RELEASE DATE:  August 28, 2002

PA NUMBER:  PA-02-159

EXPIRATION DATE:  August 23, 2005, unless reissued. 

National Institute of Nursing Research (NINR) 
National Institute on Alcohol Abuse and Alcoholism (NIAAA) 
National Heart, Lung, and Blood Institute (NHLBI) 


o Purpose of the PA
o Research Objectives
o Mechanism of Support 
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Where to Send Inquiries
o Submitting an Application
o Peer Review Process
o Review Criteria
o Award Criteria
o Required Federal Citations


The National Institute of Nursing Research (NINR), the National Institute on 
Alcohol Abuse and Alcoholism (NIAAA), and the National Heart, Lung, and Blood 
Institute (NHLBI) invite applications for research related to health 
promotion/risk reduction among adolescents. Specifically, this announcement 
seeks applications that 1) identify the determinants of health promoting and 
health compromising behaviors among adolescents and 2) identify and evaluate 
interventions and methodologies that show promise for improving the health 
profiles of adolescents by assessing, preventing, reducing and or 
ameliorating high-risk behaviors. Investigators responding to this 
announcement are required to target two or more of the high-risk behaviors in 
a single application.


Risky behaviors are defined as activities that have the potential for some 
type of loss. Parallel to the areas related to health promotion among 
adolescents outlined in Healthy People 2010 and The Youth Risk Surveillance 
System (YRBSS), this PA will place emphasis on six priority health risk 
behaviors that contribute to the leading causes of mortality and morbidity 
among youth and adults.  These six health risk behaviors include tobacco use, 
unhealthy dietary behaviors, inadequate physical activity, alcohol and other 
drug use, sexual behaviors, and unintentional (accidents) and intentional 
behaviors (firearm related injuries).  These behaviors are frequently 
established during the adolescent years and continue on to the adult years. 
These behaviors are potentially amenable to a variety of health promotion and 
prevention efforts.  For purposes of this announcement, adolescents are 
defined as individuals age 10-19.  

In 1999, approximately 40 million US residents were classified as adolescents 
ranging in age from 10–19 years.  This represents 14% of the US population.  
Among these, approximately 2/3 of the adolescent population was non-Hispanic 
and 1/3 of other racial ethnic identity.  Projections indicate that by year 
2050, the nation's racial ethnic minority groups (Black, Hispanic, American 
Indian, Asian) will constitute approximately 56% of the adolescent 
population.  While the health status of adolescents differs according to age, 
gender, race, and ethnic origin, there is ample documentation suggesting that 
adolescents, regardless of background, engage in high-risk behavior.

Today, tobacco use constitutes the single leading cause of preventable death 
in the United States.  Epidemiologists estimate that tobacco related 
illnesses will be responsible for over 5 million premature deaths among 
persons age 17 and under who begin to use tobacco products in 1995.  Data 
from the Youth Risk Behavior Surveillance System (YRBS) noted that 80% of 
individuals who use tobacco began before age 18.  Recent trends show 
increases in cigarette smoking among high school students in the 1990s after 
years of decline in tobacco use during the 1970s and the 1980s.  For example, 
from 1991-1999, the greatest increase in cigarette use occurred among African 
American adolescents.  This compares with increases of 29% and 25% for 
Hispanic and White adolescents respectively.  In contrast, the use of 
smokeless tobacco decreased from 11.4% in 1995 to 7.8% in 1999. 

Poor dietary habits or improper eating habits have been linked to the 
development of coronary heart disease, cancer, diabetes, osteoporosis, 
hypertension, and obesity.  In 1990, diet along with physical inactivity 
constituted the second most common "actual cause of death" in the US after 
tobacco use.  Data from the Youth Risk Behavior Surveillance-United States 
1999 revealed that 16% of the nation's students were at risk for becoming 
overweight while 9.9% were considered overweight. During 1988-1994, 11% of 
children and adolescents age 6-19 were considered overweight or obese.  
Despite recommendations for a healthier diet, recent data show that the usual 
diet of today's adolescents includes foods high in saturated fat, high in 
calorie dense foods, and low in fruit and vegetable consumption.

Inadequate physical activity has been linked to a variety of adverse health 
conditions and consequences.  In contrast, regular physical activity has been 
associated with increased psychological and mental well-being, reduced 
cardiovascular risk, and proper weight maintenance. In 1990, 70% of all high 
school students participated in moderate to vigorous physical activity in the 
seven days prior to being surveyed.  However, physical activity is noted to 
decline during the adolescent years leading to further declines in physical 
activity during the adult years.  The need to remain physically active is 
further underscored by the recent increases in obesity among adolescents and 
adults in the US. Physical activity is also a leading health indicator 
identified by Healthy People 2010 along with excess weight and obesity.  
Healthy People 2010 places special emphasis on increasing the proportion of 
adolescents who engage in physical activity that promotes cardiovascular 
fitness 3 or more days a week for a minimum of 20 minutes per occasion.

