10/07/2022
PA-21-151 - NIH Support for Conferences and Scientific Meetings (Parent R13 Clinical Trial Not Allowed)
PA-20-195 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed)
PA-20-194 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) is issuing this NOSI to underscore the need for multidisciplinary research that addresses the potential associations between childhood trauma, particularly chronic sexual abuse and gynecologic health and disease. The NICHD is interested in receiving applications proposing scientific meetings or developmental/exploratory projects that will catalyze this field of inquiry by bringing together multiple disciplines to determine where there are opportunities for collaboration and to identify scientific opportunities for investigation.
Background
Research supports positive associations between child maltreatment and adverse physical health outcomes including such conditions as cardiovascular disease, obesity, sexually-transmitted infections, and autoimmune diseases. Among those studies, few examine the relationship between gynecologic health and disease and cumulative effect of early life trauma—particularly sexual abuse.
Research has documented that childhood exposure to violence may underpin biological and behavioral patterns that affect health outcomes well into adulthood. However, many questions remain regarding the associations between early life adversity and reproductive and gynecologic health outcomes. Studies that yield a comprehensive view of how the biological and behavioral consequences of traumatic experiences such as child sexual abuse contribute to the etiology, prevalence, or clinical severity of gynecological health and diseases are needed.
Childhood sexual abuse (CSA) has widespread and long-lasting impact on women's lives and health. Increased knowledge and deeper understanding are needed of the impact of these experiences at different stages of development including childhood and adolescence, adolescent transition to adulthood, as well as experiences during adulthood as it relates to reproductive and gynecologic health.
Studies suggest that there is biologic plausibility for adverse effects of child sexual abuse on reproductive health outcomes through influences on health behaviors and reproductive hormone regulation. Indeed, childhood sexual trauma has been linked to dysregulation of the HPA axis and the stress response, which may affect ovarian hormone synthesis and uterine fibroid growth. Sexual abuse is also associated with reproductive tract infections, which are hypothesized to increase fibroid risk through various mechanisms. Understanding the mechanisms underlying these relations may better define the biologic impacts of abuse and the related pathophysiology of endometriosis, fibroids, and chronic pelvic pain.
Minoritized populations are disproportionately affected by adverse and traumatic experiences in childhood. The impact of these experiences persist through adulthood and may be associated with disparities in reproductive and gynecologic health outcomes. There is a dearth of research linking early adverse experiences in childhood with racial/ethnic disparities in gynecologic and reproducive health outcomes in adulthood.
Finally, many of the studies pursuing this line of inquiry have limitations including methodologies which may incorporate histories of global childhood physical abuse, but not specifically sexual abuse, for example. In addition, there are challenges in the use of cross-sectional, short-term, or adult retrospective study designs as these may limit causal inferences. More work is needed to determine the appropriate methods and measures for answering compelling questions related to the themes outlined in this NOSI.
Research Objectives
Applications submitted in response to this NOSI may address but not be limited to the following objectives:
- Explore the relationship between child sexual abuse in particular and gynecologic health and disease
- Design and test the efficacy of developmentally appropriate clinical and psychosocial interventions
- Facilitate the determination of common data elements, measures, and uniform definitions as it relates to abuse history
- Identify existing data sets, and appropriate methodologies to address key knowledge gaps
- Explore what is known about the transition to adulthood and reproductive health outcomes of women who have experienced childhood sexual trauma/abuse
- Identify vulnerabilities or risk factors in childhood that exacerbate gynecologic or reproductive health outcomes
- Identify protective factors that may buffer against challenges associated with these risk factors
- Examine the extent to which type of abuse, chronicity, and severity play a role in health outcomes
- Foster collaborations among researchers in the child abuse, child welfare, pediatric and adolescent medicine, reproductive health and gynecology to identify gaps, and to illuminate areas where more research is needed
- Foster scientific discussions on how research findings can be used to best inform guidelines for patient care
- Promote the development of research agendas that identify and address disparities in reproductive and gynecological health outcomes among women who have endorsed a trauma history
Application and Submission Information
This notice applies to due dates on or after November 16, 2022 and subsequent receipt dates through January 9, 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-21-151 - NIH Support for Conferences and Scientific Meetings (Parent R13 Clinical Trial Not Allowed)
- PA-20-195 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed)
- PA-20-194 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required)
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-22-045” (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.
Scientific/Research Contact(s)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-496-1514
Email: maholmev@mail.nih.gov
and Human Services (HHS)
