EXPIRED
National Institutes of Health (NIH)
See Part 2, Section III. 3. Additional Information on Eligibility.
The purpose of this NOFO is to solicit UG3/UH3 phased cooperative agreement research applications to conduct efficient, large-scale pragmatic clinical trials and/or implementation science demonstration projects within the infrastructure of the NIH-DOD-VA Pain Management Collaboratory (PMC) on nonopioid approaches to management of pain and other comorbid conditions, including complementary and integrative approaches used alone and in combination with standard care (e.g., mindfulness meditation combined with standard pharmaceutical treatment), and improving prevention and treatment for opioid misuse and addiction in U.S. Veterans, military personnel, and their families. Supporting the trials, the PMC has established a coordinating center that provides national leadership and technical expertise for all aspects of health care system (HCS)-focused research including assistance to UG3/UH3 grant recipients.
This Notice of Funding Opportunity (NOFO) requires a Plan for Enhancing Diverse Perspectives (PEDP).
October 7, 2024
Application Due Dates | Review and Award Cycles | ||||
---|---|---|---|---|---|
New | Renewal / Resubmission / Revision (as allowed) | AIDS - New/Renewal/Resubmission/Revision, as allowed | Scientific Merit Review | Advisory Council Review | Earliest Start Date |
November 07, 2024 | Not Applicable | Not Applicable | March 2025 | May 2025 | July 2025 |
All applications are due by 5:00 PM local time of applicant organization.
Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.
No late applications will be accepted for this Notice of Funding Opportunity (NOFO).
Not Applicable
It is critical that applicants follow the instructions in the Research (R) Instructions in the How to Apply - Application Guide, except where instructed to do otherwise (in this NOFO or in a Notice from NIH Guide for Grants and Contracts).
Conformance to all requirements (both in the How to Apply - Application Guide and the NOFO) is required and strictly enforced. Applicants must read and follow all application instructions in the How to Apply - Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the How to Apply - Application Guide, follow the program-specific instructions.
Applications that do not comply with these instructions may be delayed or not accepted for review.
There are several options available to submit your application through Grants.gov to NIH and Department of Health and Human Services partners. You must use one of these submission options to access the application forms for this opportunity.
Background
The NIH HEAL Initiative: This notice of funding opportunity (NOFO) is part of the Helping to End Addiction Long-term® Initiative, or NIH HEAL Initiative® to speed scientific solutions to the national opioid public health crisis. The NIH HEAL Initiative bolsters research across NIH to (1) improve treatment for opioid misuse and addiction and (2) enhance pain management. More information about the initiative is available at https://heal.nih.gov/.
Since 2001, more than 2.77 million U.S. troops have been deployed for Operation Enduring Freedom in Afghanistan and Operation Iraqi Freedom and Operation New Dawn in Iraq. The all-volunteer military experienced multiple redeployments to the war zone and extensive use of the reserve components of the military and National Guard, that also involved the deployment of women and parents of young children. Many of these deployed service members sustained severe injuries that in previous wars would have resulted in death. Significant and continuing improvements in outer tactical vests (body armor) and helmets have saved lives. However, despite these improvements, many service members returning from these operations and from other military operations experienced pain, traumatic brain injuries (TBIs), symptoms of post-traumatic stress disorder (PTSD), suicidal thoughts or behaviors, substance abuse, and/or related comorbidities. Studies report nearly 45 percent of active-duty service members and 50 percent of Veterans experience pain on a regular basis, and there is significant overlap among chronic pain, PTSD, and persistent post-concussive symptoms. There is an ongoing challenge with pain among military and Veteran populations and an incomplete evidence base for effective pain management. Opioid medications continue to be prescribed for the treatment of chronic pain despite the association of chronic opioid use with the potential for misuse, and they often fail to adequately control pain. As a result, there continues to be a need for additional nonopioid approaches to complement or replace opioid-based strategies for pain management and to reduce the needs and risks associated with excessive reliance on opioids.
In June 2011, the Institute of Medicine (IOM) released a Consensus Report, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. The report notes that chronic pain affects an estimated 116 million American adults— more than the total affected by heart disease, cancer, and diabetes combined. Pain also costs the nation up to $635 billion each year in medical treatment and lost productivity. The report notes that ideally, most patients with severe persistent pain would obtain pain care from an interdisciplinary team using an integrated approach that would target multiple dimensions of the chronic pain experience including disease management, reduction in pain severity, and improved functioning, emotional well-being, and health-related quality of life. The NIH, the U.S. Department of Defense (DOD), and the U.S. Department of Veterans Affairs (VA) have been working individually and collaboratively to develop and improve pain management approaches for military personnel, Veterans, and their families. In 2014, NCCIH partnered with the National Institute on Drug Abuse (NIDA) and the VA to fund 13 grants to research military and Veteran health with a focus on nonopioid approaches to pain and related conditions. This important partnership was expanded in 2017 to include the DOD and additional components of NIH [National Institute on Alcohol Abuse and Alcoholism (NIAAA), Eucine Kenney Shriver National Institute of Child Health and Human Development (NICHD), National Institute on Drug Abuse (NIDA), National Institute of Neurological Disorders and Stroke (NINDS), National Institute of Nursing Research (NINR), and Office of Research on Women's Health (ORWH)] to initiate the NIH-DOD-VA Pain Management Collaboratory (PMC). The PMC r supported 11 research projects focused on the development and testing of nonopioid approaches to pain management (RFA-AT-17-001) along with a coordinating center (RFA-AT-17-002) to support the program. A twelfth research project was funded in FY22 and a thirteenth in FY23 (RFA-AT-22-006).
Military and Veteran health care systems (HCS) and other HCS that provide services to military personnel, Veterans, and their families are the paradigmatic research platforms for this program. Research conducted in partnership with eligible VA and DOD health care providers is essential for obtaining meaningful and relevant research results in real world health care delivery systems serving veterans and military service members.
Team-based integrative care is increasingly recognized as a fundamental effective aspect of HCS. Team-based care is defined as an interprofessional, multidisciplinary team approach to patient-centered care coordinated across a variety of systems. The National Academy of Medicine (formerly known as the Institute of Medicine) predicts team-based care models will significantly reduce health care costs, saving an estimated $240 billion annually in national health care expenditures.
Despite the recognized and compelling need for research to identify and implement effective complementary nonopioid approaches for management of pain and comorbid conditions in military and Veteran populations, many challenges exist. Ethical and regulatory issues must be addressed to perform research in health care delivery settings. Health care providers focus on providing the best treatment, based on current knowledge, whereas research typically focuses on studying which treatments work best in a precisely defined population. Further, multiple challenges remain in identifying the best strategies to successfully integrate evidence-based interventions within specific health care settings. For example, research studies frequently use study endpoints that are not part of routine patient care and results may suggest adoption of interventions that are challenging to deliver. . Bridging the gap between research and practice is an important step in the direction of providing increased effective treatment options to patients.
Pain is a subjective experience impacted by a variety of biological, psychological, and social factors. Moreover, pain rarely occurs in isolation and is often accompanied by comorbid conditions or multiple pain conditions, as well as mental health disorders such as anxiety and depression. The multifaceted nature of pain necessitates a multifaceted, interdisciplinary approach in its treatment that is by definition complex, involving multiple domains spanning an individuals physiology, emotional well-being, environment, and social connection. Models of pain management that focus mainly on physiological systems are incomplete and fall short of accessing the full potential of human health and healing, and health restoration. Recognizing the importance of a multi-domain approach to health care, the DOD, the VA, and NCCIH have each developed programs or strategic plans that address health through multiple domains, namely, Total Force Fitness (DOD), Move to Health (DOD), Whole Health (VA), and Whole Person Health (NCCIH). These initiatives share a common principle that health and health restoration are most effectively achieved through addressing the whole person, not just the disease. A recent report by the National Academies of Sciences, Engineering, and Medicine highlights the need for a whole person health approach to medicine that emphasizes greater focus on promoting health, rather than reacting only to disease. A whole person health approach that encompasses the full spectrum of health and social needs of Veterans, service members, and their families could have a profound impact on pain management by addressing what is most important to the individual in treating not just the pain, but also the comorbidities that so often occur with pain. It is also important to note the well-documented racial and ethnic disparities in both the experience and in the treatment of pain. Pain disproportionately impacts African American and Hispanic adults and those of low socioeconomic status. Compounded with findings that individuals from racial and ethnic minority groups receive less analgesics for their pain compared to White persons, a whole person approach to health has the potential to bridge the pain management divide for individuals from racial and ethnic minority groups by taking into account all the factors that affect physical, emotional, social, and spiritual well-being.
