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Full Text CA-94-011


NIH GUIDE, Volume 23, Number 13, April 1, 1994

RFA:  CA-94-011



National Cancer Institute

Letter of Intent Receipt Date:  May 2, 1994
Application Receipt Date:  June 16, 1994


The National Cancer Institute (NCI) invites grant applications to
create new educational programs aimed at reducing the mortality and
morbidity of breast cancer.  These cancer education programs are
intended to disseminate what is professionally known about the
prevention, early detection, and treatment of breast cancer to
primary care physicians, other health professionals, and the lay
community with special attention to minority or underserved


The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This Request
for Applications (RFA), Breast Cancer Education Initiatives, is
related to the priority area of Educational and Community-based
programs.  Potential applicants may obtain a copy of "Healthy People
2000" (Full Report:  Stock No. 017-001-00474-0) or "Healthy People
2000" (Summary Report:  Stock No. 017-001-00473-1) through the
Superintendent of Documents, Government Printing Office, Washington,
DC 20402-9325 (telephone 202-783-3238).


Applications may be submitted by domestic for-profit and non-profit
organizations, public and private, such as universities, colleges,
Cancer Centers, hospitals, Laboratories, units of State and local
governments, and eligible agencies of the Federal government.
Foreign organizations are not eligible to apply.  Applications from
minority individuals and women are encouraged.


Support for this program will be through the NCI Education (R25)
Award.  This award is a flexible, curriculum-driven program aimed at
developing and sustaining innovative and, possibly, unique
educational approaches that ultimately will have an impact on
reducing cancer incidence, mortality, and morbidity, as well as on
improving the quality-of-life of cancer patients.  The current
guidelines for the Cancer Education Program (R25) may be obtained
from the program director listed under INQUIRIES.

Applicants will be responsible for the planning, direction, and
execution of the proposed project.  The total project period for each
application submitted in response to this RFA may not exceed three
years.  It is anticipated that the average amount of direct costs
awarded per grant will range from $50,000 to $130,000 depending upon
the proposed program.  Indirect costs will be allowed at the rate of
eight percent of total direct costs (exclusive of equipment).  The
earliest feasible start date for the initial award will be September

This RFA is a one-time solicitation.  Future competitive continuation
applications will compete with all other applications in the Cancer
Education Grant Program (R25).  However, if the NCI determines that
there is a sufficient program need, a new request for competitive
continuation and/or new applications will be announced.


For FY 1994, $1,600,000 in total costs will be available for, it is
estimated, some 15 to 20 new awards.  This funding level is dependent
on the receipt of a sufficient number of applications of high
scientific merit.  A greater or lesser amount of dollars and number
of awards may be negotiated based on the quality of the applications
and the availability of funds.



The American Cancer Society estimates that 46,000 women will die of
breast cancer or its complications in 1993 and that 182,000 new cases
will be diagnosed.  In the face of these statistics, the NCI is
committed to basic research, translational research, and educational
programs to respond to this crisis.  Even though important scientific
questions still remain unanswered, it is the considered belief of the
NCI that public and professional educational programs dealing with
breast cancer can result in better health behavior and better health
care delivery, which should have a positive public health benefit.


The purpose of this RFA, then, is to stimulate breast cancer
educational programs among health professionals and the lay public.
The NCI already supports a spectrum of basic and clinical research
efforts in breast cancer; in addition, it has allocated significant
resources to the prevention and early detection of breast cancer.
What it would like to encourage by this RFA is the translation of
current research findings and intervention practices into widely
diffused state-of-the-art information packages on breast cancer.
Since it is essential that any educational strategies to accomplish
these goals rest on a knowledge base derived from the best current
research findings, the NCI proposes that Cancer Centers and other
organizations with appropriate breast cancer expertise collaborate
with educational specialists and other professional and lay groups,
particularly those with access to underserved populations, to design
and implement programs to achieve the objectives noted above.