With respect to substance abuse, the use of alcohol and other drugs (e.g., 
cocaine, marijuana, illegal steroid use) is among the 4 risk behaviors that 
worsened among adolescents during 1991-1999.  Recent data revealed that in 
1999, nearly half of high school students (48% female and 52% male) reported 
drinking 30 days prior to being surveyed.  Most adolescents being surveyed 
reported starting using alcohol or other drugs before entering high school.  
Nationwide, statistics revealed that in 1999, among adolescents surveyed, 
47.2% admitted using marijuana during their lifetime, 9.5% using some form of 
cocaine, 3.7% admitted using illegal steroids, and 2.4% of those surveyed 
admitted using heroin.  The use of alcohol and other drugs is associated with 
a variety of consequences such as violence, motor vehicle injuries, and 
premature death.  

Responsible sexual behavior has been identified as a leading health indicator 
in Healthy People 2010 with specific behavior objectives aimed at increasing 
the proportion of adolescents who abstain from sexual intercourse or use 
condoms if sexually active.  Adolescents who engage in early sexual behaviors 
are at an increased risk of sexually transmitted diseases including HIV 
infection as well as unintended pregnancy.  In 1999, estimates were that over 
half of all high school students had been sexually active.  However, national 
trends showed that between 1991 and 1999, the prevalence of sexual experience 
among adolescents decreased 8% while the prevalence of multiple partners 
decreased 13%.

Currently, motor vehicle and firearm related injuries are the leading cause 
of death for adolescents.  Between 1996-1997, approximately 14,000 
adolescents died annually from injuries, constituting approximately 73% of 
all deaths among adolescents age 10-19 years.  The high death rates from 
motor vehicle injuries are in part, due to high-risk behaviors among 
adolescents (e.g., drunken driving, the non-use of seat belts).  Motor 
vehicle death rates were higher for male adolescents, non-Hispanic white, 
American Indian and Alaskan Native adolescents and lower among non-Hispanic 
black, Hispanic, Asian and Pacific Islander adolescents.  Death rates from 
firearm injuries increase with age with rates for males 19 years of age or 
older. Similarly, death rates from firearm injuries for females 19 years of 
age or older are 10 times higher when compared with firearm death injuries 
for females age 11.  Firearm-related death rates are strikingly higher for 
Black adolescents when compared to adolescents from other racial/ethnic 
minority groups.  These two leading causes of death are identified as high 
priority areas in Healthy People 2010.

Continued research is needed to decrease the numbers of adolescents engaging 
in high-risk behaviors, thus reducing and ameliorating the short and long-
term consequences associated with these behaviors. Further, many of these 
behaviors are interrelated and thus may be amenable to interventions that 
address multiple risk behaviors simultaneously. For example, research has 
shown that adolescents who engage in heavy drinking may also engage in high-
risk sexual behaviors. Thus, targeting both high-risk behaviors in one 
application may be more successful in improving the overall health profile of 
adolescents. Research has shown that interventions that target combinations 
of risk factors may result in more successful and long-term behavioral 

Objectives and Scope 

Investigators responding to this announcement are required to target two or 
more of the high-risk behaviors in a single application.  The following are 
potential areas of research related to this program announcement. These 
examples are not listed in any priority order and are not to be viewed as 
exhaustive or an exclusive listing of potential areas. As part of the 
national efforts to eliminate health disparities, proposals specifically 
targeting racial/ethnic minority populations are strongly encouraged. NINR's 
Strategic Plan on Reducing Health Disparities is located at 
http://www.ninr.nih.gov. Research targeting other diverse groups of 
adolescents is also encouraged (e.g., sexual orientation, religious 
background, single parent families).

o Studies investigating the effects and interrelationships among psychosocial 
and environmental factors (e.g., poverty and the adoption of high-risk 
behaviors among adolescents).

o Intervention studies that elucidate and incorporate the physiological, 
psychological, socioeconomic, emotional, environmental, cultural, and genetic 
factors that influence health compromising and or health promoting behaviors 
among adolescents.

o Interventions that incorporate protective factors that aid in preventing 
adolescents from engaging in multiple risky behaviors. 

o Intervention studies using peer-based approaches to facilitate health 
promotion/risk reduction behaviors in adolescents in rural and urban 

o Innovative intervention studies devoted to enhancing self-efficacy, 
competence, and skill development to support the initiation and or 
maintenance of health promoting behaviors.  

o Culturally and linguistically appropriate studies that incorporate the 
stages of cognitive development in adolescents of cultural and ethnic 

o Innovative interventions targeting heavy drinking and risky sexual 

o Unique and culturally sensitive interventions to promote healthier dietary 
intake and adequate activity in minority adolescents.

