 301-827-6189

Email: cinnamon.dixon@nih.gov

Jarrett A. Johnson, DrPH
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-402-1366
Email: jarrett.johnson@nih.gov

Elizabeth L Neilson, PhD, MPH, MSN
Office of Disease Prevention (ODP)
Telephone: 301-827-5578
Email: Elizabeth.Neilson@nih.gov