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This Program Announcement expired on December 17, 2004.

SOCIAL AND CULTURAL DIMENSIONS OF HEALTH

Release Date:  December 21, 2001

PA NUMBER:  PA-02-043 (This PA has been reissued, see PA-05-029)

Office of Behavioral and Social Sciences Research
National Cancer Institute
National Center for Complementary and Alternative Medicine
National Eye Institute
National Heart, Lung, and Blood Institute
National Human Genome Research Institute
National Institute of Child Health and Human Development
National Institute of Dental and Craniofacial Research
National Institute of Diabetes and Digestive and Kidney Diseases
National Institute of Environmental Health Sciences
National Institute of Mental Health
National Institute of Nursing Research
National Institute on Aging
National Institute on Alcohol Abuse and Alcoholism
National Institute on Arthritis, Musculoskeletal, and Skin Diseases
National Institute on Drug Abuse

PURPOSE

The Office of Behavioral and Social Sciences Research (OBSSR), National 
Cancer Institute (NCI), National Center for Complementary and 
Alternative Medicine (NCCAM), National Heart, Lung, and Blood Institute 
(NHLBI), National Human Genome Research Institute (NHGRI), National 
Institute of Child Health and Human Development (NICHD), National 
Institute of Dental and Craniofacial Research (NIDCR), National 
Institute of Environmental Health Sciences (NIEHS), National Institute 
of Mental Health (NIMH), National Institute of Nursing Research (NINR), 
National Institute on Aging (NIA), National Institute on Alcohol Abuse 
and Alcoholism (NIAAA), National Institute on Arthritis, 
Musculoskeletal, and Skin Diseases (NIAMS), and National Institute on 
Drug Abuse (NIDA) invite qualified researchers to submit research grant 
applications on the social and cultural dimensions of health. The goal 
of this announcement is to (a) elucidate basic social and cultural 
constructs and processes used in health research, (b) clarify social 
and cultural factors in the etiology and consequences of health and 
illness, (c) link basic research to practice for improving prevention, 
treatment, health services, and dissemination, and (d) explore ethical 
issues in social and cultural research. The goal of this program 
announcement is to encourage further development of health-related 
social sciences research relevant to the missions of the NIH Institutes 
and Centers (ICs). This program announcement is based upon 
recommendations submitted to the NIH in conjunction with the conference 
entitled "Toward Higher Levels of Analysis: Progress and Promise in 
Research on Social and Cultural Dimensions of Health," June 27-28, 
2000, Bethesda, Maryland. You may request a summary of the conference 
from the Office of Behavioral and Social Sciences Research, NIH, 
Bethesda, MD 20892. Ask for NIH Publication No. 01-5020, September 
2001. The summary is also posted on the Internet at 
http://obssr.od.nih.gov/Conf_Wkshp/higherlevel/conference.html. 

HEALTHY PEOPLE 2010

The Public Health Service (PHS) is committed to achieving the health 
promotion and disease prevention objectives of "Healthy People 2010," a 
PHS led national activity for setting priority areas. This Program 
Announcement (PA) is related to one or more of the priority areas. 
Potential applicants may obtain a copy of "Healthy People 2010" at 
http://www.health.gov/healthypeople/. 

ELIGIBILITY REQUIREMENTS

Applications may be submitted by foreign and domestic for-profit and 
non-profit organizations, public and private, such as universities, 
colleges, hospitals, laboratories, units of state and local 
governments, and eligible agencies of the Federal government. 
Racial/ethnic minority individuals, women, and persons with 
disabilities are encouraged to apply as principal investigators.

MECHANISM OF SUPPORT

All ICs participating in this PA will accept applications for the NIH 
investigator-initiated research project grant (R01) award mechanism. 
Responsibility for the planning, direction, and execution of the 
proposed research will be solely that of the applicant. The total 
project period for an application submitted in response to this PA may 
not exceed 5 years.

Note that NIH ICs may accept applications for other kinds of research 
and training grant awards. For specific information, contact the IC 
staff listed under INQUIRIES.

Specific application instructions have been modified to reflect MODULAR 
GRANT and JUST-IN-TIME streamlining efforts being examined by the NIH. 
Complete and detailed instructions and information on Modular Grant 
applications can be found at 
http://grants.nih.gov/grants/funding/modular/modular.htm. 

Applicants may consult with program staff listed under INQUIRIES 
regarding other mechanisms and relevant announcements on topics related 
to this program announcement.