This PA will use the NIH R01 award mechanism.  As an applicant, you will be 
solely responsible for planning, directing, and executing the proposed 

This PA uses just-in-time concepts.  It also uses the modular as well as non-
modular budgeting formats. (see 
https://grants.nih.gov/grants/funding/modular/modular.htm).   Specifically, if 
you are submitting an application with direct costs in each year of $250,000 
or less, the modular format is required.  Otherwise, follow the standard PHS 
398 application instructions for detailed budgets.


You may submit (an) application(s) if your institution has any of the 
following characteristics:
o For-profit or non-profit organizations 
o Public or private institutions, such as universities, colleges, hospitals, 
and laboratories 
o Units of State and local governments
o Eligible agencies of the Federal government  
o Domestic or foreign
o Faith based or community based organizations


Any individual with the skills, knowledge, and resources necessary to carry 
out the proposed research is invited to work with their institution to 
develop an application for support.  Individuals from underrepresented racial 
and ethnic groups as well as individuals with disabilities are always 
encouraged to apply for NIH programs


We encourage your inquiries concerning this PA and welcome the opportunity to 
answer questions from potential applicants.  Inquiries may fall into two 
areas:  scientific/research and financial or grants management issues:

o Direct your questions about scientific/research issues to:

Dr. Janice Phillips
Office of Extramural Programs
National Institute of Nursing Research
6701 Democracy Blvd, Room 710, MSC 4870
Bethesda, MD  20892-4870
Telephone:  (301) 594-6152
FAX:  (301) 480-8260
Email:  janice_Phillips@nih.gov

Dr. Vivian B. Faden
Chief, Epidemiology Branch
Division of Biometry and Epidemiology 
National Institute on Alcohol Abuse and Alcoholism
6000 Executive Blvd., MSC 7003
Suite 514
Bethesda, Maryland  20892-7003
(Rockville, Maryland  20852 for Fedex)
Telephone: (301) 594-6232
Fax: (301) 443-8614
Email: vfaden@willco.niaaa.nih.gov

Dr. Charlotte Pratt
National Heart, Lung and Blood Institute
Division of Epidemiology and Clinical Applications
6701 Rockledge Drive, Room 8134
MSC 7936
Bethesda, MD 20892 (20817 overnight)
Tel.: (301) 435-0382
Fax: (301) 480-1669
Email: prattc@nhlbi.nih.gov

o Direct your questions about financial or grants management matters to:

Ms. Cindy McDermott
Office of Grants and Contracts Management
National Institute of Nursing Research
6701 Democracy Blvd, Room 710, MSC 4870
Bethesda, MD  20892-4870
Telephone:  (301) 594-6869
FAX:  (301) 480-8260
Email:  cindy_mcdermott@nih.gov

Judy Simons
Chief, Grants Management Branch
Office of Planning and Resource Management
National Institute on Alcohol Abuse and Alcoholism
Willco Building, Suite 504
6000 Executive Boulevard, MSC 7003
Bethesda, MD 20892-7003
Telephone: (301) 443-4704
FAX: (301) 443-3891
Email: judy_simons@nih.gov


Applications must be prepared using the PHS 398 research grant application 
instructions and forms (rev. 5/2001).  The PHS 398 is available at 
https://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive 
format.  For further assistance contact GrantsInfo, Telephone (301) 710-0267, 
Email: GrantsInfo@nih.gov.

APPLICATION RECEIPT DATES: Applications submitted in response to this program 
announcement will be accepted at the standard application deadlines, which 
are available at https://grants.nih.gov/grants/dates.htm.  Application 
deadlines are also indicated in the PHS 398 application kit.

up to $250,000 per year in direct costs must be submitted in a modular grant 
format.  The modular grant format simplifies the preparation of the budget in 
these applications by limiting the level of budgetary detail.  Applicants 
request direct costs in $25,000 modules.  Section C of the research grant 
application instructions for the PHS 398 (rev. 5/2001) at 
https://grants.nih.gov/grants/funding/phs398/phs398.html includes step-by-step 
guidance for preparing modular grants.  Additional information on modular 
grants is available at 

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:
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 https://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-004.html. 

