October 19, 2023
National Heart, Lung, and Blood Institute (NHLBI)
National Institute on Minority Health and Health Disparities (NIMHD)
The purpose of this NOSI is to highlight NHLBI-specific needs, encourage collaboration between heart, lung, blood and sleep (HLBS) and palliative care (PC) researchers, and continue to inform the research community of NHLBI interest in palliative care research. This NOSI seeks palliative care studies, including ancillary studies to ongoing clinical research studies. Studies addressing efficacy, effectiveness, dissemination and implementation research as well as studies seeking to understand and address barriers to incorporating PC early in the care continuum are encouraged. Applicants must select the IC and associated NOFO to use for submission of an application in response to the NOSI. The selection must align with the IC requirements listed in order to be considered responsive to that NOFO. Non-responsive applications will be withdrawn from consideration for this initiative. In addition, applicants using NIH Parent announcements (listed below) will be assigned to those ICs on this NOSI that have indicated those NOFOs are acceptable and based on usual application-IC assignment practices.
Background:
Providing care that is consistent with a patient’s values, preferences, and goals is a cornerstone of palliative care (PC), an interdisciplinary patient-centered approach that aims to improve quality of life for persons with serious illness and their families. Palliative care focuses on several objectives including relief of symptoms and suffering, communication of prognosis and treatment options in the context of patient goals, and coordination of care within and across healthcare settings. Palliative care is not synonymous with hospice, which focuses on delivering care at the very end-of-life. Integration of palliative care is appropriate at any stage of a serious illness, and it is most beneficial when provided in conjunction with curative or disease-modifying treatment. A serious illness is defined as a condition that carries a high risk of mortality and symptom burden and either negatively impacts a person’s daily function or quality of life, and/or negatively impacts their caregivers. Many HLBS diseases, including heart failure, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, myelodysplastic syndromes, and aplastic anemia are serious, life-limiting, non-curable illnesses. These and other HLBS diseases may benefit from care focused on improvement of symptoms and quality of life, in addition to care focused on slowing or halting progression of disease, and integration of palliative care into cardiology, pulmonary, hematology, pediatric, maternal and critical care practice early during the continuum of care is recommended by multiple professional societies. Additionally, symptoms of HLBS diseases such as cough, shortness of breath, and fatigue may be especially burdensome, even in diseases that are not life-limiting. Research to improve burdensome symptoms has the potential to greatly improve the quality of life for all patients with HLBS diseases, not just those with life-limiting disease.
Scope:
The goal of this NOSI is to support research focused on palliative care for patients with serious HLBS diseases, and specifically encourage integrating palliative care early in the continuum of care; research on strategies to educate physicians on the role of palliative care; addressing care transitions to/from palliative care settings and coordination of care; research on symptom management; and addressing palliative care needs of populations experiencing health disparities.
National Heart, Lung, and Blood Institute (NHLBI)
Questions that could be addressed in response to this NOSI could include, but are not limited to, the following:
Applicants are encouraged to contact the Scientific/Research contact listed in this NOSI to ensure that the proposed aims are consistent with the mission of NHLBI.
National Institute on Minority Health and Health Disparities (NIMHD)
Populations experiencing health disparities may have unique preferences, decision-making, self-care strategies, access, and use of informal or complementary therapies, care-giving, and family and social networks that affect their choice and use of palliative and/or end-of-life care. There also remains an overall distrust of the health care system and institutions, as well as underutilization of current palliative care services. Racial and ethnic minorities are also more likely to have multiple chronic conditions, which impact their health-related quality of life in an exponentially larger manner and make their medical care more complex. People with disabilities may also have higher levels of distrust in both individual clinicians and the medical system. Moreover, clinicians may assume that those with disabilities have poorer quality of life prior to serious illness. In addition, populations that experience health disparities are more likely to experience racially and culturally discordant care. Less is known about palliative and/or end-of-life care consultation, utilization, care transition, and care coordination among the interdisciplinary care team, patient, and caregiver/family. NIMHD is interested in supporting research that focuses on understanding the mechanisms and pathways that contribute to disparities in palliative and/or end-of-life care consultation, utilization and care transition by examining the interplay of factors from multiple levels of influence (e.g., individual, family, community, clinician, and health systems) in one or more populations that experience health disparities (e.g., African Americans/Blacks, Hispanics/Latinos, American Indians/Alaska Natives, Asian Americans, Native Hawaiians and Other Pacific Islanders, underserved rural populations, people with lower socioeconomic status, sexual and gender minority populations, and people with disabilities), and set the foundation for tailored and effective interventions to reduce those disparities. Of specific interest is the focus on racial and ethnic minority populations and/or low socioeconomic status (SES) persons. The intersectionality of race and ethnicity and/or low SES with rural populations or sexual and gender minority (SGM) groups, and people with disabilities is also a priority. Research may propose using available secondary data, health system data, and/or collection of primary data.
Research topics of interest include, but are not limited to, the following:
National Institute of Child Health and Human Development (NICHD)
NICHD supports biomedical, behavioral, and interventional research aimed at improving the health and well-being of children, families, and communities with serious HLBS diseases and their caregivers throughout the world. The NICHD is interested in studies that focus on addressing the palliative care needs of children and pregnant or lactating people.
Research topics of particular interest include, but are not limited to, the following:
Application and Submission Information
This notice applies to due dates on or after February 5, 2024 and subsequent receipt dates through January 7, 2027. This NOSI expires on January 8, 2027; thus no applications will be accepted on or after January 8, 2027.
Submit applications for this initiative using one of the following notice of funding opportunity (NOFO) or any reissues of these announcements through the expiration date of this notice.
NOTE: The NHLBI only permits mechanistic clinical trials via the Parent R01 Clinical Trial Required NOFO PA-20-183, or its reissue, in accordance with NOT-HL-19-690. Efficacy CTs in response to this NOSI submitted to NHLBI via PA-20-183 or its reissue will be withdrawn.
All instructions in the SF424 (R&R) Application Guide and the notice of funding opportunity 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.
Please direct all inquiries to the contacts in Section VII of the listed notice of funding opportunity with the following additions/substitutions:
Scientific/Research Contact(s)
Mihaela’s Stefan, MD, PhD
National Heart, Lung, and Blood Institute (NHLBI)
Division of Lung Diseases (DLD)
Telephone: 301-435-4782
Email: mihaela.stefan@nih.gov
Lynne’s Padgett, PhD
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-827-5511
Email: lynne.padgett@nih.gov
Tessie October, MD, MPH
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-827-6757
Email: tessie.october@nih.gov
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
Email: agrestia@nhlbi.nih.gov
Priscilla Grant, JD
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-594-8412
Email: pg38h@nih.gov
Margaret Young
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-642-4552
Email: margaret.young@nih.gov