Purpose
The purpose of this NOFO is to solicit UG3/UH3 phased cooperative agreement research applications to conduct efficient, large-scale pragmatic clinical trials and/or implementation science demonstration projects within the infrastructure of the PMC that focus on nonopioid approaches to management of pain and other comorbid conditions, including complementary and integrative approaches used alone or in combination with standard care (e.g., mindfulness meditation combined with standard pharmaceutical treatment), and improving prevention and treatment for opioid misuse and addiction in U.S. military personnel, Veterans, and their families. The PMC has established a coordinating center that provides national leadership and technical expertise for all aspects of HCS-focused research including assistance to UG3/UH3 grant recipients.
Applications submitted under this NOFO are expected to:
Research projects funded through this NOFO will be expected to work with the Pain Management Collaboratory Coordinating Center (PMC3) and the other funded PMC projects. This includes participation in PMC3 work groups, working with PMC3 on detailed plans for site implementation, determining resource needs, testing data extraction methods, developing plans for all aspects of ethical and regulatory oversight/protection of human subjects, and integrating data using common data elements (CDEs) within the NIH HEAL Initiative CDE repository to increase the overall impact of findings.
Awards made under this NOFO will initially support a 1-year milestone-driven research planning phase (UG3), with possible transition to a pragmatic trial and/or implementation science demonstration project research execution phase (UH3; 2–4 years). UG3 projects that have met the scientific milestone and feasibility requirements may transition to the UH3 phase following administrative review by the respective funding agency. The UG3/UH3 application must be submitted as a single application, following the instructions described in this NOFO.
Research Objectives
All demonstration projects should address a research question important to the health of U.S. Veterans, military personnel, and their families that is focused on nonopioid approaches to the management of pain and, if applicable, co-occurring conditions. The demonstration project may provide a definitive test of the underlying question to assess intervention effectiveness or carry out implementation research (or hybrid effectiveness-implementation research). Applications that include effectiveness research aims should be guided by the Pragmatic-Explanatory Continuum Indicator Summary 2 tool (PRECIS-2) and use more pragmatic approaches rather than explanatory ones when appropriate to address the proposed hypothesis (PRECIS-2 is described in https://www.bmj.com/content/350/bmj.h2147).
We define pragmatic trials as trials primarily designed to determine the effects of an intervention under the usual conditions in which it will be applied, in contrast with explanatory trials, which are primarily designed to determine the effects of an intervention under ideal circumstances. Efficacy research involves strict limitations on who may participate to minimize error, bias, and confounding. The emphasis on internal validity enhances confidence in interpreting positive results as indicating a causal relationship between the intervention(s) and outcome(s). Effectiveness research is designed to test interventions of known efficacy in real-world settings with an emphasis on external validity, that is, whether the results can be applied to a definable group of patients in a particular clinical setting in routine practice (i.e., generalizability). In effectiveness research, limitations on who may participate are minimized in order to maximize the likelihood that study participants and the population intended to benefit from the interventions are similar. Dissemination research is the scientific study of targeted distribution of information and intervention materials to a specific public health or clinical practice audience, while implementation science is the scientific study of the use of strategies to adopt and integrate evidence-based health interventions into clinical and community settings to improve patient outcomes and benefit population health. For the purposes of this NOFO, only effectiveness research, implementation science, and hybrid effectiveness-implementation trials will be responsive. Dissemination may be included as an aim, but applications that only propose dissemination research will be considered nonresponsive.
The research question(s) proposed should be of major public health importance, focusing on nonopioid approaches to the management of pain and comorbid conditions in Veterans, military personnel, and one that will engage partnership with health care delivery systems providing services to this population. Although trials will likely be conducted in the VA and DOD health care systems, it is expected that many of the findings will be generalizable to practices across the broader health care community. The NIH HEAL Initiative prioritizes speeding scientific solutions to stem the national opioid public health crisis, and developing nonopioid approaches to pain management and co-occurring conditions remains integral to improving prevention and treatment of opioid misuse and addiction. The unique challenges to service member and Veteran health represent an opportunity to conduct pragmatic clinical trial research to identify what approaches to pain management are effective when delivered in the VA and DOD health care settings. Of special interest are effectiveness trials of approaches that have not yet been evaluated for effectiveness in the VA and/or DOD health care settings. Applicants are strongly encouraged to review the PMC website to avoid submitting a trial that overlaps significantly with other ongoing or completed PMC trials. For example, investigators should avoid overlap with approaches being evaluated in ongoing PMC trials, including remotely delivered cognitive behavioral therapy, remotely delivered mindfulness, chiropractic care dose optimization, a Screening, Brief Intervention, and Referral to Treatment for Pain Management (SBIRT) approach, percutaneous peripheral nerve stimulation, and several multi-modal coordinated care pathways. Prior to submitting to this NOFO, applicants are encouraged to speak with the NCCIH scientific/research contact person. The NIH RePORTER website at https://reporter.nih.gov, the DOD Defense Technical Information Center website at https://discover.dtic.mil, and the Patient-Centered Outcomes Research Institute website at https://www.pcori.org/ should also be reviewed to avoid submitting a trial that overlaps significantly with other ongoing or completed trials testing methods to manage pain in U.S. Veterans, military personnel, and their families. In addition, integrated models of multicomponent care that are delivered in different settings (e.g., pain care that could include collaborative care, care management, care delivered through tele-care, peer coaches, or informal caregivers) will be of higher programmatic priority.
Research projects should be performed within large HCS that use electronic health records (EHRs) to leverage data collection that occurs in health care delivery rather than requiring independent research data collection. The HCS partnerships must be able to facilitate access to all data sources relevant to the project, which may include inpatient, outpatient, clinical laboratory, and pharmacy data. Applicants, who may be from academic institutions or other organizations, must have demonstrated success in conducting clinical research in partnerships with HCS serving military or Veterans. Interdisciplinary teams should include necessary expertise to conduct the trial such as military researchers on military-focused applications and VA researchers on Veteran-focused applications. Applicants should involve appropriate HCS personnel when conducting the pragmatic clinical trial. . Applicants must document the commitment of the health care organization to the project and must include letters of support from the HCS partners that relate their commitment to the proposed research and outline how the project fits with organizational priorities
For this NOFO, multisite clinical trials are defined as trials that enroll from at least three recruitment sites that are geographically distinct and non-overlapping with respect to the population of patients engaging with services and are likely to be compliant with NIH policy on the inclusion of women and minorities as subjects in clinical research, as well as individuals across the lifespan (https://grants.nih.gov/policy/inclusion/women-and-minorities.htm and https://grants.nih.gov/policy/inclusion/lifespan.htm),. Two sites will be permitted if there is a strong justification for how fewer sites can still achieve generalizability and and be sufficient for valid analysis of the data. Multiple sites are necessary in efficacy trials to increase generalizability of findings and ensure appropriate size and diversity of eligible participants.
For projects proposing effectiveness aims:
Outcomes should include assessing pain and pain reduction, pain interference, ability to function in daily life, quality of life, and medication usage/reduction/discontinuation. Additional outcomes may focus on assessing conditions co-occurring with high frequency in this population. There is also interest in obtaining objective sensor-based measures that provide data on peoples daily activities to gain a better understanding of the relationship between ratings of pain and functional changes.
When testing effectiveness, projects are encouraged to enroll participants based on broad eligibility criteria to maximize generalizability, with minimum exclusions based on risk, age, health literacy, comorbidities, or expected adherence. Studies should enroll from the target populations the interventions are intended to benefit, namely Veterans, active-duty service members, and their beneficiaries. It is important that women are represented according to their proportion of the population being studied, preferably overrepresented, and that studies include a comparative analysis of differential effects between men and women.
Projects aimed at evaluating team-based care models should determine overall effectiveness of team-based care compared to conventional, non-team-based primary care. Secondary outcomes may assess differential benefits contributed by unique components of the team-based care package.
