Release Date:  March 13, 2000

PA NUMBER:  PAR-00-076

Agency for Healthcare Research and Quality (formerly AHCPR)

Application Receipt Dates:  May 5, 2000; September 15; January 15; 
May 15; annually.


The Agency for Healthcare Research and Quality (AHRQ), formerly known as the 
Agency for Health Care Policy and Research (AHCPR), announces its continued 
interest in supporting the health services dissertation research small grant 
program. This program supports research undertaken as part of an academic 
program to qualify for a doctorate.

The mission of AHRQ is to support, conduct, and disseminate research that 
improves access to care and the outcomes, quality, cost, and utilization of 
health care services.  The research sponsored and conducted by the Agency 
provides better information that enables better decisions about health care.  
Research that promotes the improvement of health care quality will be the 
Agency’s highest priority during the next few years.  Accordingly, the Agency 
has identified the following three strategic goals, each of which will 
contribute to improving the quality of health care for all Americans:  

o  support improvements in health outcomes
o  strengthen quality measurement and improvement
o  identify strategies to improve access, foster appropriate use, and reduce 
unnecessary expenditures 

AHRQ programs and products are designed to be responsive to the needs of 
consumers, patients, clinicians, and other providers, institutions, plans, 
purchasers, and public and private policy makers at all levels for 
evidence-based information they may need to improve quality and outcomes, 
control costs, and ensure access to needed health care services.  A copy of 
AHRQ’s strategic plan is available at

AHRQ will accept applications from students seeking a doctorate in areas 
relevant to health services research.  Total direct costs, under this 
announcement, must not exceed $30,000 for the entire project period.

This Program Announcement (PA) describes the procedures and criteria for the 
program. It updates and supersedes "Grants for Health Services Dissertation 
Research," PAR-98-111, published in the NIH Guide, September 15, 1998.


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 health improvement priorities for the 
United States.  AHRQ encourages applicants to submit grant applications with 
relevance to the specific objectives of this initiative.  Potential 
applicants may obtain a copy of "Healthy People 2010" at .


The AHRQ Dissertation program is conducted in compliance with applicable laws 
that provide that no person shall, on the grounds of race, color, national 
origin, sex, disability, or age, be excluded from participation in, be denied 
the benefits of, or be subjected to discrimination. Applicant organizations 
are required to have appropriate Assurance of Compliance forms filed with the 
Office of Civil Rights, Office of the Secretary, DHHS before a grant may be 
made to that institution. The Division of Research Education, Office of 
Research Review, Education, and Policy (ORREP), should be contacted with any 
questions concerning compliance (see INQUIRIES).


To qualify for an award under this PA, the student (Principal Investigator) 
must be enrolled in an accredited research doctoral degree (e.g., Ph.D., 
Sc.D., Dr.P.H., Ed.D.) program in health services research, including areas 
such as social, behavioral, biostatistical, epidemiological, economic, 
educational, policy, management, medical, nursing, or health sciences, which 
require a dissertation based on original research.  To be eligible, the 
dissertation must be a major part of the training program and be in an area 
of interest to AHRQ with demonstrated relevance to the delivery of health 
care in the United States.  All requirements for the doctoral degree, other 
than the dissertation, must be completed by submission date. 

The applicant may be either a public or private nonprofit institution that 
will administer the grant on behalf of the proposed Principal Investigator; 
alternatively the proposed Principal Investigator  may apply as an 
individual.  If the investigator is not a U.S. citizen and does not have a 
permanent resident visa, he/she must apply through a public or private 
nonprofit institution. 

AHRQ will make the final determination of eligibility for support.

A dissertation research grant is usually awarded for 12 months or less, but 
may be awarded for up to 17 months. The proposed Principal Investigator may 
request support only for the time necessary to complete the dissertation.  
Further, the applicant must commit to a minimum of 40 hours per week on 
dissertation work.  Clinical or other professional pursuits in addition to 
work on the dissertation must not exceed 12 hours per week.  A statement 
affirming these time commitment plans must be included with the budget 

An investigator who receives support for dissertation research under a grant 
from the AHRQ may not simultaneously receive support under a predoctoral 
program training grant, an individual fellowship grant, or any other 
dissertation grant awarded by AHRQ or any other agency of the U.S. Department 
of Health and Human Services. Other current or pending sources of support 
should be explicitly listed.

