THE NATIONAL DRUG ABUSE TREATMENT CLINICAL TRIALS NETWORK
RELEASE DATE: July 07, 2004
RFA Number: RFA-DA-05-001 (Reissued as RFA-DA-07-001)
EXPIRATION DATE: October 15, 2004
Department of Health and Human Services (DHHS)
PARTICIPATING ORGANIZATION:
National Institutes of Health (NIH)
(http://www.nih.gov)
COMPONENT OF PARTICIPATING ORGANIZATION:
National Institute on Drug Abuse (NIDA)
(http://www.nida.nih.gov)
CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER: 93.279
LETTER OF INTENT RECEIPT DATE: September 14, 2004
APPLICATION RECEIPT DATE: October 14, 2004
THIS REQUEST FOR APPLICATIONS (RFA) CONTAINS THE FOLLOWING INFORMATION:
o Purpose of this RFA
o Research Objectives
o Mechanism(s) of Support
o Funds Available
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Special Requirements
o Where to Send Inquiries
o Letter of Intent
o Submitting an Application
o Supplementary Instructions
o Peer Review Process
o Review Criteria
o Receipt and Review Schedule
o Award Criteria
o Required Federal Citations
PURPOSE OF THIS RFA
The National Institute on Drug Abuse (NIDA) invites cooperative agreement
applications from established clinical investigators to participate in the
National Drug Abuse Treatment Clinical Trials Network (CTN). Applications
from geographic areas not currently well represented in the CTN are
particularly encouraged. This Request for Applications (RFA) is the fourth
solicitation for participation in the CTN. It is intended for both new
applications and competing continuations.
As a nation-wide partnership among drug abuse treatment providers,
researchers, and NIDA staff, the mission of the CTN is to conduct studies of
behavioral, pharmacological, and integrated behavioral and pharmacological
treatment interventions in rigorous, multi-site clinical trials to determine
the effectiveness of these interventions across a broad range of community-
based treatment settings and diverse patient populations. The CTN
disseminates and promotes the adoption of proven treatments to physicians,
providers, their patients, accrediting bodies, educational institutions,
policy makers and funders to improve the quality of drug abuse treatment
throughout the country, using science as the vehicle.
CTN clinical trials are carried out in community-based treatment settings.
Each awardee functions as a CTN Research Node, consisting of a Regional
Research and Training Center (RRTC) that is linked in partnership with
community-based treatment programs (CTPs). The CTN consists of multiple
Nodes, and each Node works in concert with other Nodes and NIDA to conduct
multi-site clinical trials research. Awardees deliver and test an array of
both behavioral and pharmacological treatments and determine conditions under
which novel and efficacious treatments are successfully adopted. Studies span
multiple sites engaging diverse patient populations in dispersed geographical
regions. As a cooperative agreement, there is substantial NIDA involvement in
the management and administration of the CTN.
Current CTN Nodes are located in California, Colorado, Connecticut, Florida,
Maryland, Massachusetts, Michigan, New Mexico, New York, North Carolina,
Ohio, Oregon, Pennsylvania, South Carolina, and Washington. NIDA recognizes a
benefit in a greater geographic distribution of CTN sites as well as a desire
to encompass more subpopulations of minority groups and to broaden the range
of treatment providers who work under varying systems of reimbursement and
organization of care. By expanding in these areas, greater variety in the
types of studies conducted and greater confidence in the generalizability of
those studies will be assured. Therefore, as noted, one purpose of this
Request for Applications (RFA) is to expand the geographic distribution of
CTN sites, and applications are encouraged from investigators in those
geographic areas without CTN Nodes and where the CTN is not well represented.
Another purpose is to enable eleven existing Nodes to re-compete to continue
participation within the CTN for another five years.
