Notice of Intent to Publish a Notice of Funding Opportunity for Clinical-Community Linkages to Address Unmet Social Needs and Adverse Social Determinants of Health to Advance Health Equity among Populations Experiencing Health Disparities (R01)

Key Dates

None

National Institute of Nursing Research (NINR)

The purpose of this notice is to inform the research community of the National Institute of Nursing Research (NINR) intent to publish a notice of funding opportunity (NOFO), Clinical-Community Linkages to Address Unmet Social Needs and Adverse Social Determinants of Health to Advance Health Equity among Populations Experiencing Health Disparities: The Bridge-to-Care Initiative (R01 Clinical Trial Optional).

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

This NOFO will utilize the R01 activity code. Details of the planned NOFO are provided below.

Innovative systems and models of healthcare delivery that holistically consider the context of people s lives and living conditions have the potential to significantly improve health, especially among populations disproportionately impacted by adverse social determinants of health (SDOH). This funding opportunity solicits research to advance the development and expansion of interventions and programs that leverage existing or create new healthcare-community partnerships to address unmet social needs among individuals and families and adverse SDOH within communities. Partnerships might include, for example, a collaboration between a community clinic and a food bank to address food insecurity, or a partnership between an urgent care facility and a community-based violence prevention organization to prevent or mitigate the health sequela of violence within a defined geographical area.

This initiative focuses on populations that experience health disparities, including racial and ethnic minority populations, people with lower socioeconomic status, underserved rural populations, sexual and gender minority populations, people with disabilities, and any subpopulations that can be characterized by the intersection of two or more of these descriptors.

Research Objectives

Bridge-to-Care will support research that leverages healthcare-community partnerships to address the social circumstances and conditions that influence health. Specific studies of interest include:

1. Intervention research to address unmet social needs and adverse SDOH in the clinical or community setting by linking to existing services and resources or by collaboratively creating new health-promoting services and resources.
2. Evaluation research that assesses the health impact of existing programs that leverage healthcare-community partnerships to address individual or family unmet social needs or adverse SDOH within communities.

This initiative requires the establishment, expansion, and/or evaluation of healthcare-community partnerships to enable the effective and efficient ability to address individuals and families unmet social needs and adverse SDOH within communities. Community partners can include, but are not limited to, those in the housing, transportation, food system, economic development, education, social services, and criminal legal system sectors. Applicants should provide details on the nature and extent of their partnerships, including clearly describing the roles of partners and providing evidence of support from partner organizations.

Primary Outcome: All studies must explicitly examine the impact of the intervention or program on a health outcome. Health outcomes may reflect health or functional status, health conditions, quality of life, morbidity and mortality, and/or health behaviors. Linkage to social services or utilization of services to address social needs or SDOH are not acceptable outcomes for this funding opportunity but could be studied as mechanisms.

Individual- or Family-Level Social Needs Interventions: Studies examining the health impact of new or adapted interventions conducted in healthcare settings, in partnership with community organizations, that screen for patient or family social needs (e.g., food, utilities, housing, transportation, employment, education, financial strain, safety) and aim to address unmet patient or family social needs.

Examples of projects supported in this category include, but are not limited to, leveraging existing or creating new healthcare-community partnerships to develop and assess the effectiveness of social-needs targeted care interventions that:

• Utilize a community health worker, navigator, or case manager to facilitate the provision of social needs care for patients and/or their families
• Address food insecurity at the patient or family level
• Focus on the prevention or treatment of intimate partner violence
• Focus on the additive and synergistic health effects of addressing one or multiple unmet social needs
• Utilize implementation science to identify, understand, and develop strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of social needs programs in clinical settings

Interventions to Address SDOH: Studies that leverage healthcare-community partnerships to improve health by addressing adverse SDOH within communities. This may include new or adapted interventions focused on expanding the availability and accessibility of community-level social and economic resources or reducing exposure to community-level hazards. Health outcomes in this category should be assessed at the individual level as a primary outcome, and secondarily at the community level, if appropriate.

Examples of projects supported in this category include, but are not limited to, studies that develop and evaluate the effectiveness of interventions that leverage healthcare-community partnerships to promote health by:

• Advancing the availability of affordable nutrient-rich food in the community
• Improving the availability or quality of green spaces or recreational spaces
• Improving community conditions through community revitalization investment projects
• Improving economic stability, such as through increased job opportunities or quality employment
• Improving housing access, quality, or affordability
• Improving education quality and completion
• Reducing community-level violence, including firearm violence

Evaluation of Existing Interventions/Programs to Address Social Needs or SDOH: Studies that evaluate the health impact of existing interventions and programs at the federal, tribal, state, local, or organizational level that leverage healthcare-community partnerships to address individual or family unmet social needs or adverse SDOH within communities. Programs of interest include those aimed at addressing social needs related to food insecurity, housing instability, and/or economic circumstances or programs to address adverse SDOH within communities to mitigate the impact of concentrated poverty, neighborhood violence, education quality, employment opportunities, etc.

Examples of projects supported in this category include, but are not limited to studies that evaluate:

• Health impacts of demonstration projects aimed at addressing social needs or SDOH
• Health impacts of new standards of care, changes in health insurance coverage, expansion of access to social services, and other factors that influence social needs or SDOH
• Effects of programs designed to improve access to or quality of housing, transportation, and food on health within communities
• Health impacts of infrastructure changes related to housing, transportation, the food environment, or the built environment on health outcomes

Funding Information

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)
Small Business
For-Profit Organization (Other than Small Business)
State Government
Indian/Native American Tribal Government (Federally Recognized)
County 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)
Regional Organization
Eligible Agencies of the Federal Government

Applications are not being solicited at this time.

Inquiries

Please direct all inquiries to:

Shalanda A. Bynum, PhD, MPH
National Institute of Nursing Research (NINR)
Telephone: 301-755-4355
Email: shalanda.bynum@nih.gov