Awards are usually announced no earlier than 5 months after receipt of the 


This PA will use the small research grant (R03) mechanism.  Responsibility 
for the planning, direction, and execution of the proposed project will be 
solely that of the proposed Principal Investigator (the doctoral candidate).

The total direct costs must not exceed $30,000 for the entire project period.  
AHRQ will return without review any application that exceeds this amount to 
the applicant. No supplemental funds will be awarded.

Funds Available

AHRQ sets aside funds each year for the Dissertation Research Program.  In 
general, AHRQ expects to award up to 30 dissertation research grants per 
fiscal year (October 1 to September 30).  The number of awards will be 
contingent on the availability of funds, the quality of the applications, and 
Agency priorities. 


Through the Dissertation Research Grant Program, AHRQ seeks to expand the 
number of researchers who conduct health services research in areas 
identified in the "AHRQ Health Services Research Program Announcement" 
published in the NIH Guide on March 26, 1998. This announcement is available 
on the AHRQ web site under “Funding Opportunities” (  The 
PA outlines broad research interests as they relate to: supporting 
improvements in health outcomes, at both the clinical and system levels; 
strengthening quality measurement and improvement including the use of 
evidence-based practice information and tools; identifying strategies to 
improve access, foster appropriate use, and reduce unnecessary expenditures 
including research on the organization, financing, and delivery of health 
care and the characteristics of primary care practices; methodological 
advances in health services research, especially cost-effectiveness analysis; 
and ethical issues across the spectrum of health care delivery.  A special 
focus is on health issues related to priority populations including racial 
and ethnic minorities, women, children, older adults, low income groups, 
individuals with special health care needs, including individuals with 
disabilities and individuals who need chronic care or end-of-life health 

Applicants who have questions regarding the relevance of their research 
topics to AHRQ goals should contact by telephone, electronic mail or letter 
staff listed under INQUIRIES.

Applications judged by staff to be non-responsive to this PA will be returned 
without review.


Allowable Costs

Expenses allowed under the AHRQ Health Services Dissertation Research program 
follow the guidelines described in the application for a Department of Health 
and Human Services (DHHS) grant. Allowable costs include the following: the 
investigator's salary; direct project expenses such as travel, data 
purchasing, data processing, and supplies.  Fees for maintaining 
matriculation or other fees imposed on those preparing dissertations are 
allowable costs, provided the fees are required of all students of similar 
standing, regardless of the source of funding. 

Although all of the above costs are allowable, the following guidelines 
should be followed:

o  No salary support will be given for the dissertation committee. 
o  All data costs are to be included in the $30,000 total direct cost limit 
of the solicitation. 
o  Travel costs are allowable for one professional conference. 
o  Personal computer and statistical consultant service costs at a level not 
to exceed 80 hours are allowable. 
o  Support for a research assistant is generally not permitted. In rare 
circumstances it may be approved if the justification is acceptable to AHRQ 

Applicants applying through institutions receive facilities and 
administrative (F&A) costs in addition to the direct costs of the project.  
For calculating F&A costs, dissertation research grants are considered 
training grants.  Therefore, according to DHHS policy, the institution will 
receive F&A costs based solely on 8 percent of the total allowable direct 
costs exclusive of tuition and related fees, health insurance, and 
expenditures for equipment.

Other Conditions

The following conditions apply to dissertation grants:

A Principal Investigator who discontinues or suspends a project during the 
grant period must inform the AHRQ immediately in writing.  AHRQ may suspend 
or terminate the grant as requested by the Principal Investigator or on its 
own initiative.

The dissertation and an Executive Summary of it constitutes the final report 
of the grant. The dissertation must be officially accepted by the faculty 
committee or university official responsible for the candidate's dissertation 
and must be signed by the responsible officials.  Two copies of the 
dissertation must be submitted to the Division of Scientific Review, AHRQ, 
listed under “Application Procedures.”