RESEARCH OBJECTIVES
Background
The development of the CTN was based, in part, upon a recommendation from the
National Advisory Council on Drug Abuse and conclusions of the Physicians
Leadership on National Drug Policy. The Institute of Medicine/National
Academy of Sciences report "Bridging the Gap Between Practice and Research:
Forging Partnerships with Community-Based Drug and Alcohol Treatment" also
recommended a national network for drug abuse treatment trials. Following
the first NIDA CTN solicitation in 1999, six CTN awards were made to awardees
in California, Connecticut, New York, Oregon, Maryland, and Pennsylvania.
After a solicitation in 2000, awards were subsequently made to five
additional sites in Colorado, Florida, Michigan, Ohio, and South Carolina.
In 2001 three additional sites were awarded in New York (Long Island), North
Carolina and Washington. In 2002 there were three additional sites added in
California, Massachusetts, and New Mexico. These sites represent a variety
of treatment traditions that include pharmacological as well as behavioral
and other psychosocial interventions. Furthermore, NIDA ensured a wide
variety of patient populations in the selection of CTN recipients. Women,
minority groups, and adolescents are well represented.
The CTN is now established and is making progress in achieving its goals of
(1) providing a clinical trials research infrastructure to test the
effectiveness and usefulness of new and improved treatments in community-
based treatment settings with diverse patient populations, (2) serving as a
mechanism for the study of dissemination of new and improved interventions
into community-based drug treatment settings and (3) providing unique
opportunities to train clinical researchers. The infrastructure of the CTN is
available for non-network researchers to use a study platform. A number of
functional committees to provide governance to the CTN are established,
protocols for the study of both pharmacological and behavioral interventions
are currently underway, data management and safety monitoring procedures are
in place, and new studies are being planned and approved. Details on the
status of the CTN initiative may be found on the NIDA web site at:
http://www.nida.nih.gov/CTN/Index.htm.
Strong partnerships and bi-directional collaboration between researchers and
practitioners are an essential and defining characteristic of the CTN.
Although treatments for drug abuse exist and considerable research has been
directed toward the improvement of treatment alternatives, most addiction
treatment research prior to the CTN was conducted primarily in specialized
research settings. Through the researcher-practitioner partnership that
characterizes the CTN, the CTN accelerates the use of research outcomes, the
pace of research, and its application to community treatment settings by
conducting large scale multi-site clinical treatment studies in community
based treatment programs (CTPs).
Knowledge gained through the CTN is also expected to further the
dissemination and the adoption of research-based treatments. That is, CTN
research will not only help determine which treatments should be implemented,
it will also inform the process of implementation and dissemination to ensure
the acceptability and sustainability of new approaches
CTN DEFINITIONS, ORGANIZATION, AND FUNCTIONS
Clinical Trials Network (CTN). A collaborative group of geographically
diverse regional research Nodes working collaboratively with NIDA to conduct
multi-site and cross-regional (nationwide) clinical trials research on
promising behavioral, pharmacological, or integrated drug abuse treatments.
Node. A Node is the functional unit within the CTN. The Node consists of the
Regional Research and Training Center (RRTC) and its affiliated Community
Treatment Programs (CTPs). The RRTC coordinates and arranges a research
partnership between the RRTC and CTPs. The CTN is comprised of multiple
Nodes. Activities that occur primarily within a single Node (e.g., hiring of
staff, RRTC-CTP activities) are called "Intra-Node" activities, as opposed to
CTN-wide or "Inter-Node" activities such as implementation of protocols
across one or more Nodes, development of CTN-wide policies, etc. A "Lead
Node" is a Node that has primary responsibility for leading a research
project.
Regional Research and Training Center (RRTC). The RRTC is the recipient of
the cooperative agreement award. It is one of the two components of a Node.
It typically resides in the Principal Investigator’s research institute or
organization. The RRTC provides scientific leadership and design of clinical
trials. The RRTC has primary responsibility for 1) establishing the
infrastructure, 2) generating a research agenda in collaboration with the
CTPs, 3) providing administration and operations support, 4) building
partnerships with the CTPs, and, 5) collaborating with NIDA and other Nodes
to develop, implement, and disseminate findings from CTN research projects,
and 6) working with the CTN Clinical Coordinating Center and Data and
Biostatistics Center.