RESEARCH OBJECTIVES

Social scientists have made significant strides in shedding light on 
the basic social and cultural structures and processes that influence 
health. Social and cultural factors influence health by affecting 
exposure and vulnerability to disease, risk-taking behaviors, the 
effectiveness of health promotion efforts, and access to, availability 
of, and quality of health care. Social and cultural factors also play a 
role in shaping perceptions of and responses to health problems and the 
impact of poor health on individuals" lives and well-being. In 
addition, such factors contribute to understanding societal and 
population processes such as current and changing rates of morbidity, 
survival, and mortality. Consequently, social science research should 
be integrated into interdisciplinary, multi-level studies of health. 
Linking research from the macro-societal levels, through behavioral and 
psychological levels, to the biology of disease will provide the 
integrative health research necessary to fully understand health and 
illness. 

This program announcement invites applications for research on the 
social and cultural dimensions of health in five areas: 

A. Basic social and cultural constructs and processes used in health 
research.
B. Etiology of health and illness
C. Consequences of poor health for individuals and social groups.
D. Linking science to practice to improve prevention, treatment, health 
services, and dissemination. 
E. Ethical issues in social and cultural research.

The goal is to encourage further development of health-related social 
sciences research relevant to the missions of the NIH Institutes and 
Centers (ICs). These missions encompass a broad range of scientific 
questions related to the health and well-being of our nation"s people. 
Information about the specific missions of the ICs participating in 
this program announcement is posted on the NIH HomePage at 
http://www.nih.gov/icd/. 

The broad topical areas included in this Announcement are drawn from 
the recommendations submitted to the NIH in conjunction with the 
conference entitled "Toward Higher Levels of Analysis: Progress and 
Promise in Research on Social and Cultural Dimensions of Health," June 
27-28, 2000, Bethesda, Maryland. For more detailed examples of research 
questions, see 
http://obssr.od.nih.gov/Conf_Wkshp/higherlevel/conference.html. Within 
the broad spectrum of research defined by these areas, applicants are 
encouraged (but are not required) to consider studies that involve 
multiple levels of analysis.

BASIC CONSTRUCTS AND PROCESSES 

Advances in social science research on health depend on a foundation of 
basic theory and knowledge that describes social structures, the 
dynamics of social and cultural processes, and the ways in which 
individuals are located in and interact with the environment, social 
structures, and cultural factors. Several key sociodemographic 
constructs, including race, ethnicity, gender, age, and socioeconomic 
status, are widely used in studies of the etiology of health and 
disease and in research that describes and monitors the distribution of 
disease across social categories, geographic areas, and time. However, 
the meanings of such constructs depend on their cultural, geographical, 
and historical context, and their utility in health research depends on 
their use in ways that are theoretically and historically grounded. In 
addition, the concept of "culture" requires careful theoretical 
grounding in health studies. Most social scientists agree that the 
concept of culture is complex and implies a dynamic and ever-changing 
process. 

This program announcement encourages research on basic social and 
cultural constructs and processes in the following areas: 

Social Stratification and Inequalities

Research to explore the implications of different conceptualizations 
and measurements of social stratification systems and processes, such 
as socioeconomic status (SES) and social class, age, gender, and 
race/ethnicity for understanding health at the individual and higher 
levels of aggregation (e.g., community). Research to improve the 
monitoring and understanding of inequalities in health and disease 
among diverse groups, and the implications for monitoring of strategies 
used to measure basic constructs such as socioeconomic status and 
social class, age, gender, race, and ethnicity.

Social Integration

Research to clarify the social, cultural, and economic factors that 
influence the social integration of individuals and the social cohesion 
of groups, including the causal dynamics of social networks.

Culture

Studies to improve the conceptualization and operationalization of 
culture as well as of social and cultural change in health research. 
Efforts are needed to identify those definitions and dimensions of 
cultural phenomena and intra-cultural and inter-cultural variation and 
change that are most useful in understanding health, and the mechanisms 
through which cultural phenomena influence health.

ETIOLOGY

Social science research on the etiology of health and illness 
recognizes that health may be affected by a diverse set of mechanisms 
operating among and within social structures existing at different 
levels. At the highest levels are structures and processes that involve 
and affect populations broadly: government, media, economic systems, 
social stratification, political processes and policy-making, and 
broadly-held cultural values and practices. Some of these processes 
also operate in communities and neighborhoods, in social institutions 
(e.g., schools, churches, and businesses), and in social or 
professional organizations. However, at these levels processes 
contributing to social cohesion, social support, social control, social 
and cultural conflict, and the development and enforcement of social 
and cultural norms play a larger role. In families and small groups, 
interpersonal processes such as conflict and support, socialization, 
and sharing of resources play a dominant role. 

A valuable contribution of the social sciences is to understand health 
and disease not solely as an individual biological problem, but as a 
social phenomenon associated with social ties and other forms of social 
influences. From this perspective, research must address how mechanisms 
that link social and cultural phenomena to health operate within and 
emerge from specific social contexts. Social contexts provide the stage 
for social and cultural factors to influence health, and the 
characteristics of social context directly affect social and cultural 
processes.