In some cases, a stepped-wedge design may be the only practical way to generate the appropriate data. Nevertheless, considering the practical, ethical, and analytical challenges as outlined by the PMC, stepped-wedge designs should be avoided when another rigorous study design is feasible and will answer the study question. If proposed, a strong justification for a stepped-wedge design should be provided, including why an alternative design is not superior.
For projects proposing implementation science aims:
Outcomes of implementation trials should focus on rigorous assessment of the strategies designed to increase uptake and adoption of evidence-based nonopioid pain interventions. Investigators are encouraged to incorporate theories, models, and/or frameworks appropriate for implementation research when considering study hypotheses, measures, and outcomes. When designing an application, applicants are also encouraged to use the extant literature on barriers to and facilitators of the implementation of practices to manage pain and to consider the multilevel context and environment in which the proposed research will be conducted.
Research Planning Phase and Research Execution Phase
These projects will be funded as phased awards with a 1-year research planning phase (UG3) and a 2–4-year research execution phase (UH3). The UH3 budget will undergo reassessment during the UG3 planning phase. Activities in both phases will depend on the specific study (e.g., type of intervention, randomization strategy, and proposed outcome measures).
During the UG3 or research planning phase, activities should generally include, but are not limited to:
The objective of the 2–4-year UH3 research execution phase is to conduct the effectiveness and/or implementation research within the PMC, in accordance with activities planned in the UG3 planning phase. UH3 activities will depend upon the study, but in general the following goals should be achieved:
Research Questions
Applicants who propose effectiveness aims should address one or more critical research questions to improve pain management for U.S. Veterans and military personnel. The following list provides examples of some potential research that addresses the effectiveness of evidence-based approaches delivered in the VA and DOD health care settings:
Applicants who propose implementation science should address one or more critical research questions for implementing evidence-based pain management interventions for U.S. military personnel and Veterans. The following list provides examples of some of the potential research questions that might be addressed by such trials:
Milestones and UG3/UH3 Transition
Projects should include well-defined milestones for the research planning phase (UG3) and annual milestones for the research execution phase (UH3). It is understood that the proposed milestones for the UH3 phase will be revised as activities in the UG3 phase progress In the event of an award, the program director/principal investigator (PD/PI) and NIH staff will negotiate a final list of milestones for each year of support prior to releasing an award.
Prior to the completion of the UG3 research planning phase, the applicant will be required to submit a detailed transition request for the UH3 demonstration project research execution phase at least 60 days before the anticipated transition date. UH3 transition requests will undergo an administrative review by the respective funding agency to determine whether the demonstration project will be awarded the research execution phase (UH3). Prospective applicants should note that initial funding of the UG3/UH3 cooperative agreement does not guarantee support of the UH3 demonstration project research execution phase. Successful completion of all UG3 milestones also does not guarantee transition to nor full support of the UH3 phase. Applicants should understand that transition to the UH3 phase of the project will occur only if an administrative review process concludes that the UG3 planning milestones have been successfully met and that the UH3 phase can proceed with confidence of success, continued relevance to the funding agency, and availability of funds.
Additional Information
Diversity
In addition to scientific diversity, applicants should strive to incorporate diversity in their team development plan. Research shows that diverse teams working together and capitalizing on innovative ideas and distinct perspectives outperform homogeneous teams. Scientists and trainees from diverse backgrounds and life experiences bring different perspectives, creativity, and individual enterprise to address complex scientific problems. There are many benefits that flow from a diverse NIH-supported scientific workforce, including: fostering scientific innovation, enhancing global competitiveness, contributing to robust learning environments, improving the quality of the research, advancing the likelihood that underserved or health disparity populations participate in, and benefit from health research, and enhancing public trust. In spite of tremendous advancements in scientific research, information and, educational and research opportunities are not equally available to all. NIH encourages institutions to diversify their student and faculty populations to enhance the participation of individuals from groups that are underrepresented in the biomedical, clinical, behavioral, and social sciences. Please refer to Notice of NIH's Interest in Diversity NOT-OD-20-031 for more details.
Engaging People with Lived Experience and Other Collaborators:
People with lived experience (e.g., patients, patient advocates, caregivers, families, community leaders) have important insights that can improve meaningful outcomes, uptake of research findings, and health equity across the continuum of research from basic through implementation studies. The perspectives of other relevant collaborators (e.g., health service providers, payors, public health agencies, community-based organizations, biotech, pharma) can further improve research impact. The NIH HEAL initiative strongly encourages applicants to specify their plan for meaningful engagement of people with lived experience and other collaborators in the research process. Meaningful engagement will vary with the focus of the research but should at minimum ensure that researchers are connecting with relevant collaborators and incorporating their perspectives throughout the conception, implementation, and dissemination of the research. Meaningful engagement should address what the researchers will learn and how the people with lived experience and/or collaborators will benefit from the partnership. To promote health equity, as is relevant for the research proposed, it is recommended that at least two people with lived experience from populations who experience health disparities should be meaningfully engaged in these efforts (see NIHs Notice of Interest in Diversity for more information: NOT-OD-20-031).
See this resource for more information in engaging people with lived experience: https://aspe.hhs.gov/lived-experience).
Governance: The awards funded under this NOFO will be cooperative agreements (see Section VI.2 Cooperative Agreement Terms and Conditions of Award).
Participation in the work groups established by the PMC3 is a core collaborative activity of this program. The work groups provide a forum for discussion of challenges and solutions across projects; harmonized and standardized policies and processes are vetted in these groups. Work groups include Stakeholder Engagement, Patient Resources, Ethical/Regulatory, Design/Biostatistics, Phenotype/Outcomes, Electronic Health Records, Implementation Science, and Data Sharing. Work groups comprise individuals from the demonstration projects, the PMC3, and staff from NIH, the DOD, and the VA.
The PMC3 has established a steering committee to address issues that span all projects, provide input into the policies and processes of the PMC, and assist in dissemination of policies and processes that enable research in HCS serving the military and Veterans, involving their patients and practitioners. The steering committee includes at a minimum, one representative from each of the demonstration projects, one representative from each work group, one representative from the PMC3, program officers and project scientists from NIH and representatives from various NIH institutes and centers (ICs). All members are expected to actively participate in all steering committee activities.
Types of Research Not Responsive to This NOFO
The following types of research are not responsive to this NOFO, and applications proposing such activities will be deemed nonresponsive and will not be reviewed:
Special Considerations:
PI Meeting Attendance
The NIH HEAL Initiative will require a high level of coordination and sharing between investigators. It is expected that NIH HEAL Initiative awardees will cooperate and coordinate their activities after awards are made by participating in Program Director/Principal Investigator (PD/PI) meetings, including an annual HEAL Investigators Meeting, as well as other activities. Additionally, applications must budget for project PD(s)/PI(s) travel to attend an annual one-and-a-half-day PMC steering committee meeting in the greater Washington D.C. area.
Clinical Trial Accrual:
This NOFO will support applications that include a series of recruitment milestones for completion of the clinical trial and provide contingency plans to proactively confront potential delays or disturbances in attaining the milestones. Continuation of the award is conditional upon satisfactory progress, availability of funds, and scientific priorities of the HEAL Initiative. If, at any time, recruitment falls significantly below the projected milestones for recruitment, NIH will consider ending support and negotiating an orderly phase-out of the award. NIH retains the option of periodic external peer review of progress. NIH program staff will closely monitor progress at all stages for milestones, accrual, and safety.
See Section VIII. Other Information for award authorities and regulations.
Plan for Enhancing Diverse Perspectives (PEDP)
The NIH recognizes that teams comprised of investigators with diverse perspectives working together and capitalizing on innovative ideas and distinct viewpoints outperform homogeneous teams. There are many benefits that flow from a scientific workforce rich with diverse perspectives, including: fostering scientific innovation, enhancing global competitiveness, contributing to robust learning environments, improving the quality of the research, advancing the likelihood that underserved populations participate in, and benefit from research, and enhancing public trust.
To support the best science, the NIH encourages inclusivity in research guided by the consideration of diverse perspectives. Broadly, diverse perspectives can include but are not limited to the educational background and scientific expertise of the people who perform the research; the populations who participate as human subjects in research studies; and the places where research is done.