The dissertation and all financial status reports must be submitted in 

The grantee is encouraged to report all publications resulting from the grant 
to AHRQ even after completion of the grant.  Further, the grantee should cite 
AHRQ support in the dissertation and all publications resulting from the 
dissertation grant.

AHRQ Data Usage

AHRQ encourages research applications that will use data from the Medical 
Expenditure Panel Survey (MEPS), the Healthcare Cost and Utilization Project 
(HCUP), and other AHRQ data. 

MEPS is a rich data source for health care utilization, expenditure, and 
insurance information, directly linking data about persons and their families 
with information obtained from their employers, insurers, and health care 
providers.  It is the third in a series of nationally representative surveys 
of medical care use and expenditures in the United States.  The 1996 MEPS 
updates previous survey data to reflect the changes that have occurred over 
the past decade. MEPS collects data on the specific health services that 
Americans use, how frequently they use them, the cost and source of payment 
for services, and information on the types and costs of private health 
insurance held by and available to the U.S. population.  It provides a 
foundation for estimating the impact of changes in sources of payment and 
insurance coverage on different economic groups or special populations of 
interest, such as the poor, elderly, uninsured, and racial and ethnic 

Some data from the Household and Nursing Home Components of the 1996 MEPS 
became available for use by researchers beginning in March 1997.  The release 
schedule for other data through calendar year 1998 is available from the 
“Data and Survey” section of the AHRQ Web site (see above address). 

The HCUP includes two data bases covering 1988-95, with 1996 data available 
in early 1999. These all-payer databases were created through a 
Federal-state-industry partnership to build a multistate health care data 
system.  Both data bases contain patient-level information for inpatient 
hospital stays in a uniform format with privacy protections.  The Nationwide 
Inpatient Sample (NIS) is a national sample of about 900 hospitals.  The 
State Inpatient Database (SID), available from the partner states, contains 
inpatient records for all community hospitals in 17 states, and ambulatory 
surgery data from five states.  These data bases can be directly linked to 
county-level data from the Health Resources and Services Administration's 
Area Resource File and to hospital-level data from the Annual Survey of the 
American Hospital Association. 

Information on MEPS and HCUP-3 is available from the Data and Surveys section 
of the AHRQ Web site and AHRQ staff (see Inquiries). 

Data Privacy

Pursuant to section 903(c) of the Public Health Service Act (42 USC 299a-
1(c)), information obtained in the course of any AHRQ-study that identifies 
an individual or entity must be treated as confidential in accordance with 
any promises made or implied regarding the use and purposes of the data 
collection.  Applicants must describe in the Human Subjects section of the 
application procedures for ensuring the confidentiality of such  identifying 
information.  The description of the procedures should include a discussion 
of who will be permitted access to the information, both raw data and machine 
readable files, and how personal identifiers and other identifying or 
identifiable data will be safeguarded.

The grantee should ensure that computer systems containing confidential data 
have a level and scope of security that equals or exceeds those established 
by the Office of Management and Budget (OMB) in OMB Circular No. A-130, 
Appendix III - Security of Federal Automated Information Systems.  The 
National Institute of Standards and Technology (NIST) has published several 
implementation guides for this circular.  They are: An Introduction to 
Computer Security: The NIST Handbook; Generally Accepted Principals and 
Practices for Securing Information Technology Systems; and Guide for 
Developing Security Plans for Information Technology Systems.  The circular 
and guides are available on the web at     

Rights in Data

AHRQ grantees may copyright or seek patents, as appropriate, for final and 
interim products and materials including, but not limited to, methodological 
tools, measures, software with documentation, literature searches, and 
analyses, which are developed in whole or in part with AHRQ funds.  Such 
copyrights and patents are subject to a Federal government license to use and 
permit others to use these products and materials for AHRQ purposes.  In 
accordance with its legislative dissemination mandate, AHRQ purposes may 
include, subject to statutory confidentiality protections, making research 
materials, data bases, and algorithms available for verification or 
replication by other researchers; and subject to AHRQ budget constraints, 
final products may be made available to the health care community and the 
public by AHRQ, or its agents, if such distribution would significantly 
increase access to a product and thereby produce public health benefits.  
Ordinarily, to accomplish distribution, AHRQ publicizes research findings but 
relies on grantees to publish in peer-reviewed journals and to market grant-
supported products.