This Program announcement encourages research on topics and questions 
relevant to:

Overarching Issues

Research to improve understanding of how macro-level (societal) 
factors, such as social policies, structures, and cultural norms, are 
linked to micro-level (individual) factors, such as a person"s 
behaviors, and ultimately to health. What are the causal pathways that 
lead from the sociocultural environment to general vulnerability to 
disease and disease-specific outcomes? 

Interpersonal, Social, and Cultural Factors

Studies of the implications for health of the characteristics and 
content of network ties and of how individuals and groups organize 
themselves into networks and other social arrangements, including the 
mechanisms through which social integration/cohesion and exclusion 
affect the health of individuals and contribute to health disparities. 
Research on cultural belief systems (such as religion or the nature of 
health/disease), at the individual, family, community, and 
institutional levels, and their relationships to health, including 
recovery from disease and addiction, with particular attention to 
potential mediating mechanisms (e.g., socially-determined patterns of 
stress and coping with stress). 

Social Contexts

Research on the role of social contexts (e.g., family and households, 
religious institutions, work places, schools, health-care organizations 
and systems, neighborhoods, and communities, geographic location, 
residential segregation, legal and administrative policies, 
communication environments) in mediating or moderating sociocultural 
influences on health of individuals. Studies are required to 
conceptualize and measure social contexts in order to specify which 
particular aspects of social context are relevant to health and the 
mechanisms through which they operate. Research on how health policies 
impact on diverse populations, such as those defined by immigration 
status, gender, race/ethnicity, sexual orientation, or age, and on the 
pathways through which social policies (such as gun control, urban 
renewal, welfare reform, and taxes on alcohol and tobacco products) 
affect the health of diverse populations.

CONSEQUENCES OF POOR HEALTH

Connections among health, functional capacity, and productivity are 
complex and difficult to disentangle, but empirical research is 
emerging that addresses the consequences of poor health for economic 
well-being at the individual, family, and population levels. 
Understanding the consequences of health and illness is important to 
the mission of the NIH. First, health disparities among groups varying 
in socioeconomic status result in part from the reciprocal influence of 
SES on health and health on SES. The nature of these feedbacks needs to 
be fully understood if we are to understand the mechanisms underlying 
health disparities. Second, the value of investment in improving health 
can be only partially understood by focusing on health outcomes alone. 
For example, improvements in quality of life resulting from social, 
economic, and cultural change at both the individual and societal level 
are an important part of the picture. 

This program announcement encourages research on the consequences of 
poor health in the following areas: 

Self Care

Research on self-care or self-regulation as a response to illness and 
in the management of health conditions, considering the influence of 
social, cultural, and economic factors on the adoption and consequences 
of this strategy.

Coping Strategies

Investigations of the coping strategies people use to adapt to illness 
and disability, the influence of social, cultural, and economic factors 
on these strategies, and the impact of these strategies on health and 
well-being at the individual, family, and community level. Research on 
the consequences of death and dying for the health and well-being of 
the deceased"s relatives and friends as well as on the coping 
strategies people use to adapt to illness, disability, and death of a 
relative or close friend.

Social Stigma

Studies of stigma across physical and mental health conditions 
(including addictions), care settings, outcomes and groups, including 
research on the social and cultural origins of stigmatization of 
illnesses. What are the implications of stigma for access to care and 
treatment? How does stigma affect outcomes across health conditions? 

Impact of Health on Society

Examination of how the health of individuals impacts upon macro-level 
processes and systems is also needed. How does the health of individual 
members of a group (e.g., family, household, firm) affect the 
composition and functioning of the group? Also of interest is research 
on the influence of poor health on economic performance of 
organizations and societies. (For example, see International Studies of 
Health and Economic Development, NIH Guide to Grants and Contracts, May 
30, 2000, http://grants.nih.gov/grants/guide/rfa-files/RFA-TW-01-001.html).

LINKING SCIENCE TO PRACTICE TO IMPROVE PREVENTION, TREATMENT,
HEALTH SERVCES, AND DISSEMINATION

The social sciences are important in efforts to prevent and treat 
illness. Research in the social sciences can pinpoint environmental 
contexts, social relationships, interpersonal processes, and cultural 
factors that lead people to engage in healthy behaviors, seek health 
services before disease symptoms worsen, and participate with medical 
professionals in treating illness. The incorporation of social science 
research and theory into prevention, treatment, and service programs 
will likely result in more effective interventions. In addition, 
research on the dissemination and translation of social science 
research findings can ensure that investments in basic research have 
their maximum impact on health.

This program announcement encourages social sciences research on 
prevention, treatment, health services, and dissemination in the 
following areas: 

Prevention

Theoretical development and conceptual work in the field of prevention, 
including clarifying the concepts of risk and protection and their 
meanings within distinct populations, defining the distinctions between 
health promotion and disease prevention, and promoting generalizability 
of theoretical frameworks. Research to design, implement, and evaluate 
interventions based upon the theories, concepts, and methods identified 
earlier in this announcement (e.g., social networks, social contexts, 
cultural beliefs).