This NOFO requires a Plan for Enhancing Diverse Perspectives (PEDP), which will be assessed as part of the scientific and technical peer review evaluation. Assessment of applications containing a PEDP are based on the scientific and technical merit of the proposed project. Consistent with federal law, the race, ethnicity, or sex (including gender identify, sexual orientation, or transgender status) of a researcher, award participant, or trainee will not be considered during the application review process or when making funding decisions. Applications that fail to include a PEDP will be considered incomplete and will be administratively withdrawn before review.
The PEDP will be submitted as Other Project Information as an attachment (see Section IV). Applicants are strongly encouraged to read the NOFO instructions carefully and view the available PEDP guidance materials.
Investigators proposing NIH-defined clinical trials may refer to the Research Methods Resources website for information about developing statistical methods and study designs.
Cooperative Agreement: A financial assistance mechanism used when there will be substantial Federal scientific or programmatic involvement. Substantial involvement means that, after award, NIH scientific or program staff will assist, guide, coordinate, or participate in project activities. See Section VI.2 for additional information about the substantial involvement for this NOFO.
The OER Glossary and the How to Apply - Application Guide provide details on these application types. Only those application types listed here are allowed for this NOFO.
Required: Only accepting applications that propose clinical trial(s).
The NIH HEAL Initiative intends to commit an estimated total of $850,000 to fund one award in FY 2025. Awards pursuant to this funding opportunity are contingent upon NIH appropriations and the submission of a sufficient number of meritorious applications.
The application budget for the UG3 phase is limited to $500,000/year in direct costs. Costs for each year of the UH3 phase are limited to $1,000,000/year in direct costs.
The UG3 phase is limited to 1 year, and the UH3 phase can request up to 4 years of support. The total project period for an application submitted in response to this NOFO may not exceed 5 years.
NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made from this NOFO.
Higher Education Institutions
The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education:
Nonprofits Other Than Institutions of Higher Education
For-Profit Organizations
Local Governments
Federal Governments
Other
Non-domestic (non-U.S.) Entities (Foreign Organizations) are not eligible to apply.
Non-domestic (non-U.S.) components of U.S. Organizations are not eligible to apply.
Foreign components, as defined in the NIH Grants Policy Statement, are allowed.
Applicant Organizations
Applicant organizations must complete and maintain the following registrations as described in the How to Apply - Application Guide to be eligible to apply for or receive an award. All registrations must be completed prior to the application being submitted. Registration can take 6 weeks or more, so applicants should begin the registration process as soon as possible. Failure to complete registrations in advance of a due date is not a valid reason for a late submission, please reference NIH Grants Policy Statement Section 2.3.9.2 Electronically Submitted Applications for additional information
Program Directors/Principal Investigators (PD(s)/PI(s))
All PD(s)/PI(s) must have an eRA Commons account. PD(s)/PI(s) should work with their organizational officials to either create a new account or to affiliate their existing account with the applicant organization in eRA Commons. If the PD/PI is also the organizational Signing Official, they must have two distinct eRA Commons accounts, one for each role. Obtaining an eRA Commons account can take up to 2 weeks.
Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the Program Director(s)/Principal Investigator(s) (PD(s)/PI(s)) is invited to work with their organization to develop an application for support. Individuals from diverse backgrounds, including individuals from underrepresented racial and ethnic groups, individuals with disabilities, and women are always encouraged to apply for NIH support. See, Reminder: Notice of NIH's Encouragement of Applications Supporting Individuals from Underrepresented Ethnic and Racial Groups as well as Individuals with Disabilities, NOT-OD-22-019.
For institutions/organizations proposing multiple PDs/PIs, visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the How to Apply - Application Guide.
This NOFO does not require cost sharing as defined in the NIH Grants Policy Statement NIH Grants Policy Statement Section 1.2 Definition of Terms.
Number of Applications
Applicant organizations may submit more than one application, provided that each application is scientifically distinct.
The NIH will not accept duplicate or highly overlapping applications under review at the same time, per NIH Grants Policy Statement Section 2.3.7.4 Submission of Resubmission Application. This means that the NIH will not accept:
The application forms package specific to this opportunity must be accessed through ASSIST, Grants.gov Workspace or an institutional system-to-system solution. Links to apply using ASSIST or Grants.gov Workspace are available in Part 1 of this NOFO. See your administrative office for instructions if you plan to use an institutional system-to-system solution.
It is critical that applicants follow the instructions in the Research (R) Instructions in the How to Apply - Application Guide nbsp;except where instructed in this notice of funding opportunity to do otherwise. Conformance to the requirements in the How to Apply - Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.
Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows IC staff to estimate the potential review workload and plan the review.
By the date listed in Part 1. Overview Information, prospective applicants are asked to submit a letter of intent that includes the following information:
The letter of intent should be sent to:
Jessica McKlveen, Ph.D.
Telephone: 301-594-8018
Email: [email protected]
All page limitations described in the How to Apply – Application Guide and the Table of Page Limits must be followed.
, with the following exceptions or additional requirements;
For this specific NOFO, the Research Strategy section is limited to 30 pages.
The following section supplements the instructions found in the How to Apply – Application Guide and should be used for preparing an application to this NOFO.
All instructions in the How to Apply - Application Guide must be followed.
All instructions in the How to Apply - Application Guide must be followed.
All instructions in the How to Apply - Application Guide must be followed.
Plan for Enhancing Diverse Perspectives (PEDP)
Examples of items that advance inclusivity in research and may be appropriate for a PEDP can include, but are not limited to:
Examples of items that are not appropriate in a PEDP include, but are not limited to:
For further information on the Plan for Enhancing Diverse Perspectives (PEDP), please see PEDP guidance materials.
All instructions in the How to Apply - Application Guide must be followed.
Biosketches should reflect the PD(s)/PI(s) and key personnels expertise in design and conduct of large-scale clinical and/or implementation trials within U.S. military and Veteran health care delivery organizations. The experience of the investigative team with successful recruitment and retention of participants should be described.
All instructions in the How to Apply - Application Guide must be followed.
Budgets for both phases (UG3/UH3) should be included; the UH3 budget will undergo reassessment during the UG3 planning phase.
Minimum effort of personnel: The PD/PI must devote a minimum level of effort of 20 percent annually (2.4 person months) to the project. If a project includes multiple PDs/PIs, the total annual PD/PI effort must be at least 2.4 person months. There must be an appropriate mix of time allocated for more established and early career stage scientists to ensure the successful conduct of the study. Budgeted effort of other personnel must be appropriate to the needs of the project. The budget must include personnel at all participating DOD and VA HCS with expertise relevant to the project, which might include a health informatics expert, clinical investigators, and staff with expertise in the administrative aspects of clinical trials oversight.
Applications should budget for study personnel to participate in the work groups.
Applications must budget for project PD(s)/PI(s) travel to attend an annual one-and-a-half-day PMC steering committee meeting in the greater Washington, D.C. area.
PEDP implementation costs:
Applicants may include allowable costs associated with PEDP implementation (as outlined in the Grants Policy Statement section 7): https://grants.nih.gov/grants/policy/nihgps/html5/section_7/7.1_general.htm.
All instructions in the How to Apply - Application Guide must be followed.
All instructions in the How to Apply - Application Guide must be followed.
All instructions in the How to Apply - Application Guide must be followed, with the following additional instructions:
To clearly distinguish between the two phases, applicants should specify separate UG3 and UH3 information in each subsection (Specific Aims and Research Strategy) of the PHS 398 Research Plan as appropriate. Activities in both phases will depend on the specific study (e.g., disease domains, type of interventions, experimental design, randomization strategy, and proposed outcome measures).
In preparing the application, investigators should consider that applications will be assigned a single impact score for both UG3 and UH3 phases.
Specific Aims: Applicants should address the scientific questions to be answered, what specifically will be done during the proposed funding periods, and the impact of addressing the research question on public health. Specific aims should be scientifically appropriate for the distinct phases of the project. Within the designated page limit, include separate aims for both the UG3 and UH3 phases, and clearly label them as UG3 specific aims and UH3 specific aims.
Research Strategy: Description of the demonstration project should provide background on the underlying health question and the evidence supporting the potential of the tested intervention(s) to improve management of pain and, if applicable, other co-occurring conditions.
