The purpose of this Notice of Special Interest is to encourage innovative health services research that can directly and demonstrably contribute to the improvement of minority health and/or the reduction of health disparities at the health care system-level as well as within clinical settings.

The National Institute of Minority Health and Health Disparities (NIMHD) is issuing this Notice to highlight interest in receiving NIH Research Project Grant (R01) applications focused in the following area(s):?

• Research to understand and address population-specific clinical presentation and/or manifestation of diseases, and their complications and differences in response to treatment among populations affected by health disparities. For example, identifying optimal screening criteria to determine disease risk, tailoring disease management strategies or biomarkers, based on clinical presentation of diseases and their complications, or findings from interventions or clinical trials assessing differences in response to treatment (e.g., precision medicine).
• Studies of strategies to ensure that populations affected by health disparities receive prevention, screening, diagnosis and treatment services consistent with national evidence-based recommendations in clinical settings (including rural health care settings), especially for conditions of greatest burden, such as but not limited to diabetes mellitus, coronary artery disease, cancer, cerebrovascular disease, cognitive impairment, asthma, mental and substance use disorders, and perinatal complications.
• Studies of strategies to ensure that vulnerable groups (e.g., pregnant women, women with severe maternal morbidity, infants and children with complex medical care needs, older adults, persons with disabilities) within populations affected by health disparities receive prevention, screening, diagnosis, and treatment services consistent with national evidence-based recommendations, or most compelling recent peer-reviewed evidence, and recommended support services outside clinical settings.
• Studies of strategies to effectively identify and treat common risk factors or causes of maternal and infant mortality in populations affected by health disparities.
• Studies of strategies to improve patient safety and reduce medical errors, including adverse events related to medications, devices and medical and/or surgical procedures, in populations affected by health disparities.
• Development and assessment of innovative preventive or health promotion interventions (e.g., health education, wellness programs, early screening, immunizations/vaccinations) delivered within the healthcare system including underserved rural healthcare settings, and targeting populations affected by health disparities.
• Research on innovative models of healthcare delivery in rural areas and their impact on health outcomes. Examples include integration and coordination of delivery of services between rural community health clinics and larger healthcare hubs, use of telehealth or other telecommunication to coordinate care between local primary clinics and nearest large healthcare system, coordination and communication between stand-alone emergency rooms, birth centers and other stand-alone services and regional healthcare hubs, and integration of pharmacies and other community resources (e.g., fire stations, schools) in health promotion strategies.
• Assessment of initiatives that integrate social determinants of health with other health care data and their impact on health care access and health outcomes of populations affected by health disparities.
• Studies of strategies to improve quality of health care for populations affected by health disparities, including emerging innovative strategies such as but not limited to evidence-based health care safety bundles, health improvement collaboratives, and innovative primary care models.
• Research to understand factors that trigger, facilitate or deter engagement/partnership of patients from populations affected by health disparities in clinical care across the care cascade (screening, diagnosis, engagement in care, treatment adherence), and assessment of interventions to enhance patient engagement, and the impact of these interventions on health outcomes.
• Research to identify patterns and elucidate mechanisms for different patterns of healthcare utilization, quality and outcomes in populations affected by health disparities
• Assessment of the impact of the structure and organization of healthcare systems on healthcare service utilization and health outcomes, including strategies to increase health equity.
• Assessment of interventions to reduce clinician and/or health care system bias and examining how these interventions impact quality of care, patients health outcomes (e.g. severe maternal morbidity and mortality, infant mortality), and health and healthcare disparities.
• The incorporation of specific research tools or methodologies into system-level service delivery practices that identify or measure patient-reported outcomes such as health-related quality of life, preference-based decision making, functional status, symptoms and adherence in populations affected by health disparities within the context of assessing clinical and/or services outcomes.
• Analysis of initiatives to increase the supply of and access to health care practitioners (including allied health professionals, paraprofessionals or peer-led health services) in medically underserved areas, including underserved rural areas.
• Studies of strategies to manage, finance, and deliver health care to improve minority health or reduce health disparities. Analysis of local, state, or national healthcare and non-health care policies that increase or reduce health care and health disparities, such as those related to insurance coverage or reimbursement, sick leave policies, family and medical leave policies, language access policies, and organization of government-run or -funded health care services.
• Research to understand or improve formal care for populations affected by health disparities in community-based mental health and drug treatment settings, including clinics, private practice settings, residential treatment facilities and detoxification centers.