Treatment and Management of Disease

Research on cultural competence at multiple levels, including health 
systems, agencies and providers, with an emphasis on primary care and 
mental health settings. Also, research is needed to define what 
constitutes "culturally competent care", develop and test different 
models (best practices) of culturally competent care, and test models 
in randomized controlled trials. Research that explores the interface 
between traditional/alternative and allopathic/western medicine and 
health maintenance practices and identifies the circumstances under 
which either or both function more effectively.

Services

Research on the development, dissemination, and accessibility of new 
therapies, technologies and services, such as retrovirals and anti-
psychotics. How do social and cultural factors affect these processes 
and what impact do they have on services and treatment? How do social, 
cultural, economic, and policy mechanisms influence equitable access to 
health care and the quality of care received?

Dissemination and Adoption

Research on the processes through which social and behavioral 
interventions are incorporated into general practice. What accounts for 
success or failure (i.e., adoption vs. non-adoption)? How does this 
differ from the adoption of biomedical treatments and interventions? 
Systematic research on methods to increase the adoption of tested and 
effective preventive interventions, treatment models, and service 
delivery strategies, research that will allow rigorous comparisons of 
the effects of alternative methods of diffusion and dissemination.

ETHICAL ISSUES IN SOCIAL AND CULTURAL RESEARCH

The development of new and more complex research methods in the social 
sciences, combined with dramatic advances in computing power, 
complicates standard ethical concerns of confidentiality, privacy, and 
consent. Higher levels of analysis imply analysis of data at the group, 
institution, or community level, raising the prospects of consent at 
these levels and how such consent might be obtained. Sensitivity exists 
not only at the individual level but also for the groups and 
institutions with which individuals affiliate.

This program announcement encourages social sciences research on 
ethical issues in the following areas: 

Ethical issues arising from research that links the individual to 
higher levels of analysis.

Research to address threats to confidentiality of data collected in 
multi-level studies by advancing statistical methods for masking or 
altering individual data and studying how such procedures impinge on 
the ability to conduct valid analyses. 

Unintended consequences of research aimed at understanding variation 
among individuals and among groups. How to avoid overemphasizing 
individual and group differences and thereby reinforcing existing 
patterns of stratification in health care or other areas.

Studies of community consultation in research projects involving 
identified population groups. How can individual informed consent best 
be accomplished in this setting?

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of the NIH that women and members of minority groups 
and their sub-populations must be included in all NIH-supported 
clinical research projects unless a clear and compelling justification 
is provided indicating that inclusion is inappropriate with respect to 
the health of the subjects or the purpose of the research. This policy 
results from the NIH Revitalization Act of 1993 (Section 492B of Public 
Law 103-43).

All investigators proposing clinical research should read the AMENDMENT 
"NIH Guidelines for Inclusion of Women and Minorities as Subjects in 
Clinical Research - Amended, October, 2001," published in the NIH Guide 
for Grants and Contracts on October 9, 2001 
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html), 
a complete copy of the updated Guidelines are available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.  
The amended policy incorporates: the use of an NIH 
definition of clinical research, updated racial and ethnic categories 
in compliance with the new OMB standards, clarification of language 
governing NIH-defined Phase III clinical trials consistent with the new 
PHS Form 398, and updated roles and responsibilities of NIH staff and 
the extramural community.  The policy continues to require for all NIH-
defined Phase III clinical trials that: a) all applications or 
proposals and/or protocols must provide a description of plans to 
conduct analyses, as appropriate, to address differences by sex/gender 
and/or racial/ethnic groups, including subgroups if applicable, and b) 
investigators must report annual accrual and progress in conducting 
analyses, as appropriate, by sex/gender and/or racial/ethnic group 
differences.

Investigators may obtain copies of this policy from the program staff 
listed under INQUIRIES. Program staff may also provide additional 
relevant information concerning the policy.

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of NIH that children (i.e., individuals under the age 
of 21) must be included in all human subjects research, conducted or 
supported by the NIH, unless there are scientific and ethical reasons 
not to include them. This policy applies to all initial (Type 1) 
applications submitted for receipt dates after October 1, 1998.

All investigators proposing research involving human subjects should 
read the "NIH Policy and Guidelines on the Inclusion of Children as 
Participants in Research Involving Human Subjects" that was published 
in the NIH Guide for Grants and Contracts, March 6, 1998, and is 
available at the following URL address: 
http://grants.nih.gov/grants/guide/notice-files/not98-024.html.

Investigators also may obtain copies of these policies from the program 
staff listed under INQUIRIES. Program staff may also provide additional 
relevant information concerning the policy.