It is not necessary to repeat background information or details of methods in the UH3 portion that were provided in the UG3 portion. The UH3 phase must be described in sufficient detail to permit reviewers to assess significance and innovation of the proposed work and the strength of the experimental design.
Applications should describe the significance of the proposed demonstration project to improve and/or implement nonopioid approaches for the management of pain and comorbidities in U.S. Veterans and military personnel. Innovative strategies to impact current conventional approaches to trials utilizing novel approaches or methodologies for a pragmatic or implementation trial that will increase uptake of the approach in a DOD/VA environment should be described.
Applications should describe the expertise of the interdisciplinary teams as a whole, including military researchers on military-focused applications and VA researchers on Veteran-focused applications. Study team should also include expertise in the design and conduct of large-scale pragmatic trials and/or implementation science within an HCS network serving military personnel, Veterans, and their families (including using EHRs for recruitment and outcomes assessment). Do not repeat information described in individual biosketches.
For applications proposing effectiveness aims, the application must include a thorough description of the proposed trial including appropriate controls with broad but adequate eligibility criteria. For applications proposing implementation aims, the application must include a thorough description of the implementation strategies to be tested. Investigators should include any plans to adapt implementation strategies during the study.
In the Research Strategy, both the UG3 research planning phase and the UH3 research execution phase must each have a section of proposed milestones provided in a separate subheading at the end of the specificci UG3 and UH3 portions. Milestones should be well described, feasible, quantifiable, and scientifically justified to allow an assessment of progress. For UG3 milestones, applicants should delineate what they aim to achieve to justify proceeding to the UH3 phase. The UG3 milestones should include a timeline, a discussion of the suitability of the milestones for assessing success in the UG3 phase, and a discussion of the implications of successful completion of these milestones for the proposed UH3 phase. Proposed annual milestones for the UH3 phase should be included, although it is understood that timelines and milestones included in the application will likely evolve as activities in the UG3 phase progress.
Applicants must indicate their willingness to participate in PMC work groups and comply with policies and practices developed by the work groups, and to work with the PMC3 in providing relevant information and material.
To increase the yield of the programs and improve comparisons between studies, as well as facilitate data sharing, multiple ICs encourage the use of CDEs. A plan to incorporate CDEs, where appropriate, should be included in the Approach.
Letters of Support: Applications must include letters of support from the HCS partners that relate their commitment to the proposed research and outline how the project fits with organizational priorities. The letters of support must address the quality of the proposed EHR and data systems and the commitment of their IT staff to the project including commitment/support during any transition in EHR platform. The letters must provide a description of how the project would directly impact delivery of health care within their organizations. The letters must also relate a willingness to adopt and implement the proposed Resource Sharing and Data Management and Sharing Plans.
Resource Sharing Plan: Individuals are required to comply with the instructions for the Resource Sharing Plans as provided in the How to Apply - Application Guide.
Other Plan(s):
All instructions in the How to Apply - Application Guide must be followed, with the following additional instructions:
PMC Resources and Data Sharing
The PMC encourages sharing of data, resources, policies, best practices, materials, and tools to facilitate collaboration, use, and replication of results. The PMC demonstration projects will work with the PMC3 in the following areas:
All applicants planning research (funded or conducted in whole or in part by NIH) that results in the generation of scientific data are required to comply with the instructions for the Data Management and Sharing Plan. All applications, regardless of the amount of direct costs requested for any one year, must address a Data Management and Sharing Plan.
The HEAL Initiative has additional requirements that must be addressed in the Data Management and Sharing plan. All HEAL-generated data must be shared through the HEAL Initiative Data Ecosystem following HEALs compliance guidance (https://heal.nih.gov/data/complying-heal-data-sharing-policy). Specifically, HEAL applicants must include:
HEAL has developed additional details and resources to fulfill these requirements (https://www.healdatafair.org/resources/road-map). Budgeting guidance for data sharing can be found in NOT-OD-21-015 and the NIH Scientific Data Sharing site.
HEAL Public Access and Data Sharing Policy:
NIH intends to maximize the impact of HEAL Initiative-supported projects through broad and rapid data sharing and immediate access to publications (https://heal.nih.gov/about/public-access-data). Guidelines for complying with the HEAL Public Access and Data Sharing Policy can be found at https://heal.nih.gov/data/complying-heal-data-sharing-policy. Resources and tools to assist with data related activities can be found at https://www.healdatafair.org/. For more detail and specific data sharing requirements, see Section 4. Other plans.
Publications resulting from NIH HEAL Initiative funded studies must be immediately publicly available upon publication.
Appendix: Only limited Appendix materials are allowed. Follow all instructions for the Appendix as described in the How to Apply - Application Guide.
When involving human subjects research, clinical research, and/or NIH-defined clinical trials (and when applicable, clinical trials research experience) follow all instructions for the PHS Human Subjects and Clinical Trials Information form in the How to Apply - Application Guide, with the following additional instructions:
If you answered Yes to the question Are Human Subjects Involved? on the R&R Other Project Information form, you must include at least one human subjects study record using the Study Record: PHS Human Subjects and Clinical Trials Information form or Delayed Onset Study record.
Study Record: PHS Human Subjects and Clinical Trials Information
All instructions in the How to Apply - Application Guide must be followed.
Section 2 - Study Population Characteristics
2.5 Recruitment and Retention Plan
Describe the following: 1) recruitment milestones; 2) the planned recruitment methods, including use of contact lists (participants and/or sites), databases or other pre-screening resources, advertisements, outreach, media / social media and referral networks or groups; 3) if there are known participant or study-related barriers to accrual or participation (based on literature or prior experience), please list these barriers and describe plans to address them to optimize success; 4) contingency plans for participant accrual if enrollment significantly lags behind accrual benchmarks; 5) participant retention and adherence strategies; and 6) possible competition from other trials for study participants.
2.7 Study Timeline
Include a table or graph of the overall study timeline. This is expected to be a visual representation (such as a Gantt chart) of recruitment milestones and key project management activities. A narrative is not expected in this section.
The study timeline should include core criteria and milestones that need to be met throughout the life cycle of the clinical trial (to include both the UG3 and UH3 phases) to ensure its success, and the subtasks that will be used to reach the milestones. In the timeline, the study duration is expected to be displayed in months. The timeline should include, but is not limited to, the following:
(a) When the study opens to enrollment
(b) When recruitment milestones (see below) are met
(c) What subtasks are needed to reach of the recruitment milestones
(d) When final transfer of the data will occur
(e) When analysis of the study data will occur
(f) When the primary study manuscript will be submitted for publication
Delayed Onset Study
Note: Delayed onset does NOT apply to a study that can be described but will not start immediately (i.e., delayed start). All instructions in the How to Apply - Application Guide must be followed.
All instructions in the How to Apply - Application Guide must be followed.
See Part 2. Section III.1 for information regarding the requirement for obtaining a unique entity identifier and for completing and maintaining active registrations in System for Award Management (SAM), NATO Commercial and Government Entity (NCAGE) Code (if applicable), eRA Commons, and Grants.gov
Part I. contains information about Key Dates and times. Applicants are encouraged to submit applications before the due date to ensure they have time to make any application corrections that might be necessary for successful submission. When a submission date falls on a weekend or Federal holiday, the application deadline is automatically extended to the next business day.
Organizations must submit applications to Grants.gov (the online portal to find and apply for grants across all Federal agencies). Applicants must then complete the submission process by tracking the status of the application in the eRA Commons, NIHs electronic system for grants administration. NIH and Grants.gov systems check the application against many of the application instructions upon submission. Errors must be corrected and a changed/corrected application must be submitted to Grants.gov on or before the application due date and time. If a Changed/Corrected application is submitted after the deadline, the application will be considered late. Applications that miss the due date and time are subjected to the NIH Grants Policy Statement Section 2.3.9.2 Electronically Submitted Applications.
Applicants are responsible for viewing their application before the due date in the eRA Commons to ensure accurate and successful submission.
Information on the submission process and a definition of on-time submission are provided in the How to Apply – Application Guide.
This initiative is not subject to intergovernmental review.
All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Pre-award costs are allowable only as described in the NIH Grants Policy Statement Section 7.9.1 Selected Items of Cost.
Applications must be submitted electronically following the instructions described in the How to Apply - Application Guide. Paper applications will not be accepted.
