Notice of Special Interest (NOSI): Behavioral Economics for Implementation Research (BEIR) to improve use of Evidence-Based Practices for HLBS conditions
Notice Number:

Key Dates

Release Date:

June 3, 2021

First Available Due Date:
October 05, 2021
Expiration Date:
September 08, 2024

Related Announcements

PAR-19-274 - Dissemination and Implementation Research in Health (R01 Clinical Trial Optional)

NOT-OD-19-122 - Fast Healthcare Interoperability Resources (FHIR ) Standard

NOT-OD-16-025 - Clarifying NIH Priorities for Health Economics Research

Issued by

National Heart, Lung, and Blood Institute (NHLBI)


This Notice of Special Interest (NOSI) is intended to stimulate the use of behavioral economics strategies for implementation research (BEIR) in order to develop more effective strategies for implementaion of evidence-based practices (EBP) to address heart, lung, blood, and sleep (HLBS) conditions. NHLBI encourages applications that recognize the importance of cultural context, patterns of behavior change, and motivators for change across decision-making levels, including individuals (e.g., patients, parents, clinicians, others), groups, healthcare systems and/or communities. Applications that focus on the use of behavioral economics to develop implementation strategies for user-driven, sustainable interventions that may be simplified and minimally disruptive when possible are encouraged. Applications may propose either a clinical trial or non-clinical trial design, as appropriate to the research objectives.


More effective implementation strategies can be developed when motivators of behavior change are understood and that information is incorporated within the implementation strategy. The interface of behavioral economics and implementation research (BEIR) can facilitate the development of an implementation strategy which is explicitly designed and maintained to optimize the desired behaviors (i.e., actions) with ease, efficiency, and consistency, once the desired outcome(s) and the recommended behaviors/action(s) needed to support those desired outcomes (as specified in an EBP) have been identified. BEIR studies are designed to reflect the realities of human behavior and employ heuristics, or mental shortcuts, to make decisions. Behavioral economics strategies include performance assessment; choice architecture; hovering (i.e., observation); incentives, including behavioral nudges; maintaining consistency; making harms more immediate/salient; modelling behavior; remuneration; social proofs, and more. Effective BEIR strategies recognize the importance of cultural context and patterns of behavior change. BEIR implementation strategies can be multi-level and/or multi-actor and/or span across levels of patients, care providers, groups, and/or system-wide procedures.

Collaborations among multiple disciplines are encouraged for this NOSI, including implementation scientists, behavioral health experts, social-psychologists, shared-decision making analysts, professional training, organizational-change experts, health system analysts, methodologists, etc. The community-based stakeholders, decision makers, and other end-users (e.g., clinicians, public health analysts, patients, parents, clinicians, public health analysts, patient representatives) are welcome along the research continuum, from initial study conception to dissemination and implementation.

Applicants are encouraged to clearly identify the HLBS EBP for which the behavioral economic strategies will be applied in the implementation research project. The development and dissemination of the implementation strategy plan should include reusable infrastructure such as national standards for data extraction and interoperability (e.g., findability, accessibility, interoperability, and reusability; FAIR (see NOT-OD-19-122), as well as Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) (see so that the approach may be replicated longitudinally and allow others to adapt the implementation strategies. Applicants are encouraged to become familiar with the most-recent NIH Strategic Plan for Data Science ( , November 2020).

Behavioral economics analyses are distinct from traditional economic analyses, but applicants may choose to include both approaches in the proposed implementation research project . Applicants seeking to include economic analyses are encouraged to review NOT-OD-16-025 for the NIH policy related to funding health economics research.

Prospective applicants are encouraged to direct inquiries to the appropriate NLHBI scientific research contact(s) listed below to ensure that the proposed aims are consistent with NHLBI's mission and to advise on the NIH's criteria for defining a clinical trial.

Research projects proposed in response to this NOSI that seek to improve decisions made toward achieving improved fulfillment of HLBS-related EBP could include, but are not limited to the following:

  • Implementation research projects that use tested, validated behavioral economics approaches (e.g., use of behavioral nudges, motivational interviewing, audit and feedback, determination of choice architecture configurations, defaults, opt-in/out decisions, ordering, active choice, etc.) to incorporate EBP recommendations that address HLBS conditions into everyday practice.
  • Implementation research studies which evaluate the potential of BEIR incentives to result sustainable behavior change.
  • BEIR studies that reflect a complex decision-making enterprise, whereby the implementation research strategy facilitates appropriate behavior across multiple decision-makers (e.g., engagement of children, parents, and clinicians in order increase children’s healthy lifestyle, activity, and weight.)
  • BEIR studies that focus on strategies for behavior change related to frequently-made decisions that may bemore difficult to change.
  • BEIR studies that use incentive designs such as gamification, regret, timing, deposit contracts, variable reinforcement etc., to induce a behavior change within a defined period of feedback.
  • BEIR studies which include microsimulation models that produce estimates of the long-term trajectory of the implementation strategy including implementation costs, cost-effectiveness, and impact on desired outcomes.
  • Innovative BEIR research about use and form of intrinsic motivators across the levels of patients, care providers, groups, or system-wide procedures.
  • New BEIR research that assess the transition of a currently successful BEIR implementation strategy that relies on external motivations to one that BEIR implementation strategy which relies on intrinsic motivations.
  • Projects which include multi-level and multi-actor BEIR strategies.
  • BEIR research studies that facilitate the synergistic alignment of workflow and functionality of health information technology to generate insights on the determination of choice architecture configurations such as defaults, opt-in/out decisions, ordering, active choice and simplicity within a implementation strategy for EBP.

NHLBI strongly encourages applications that specify the EBP for which an intervention strategy will be developed and tested.

Application and Submission Information

This notice applies to due dates on or after . 10/05/2021

Submit applications for this NOSI using the following funding opportunity announcement (FOA) or any reissues of this announcement through the expiration date of this notice.

  • PAR-19-274- Dissemination and Implementation Research in Health (R01 Clinical Trial Optional)
    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-HL-21-010" (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.


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)

Sue Shero, RN, MS
Center for Translation Research and Implementation Science
National Heart, Lung and Blood Institute (NHLBI)
Telephone: 301-496-1051

Michelle M. Freemer, MD, MPH
Division of Lung Diseases
National Heart, Lung and Blood Institute (NHLBI)

Kathleen Fenton, MD, MPH
Division of Cardiovascular Sciences
National Heart, Lung and Blood Institute (NHLBI)

Peer Review Contact(s)

Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).

Financial/Grants Management Contact(s)

Anthony Agresti
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-435-0186

Weekly TOC for this Announcement
NIH Funding Opportunities and Notices