REQUIRED EDUCATION IN THE PROTECTION OF HUMAN RESEARCH PARTICIPANTS

All investigators proposing research involving human subjects should 
read the policy that was published in the NIH Guide for Grants an 
Contracts, June 5, 2000 (Revised August 25, 2000), available at: 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html. 

INTERNET ADDRESSES (URLs) IN NIH GRANT APPLICATIONS OR APPENDICES

All applications and proposals for NIH funding must be self-contained 
within specified page limitations. Unless otherwise specified in an NIH 
solicitation, Internet addresses (URLs) should not be used to provide 
information necessary to the review because reviewers are under no 
obligation to view the Internet sites. Reviewers are cautioned that 
their anonymity may be compromised when they directly access an 
Internet site.

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT

The Office of Management and Budget (OMB) Circular A-110 has been 
revised to provide public access to research data through the Freedom 
of Information Act (FOIA) under some circumstances. Data that are (1) 
first produced in a project that is supported in whole or in part with 
Federal funds and (2) cited publicly and officially by a Federal agency 
in support of an action that has the force and effect of law (i.e., a 
regulation) may be accessed through FOIA. It is important for 
applicants to understand the basic scope of this amendment. NIH has 
provided guidance at: 
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm. 

Applicants may wish to place data collected under this program 
announcement in a public archive, which can provide protections for the 
data and manage the distribution for an indefinite period of time. If 
so, the application should include a description of the archiving plan 
in the study design and include information about this in the budget 
justification section of the application. In addition, applicants 
should think about how to structure informed consent statements and 
other human subjects procedures given the potential for wider use of 
data collected under this award.

APPLICATION PROCEDURES

The PHS 398 research grant application instructions and forms (rev. 
5/2001) at http://grants.nih.gov/grants/funding/phs398/phs398.html must 
be used in applying for these grants and will be accepted at the 
standard application deadlines (http://grants.nih.gov/grants/dates.htm) 
as indicated in the application kit. This version of the PHS 398 is 
available in an interactive, searchable format. Although applicants are 
strongly encouraged to begin using the 5/2001 revision of the PHS 398 
as soon as possible, the NIH will continue to accept applications 
prepared using the 4/1998 revision until January 9, 2002. Beginning 
January 10, 2002, however, the NIH will return applications that are 
not submitted on the 5/2001 version. For further assistance contact 
GrantsInfo, Telephone 301/710-0267, Email:  [email protected].

SPECIFIC INSTRUCTIONS FOR APPLICATIONS REQUESTING $500,000 OR MORE PER YEAR: 

Applications requesting $500,000 or more in direct costs for any year 
must include a cover letter identifying the NIH staff member within one 
of NIH institutes or centers who has agreed to accept assignment of the 
application.   

Applicants requesting more than $500,000 must carry out the following 
steps:
	
1)	Contact the IC program staff at least 6 weeks before submitting the 
application, i.e., as you are developing plans for the study, 

2) Obtain agreement from the IC staff that the IC will accept your 
application for consideration for award, and,
  
3) Identify, in a cover letter sent with the application, the staff 
member and IC who agreed to accept assignment of the application.  

This policy applies to all investigator-initiated new (type 1), 
competing continuation (type 2), competing supplement, or any amended 
or revised version of these grant application types. Additional 
information on this policy is available in the NIH Guide for Grants and 
Contracts, October 19, 2001 at 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-004.html. 

Specific Instructions for Modular Grant Applications

The MODULAR GRANT concept establishes specific modules in which direct 
costs may be requested as well as a maximum level for requested 
budgets. Only limited budgetary information is required under this 
approach. The JUST-IN-TIME concept allows applicants to submit certain 
information only when there is a possibility for an award. It is 
anticipated that these changes will reduce the administrative burden 
for the applicants, reviewers and Institute staff. The research grant 
application form PHS 398 (rev. 5/2001) at 
http://grants.nih.gov/grants/funding/phs398/phs398.html must be used in 
applying for these grants, with modular budget instructions beginning 
in Section C of the application instructions.

Modular Grant applications will request direct costs in $25,000 
modules, up to a total direct cost request of $250,000 per year. 
(Applications that request more than $250,000 direct costs in any year 
must follow the traditional PHS 398 application instructions.) The 
total direct costs must be requested in accordance with the program 
guidelines and the modifications made to the standard PHS 398 
application instructions described at 
http://grants.nih.gov/grants/funding/modular/modular.htm. 

The title and number of this program announcement must be entered on 
line 2 of the face page of the application (PHS 398) form and the YES 
box must be marked.

Submit a signed, printed original of the application, including the 
Checklist, and five signed photocopies in one package to:

Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD  20892-7710
Bethesda, MD  20817 (For Express/Courier Service)

Please note that NIH will no longer accept hand-delivered applications.