Specific Areas of Research Interest for NIAAA:

• Evaluation of screening, brief intervention, and referral to treatment (SBIRT) and treatment retention and relapse rates in health disparity populations and identifying strategies for improving these
• Assessment of stigma and bias as they relate to healthcare quality, health systems delivery, and access to care in health disparity populations, their impact, and interventions to address this impact
• Analysis of differences in rates of fetal exposure to alcohol and FASD between health disparity populations
• Evaluation of the ways in which dissemination and implementation of evidence-based strategies for prevention and treatment of alcohol-related problems may be tailored to improve outcomes in health disparity populations
• Evaluation of how the determinants of health disparities (i.e., environmental, social, biological/genetic, psychosocial, and economic) are associated with disparities in healthcare quality, health systems delivery, and access to care in health disparity populations.

Specific Areas of Research Interest for NIDCR:

The National Institute of Dental and Craniofacial Research (NIDCR) is interested in encouraging health services research that can contribute to the improvement of oral health in vulnerable and underserved populations, and reduce oral health disparities and inequities.

NIDCR is interested in research that includes, but is not limited to, the following:

• Research to understand and address population-specific clinical presentation and/or manifestation of oral diseases, and their complications and differences in response to treatment, among populations affected by health disparities. For example, identifying optimal screening criteria or biomarkers to determine oral disease risk, or tailoring disease management strategies based on clinical presentation of diseases and their complications.
• Research on strategies to ensure that populations affected by oral health disparities receive oral prevention, screening, diagnosis and treatment services consistent with national evidence-based recommendations in clinical settings (including rural health care settings).
• Research on strategies to effectively identify and treat common risk factors or causes of both oral diseases and other general health conditions/diseases, such as high sugar intake, poor diet quality, alcohol use, or use of tobacco and/or nicotine-containing products (including e-cigarettes).
• Research on innovative models of oral healthcare delivery in rural areas and their impact on oral health outcomes.
• Research to identify patterns and elucidate mechanisms for different patterns of oral healthcare utilization, quality and outcomes in populations affected by health disparities.
• Research that assesses the impact of the structure and organization of healthcare systems that deliver oral healthcare on oral healthcare utilization and oral health outcomes, including strategies to increase health equity.
• Research that examines strategies to manage, finance, and deliver oral healthcare to improve or reduce oral health disparities and inequities in vulnerable and underserved populations. Analysis of local, state, or national healthcare and non-health care policies that impact oral healthcare and health disparities, such as those related to insurance coverage or reimbursement, access policies, and organization of government-run or -funded healthcare services. Attention should be given to NOT-OD-16-025, which clarifies NIH’s priorities for health economics research.

Application and Submission Information

This notice applies to due dates on or after June 5, 2020 and subsequent receipt dates through September 8, 2022.

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-19-055 - NIH Research Project Grant (Parent R01 Clinical Trial Required)
• PA-19-056 - NIH Research Project Grant (Parent R01 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-MD-20-011 (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 be 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 for NIMHD

Rada Dagher, PhD
National Institute on Minority Health and Health Disparities (NIMHD/http://www.nimhd.nih.gov/)
Telephone: 301-451-2187
[email protected] (mailto:[email protected]

Scientific/Research Contact for NCI

Brenda Adjei, M.P.A., Ed.D.
National Cancer Institute (NCI/https://www.cancer.gov/)
Telephone: 240-276-6185
Email: [email protected]

Scientific/Research Contact for NIDCR

Darien Weatherspoon, DDS, MPH
National Institute of Dental and Craniofacial Research (NIDCR)
Telephone: 301-594-5394
Email:[email protected]

Scientific/Research Contact for NIAAA

Laura E. Kwako, PhD
National Institute on Alcohol Abuse and Alcoholism (NIAAA/http://niaaa.nih.gov)
Telephone: 301-451-8507
Email: [email protected] (mailto:[email protected])

Scientific/Research Contact for NIDA

Minnjuan Flournoy-Floyd, Ph.D.
National Institute on Drug Abuse (NIDA/http://www.nida.nih.gov)
Telephone: 301-827-6474
Email: [email protected]