Infrastructure. Infrastructure refers to the capacity of the RRTC and CTPs
to 1) arrange and manage collaborative activities of at least five CTPs with
the RRTC, 2) maintain scientific and technical personnel for protocol
development and implementation, 3) coordinate intra-Node activities, and 4)
provide resources for intra-Node activities. It also refers to the physical
resources (buildings, clinics, etc.) available.
Research Agenda. In partnership with its affiliated CTPs, the RRTC develops
and submits research concepts and protocols to the CTN Steering Committee for
review and approval. For each approved concept, a protocol specific project
team is established to develop and implement the research project across the
CTN. It is expected that there will be a Lead Investigator (LI) from the Node
where the research concept and protocol originated. NIDA scientific and
technical personnel may be designated as collaborators on the project team.
The LI assumes the leadership role for all aspects of that specific protocol
and serves as the primary liaison to CTN-wide coordination/support centers as
needed. The project team for each CTN research project includes personnel
and experts across the network from all disciplines required for the
development and implementation of the project.
Training Agenda: In partnership with the training support for clinical
researchers the CCTN strongly encourages the RRTC to apply for training
grants to support physicians, clinical psychologists, post-doctoral
candidates, and junior faculty. The CTN provides many opportunities for
these researchers to gain valuable experience in designing and managing
multi-site clinical trials.
Administrative and Operations Support. The RRTC ensures appropriate
administrative and operational support for Node activities. The support must
ensure adherence to the Terms and Conditions of the Award and the policies
and procedures of the CTN Steering Committee to: 1) design and develop CTN
research projects; 2) formulate and conduct project specific training; 3)
develop patient safety and other regulatory documents to obtain approvals
needed to implement studies within the Node; and, 4) ensure the quality of
research within the Node through on-site monitoring at participating clinical
sites.
Partnership with and Responsibility toward Affiliated CTPs. The RRTC
functions as a partner with its associated CTPs. It provides CTPs with 1)
support for the CTP Director representing the Node on the Steering Committee,
2) scientific guidance and mentoring as the RRTC develops research concepts
for the CTN 3) support for the CTP Director to participate in Special
Interest Groups, Subcommittee activities and protocol development teams 4)
support for CTP participation in CTN Blending Meetings.
Community Treatment Programs (CTPs). Drug abuse treatment programs in the
community setting (typically non-university-based) that have a history of
providing quality treatment to large and diverse patient populations,
including women, members of minority groups, and adolescents, and have the
capability for and interest in participating in controlled clinical trials.
Working as an equal partner with its RRTC, each CTP must:
o Agree to participate in controlled clinical trials, including randomization
methods for assignment of patients to experimental or control groups or
randomization of therapists to different conditions;
o Screen and recruit adequate numbers of patients required to meet the
expectation of specific protocols. This frequently requires recruiting one
patient per week.
o Agree to provide routine clinical care to patients participating in
protocols;
o Agree to provide experimental/standard care in accord with approved
research protocols;
o Provide HIV risk reduction counseling and access to HIV testing;
o Provide HCV education and referral for testing and treatment;
o Maintain patient records and other source documents required for each
protocol;
o Collect clinical and laboratory data, including biological specimens when
indicated;
o Cooperate with quality assurance activities of the CTN and adhere to
guidelines set by the RRTC, the Steering Committee, and NIDA;
o Cooperate with NIDA’s Clinical Coordinating Center and Data and Statistics
Center;
o Participate in the development of research concepts and protocols for
trials to be conducted in the CTN;
o Agree not to report data prior to collaborative reporting;
o Agree to periodic on-site audits by representatives of its RRTC, NIDA, or a
NIDA designee to ensure appropriate use of investigational drugs; compliance
with regulations for IRB approval and informed consent (compliance with 45
CFR 46); compliance with protocol specifications; quality assurance and
accuracy of data recording; and completeness of reporting of adverse drug
reactions.
Principal Investigator. The senior scientist named in the grant by the
applicant institution to lead and manage the activities within the Node.