REVIEW CONSIDERATIONS

Applications will be assigned on the basis of established Public Health 
Service referral guidelines. Appropriate review committees of NIH, in 
accordance with the standard NIH peer review procedures, will review 
applications for scientific and technical merit. As part of the initial 
merit review, all applications will receive a written critique and 
undergo a process in which only those applications deemed to have the 
highest scientific merit, generally the top half of applications under 
review, will be discussed, assigned a priority score, and receive a 
second level review by the appropriate national advisory council or 
board.

REVIEW CONSIDERATIONS

Applications will be assigned on the basis of established PHS referral 
guidelines. Applications will be evaluated for scientific and technical 
merit by an appropriate scientific review group convened in accordance 
with the standard NIH peer review procedures. As part of the initial 
merit review, all applications will receive a written critique and 
undergo a process in which only those applications deemed to have the 
highest scientific merit, generally the top half of applications under 
review, will be discussed, assigned a priority score, and receive a 
second level review by the appropriate national advisory council or 
board.

Review Criteria

The goals of NIH-supported research are to advance our understanding of 
biological systems, improve the control of disease, and enhance health. 
In the written comments reviewers will be asked to discuss the 
following aspects of the application in order to judge the likelihood 
that the proposed research will have a substantial impact on the 
pursuit of these goals. Each of these criteria will be addressed and 
considered in assigning the overall score, weighting them as 
appropriate for each application. Note that the application does not 
need to be strong in all categories to be judged likely to have major 
scientific impact and thus deserve a high priority score. For example, 
an investigator may propose to carry out important work that by its 
nature is not innovative but is essential to move a field forward.

o  Significance: Does this study address an important problem? If the 
aims of the application are achieved, how will scientific knowledge be 
advanced? What will be the effect of these studies of the concepts or 
methods that drive this field?

o  Approach: Are the conceptual framework, design, methods, and 
analyses adequately developed, well-integrated, and appropriate to the 
aims of the project? Does the applicant acknowledge potential problem 
areas and consider alternative tactics?

o  Innovation: Does the project employ novel concepts, approaches or 
method? Are the aims original and innovative? Does the project 
challenge existing paradigms or develop new methodologies or 
technologies?

o  Investigator: Is the investigator appropriately trained and well 
suited to carry out this work? Is the work proposed appropriate to the 
experience level of the principal investigator and other researchers 
(if any)?

o  Environment: Does the scientific environment in which the work will 
be done contribute to the probability of success? Do the proposed 
experiments take advantage of unique features of the scientific 
environment or employ useful collaborative arrangements? Is there 
evidence of institutional support?

In addition to the above criteria, in accordance with NIH policy, all 
applications will also be reviewed with respect to the following:

o  The adequacy of plans to include both genders, minorities and their 
subgroups, and children as appropriate for the scientific goals of the 
research. Plans for the recruitment and retention of subjects will also 
be evaluated.

o  The reasonableness of the proposed budget and duration in relation 
to the proposed research.

o  The adequacy of the proposed protection for humans, animals or the 
environment, to the extent they may be adversely affected by the 
project proposed in the application.

AWARD CRITERIA

Applications will compete for available funds with all other 
recommended applications. Award criteria that will be used to make 
award decisions include:

o  Scientific merit (as determined by peer review)
o  Availability of funds
o  Programmatic priorities.

INQUIRIES

Inquiries are strongly encouraged. The opportunity to clarify any 
issues or questions from potential applicants is welcome. Applicants 
are encouraged to read the Executive Summary of the conference "Toward 
Higher Levels of Analysis: Progress and Promise in Research on Social 
and Cultural Dimensions of Health" that provides extensive examples of 
research questions. The report is available at 
http://obssr.od.nih.gov/Publications/HigherLevels_Final.PDF. Also 
applicants may find "Qualitative Methods in Health Research: 
Opportunities and Considerations in Application and Review," NIH 
Publication No. 02-5046, to be useful in preparing an application 
(http://obssr.od.nih.gov/Documents/Publications/Qualitative.PDF).

GENERAL INQUIRIES regarding the scope and content of this program 
announcement should be directed to:

Ronald P. Abeles, Ph.D.
Special Assistant to the Director
Office of Behavioral and Social Sciences Research
National Institutes of Health
Gateway Building, Room 2C234, MSC 9205
7201 Wisconsin Avenue
Bethesda, MD  20892-9205
Telephone:  301-496-7859
Fax:  301-435-8779
E-mail:  [email protected]

Direct inquiries regarding PROGRAMMATIC ISSUES, including questions of 
research areas of particular interest to and of available funding 
mechanisms at each IC, to the staff of the appropriate IC:

Morgan D. Jackson, M.D., MPH
National Center for Complementary and Alternative Medicine
6701 Democracy Blvd., Suite 106
Bethesda, MD  20892-5475
Telephone:  301-402-1278
Fax:  301-480-3621
E-mail:  [email protected]

