Key Dates

Related Announcements

• November 4, 2022 - Urgent Competitive Revision to Existing NIH Grants and Cooperative Agreements (Urgent Supplement -  Clinical Trial Optional). See NOFO PA-23-044.
• April 14, 2021 - Centers for Multiple Chronic Diseases Associated with Health Disparities: Prevention, Treatment, and Management (P50 Clinical Trial Required). See NOFO RFA-MD-21-007.

Issued by

National Institute on Minority Health and Health Disparities (NIMHD)

Purpose

This Notice of Special Interest (NOSI) invites applications for competitive revisions from the National Institute on Minority Health and Health Disparities (NIMHD) Multiple Chronic Disease Centers established under RFA-MD-21-007, “Centers for Multiple Chronic Diseases Associated with Health Disparities: Prevention, Treatment, and Management (P50 Clinical Trial Required)” as result of a Congressional earmark. The FY 2023 Omnibus Appropriations provided the specific language below.

Chronic Disease Centers - In fiscal year 2021, NIMHD undertook an initiative to support regional comprehensive research and coordinating centers on the prevention, treatment, and management of multiple chronic diseases associated with health disparities. The agreement includes an additional $11,000,000 for NIMHD to provide supplemental grants to the l l Centers, with a focus on developing and delivering emerging therapeutic interventions addressing the disproportionate burden of disease. 

Research Objectives

The prevalence of multiple chronic conditions (MCCs) is increasing in the United States and worldwide. Chronic diseases account for a considerable proportion of the United States' health care services utilization, cost, and early mortality. However, most research on chronic conditions focuses on individual conditions, in isolation from chronic comorbidities. Consequently, research results often have limitations on the improvement of overall health outcomes in individuals with multiple chronic diseases. Health disparities exist among the common chronic diseases, such as hypertension, diabetes mellitus, HIV/AIDS, cancer, cardiovascular disease, and obesity, with racial/ethnic minorities and those who are financially disadvantaged having higher incidence or worse outcomes. Strategies to eliminate these disparities in chronic diseases require a transdisciplinary framework and interventions on health determinants beyond the individual level, at the interpersonal, family, organizational, neighborhood, community, and societal levels (see NIMHD Research Framework). Tackling the complex drivers of health disparities requires strong collaborations between researchers, community organizations, clinicians, health care delivery organizations, public health agencies, policymakers, and patients to ensure that relevant, contextually appropriate research is conducted and, more importantly, that findings can be translated into sustainable community and system-level changes that promote health equity.

This NOSI seeks to support the development of innovative interventions to address MCCs and its consequences. Intervention research supported by this initiative should be designed to study: (1) mechanisms or pathways that prevent MCCs, including the identification of early biomarkers, behavioral pathways, and individual and contextual risk factors and interactions that contribute to the development of common MCCs; (2) targeted therapies and management, including self-management, of MCCs to delay progression and prevent onset of new diseases; and (3) innovative health care models for managing or treating MCCs.

Appropriate topics for investigation include, but are not limited to:

• Strategies to improve the clinical identification of chronic diseases or disorders that may facilitate or accelerate early intervention, particularly in populations which bear a disproportionate burden of disease,
• Strategies to address social needs and stressors (lack of access to quality food or housing, transportation needs, food insecurity, neighborhood factors, safety, digital access, and others) in healthcare contexts that may include partnerships with community resource organizations/entities with expertise to address social needs.
• Implementation of food is medicine strategies (e.g., produce prescriptions, food vouchers) for diet-related chronic disease prevention and management among community members/patient populations that are medically underserved.
• Interventions, including those involving natural experiments, targeting the built, sociocultural, communication, and policy environments that affect chronic disease outcomes and risk factors.
• Multi-level interventions, including combinations of at least two levels of analysis (e.g., community and clinical settings) that are hypothesized to produce both independent and joint effects and that address complex behaviors.
• Multi-behavior interventions (e.g., targeting bundles or clusters of behavioral risk factors) including combinations of at least two behaviors, with innovations in the combination of behaviors, the intervention approach, or both.
• Strategies to slow the progression of chronic diseases and disorders and reduce risk factors for the development of complications, such as but not limited to cardiovascular disease, liver disease, kidney disease, gastrointestinal disease, retinopathy, genitourinary disease and disorders, neuropathy, malnutrition, frailty and/or sarcopenia, metabolic bone disease, oseoarthritis, and depression, especially in populations with increased risk for disease progression and complications.
• Innovative approaches (e.g., peer mentoring, mobile phone apps) to promote the adoption and maintenance of individual-level behaviors and self-management strategies shown to improve outcomes, including, but not limited to dietary intake, physical activity and sedentary behavior, risk factor management, mental health management, and medication and/or treatment adherence.
• Studies that leverage the utility of electronic health records and targeted precision medicine approaches that will inform clinical and translational research,
• Studies designed to better understand racial, ethnic and socioeconomic disparities in screening, diagnosis, incidence, prevalence, progression, clinical care, and outcomes related to chronic diseases, with an emphasis on identifying factors that help inform treatment development, practice, or policy designed to reduce or eliminate disparities,
• Implementation of food is medicine strategies (e.g., produce prescriptions, food vouchers, etc.) for diet-related chronic disease prevention and management among community members/patient populations that are medically underserved.
• Interventions to reduce racial, ethnic, and socioeconomic disparities in access to and quality of healthcare as well as in incidence, progression and outcomes related to chronic diseases.
• Strategies to improve health care system design, practices, and workflows to improve the efficiency or effectiveness of patient/provider interactions and access to plain language health information (e.g., shared decision-making, racially concordant care).
•  Dissemination and implementation of evidence-based and informed interventions in novel settings to improve outcomes in populations that experience health disparities with one or more chronic diseases (i.e., obesity, HIV/AIDS, non-alcoholic fatty liver disease, osteoarthrits, Type 2 diabetes, cardiovascular disease, kidney diseases, and other conditions).
•  Clinical or organizational-based interventions to increase access to novel chronic disease interventions including new medications, other therapeutics, and novel behavioral approaches.
• Care coordination/care planning for individuals with multiple chronic conditions (e.g., diabetes + cardiovascular disease + obesity + chronic kidney disease).

Application and Submission Information

Submit applications for this initiative using the following notice of funding opportunity (NOFO) with a receipt date of July 21, 2023 and an expiration date of July 22, 2023.  

• PA-23-044, Urgent Competitive Revision to Existing NIH Grants and Cooperative Agreements (Urgent Supplement - Clinical Trial Optional)

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:

• For funding consideration, applicants must include “NOT-MD-23-009” (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 notice of funding opportunity with the following additions/substitutions:

Scientific/Research Contact(s)

Nathan Stinson, Jr., PhD, MD, MPH
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-594-8704
Email: stinsonn@mail.nih.gov

Peer Review Contact(s)

Yujing Liu, MD, PhD
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-827-7815
Email: liuyujin@mail.nih.gov

Financial/Grants Management Contact(s)

Priscilla Grant, JD
National Institute on Minority Health and Health Disparities (NIMHD)
Telephone: 301-594-8412
Email: pg38h@nih.gov