Important legal rights and requirements applicable to AHRQ grantees are set 
out or referenced in the AHRQ’s grants regulation at 42 CFR Part 67, Subpart 
A (Available in libraries and from the GPO’s website

It is the policy of AHRQ that women and members of minority groups should be 
included in all AHRQ-supported research projects involving human subjects, 
unless a clear and compelling rationale and justification is provided that 
inclusion is inappropriate with respect to the health of the subjects or the 
purpose of the research.  

All investigators proposing research involving human subjects should read the 
"NIH Guidelines on the Inclusion of Women and Minorities as Subjects in 
Clinical Research," which was published in the Federal Register of March 28, 
1994 and in the NIH Guide for Grants and Contracts of March 18, 1994.  AHRQ 
follows the NIH Guidelines.  

Investigators may obtain copies from the above sources or from the AHRQ 
contractor listed under INQUIRIES, or from the NIH Guide Website

AHRQ is also encouraging investigators to consider including children in 
study populations, as appropriate.  AHRQ announced in the NIH Guide of May 9, 
1997, that it is developing a policy and implementation plan on the inclusion 
of children in health services research.  This notice is available through 
the AHRQ Web site (see above address) under “Funding Opportunities” and 
through InstantFax (see instructions under INQUIRIES).  

AHRQ program staff may also provide information concerning these policies 


Applicants should use the research grant application form PHS 398 (rev. 
04/98) in applying for these grants. (State and local government applicants 
may use form PHS-5161-1, Application for Federal Assistance (rev. 05/96), and 
follow those requirements for copy submission.)

Application kits are available at most institutional offices of sponsored 
research.  They may also be obtained from the Division of Extramural Outreach 
and Information Resources, National Institutes of Health, 6701 Rockledge 
Drive, MSC 7910, Bethesda, MD 20892-7910, telephone (301)-710-0267, email:  .

AHRQ applicants are encouraged to obtain application materials from the AHRQ 
Publications Clearinghouse (see INQUIRIES).

The PA title and number must be typed on line two of the face page of the 
application form and the YES box must be marked. 

The PHS 398 type size requirements (p.6) will be enforced rigorously and non-
compliant applications will be returned.

The completed, signed, typewritten original application, including the 
Checklist, and three signed photocopies in one package must be sent to:

Center for Scientific Review
National Institutes of Health 
6701 Rockledge Drive, Room 1040, MSC 7710 
Bethesda, MD 20892-7710 or
Bethesda, MD 20817 (for express/courier service)

At the time of submission, two additional copies of the application must also 
be sent to:

Division of Scientific Review/Dissertation Program
Office of Research Review, Education and Policy
Agency for Healthcare Research and Quality
2101 East Jefferson Street, Suite 400
Rockville, MD 20852-4908

The next application receipt is May 5, 2000.  After that, receipt dates will 
be September 15, January 15, and May 15 annually. 

No application can be submitted more than once, even in revised form.

Special Instructions

The proposed Principal Investigator for a dissertation grant is encouraged to 
have the application administered through an institution whenever feasible.  
This may be either the degree-granting institution or another nonprofit 
institution with which the proposed Principal Investigator is professionally 
affiliated.  In determining which institution is more appropriate, the 
student must
consider the extent to which the resources of the designated institution are 
capable of supporting the proposed research effort.

In addition to the instructions in the PHS 398 form, the following special 
instructions should be followed:

o  The graduate student should be identified as the Principal Investigator. 

o  The section entitled Research Plan, excluding references, may not exceed 
20 pages. 

o  The only acceptable appendix material is a copy of the survey 
instrument(s) being used in the proposed research project. 

o  A list of literature citations is required, but will not be counted toward 
the 20 page limit requirement for the Research Plan.

o  A letter from the faculty committee or the university official directly 
responsible for supervising the dissertation research must be submitted with 
the grant application. The letter must certify that: 

1.  The dissertation faculty committee has approved the dissertation 
proposal.  If this certification is not received, the application will be 
withdrawn administratively but can be resubmitted for the subsequent 
dissertation application round.