SENDING AN APPLICATION TO THE NIH: Submit a signed, typewritten 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)

APPLICATION PROCESSING: Applications must be received by or mailed on or 
before the receipt dates described at 
https://grants.nih.gov/grants/funding/submissionschedule.htm.  The CSR will 
not accept any application in response to this PA that is essentially the 
same as one currently pending initial review unless the applicant withdraws 
the pending application.  The CSR will not accept any application that is 
essentially the same as one already reviewed.  This does not preclude the 
submission of a substantial revision of an application already reviewed, but 
such application must include an Introduction addressing the previous 


Applications submitted for this PA will be assigned on the basis of 
established PHS referral guidelines.  An appropriate scientific review group 
convened in accordance with the standard NIH peer review procedures 
(http://www.csr.nih.gov/refrev.htm) will evaluate applications for scientific 
and technical merit.  

As part of the initial merit review, all applications will:

o Receive a written critique
o Undergo a selection process in which only those applications deemed to have 
the highest scientific merit, generally the top half of applications under 
review, will be discussed and assigned a priority score
o Receive a second level review by the appropriate national advisory council 
or board

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 your application in order to judge the likelihood that the 
proposed research will have a substantial impact on the pursuit of these 

o Significance 
o Approach 
o Innovation
o Investigator
o Environment
The scientific review group will address and consider each of these criteria 
in assigning your application's overall score, weighting them as appropriate 
for each application.  Your 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, you may propose to carry out 
important work that by its nature is not innovative but is essential to move 
a field forward.

(1) SIGNIFICANCE:  Does your study address an important problem? If the aims 
of your application are achieved, how do they advance scientific knowledge?  
What will be the effect of these studies on the concepts or methods that 
drive this field?

(2) APPROACH:  Are the conceptual framework, design, methods, and analyses 
adequately developed, well integrated, and appropriate to the aims of the 
project?  Do you acknowledge potential problem areas and consider alternative 

(3) INNOVATION:  Does your project employ novel concepts, approaches or 
methods? Are the aims original and innovative?  Does your project challenge 
existing paradigms or develop new methodologies or technologies?

(4) INVESTIGATOR: Are you appropriately trained and well suited to carry out 
this work?  Is the work proposed appropriate to your experience level as the 
principal investigator and to that of other researchers (if any)?

(5) ENVIRONMENT:  Does the scientific environment in which your 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 

ADDITIONAL REVIEW CRITERIA: In addition to the above criteria, your 
application will also be reviewed with respect to the following:

PROTECTIONS:  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.

INCLUSION:  The adequacy of plans to include subjects from both genders, all 
racial and ethnic groups (and subgroups), and children as appropriate for the 
scientific goals of the research.  Plans for the recruitment and retention of 
subjects will also be evaluated. (See Inclusion Criteria included in the 
section on Federal Citations, below)

DATA SHARING:  The adequacy of the proposed plan to share data.  See 
https://grants.nih.gov/grants/policy/data_sharing/index.htm for more 

BUDGET:  The reasonableness of the proposed budget and the requested period 
of support in relation to the proposed research.


Applications submitted in response to a PA will compete for available funds 
with all other recommended applications.  The following will be considered in 
making funding decisions:  

o Scientific merit of the proposed project as determined by peer review
o Availability of funds 
o Relevance to program priorities


involving Phase I and II clinical trials must include provisions for 
assessment of patient eligibility and status, rigorous data management, 
quality assurance, and auditing procedures.  In addition, it is NIH policy 
that all clinical trials require data and safety monitoring, with the method 
and degree of monitoring being commensurate with the risks (NIH Policy for 
Data Safety and Monitoring, NIH Guide for Grants and Contracts, June 12, 
1998: https://grants.nih.gov/grants/guide/notice-files/not98-084.html).  

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 
(https://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html); a complete 
copy of the updated Guidelines are available at 
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 

The NIH maintains a policy 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 is available at 

policy requires education on the protection of human subject participants for 
all investigators submitting NIH proposals for research involving human 
subjects.  You will find this policy announcement in the NIH Guide for Grants 
and Contracts Announcement, dated June 5, 2000, at 

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 

Applicants may wish to place data collected under this PA 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.

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.   Furthermore, 
we caution reviewers that their anonymity may be compromised when they 
directly access an Internet site.

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 PA 
is related to one or more of the priority areas. Potential applicants may 
obtain a copy of "Healthy People 2010" at 

AUTHORITY AND REGULATIONS: This program is described in the Catalog of 
Federal Domestic Assistance Nos. 93.361 (NINR), 93.273 (NIAAA), and 93.837 
(NHLBI), and is not subject to the intergovernmental review requirements of 
Executive Order 12372 or Health Systems Agency review.  Awards are made under 
authorization of Sections 301 and 405 of the Public Health Service Act as 
amended (42 USC 241 and 284 and administered under NIH grants policies 
described at https://grants.nih.gov/grants/policy/policy.htm and under Federal 
Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. 

The PHS strongly encourages all grant recipients to provide a smoke-free 
workplace and discourage the 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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