Applicants must complete all required registrations before the application due date. Section III. Eligibility Information contains information about registration.
For assistance with your electronic application or for more information on the electronic submission process, visit How to Apply – Application Guide. If you encounter a system issue beyond your control that threatens your ability to complete the submission process on-time, you must follow the Dealing with System Issues guidance. For assistance with application submission, contact the Application Submission Contacts in Section VII.
Important reminders:
All PD(s)/PI(s) must include their eRA Commons ID in the Credential field of the Senior/Key Person Profile form. Failure to register in the Commons and to include a valid PD/PI Commons ID in the credential field will prevent the successful submission of an electronic application to NIH. See Section III of this NOFO for information on registration requirements.
The applicant organization must ensure that the unique entity identifier provided on the application is the same identifier used in the organizations profile in the eRA Commons and for the System for Award Management. Additional information may be found in the How to Apply - Application Guide.
See more tips for avoiding common errors.
Applications must include a PEDP submitted as Other Project Information as an attachment. Applications that fail to include a PEDP will be considered incomplete and will be administratively withdrawn before review.
Upon receipt, applications will be evaluated for completeness and compliance with application instructions by the Center for Scientific Review and responsiveness by components of participating organizations, NIH. Applications that are incomplete, noncompliant, and/or nonresponsive will not be reviewed.
In order to expedite review, applicants are requested to notify the NCCIH Referral Office by email at [email protected] when the application has been submitted. Please include the NOFO number and title, PD/PI name, and title of the application.
Recipients or subrecipients must submit any information related to violations of federal criminal law involving fraud, bribery, or gratuity violations potentially affecting the federal award. See Mandatory Disclosures, 2 CFR 200.113 and NIH Grants Policy Statement Section 4.1.35.
Send written disclosures to the NIH Chief Grants Management Officer listed on the Notice of Award for the IC that funded the award and to the HHS Office of Inspector Grant Self Disclosure Program at [email protected].
Applicants are required to follow the instructions for post-submission materials, as described in the policy
Only the review criteria described below will be considered in the review process. Applications submitted to the NIH in support of the NIH mission are evaluated for scientific and technical merit through the NIH peer review system.
For this particular NOFO, note the following:
This NOFO supports demonstration projects that are feasible and impactful in nature and will significantly move the overall program forward.
A proposed Clinical Trial application may include study design, methods, and intervention that are not by themselves innovative but address important questions or unmet needs. Additionally, the results of the clinical trial may indicate that further clinical development of the intervention is unwarranted or lead to new avenues of scientific investigation.
Reviewers will provide an overall impact score to reflect their assessment of the likelihood for the project to exert a sustained, powerful influence on the research field(s) involved, in consideration of the following review criteria and additional review criteria (as applicable for the project proposed).As part of the overall impact score, reviewers should consider and indicate how the Plan to Enhance Diverse Perspectives affects the scientific merit of the project.
Reviewers will consider each of the review criteria below in the determination of scientific merit and give a separate score for each. An application does not need to be strong in all categories to be judged likely to have major scientific impact. For example, a project that by its nature is not innovative may be essential to advance a field.
Does the project address an important problem or a critical barrier to progress in the field? Is the prior research that serves as the key support for the proposed project rigorous? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?
Are the scientific rationale and need for a clinical trial to test the proposed hypothesis or intervention well supported by preliminary data, clinical and/or preclinical studies, or information in the literature or knowledge of biological mechanisms? For trials focusing on clinical or public health endpoints, is this clinical trial necessary for testing the safety, efficacy or effectiveness of an intervention that could lead to a change in clinical practice, community behaviors or health care policy? For trials focusing on mechanistic, behavioral, physiological, biochemical, or other biomedical endpoints, is this trial needed to advance scientific understanding?
Specific to this NOFO:
Does the application provide a rationale to indicate that the proposed intervention(s) has/have sufficient evidence to move to this stage of research? Is the proposed trial addressing a major public health issue focused on nonopioid approaches to management of pain and comorbidities in U.S. Veterans, military personnel, and their families? How will the completion of the proposed trial change the concepts, methods, and technologies used in pain management research and/or care?
Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or those in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)? If the project is collaborative or multi-PD/PI, do the investigators have complementary and integrated expertise; are their leadership approach, governance and organizational structure appropriate for the project?
With regard to the proposed leadership for the project, do the PD/PI(s) and key personnel have the expertise, experience, and ability to organize, manage and implement the proposed clinical trial and meet milestones and timelines? Do they have appropriate expertise in study coordination, data management and statistics? For a multicenter trial, is the organizational structure appropriate and does the application identify a core of potential center investigators and staffing for a coordinating center?
Specific to this NOFO:
Do interdisciplinary teams include necessary expertise to conduct the trial? For example, do PD(s)/PI(s) have experience conducting pragmatic and/or implementation research trials within health delivery organizations? Do the PD(s)/PI(s) and key personnel have the necessary expertise in design and implementation of large-scale effectiveness and/or implementation trials within a health care system (HCS) network serving military personnel, Veterans, and their families? For example, do they have expertise in using electronic health records for recruitment and outcomes assessment? Lastly, are VA researchers included on Veteran-focused applications and military researchers on military-focused applications?
Does the application challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions? Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Is a refinement, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation, or interventions proposed?
Does the design/research plan include innovative elements, as appropriate, that enhance its sensitivity, potential for information or potential to advance scientific knowledge or clinical practice?
Specific to this NOFO:
Does the application challenge and seek to impact current conventional approaches to research and/or practice by using novel approaches or methodologies for a trial that will allow it to be successfully implemented in a DOD/VA environment? Does the application include mechanisms for leveraging novel collaboration and study oversight strategies?
Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? Have the investigators included plans to address weaknesses in the rigor of prior research that serves as the key support for the proposed project? Have the investigators presented strategies to ensure a robust and unbiased approach, as appropriate for the work proposed? Are potential problems, alternative strategies, and benchmarks for success presented? If the project is in the early stages of development, will the strategy establish feasibility and will particularly risky aspects be managed? Have the investigators presented adequate plans to address relevant biological variables, such as sex, for studies in vertebrate animals or human subjects?
If the project involves human subjects and/or NIH-defined clinical research, are the plans to address 1) the protection of human subjects from research risks, and 2) inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion or exclusion of individuals of all ages (including children and older adults), justified in terms of the scientific goals and research strategy proposed?
Does the application adequately address the following, if applicable
Study Design
Is the study design justified and appropriate to address primary and secondary outcome variable(s)/endpoints that will be clear, informative and relevant to the hypothesis being tested? Is the scientific rationale/premise of the study based on previously well-designed preclinical and/or clinical research? Given the methods used to assign participants and deliver interventions, is the study design adequately powered to answer the research question(s), test the proposed hypothesis/hypotheses, and provide interpretable results? Is the trial appropriately designed to conduct the research efficiently? Are the study populations (size, gender, age, demographic group), proposed intervention arms/dose, and duration of the trial, appropriate and well justified?
Are potential ethical issues adequately addressed? Is the process for obtaining informed consent or assent appropriate? Is the eligible population available? Are the plans for recruitment outreach, enrollment, retention, handling dropouts, missed visits, and losses to follow-up appropriate to ensure robust data collection? Are the planned recruitment timelines feasible and is the plan to monitor accrual adequate? Has the need for randomization (or not), masking (if appropriate), controls, and inclusion/exclusion criteria been addressed? Are differences addressed, if applicable, in the intervention effect due to sex/gender and race/ethnicity?
Are the plans to standardize, assure quality of, and monitor adherence to, the trial protocol and data collection or distribution guidelines appropriate? Is there a plan to obtain required study agent(s)? Does the application propose to use existing available resources, as applicable?
Data Management and Statistical Analysis
Are planned analyses and statistical approach appropriate for the proposed study design and methods used to assign participants and deliver interventions? Are the procedures for data management and quality control of data adequate at clinical site(s) or at center laboratories, as applicable? Have the methods for standardization of procedures for data management to assess the effect of the intervention and quality control been addressed? Is there a plan to complete data analysis within the proposed period of the award?