2.  The candidate demonstrates future career objectives and potential as a 
health services researcher.

3.  An institutional infrastructure exists to support the candidate and 
proposed research project.

4.  The grant application represents the dissertation proposal. 

5.  A collaborative process was established between the applicant and 
advisors in the development, review, and editing of the research application.

6.  The applicant has completed all requirements for the doctoral degree, 
except the dissertation, prior to submission of the application. 

o  The applicant should include a brief cover letter with the application, 
which discusses his/her career goals, his/her background and interest in 
health services research, how the proposed dissertation will contribute to 
career goals and the field of health services research, and the relevance of 
the proposed dissertation to AHRQ priorities and interests, as described 

o  Section C of the application should be used as an extension of the 
literature review or publications of the faculty committee as they relate to 
this research.  The application must identify all members of the faculty 
committee by listing the names on Form BB.  As explained in form PHS 398, a 
brief biographical sketch (see page FF) and listing of Other Support (see 
page GG) should be provided for dissertation committee members, consultants, 
and other key personnel.  

Applicants should give special attention to the sections of the application 
dealing with human subjects protection and gender and minority 
representation.  For those projects involving human subjects or individually 
identifiable data, IRB approval at the time of application submission is 

Application Preparation (for Using HCFA Data) 

For applications that propose to use Medicare or Medicaid data that are 
individually identifiable, applicants should state explicitly in the Research 
Design and Methods section of the Research Plan (form PHS 398) the specific 
files, time periods, and cohorts proposed for the research.  In consultation 
with the Health Care Financing Administration (HCFA), AHRQ will use this 
information to develop an estimate of the cost of borrowing the data.  This 
estimate will be included in the estimated AHRQ cost of funding the grant and 
may affect the fundability of the application.  To avoid double counting, 
applicants should not include the cost of the data in the budget.  Small 
grant applicants should be aware that the direct cost of the grant plus the 
cost of HCFA data cannot exceed $55,000.  (This limit is based on the 
statutory limit on “small” grants of $50,000 in section 922(d)(2) of the PHS 
Act plus discretionary supplements limited in aggregate to 10% of the direct 

Applicants should be aware that for individually identifiable Medicare and 
Medicaid data, Principal Investigators and their grantee institutions will be 
required to enter into a Data Use Agreement (DUA) with HCFA to protect the 
confidentiality of data in accordance with standards set out in OMB Circular 
A-130, Appendix III–Security of Federal Automated Information Systems.  The 
use of the data is restricted to the purposes and time period specified in 
the DUA.  At the end of this time period, the grantee is required to return 
the data to HCFA or certify that the data have been destroyed.  

Grantees must also comply with the confidentiality requirements of Section 
903(c) of the PHS Act.  See the Data Privacy section for details on these 
requirements as well as references to Circular A-130 and its implementation 
guides from the National Institute of Standards and Technology.

In developing research plans, applicants should allow time for refining, 
approving, and processing their data requests.  Requests may take 6 months 
from the time they are submitted to complete.  Applications proposing to 
contact beneficiaries or their provider require the approval of the HCFA 
Administrator and may require meeting(s) with HCFA staff.

HCFA data are provided on IBM mainframe tapes using the record and data 
formats commonly employed on these computers.  Applicants should either have 
the capability to process these tapes and formats or plan to make 
arrangements to securely convert them to other media and formats.

Questions regarding HCFA data should be directed to the AHRQ program official 
listed under INQUIRIES.


Upon receipt, AHRQ staff will review applications for completeness and 
relevance to the AHRQ mission.  Incomplete applications and applications 
proposing research in areas outside the mission of the Agency will be 
returned to the applicant without further consideration.

Applications that are complete will be evaluated for scientific and technical 
merit by an appropriate peer review group convened in accordance with AHRQ 
peer review procedures.  All applications will receive a written critique, 
and also may undergo a process in which only those applications deemed to 
have the highest scientific merit will be discussed and assigned a priority 

General Review Criteria

Review criteria for grant applications are: significance and originality from 
a scientific or technical viewpoint; adequacy of the method(s); availability 
of data or adequacy of the proposed plan to collect data required for the 
project; adequacy and appropriateness of the plan for organizing and carrying 
out the project; qualifications and experience of the Principal Investigator; 
reasonableness of the proposed budget and the time frame for the project in 
relation to the work proposed; adequacy of the facilities and resources 
available to the applicant; the extent to which women, minorities, and if 
applicable children, are adequately represented in study populations; and as 
applicable, the adequacy of the proposed means for protecting human subjects. 