Some examples of target populations for this initiative, therefore,
might include: primary care physicians, health professional faculty,
health professional students, women's groups, minority or underserved
groups, employer-based groups, and breast cancer patients and their

Some of the reasoning involved in the choice of these target groups
is as follows.  Breast cancer patients, once diagnosed, will need
data, perspectives, and risk/benefit analyses to enable them to
communicate with physicians and to participate with health care
providers in the series of choices that must be made about their
treatment and the future course of their lives.  Those free of cancer
may need different information in regards to cancer in general, the
importance of mammograms, issues of radiation risk, and ways of
overcoming a general sense of unease in the face of this disease.

Health care professionals who have contact with women in a health
maintenance setting or who treat breast cancer patients along with
other patients in a community setting may wish to have their
knowledge and skills updated or expanded in order to provide better
care and comfort to women.  This target population might profit from
current information concerning breast cancer risk evaluation for
different age populations, the formal range of current breast cancer
screening guidelines, how to conduct proper physical breast
examinations, and how to follow up on an abnormal physical finding or

Health professional students could be given early in their career
training a comprehensive orientation to the range of breast cancer
issues, especially the importance and impact of clinical trials in
the nation's effort against breast cancer.  The NCI feels that these
types of educational programs should focus on the knowledge and
attitudes of both professional and lay audiences concerning the
rationale, selection criteria, and procedures for any referral to
treatment and prevention clinical trials dealing with breast cancer.

Minority or underserved populations have special needs in regard to
breast cancer education.  Breast cancer is generally diagnosed at a
later stage in these groups, resulting in a higher mortality rate
compared to the general population.  In addition, early onset breast
cancer in younger members of these distinctive populations may
present special problems in the diagnosis and treatment of their
disease.  The costs necessary to attract and involve underserved
populations may be requested and supported if appropriately

The NCI strongly encourages submission of applications from minority
health professional schools and other organizations that have
traditionally served minority communities and geographically isolated
populations.  These schools and organizations are invited to provide
structured, state-of-the-art breast cancer educational programs to
address specifically the needs of their faculty, students, and
members.  The proposals should, where feasible, also include
educational outreach activities involving civic, fraternal, and
religious groups with access to minority or underserved women.

Participation, therefore, in this cancer education initiative by
these appropriate institutions will help to achieve the goals of the
NCI Minority Health Professional Training Initiative.  The latter is
intended to strengthen the oncology faculty and infrastructure of
minority health professional schools through the use of a variety of
research training and career development grant awards.

In summary, NCI seeks to support innovative programs using
educational techniques and media that are most appropriate for
specific target groups.  It especially encourages educational
programs that include segments that offer information on and
practical guidance in the use of the NCI Physician Data Query (PDQ)
system, Cancer FAX databases, and the network of the Cancer
Information Service (CIS).


Applicants are requested to identify clearly in their application the
following aspects of their proposed initiative:  (1) the content and
scope of the educational activities; (2) the specific population(s)
to be educated and their availability; (3) the procedures to be used
to announce these educational activities and to recruit participants;
(4) the potential benefits to health professionals, the lay public,
or cancer patients and their families likely to arise as the result
of these educational programs; (5) the methods of evaluation of the
program outcomes; and (6) the specific plans to disseminate aspects
of the educational activities that prove to be effective.

If several institutions are jointly involved or if several
departments within an institution are cooperating in this RFA, a
special, central, interdisciplinary Cancer Education Committee
consisting of members from the collaborating organizations should be
in place.  The functions of the Committee would be to provide
effective monitoring and coordination of the program.


Prospective applicants are asked to submit, by May 2, 1994, a letter
of intent that includes a descriptive title of the proposed
educational activity, the name, address, and telephone number of the
Principal Investigator/Educator, the identities of other key
personnel and participating institutions, and the number and title of
the RFA in response to which the application may be submitted.
Although a letter of intent is not required, is not binding, and does
not enter into the review of subsequent applications, the information
that it contains allows NCI staff to estimate the potential review
workload and to avoid conflict of interest in the review.

The letter of intent is to be sent to Dr. Robert C. Adams at the
address listed under INQUIRIES.