CTP Director. The individual designated by the participating community
treatment program to represent the CTP on the Node. This individual is also
responsible for the CTP’s obligations to the Lead Investigator during the
course of a protocol.
CTN Steering Committee. The Steering Committee constitutes the primary
governing body of the Network. The committee membership consists of the
Principal Investigator and one CTP Director from each Node, two NIDA
representatives (one of which is the NIDA Director of the Center for Clinical
Trials Network), one representative from the CTN Clinical Coordinating Center
and one representative from the CTN Data and Statistics Center. This group
reviews and approves the research agenda, formulates and monitors policies
and procedures guiding the research activities, and oversees communications
within the CTN, as well as with the greater scientific community and the
public.
All major network decisions are determined by majority vote of the Steering
Committee. All participating RRTCs and CTPs must agree to abide by the study
designs and policies approved by the Steering Committee. It is important to
note that research to be undertaken within the CTN is not limited to research
concepts contained within awardees applications, but are and will be
determined by the Steering Committee based on input from the Nodes and
subject to the approval of NIDA. Future research must be within and
consistent with the scientific objectives of the RFA.
The Steering Committee uses established subcommittees and workgroups to
assist it in carrying out its functions. The Steering Committee meets no more
than four times per year. Applicants should include costs for travel to
these Steering Committee meetings and subcommittee/workgroup meetings in
their applications and should assure that adequate provisions are made to
allow the Principal Investigator, Node personnel and CTP representatives to
participate fully in activities of the Steering Committee and its
subcommittees and workgroups. http://www.nida.nih.gov/CTN/Index.htm.
NIDA Protocol Review Board. An independent expert board authorized by the
Director of NIDA to advise the Director CCTN on scientific and regulatory
issues.
Data and Safety Monitoring Board (DSMB). The DSMB is an independent expert
board, appointed by and reporting to the Director of CCTN that oversees and
monitors the conduct of the clinical trials to ensure the safety of
participants and the validity and integrity of data for each study. The DSMB
also makes an independent assessment of the interventions under study and
whether or not any trial undertaken in the CTN will continue. One or more
NIDA staff serves as non-voting members on the DSMB.
Data and Statistics Center (DSC). A contract awarded by NIDA to provide
clinical data information systems as required to implement standards
established by NIDA and the CTN Steering Committee. Such standards guide
development and implementation of the protocol-specific electronic case
report form (eCRF) applications that each Node must implement at
participating CTP sites. The DSC reports directly to NIDA, although it
functions as a resource to the CTN Steering Committee in all matters related
to data management--from study design, data acquisition and analyses to
report of study findings and conclusions.
1) Provide logistical support for specific trials, e.g. hire research staff,
provide computer hardware and software to participating CTPs if needed, and
provide Internet access to participating CTPs if needed.
2) Assist the Lead Investigator in protocol development with respect to data
management, design and analysis, and interim analysis plan (if applicable).
3) Manage all aspects of data collection.
4) Analyze data to test primary and secondary study hypotheses.
5) Monitor trial progress.
6) Conduct data quality assurance monitoring.
7) Produce reports for the Data and Safety Monitoring Board (DSMB)
8) Provide data/facts that will assist NIDA staff with producing Node
performance reports based on CTN’s performance criteria.
Clinical Coordinating Center (CCC): NIDA provides via a contract certain
resources and common services for CTN clinical trials, including support for
administrative requirements and oversight functions mandated by NIH.
Specifically:
1) Regulatory affairs and Investigational New Drug (IND) filing;
2) Monitoring for clinical study sites;
3) Administrative support for protocol development;
4) Project management;
5) Training in Good Clinical Practice (GCP) etc.;
6) Central pharmacy services for medication packaging and shipping;
7) Clinical laboratory support.
8) Coordinate activities (face-to-face meetings and/or conference calls) for
specific protocols (not core CTN meetings).
9) Coordinate the distribution of trial supplies, e.g. medication, forms,
manuals.