Natalie Kurinij, Ph.D.
National Eye Institute
EPS Rm. 350
Bethesda, MD  20892
Telephone:  301-496-5983
E-mail:  [email protected]

Deborah Ader, Ph.D.
National Institute on Arthritis, Musculoskeletal, and Skin Diseases
45 Center Drive
Building 45, Room 5As19H
Bethesda. MD  20892
Telephone:  301/594-4032
Fax:  301/480-4543
E-mail:  [email protected]

Patricia Bryant, Ph.D.
Division of Extramural Research
National Institute of Dental and Craniofacial Research
Building 45, Room 4AN-24E
Telephone:  301/594-2095
Fax:  301/480-8318
E-mail:  [email protected]

Christine A. Bachrach, Ph.D.
Center for Population Research
National Institute of Child Health and Human Development
6100 Executive Boulevard, Rm. 8B07, MSC 7510
Bethesda, Maryland  20892-7510
Telephone:  301 496-1174
Fax:  301 496-0962
Email:  [email protected]

Jared B. Jobe, Ph.D.
National Heart, Lung, and Blood Institute
6702 Rockledge Drive, Room 8122
Bethesda, MD  20892
Telephone:  301/435-0407
E-mail:  [email protected]

Jon F. Kerner, Ph.D.
Division of Cancer Control and Population Sciences
National Cancer Institute
EPN 6144
6130 Executive Boulevard
Rockville, MD  20852
Telephone:  301-594-7294
Fax:  301-594-6787
E-mail:  [email protected]

Jean E. McEwen, J.D., Ph.D.
National Human Genome Research Institute
Building 31, Room B2B07
Bethesda, MD  20892-2033
Telephone:  301-402-4997
Fax:  301-402-1950
E-mail:  [email protected]

Susan Martin, Ph.D.
Prevention Research Branch
Division of Clinical and Prevention Research
National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
6000 Executive Boulevard, Suite 505
Bethesda, MD  20892-7003
Telephone:  301/443-8767
Fax:  301/443-8774
E-mail:  [email protected]

Moira O"Brien, M.Phil.
Epidemiology Research Branch
Division of Epidemiology, Services, and
Prevention Research
National Institute of Drug Abuse
6001 Executive Boulevard, Room 5153
Bethesda, MD  20892-9589
Telephone:  301/402-1881
Fax:  301/443-2636
E-mail:  [email protected]

Sanford A. Garfield, Ph.D.
Division of Endocrinology and Metabolic Diseases
National Institute on Diabetes and Digestive and Kidney Diseases
6707 Democracy Boulevard, Rm. 685
Bethesda, MD  20892-5452
Telephone:  301-594-8803
E-mail:  [email protected]

Emeline Otey, Ph.D.
Division of Mental Disorders, Behavioral Research, and AIDS
National Institute of Mental Health
National Institutes of Health
6001 Executive Blvd, Room 6186
Bethesda, MD  20892-9625
Telephone:  301/443-1636
Fax:  301/443-4611
E-mail:  [email protected]

Janice Phillips, Ph.D., RN
National Institute of Nursing Research
Building 45, Room 3AN-12
Bethesda, MD  20892-6300
Telephone:  301/594-6152
Fax:  301/480-8260
E-mail:  [email protected]

Sidney Stahl, Ph.D.
Behavioral and Social Research Program
National Institute on Aging
Gateway Building, Room 525 MSC 9205
7201 Wisconsin Avenue
Bethesda, MD  20892-9205
Telephone:  301-402-4156
Fax:  301-402-0051
E-mail:  [email protected]

Shobha Srinivasan, Ph.D.
Chemical Exposures and Molecular Biology Branch
Division of Extramural Research and Training
National Institute of Environmental Health Sciences
P.O. Box 12233, MD EC-21
111 T.W. Alexander Drive
Research Triangle Park, NC  27709
Telephone:  919-541-2506
Fax:  919-316-4606
E-mail:  [email protected]

Direct inquiries regarding FISCAL MATTERS to:

Mr. William W. Darby
Grants Management Office
National Eye Institute
EPS 350
Bethesda, MD  20892
Telephone:  301-496-5983
Email:  [email protected]

Ms. Judy Simons
Grants Management Branch
National Institute on Alcohol Abuse and Alcoholism
Willco Building, Suite 504
6000 Executive Blvd., MSC 7003
Bethesda, MD  20892-7003
Telephone:  301-443-4704
Fax:  301-443-0788
Email:  [email protected]

Mr. Gary Fleming, J.D., M.A.
Grants Management Branch
National Institute on Drug Abuse
6001 Executive Boulevard, Room 3131, MSC 9541
Bethesda, MD  20892-9541
Telephone:  301-443-6710
Fax:  301-594-6849