The research grant application form PHS 398 (rev. 9/91) is to be used
in applying for these grants.  These forms are available at most
institutional offices of sponsored research; from the Office of
Grants Information, Division of Research Grants, National Institutes
of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone
301/710-0267; and from the NCI Program Director listed under

The RFA label available in the application form PHS 398 must be
affixed to the bottom of face page of the application.  Failure to
use this label could result in delayed processing of the application
such that it may not reach the review committee in time for review.
In addition, the RFA number and title of this RFA must be typed on
line 2a of the face page of the application form.

Submit a signed, typewritten original of the application including
the Checklist and three signed, exact, clear and single-sided
photocopies, in one package to:

Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**

At time of submission, also send two additional copies of the
application to:

Ms. Toby Friedberg
Division of Extramural Activities
National Cancer Institute
Executive Plaza North, Room 636
6130 Executive Boulevard
Bethesda, MD  20892

Applications must be received by June 16, 1994.  If an application is
received after that date, it will be returned.  If the application
submitted in response to this RFA is substantially similar to a grant
application already submitted to the NIH for review but not yet
reviewed, the applicant will be asked to withdraw either the pending
application or the new one.  Simultaneous submission of identical
applications will not be allowed, nor will essentially identical
applications be reviewed by different review committees.  An
application, therefore, cannot be submitted in response to this RFA
that is essentially identical to one that has already been reviewed.
This does not preclude the submission of substantial revisions of
applications already reviewed, but such applications must include an
introduction addressing the previous critique.


Review Procedure

Upon receipt, applications will be reviewed initially by the Division
of Research Grants (DRG) for completeness.  Incomplete applications
will be returned to the applicant without further consideration.
Applications subsequently will be evaluated by NCI scientific
administration staff to determine how well they meet the objectives
of the program as described in this RFA.  Applications that are not
primarily oriented to the goals of this RFA will be judged
non-responsive and will be returned.  All basic research applications
on breast cancer, for example, should be submitted under a regular
research project mechanism or in response to another RFA.  Program
staff listed under INQUIRIES will be happy to address questions
concerning the relevance of any proposed educational or training
activity to this RFA.

If the number of applications is quite large compared to the number
of awards to be made, the NCI may conduct a preliminary scientific
peer review (triage) to eliminate those applications that are clearly
not competitive, and will notify the applicant and institutional
business official of this action.

Those applications judged to be both competitive and responsive will
be further evaluated according to the review criteria stated below
for scientific and technical merit by an appropriate peer review
group convened by the Division of Extramural Activities, NCI.  The
second level of review by the National Cancer Advisory Board will
consider the special needs of the NCI and the priorities of the
National Cancer Program.

Review Criteria

o  The overall quality of the proposed education programs.

o  The responsiveness of the application to the SPECIAL REQUIREMENTS
section described above.

o  Scientific, pedagogic, and administrative qualifications and
experience of the principal investigator and staff.

o  The availability of appropriate resources and facilities for the
proposed activities.

The review committee will critically examine the proposed budget and
recommend an appropriate budget for each approved application.


The anticipated date of award is September 1994.  Awards will be made
according to priority score, availability of funds, and programmatic


Written and telephone inquiries concerning this RFA are encouraged.
The opportunity to clarify any issues or questions from potential
applicants is welcome.

Direct inquiries regarding programmatic issues and address the letter
of intent to:

Dr. Robert C. Adams
Division of Cancer Biology, Diagnosis, and Centers
National Cancer Institute
Executive Plaza North, Room 520
Bethesda, MD  20892
Telephone:  (301) 496-8580
FAX:  (301) 402-4472

Direct inquiries regarding grants management issues to:

Mr. Robert Hawkins
Grants Administration Branch
National Cancer Institute
Executive Plaza South, Room 242
Bethesda, MD  20892
Telephone:  (301) 496-7800, ext. 213


This program is described in the Catalog of Federal Domestic
Assistance Number 93.398, Cancer Research Manpower.  Awards are made
under the authorization of the Public Health Service Act, Title IV,
Part A, Public Law 78-410, as amended by Public Law 99-158, 42 USC
241 and 285 and administered under HHS regulations and PHS grant
policies.  The Public Health Service (PHS) strongly encourages all
grant recipients to provide a smoke-free workplace and promote the
non-use of all tobacco products.  This is consistent with the PHS
mission to protect and advance the physical and mental health of the
american people.


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