In evaluating the above criteria, strong emphasis is placed on the reviewers' 
assessment of the applicant's potential as a future contributor to health 
services research, including the quality and relevance of the written 
proposal, the caliber of the infrastructure to provide necessary guidance and 
support to the student, the dissertation chair or faculty advisor evaluation 
of the student in the certification letter, and faculty biosketches. 

Summary Statements on applications are prepared by AHRQ staff using the 
comments of the reviewers, and are generally completed and provided to the 
applicant within 16 weeks of receipt of applications.


AHRQ sets aside funds each fiscal year for the Dissertation Research Program.  
Applications will compete for available funds with all other recommended 

Factors that influence the final funding decisions on applications for 
support of dissertations include: reviewers' evaluation of the application, 
the applicant’s potential to contribute to the field, program balance, and 
the availability of funds. The earliest anticipated date of an award will 
generally be 5 months after the due date of the application.

It is anticipated that some awards will specifically be made to highly 
meritorious applicants pursuing research which addresses ethnic and racial 
minority populations, health care issues related to children or older adults, 
or to individual investigators from predominantly minority or other 
geographically under-represented institutions (i.e., institutions that are 
not traditional recipients of AHRQ-supported health services research 
grants).  Similarly, it is anticipated that some awards will be made to 
applicants from discipline-specific departments (e.g., economics, 
biostatistics, sociology, epidemiology, anthropology, political science) 
whose faculty and students may conduct health services research. 


Copies of this PA and copies of the grant application form PHS 398 (rev. 
4/98) are available from: 

AHRQ Publications Clearinghouse
P.O. Box 8547 
Silver Spring, MD 20907-8547
Telephone: (800) 358-9295
TDD Service: 888-586-6340 

The PA is available through AHRQ InstantFAX at (301) 594-2800. To use 
InstantFAX, you must call from a facsimile (FAX) machine with a telephone 
handset. Follow the voice prompt to obtain a copy of the InstantFAX table of 
contents, which has the document order number (not the same as the PA 
number). The PA will be sent at the end of the ordering process.  AHRQ 
InstantFAX operates 24 hours a day, 7 days a week.  For comments or problems 
concerning AHRQ InstantFax, please call (301) 594-6344. 

AHRQ welcomes the opportunity to clarify any issues or questions from 
potential applicants. Written and telephone inquiries concerning this PA are 
encouraged.  Direct inquiries regarding programmatic issues, including 
information on the inclusion of women, minorities, and children in study 
populations to:

Dissertation Program Specialist
Division of Research Education 
Office of Research, Review, Education, and Policy
Agency for Healthcare Research and Quality
2101 East Jefferson Street, Suite 400
Rockville, MD 20852-4908
Telephone: (301) 594-1449

Direct inquiries regarding fiscal matters to: 

Al Deal
Grants Management Specialist
Agency for Healthcare Research and Quality 
2101 East Jefferson Street, Suite 601 
Rockville, MD 20852-4908 
Telephone: (301) 594-1843
FAX (301) 594-3210 

Inquiries Concerning Data Sources:

MEPS Household Component

Nancy Krauss
Center for Cost and Financing Studies
Telephone: (301) 594-0846

MEPS Nursing Home Component

Jeffrey Rhodes
Center for Cost and Financing Studies
Telephone: (301) 594-0891


Kelly Carper
Telephone: (301) 594-3075


This program is described in the Catalog of Federal Domestic Assistance 
Number 93.226.  Awards are made under authorization of Title IX of the Public 
Health Service Act (42 U.S.C. 299-299c-6).  Awards are administered under the 
PHS Grants Policy Statement and Federal regulations 42 CFR 67, Subpart A, and 
45 CFR Parts 74 and 92. 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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