Notice of Intent to Publish a Funding Opportunity Announcement for End-of-Life and Palliative Care Approaches to Advanced Signs and Symptoms (R21- Clinical Trial Optional)

---

Notice Number: NOT-NR-18-014

Key Dates

Release Date: July 23, 2018
Estimated Publication Date of Funding Opportunity Announcement: November 01, 2018
First Estimated Application Due Date: February 16, 2019
Earliest Estimated Award Date: October 01, 2019
Earliest Estimated Start Date: November 01, 2019

Related Announcements
NOT-NR-18-013
PAR-19-044

Issued by
National Institute of Nursing Research (NINR)

Purpose

The National Institute of Nursing Research (NINR) intends to promote a new initiative by publishing a Funding Opportunity Announcement (FOA) to solicit applications for research grants that examine the multi-dimensional foundations, expressions and management of complex, advanced signs and symptoms at the end of life.

This Notice is being provided to allow potential applicants sufficient time to develop meaningful collaborations and responsive projects.

The FOA is expected to be published in Fall 2018 with an expected application due date in Winter 2019.

This FOA will utilize the R21 activity code. Details of the planned FOA are provided below.

Research Initiative Details

The objectives of the FOA will focus on research that examines the multi-dimensional foundations, expressions and management of complex, advanced signs and symptoms at the end of life.

This Notice encourages investigators and multidisciplinary teams with expertise and insight into end-of-life and palliative approaches to advanced signs and symptoms to begin to consider applying for this FOA. Because of the complex, multi-factorial nature of this issue, multi-disciplinary teams are highly encouraged. Investigators are encouraged to consider using existing palliative care research networks, such as the Palliative Care Research Cooperative Group, to carry out small, multi-site trials when appropriate. Inclusion of patient- and family-representatives in the design of the study and in the development of interventions is strongly recommended. Inclusion of under-studied populations including NIH-designated health disparity, socioeconomically disadvantaged, rural and/or remote, and sexual and gender minority populations with advanced, serious illness at the end of life is encouraged. To fully explore the patient- and family-centered experience of advanced signs and symptoms, a wide variety of research methodologies may be appropriate including qualitative, mixed methods, quasi-experimental, laboratory, pragmatic techniques and innovative methods.

NINR is interested in studies examining the multi-dimensional foundations, expressions and management of advanced signs and symptoms specific to individuals with advanced serious illness within the period of end of life including, but not limited to:

• Pain
• Fatigue
• Respiratory signs and symptoms, including dyspnea, audible secretions/congestion, cough, respirations with mandibular movement, hemoptysis, etc.
• Cardiovascular signs and symptoms, including edema, mottling, cyanosis, weakness, etc.
• Gastrointestinal or digestive signs symptoms, including anorexia, cachexia, constipation, diarrhea, dysphagia, involuntary bowel movements, nausea, stomatitis, vomiting, etc.
• Urinary signs and symptoms including incontinence, urinary obstruction, decreased urinary output, etc.
• Integumentary symptoms including itching, skin failure, etc.
• Symptoms related to fluid balance including dizziness, dehydration, dry mouth, fever, etc.
• Neurological and behavioral signs and symptoms including agitation, confusion, delirium, hallucination, irritability, myoclonus, seizures, sleep disturbances, terminal restlessness, etc.
• Psychosocial signs and symptoms of anxiety, depression, loneliness, social withdrawal, social isolation, etc.
• Signs associated with dying including cyanosis of extremities, cold extremities, mottling, etc.

It is strongly recommended that investigators communicate with the program contact for this funding opportunity announcement prior to application.

Funding Information

Estimated Total Funding TBD
Expected Number of Awards TBD
Estimated Award Ceiling TBD
Primary CFDA Numbers 93.361

Anticipated Eligible Organizations

Public/State Controlled Institution of Higher Education
Private Institution of Higher Education
Nonprofit with 501(c)(3) IRS Status (Other than Institution of Higher Education)
Nonprofit without 501(c)(3) IRS Status (Other than Institution of Higher Education)
Small Business
For-Profit Organization (Other than Small Business)
State Government
Indian/Native American Tribal Government (Federally Recognized)
County governments
City or township governments
Special district governments
Independent school districts
Public housing authorities/Indian housing authorities
Indian/Native American Tribally Designated Organization (Native American tribal organizations (other than Federally recognized tribal governments)
U.S. Territory or Possession
Indian/Native American Tribal Government (Other than Federally Recognized)
Non-domestic (non-U.S.) Entity (Foreign Organization)
Regional Organization

Inquiries

Please direct all inquiries to:

---

Weekly TOC for this Announcement
NIH Funding Opportunities and Notices

---