Specific to this NOFO:
Will rigorous controls be included in the design? Will broad but adequate eligibility criteria be used, as proposed? Can interventions be feasibly implemented? How will the approaches proposed overcome barriers to research in the HCS setting? Are the goals and outlined planning activities during the UG3 phase reasonable (including plans for identifying a sufficiently large target patient population) and if accomplished, will provide the basis for execution of the demonstration project during the UH3 phase?
Are all the steps and milestones proposed to ensure progress during the UG3 and UH3 phase clearly defined and appropriate? Are the milestones feasible, well developed and quantifiable with regard to specific goals and accomplishments? Are adequate criteria provided for the UG3 phase that will be used in determining milestone completion before proceeding to the next phase of the project? Are the UH3 milestones appropriate for the research execution phase of the project?
Will the scientific environment in which the work will be done contribute to the probability of success? Are the institutional support, equipment and other physical resources available to the investigators adequate for the project proposed? Will the project benefit from unique features of the scientific environment, subject populations, or collaborative arrangements?
If proposed, are the administrative, data coordinating, enrollment and laboratory/testing centers, appropriate for the trial proposed?
Does the application adequately address the capability and ability to conduct the trial at the proposed site(s) or centers? Are the plans to add or drop enrollment centers, as needed, appropriate?
If international site(s) is/are proposed, does the application adequately address the complexity of executing the clinical trial?
If multi-sites/centers, is there evidence of the ability of the individual site or center to: (1) enroll the proposed numbers; (2) adhere to the protocol; (3) collect and transmit data in an accurate and timely fashion; and, (4) operate within the proposed organizational structure?
Specific to this NOFO:
Does the application provide sufficient rationale for the HCS selected for the demonstration project? Has/have the HCS successfully conducted similar research, such that there are sufficient infrastructure and expertise (e.g., clinical investigators, informaticists) to implement the proposed trial within all proposed HCS? Does the application include letters of support from the partnering HCS that outline strong commitment to the project planning and trial conduct?
As applicable for the project proposed, reviewers will evaluate the following additional items while determining scientific and technical merit, and in providing an overall impact score, but will not give separate scores for these items.
Is the study timeline described in detail, taking into account start-up activities, the anticipated rate of enrollment, and planned follow-up assessment? Is the projected timeline feasible and well justified? Does the project incorporate efficiencies and utilize existing resources (e.g., CTSAs, practice-based research networks, electronic medical records, administrative database, or patient registries) to increase the efficiency of participant enrollment and data collection, as appropriate?
Are potential challenges and corresponding solutions discussed (e.g., strategies that can be implemented in the event of enrollment shortfalls)?
Specific to this NOFO:
Are the clinical trial recruitment milestones feasible given the proposed study timeline?
For research that involves human subjects but does not involve one of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate the justification for involvement of human subjects and the proposed protections from research risk relating to their participation according to the following five review criteria: 1) risk to subjects, 2) adequacy of protection against risks, 3) potential benefits to the subjects and others, 4) importance of the knowledge to be gained, and 5) data and safety monitoring for clinical trials.
For research that involves human subjects and meets the criteria for one or more of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate: 1) the justification for the exemption, 2) human subjects involvement and characteristics, and 3) sources of materials. For additional information on review of the Human Subjects section, please refer to the Guidelines for the Review of Human Subjects.
When the proposed project involves human subjects and/or NIH-defined clinical research, the committee will evaluate the proposed plans for the inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion (or exclusion) of individuals of all ages (including children and older adults) to determine if it is justified in terms of the scientific goals and research strategy proposed. For additional information on review of the Inclusion section, please refer to the Guidelines for the Review of Inclusion in Clinical Research.
The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following three points: (1) a complete description of all proposed procedures including the species, strains, ages, sex, and total numbers of animals to be used; (2) justifications that the species is appropriate for the proposed research and why the research goals cannot be accomplished using an alternative non-animal model; and (3) interventions including analgesia, anesthesia, sedation, palliative care, and humane endpoints that will be used to limit any unavoidable discomfort, distress, pain and injury in the conduct of scientifically valuable research. Methods of euthanasia and justification for selected methods, if NOT consistent with the AVMA Guidelines for the Euthanasia of Animals, is also required but is found in a separate section of the application. For additional information on review of the Vertebrate Animals Section, please refer to the Worksheet for Review of the Vertebrate Animals Section.
Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.
Not applicable
Not applicable
Not applicable
As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall impact score.
Reviewers will assess whether the project presents special opportunities for furthering research programs through the use of unusual talent, resources, populations, or environmental conditions that exist in other countries and either are not readily available in the United States or augment existing U.S. resources.
Not applicable
Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).
Reviewers will comment on whether the Resource Sharing Plan(s) (e.g., Sharing Model Organisms) or the rationale for not sharing the resources, is reasonable.
For projects involving key biological and/or chemical resources, reviewers will comment on the brief plans proposed for identifying and ensuring the validity of those resources.
Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.
Applications will be evaluated for scientific and technical merit by (an) appropriate Scientific Review Group(s) convened by NCCIH, in accordance with NIH peer review policies and practices, using the stated review criteria. Assignment to a Scientific Review Group will be shown in the eRA Commons.
As part of the scientific peer review, all applications will receive a written critique.
Applications may undergo a selection process in which only those applications deemed to have the highest scientific and technical merit (generally the top half of applications under review) will be discussed and assigned an overall impact score.
Appeals of initial peer review will not be accepted for applications submitted in response to this NOFO.
Applications will be assigned to the NCCIH. Applications will compete for available funds with all other recommended applications submitted in response to this NOFO. Following initial peer review, recommended applications will receive a second level of review by the National Advisory Council for Complementary and Integrative Health (NACCIH). The following will be considered in making funding decisions:
Please note that reviewers will not consider race, ethnicity, age, or sex (including gender identity, sexual orientation or transgender status) of a researcher, award participant, or trainee, even in part, in providing critiques, scores, or funding recommendations. NIH will not consider such factors in making its funding decisions.
If the application is under consideration for funding, NIH will request "just-in-time" information from the applicant as described in the NIH Grants Policy Statement Section 2.5.1. Just-in-Time Procedures. This request is not a Notice of Award nor should it be construed to be an indicator of possible funding.
Prior to making an award, NIH reviews an applicants federal award history in SAM.gov to ensure sound business practices. An applicant can review and comment on any information in the Responsibility/Qualification records available in SAM.gov. NIH will consider any comments by the applicant in the Responsibility/Qualification records in SAM.gov to ascertain the applicants integrity, business ethics, and performance record of managing Federal awards per 2 CFR Part 200.206 Federal awarding agency review of risk posed by applicants. This provision will apply to all NIH grants and cooperative agreements except fellowships.
After the peer review of the application is completed, the PD/PI will be able to access his or her Summary Statement (written critique) via the eRA Commons. Refer to Part 1 for dates for peer review, advisory council review, and earliest start date.
Information regarding the disposition of applications is available in the NIH Grants Policy Statement Section 2.4.4 Disposition of Applications.
A Notice of Award (NoA) is the official authorizing document notifying the applicant that an award has been made and that funds may be requested from the designated HHS payment system or office. The NoA is signed by the Grants Management Officer and emailed to the recipients business official.
In accepting the award, the recipient agrees that any activities under the award are subject to all provisions currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.
Recipients must comply with any funding restrictions described in Section IV.6. Funding Restrictions. Any pre-award costs incurred before receipt of the NoA are at the applicant's own risk. For more information on the Notice of Award, please refer to the NIH Grants Policy Statement Section 5. The Notice of Award and NIH Grants & Funding website, see Award Process.
Individual awards are based on the application submitted to, and as approved by, the NIH and are subject to the IC-specific terms and conditions identified in the NoA.
ClinicalTrials.gov: If an award provides for one or more clinical trials. By law (Title VIII, Section 801 of Public Law 110-85), the "responsible party" must register and submit results information for certain applicable clinical trials on the ClinicalTrials.gov Protocol Registration and Results System Information Website (https://register.clinicaltrials.gov). NIH expects registration and results reporting of all trials whether required under the law or not. For more information, see https://grants.nih.gov/policy/clinical-trials/reporting/index.htm
Institutional Review Board or Independent Ethics Committee Approval: Recipient institutions must ensure that all protocols are reviewed by their IRB or IEC. To help ensure the safety of participants enrolled in NIH-funded studies, the recipient must provide NIH copies of documents related to all major changes in the status of ongoing protocols.