Ms. Kathy Hancock
Grants Management Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, Room 8A17O, MSC 7510
Bethesda, MD  20892-7510
Telephone:  301-496-5482
Fax:  301-402-0915
E-mail:  [email protected]

Ms. Melinda B. Nelson
Chief Grants Management Officer
National Institute of Arthritis and Musculoskeletal and Skin Diseases
45 Center Drive, Room 5AS49
Bethesda, Maryland  20892
Telephone:  301-435-5278
Fax:  301-480-4543
Email:  [email protected]

Mr. Martin Rubinstein
Office of Grants Management
National Institute of Dental and Craniofacial Research
Natcher Building, Room 4AN-44A
Bethesda, MD  20892-6402
Telephone:  301-594-4800
Fax:  301-480-8301
Email:  [email protected]

Mr. David L. Mineo
Chief Grants Management Officer
Division of Extramural Activities
National Institute of Diabetes and Digestive
and Kidney Diseases
Two Democracy Plaza, Room 731
6707 Democracy Blvd., MSC 5456
Bethesda, MD  20892-5456
Telephone:  301-594-885
Email:  [email protected]

Ms. Diana S. Trunnell
Grants Management Branch
National Institute of Mental Health
6001 Executive Boulevard, Room 6115, MSC 9605
Bethesda, MD  20892-9605
Telephone:  301-443-2805
Fax:  301-443-6885
Email:  [email protected]

Mr. Robert Vinson
Grants Operations Branch
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
6701 Rockledge Drive, Room 7156, MSC 7926
Bethesda, Maryland  20892-7926
Telephone:  301-435-0171
Fax:  301-480-3310
E-mail:  [email protected]

Ms. Sally York
Office of Grants and Contract Management
National Institute of Nursing Research
Building 45, Room Number 3AN12, MSC 6300
Bethesda, MD  20892-6300
Telephone:  301-594-2154
Fax:  301-480-8260
Email:  [email protected]

Ms. Jean Cahill
Grants Administration Branch
National Human Genome Research Institute, NIH
Bldg. 31, Room B2-B34 
Bethesda, MD  20892-2031 
TEL:  301-402-0733 
Fax:  301-402-1951
E-mail:  [email protected]

Ms. Victoria C. Carper, MPA 
Chief, Grants Management Officer, 
National Center for Complementary and Alternative Medicine 
6707 Democracy Boulevard 
Democracy Two, Room 106 
Bethesda, Maryland  20892 
Direct:  301-594-9102 
Office:  301-496-4792 
Fax:  301-480-3621 
E-mail:  [email protected]

Mr. Bill Wells
Grants Administration Branch
National Cancer Institute
Executive Plaza South, Room 243
6120 Executive Boulevard, MSC 7150
Bethesda, MD  20892-7150
Telephone:  301-496-8796
Fax:  301-496-8601
E-mail:  [email protected]

Ms. Grace Poe
Grants and Contracts Management Office
National Institute on Aging
Gateway Building, Room 2N212, MSC 2292
7201 Wisconsin Avenue
Bethesda, MD  20892-2292
Telephone:  301-496-1472
Fax:  301-402-3672
Email:  [email protected]

Ms. Carolyn Winters
Grants Management Branch
Division of Extramural Research and Training
National Institute of Environmental Health Sciences
P.O. Box 12233, MD EC-24
111 T.W. Alexander Drive
Research Triangle Park, NC  27709
Telephone:  919-541-7823
Fax:  919-541-2860
Email:  [email protected]

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance 
Nos. 93.399 (NCI), 93.213 (NCCAM), 93.867 (NEI), 93.937 (NHLBI), 93.172 
(NHGRI), 93.866 (NIA), 93.891 (NIAAA), 93.846 (NIAMS), 93.929 (NICHD), 
93.121 (NIDCR), 93.279 (NIDA), 93.847/848/849 (NIDDK), 93.113, 93.114, 
and 93.115 (NIEHS), 93.242 (NIMH), and 93.361(NINR). Awards are made 
under authorization of the Public Health Service Act, Title IV, Part A 
(Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and 
285) and administered under PHS grants policies and Federal Regulations 
42 CFR 52 and 45 CFR Part 74. This program is not subject to the 
intergovernmental review requirements of Executive Order 12372 or 
Health Systems Agency review.

The PHS strongly encourages all grant and contract recipients to 
provide a smoke-free workplace and promote the non-use of all tobacco 
products. In addition, Public Law 103-227, the Pro-Children Act of 
1994, prohibits smoking in certain facilities (or in some cases, any 
portion of a facility) in which regular or routine education, library, 
day care, health care or early childhood development services are 
provided to children. This is consistent with the PHS mission to 
protect and advance the physical and mental health of the 
American people.





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