Data and Safety Monitoring Requirements: The NIH policy for data and safety monitoring requires oversight and monitoring of all NIH-conducted or -supported human biomedical and behavioral intervention studies (clinical trials) to ensure the safety of participants and the validity and integrity of the data. Further information concerning these requirements is found at http://grants.nih.gov/grants/policy/hs/data_safety.htm and in the application instructions (SF424 (R&R) and PHS 398).
Investigational New Drug or Investigational Device Exemption Requirements: Consistent with federal regulations, clinical research projects involving the use of investigational therapeutics, vaccines, or other medical interventions (including licensed products and devices for a purpose other than that for which they were licensed) in humans under a research protocol must be performed under a Food and Drug Administration (FDA) investigational new drug (IND) or investigational device exemption (IDE).
The following Federal wide and HHS-specific policy requirements apply to awards funded through NIH:
All federal statutes and regulations relevant to federal financial assistance, including those highlighted in NIH Grants Policy Statement Section 4 Public Policy Requirements, Objectives and Other Appropriation Mandates.
Recipients are responsible for ensuring that their activities comply with all applicable federal regulations. NIH may terminate awards under certain circumstances. See 2 CFR Part 200.340 Termination and NIH Grants Policy Statement Section 8.5.2 Remedies for Noncompliance or Enforcement Actions: Suspension, Termination, and Withholding of Support.
The following special terms of award are in addition to, and not in lieu of, otherwise applicable U.S. Office of Management and Budget (OMB) administrative guidelines, U.S. Department of Health and Human Services (HHS) grant administration regulations at 2 CFR Part 200, and other HHS, PHS, and NIH grant administration policies.
The administrative and funding instrument used for this program will be the cooperative agreement, an "assistance" mechanism (rather than an "acquisition" mechanism), in which substantial NIH programmatic involvement with the recipients is anticipated during the performance of the activities. Under the cooperative agreement, the NIH purpose is to support and stimulate the recipients' activities by involvement in and otherwise working jointly with the recipients in a partnership role; it is not to assume direction, prime responsibility, or a dominant role in the activities. Consistent with this concept, the dominant role and prime responsibility resides with the recipients for the project as a whole, although specific tasks and activities may be shared among the recipients and NIH as defined below.
The PD(s)/PI(s) will have the primary responsibility for the following:
NIH staff have substantial programmatic involvement that is above and beyond the normal stewardship role in awards, as described below:
Areas of joint responsibility include:
Dispute Resolution:
Any disagreements that may arise in scientific or programmatic matters (within the scope of the award) between award recipients and NIH may be brought to dispute resolution. A dispute resolution panel composed of three members will be convened. The three members will be a designee of the steering committee chosen without NIH staff voting, one NIH designee, and a third designee with expertise in the relevant area who is chosen by the other two; in case of individual disagreement, the first member may be chosen by the individual recipient. This special dispute resolution procedure does not alter the recipients right to appeal an adverse action that is otherwise appealable in accordance with PHS regulation 42 CFR Part 50, Subpart D and DHHS regulation 45 CFR Part 16.
Consistent with the 2023 NIH Policy for Data Management and Sharing, when data management and sharing is applicable to the award, recipients will be required to adhere to the Data Management and Sharing requirements as outlined in the NIH Grants Policy Statement. Upon the approval of a Data Management and Sharing Plan, it is required for recipients to implement the plan as described.
Consistent with the NIH Policy for Data Management and Sharing, when data management and sharing is applicable to the award, recipients will be required to adhere to the Data Management and Sharing requirements as outlined in the NIH Grants Policy Statement. Upon the approval of a Data Management and Sharing Plan, it is required for recipients to implement the plan as described.
HEAL Data Sharing Requirements
NIH intends to maximize the impact of HEAL Initiative-supported projects through broad and rapid data sharing. All HEAL Initiative award recipients, regardless of the amount of direct costs requested for any one year, are required to comply with the HEAL Public Access and Data Sharing Policy. HEAL award recipients must following all requirements and timelines developed through the HEAL Initiative Data Ecosystem (https://heal.nih.gov/about/heal-data-ecosystem), as described in HEALs compliance guidance (See Already Funded section: https://heal.nih.gov/data/complying-heal-data-sharing-policy):
1. Select a HEAL – Compliant data repository (https://www.healdatafair.org/resources/guidance/selection)
2. Within one year of award, register your study with the HEAL platform (https://heal.github.io/platform-documentation/study-registration/)
3. Within one year of award, submit HEAL-specific study-level metadata.
4. Submit data and metadata (and code, if applicable) to HEAL-Compliant repository
6. Additional Requirements for HEAL Initiative studies conducting clinical research or research involving human subjects.
These studies must meet the following additional requirements:
Additional details, resources, and tools to assist with data related activities can be found at https://www.healdatafair.org/. Budgeting guidance for data sharing can be found in NOT-OD-21-015 and the NIH Scientific Data Sharing site.
All data collected as part of the NIH HEAL Initiative are so collected under a Certificate of Confidentiality and entitled to the protections thereof. Institutions who receive Data and/or Materials from this award for performance of activities under this award are required to use the Data and/or Materials only as outlined by the NIH HEAL Initiative, in a manner that is consistent with applicable state and federal laws and regulations, including any informed consent requirements and the terms of the institutions NIH funding, including NOT-OD-17-109 and 42 U.S.C. 241(d). Failure to adhere to this criterion may result in enforcement actions.
When multiple years are involved, recipients will be required to submit the Research Performance Progress Report (RPPR) annually and financial statements as required in the NIH Grants Policy Statement Section 8.4.1 Reporting. To learn more about post-award monitoring and reporting, see the NIH Grants & Funding website, see Post-Award Monitoring and Reporting.
Publications resulting from NIH HEAL Initiative funded studies must be immediately publicly available upon publication.
Prior to publication, HEAL expects investigators to alert their program officers of upcoming manuscripts to ensure coordination of communication and outreach efforts.
Award recipients and their collaborators are required to acknowledge HEAL Initiative support by referencing in the acknowledgment sections of any relevant publication:
This research was supported by the National Institutes of Health through the NIH HEAL Initiative (https://heal.nih.gov/) under award number [include specific grant/contract/award number; with NIH grant number(s) in this format: R01GM987654].
A final RPPR, invention statement, and the expenditure data portion of the Federal Financial Report are required for closeout of an award, as described in the NIH Grants Policy Statement Section 8.6 Closeout. NIH NOFOs outline intended research goals and objectives. Post award, NIH will review and measure performance based on the details and outcomes that are shared within the RPPR, as described at 2 CFR Part 200.301.
We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants.
eRA Service Desk (Questions regarding ASSIST, eRA Commons, application errors and warnings, documenting system problems that threaten submission by the due date, and post-submission issues)
Finding Help Online: https://www.era.nih.gov/need-help (preferred method of contact)
Telephone: 301-402-7469 or 866-504-9552 (Toll Free)
General Grants Information (Questions regarding application instructions, application processes, and NIH grant resources)
Email: [email protected] (preferred method of contact)
Telephone: 301-480-7075
Grants.gov Customer Support (Questions regarding Grants.gov registration and Workspace)
Contact Center Telephone: 800-518-4726
Email: [email protected]
Peter Murray, Ph.D.
National Center for Complementary and Integrative Health (NCCIH)
Telephone: 301-496-4054
Email: [email protected]
Mark Egli, Ph.D.
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Phone: 301-594-6382
E-mail: [email protected]
David Frankowski, Ph.D.
National Institute on Aging (NIA)
E-mail: [email protected]
Jessica McKlveen, Ph.D.
National Center for Complementary and Integrative Health (NCCIH)
Telephone: 301-594-8018
Email: [email protected]
Debbie Chen
National Center for Complementary and Integrative Health (NCCIH)
Telephone: 301-594-3788
Email: [email protected]
Judy Fox
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Telephone: 301-443-4704
Email: [email protected]
Kathleen Moy
National Institute on Aging (NIA)
Phone: 301.827.2856
E-mail: [email protected]
Recently issued trans-NIH policy notices may affect your application submission. A full list of policy notices published by NIH is provided in the NIH Guide for Grants and Contracts. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 2 CFR Part 200.