10) Coordinate the distribution of materials with laboratories involved in
CTN’s clinical trials.
11) Assist the Lead Investigator in protocol development with respect to
regulatory, QA and training plans.
12) Provide training of general clinical research conduct (GRP) and CTN
protocol common assessment batteries (CAB).
13) Monitor GCP compliance according to the Quality Assurance Plan defined
by each Lead Investigator of the protocol.
14) Monitor regulatory compliance.
15) Provide data/facts that will assist NIDA staff with producing Node
performance reports based on CTN’s performance criteria.
Logistic Support Center (LSC). A contract awarded by NIDA to support many of
the administrative and logistic functions of the CTN including:
1) Coordinating logistic and operational support for a variety of CTN
meetings with up to 250 attendees;
2) Handling all logistics and costs with coordinating over 400 conference
calls on an as needed basis per year;
3) Support for consultants providing NIDA and the CTN grantees with expert
advice on a variety of topics regarding the Network;
4) Preparing publicity, meeting, and protocol related materials as required;
5) Providing scientific writers/editors to prepare reports, take minutes of
meetings and conference calls, edit documents;
6) Reproducing and distributing research materials, protocol related
documents, and educational materials;
7) Creating and maintaining administrative records to support the CTN
activities;
8) Providing translation services for CTN materials in languages other than
English;
9) Maintaining a CTN web site; and
10) Miscellaneous support services.
NOTE: Funds to support Node personnel travel to meetings will not be
disbursed by the LSC. Applicants should make adequate provision for these
funds in the budgets submitted under the present RFA. See the Subsection
"Budget" in the "APPLICATION PACKAGE" section below for more guidance on this
issue.
Center for the Clinical Trials Network (CCTN). The organization within NIDA
responsible for the scientific, administrative, and operational management of
the CTN research program funded by NIDA.
OBJECTIVES AND SCOPE
The overall goal of the National Drug Abuse Treatment Clinical Trials Network
is to improve the quality of drug abuse and addiction treatment throughout
the Nation using science as the vehicle.
Specific objectives include:
o A standard frame of reference in research on drug abuse and development of
comprehensive drug abuse treatment programs that integrates co-morbid
medical/mental health conditions (e.g., mental disorders, HIV, Hepatitis B &
C, tuberculosis, sexually transmitted diseases (STDs) and other blood-borne
infections.
o Supporting rigorous, multi-site clinical trials of efficacious behavioral,
pharmacological, and combined behavioral and pharmacological treatment
interventions in community-based treatment programs to determine
effectiveness across a broad range of treatment settings and patient
populations.
o Encouraging research on effective strategies for transporting science-based
treatment interventions into clinical practice.
o Furthering the development of effective treatments by integrating
behavioral and pharmacological interventions.
o Ensuring that treatment research in drug abuse and addiction is extended to
the wider community, such as minorities, women, children, adolescents, and
underserved populations.
o Ensuring that treatment research in drug abuse and addiction addresses the
needs of special populations within the wider community, including court-
involved patients and patients with co-morbid psychiatric or medical
conditions.
o Fostering the collaboration between community practitioners and treatment
researchers by providing opportunities for bi-directional education, exchange
of ideas, information, and values.
o Investigating the impact of community-based treatment research on community
treatment practices.
o Exploring the effectiveness of behavioral, pharmacological, and integrated
behavioral and pharmacological treatment interventions to reduce the
transmission of HIV and other disease (such as hepatitis B and C or sexually
transmitted infections) and to enhance adherence to treatment for HIV and
other disease among drug users. Additionally, small efficacy trials of
promising, theoretically grounded behavioral interventions may be conducted.
This RFA also seeks a broad range of research on disease prevention for drug
users in treatment including, but not limited to, the following topics.
o The effectiveness of behavioral and/or pharmacological drug treatment
modalities in reducing drug-related transmission risks for HIV and other
disease;
o The effectiveness of drug use relapse prevention programs and other
enhanced engagement-in-drug-treatment interventions in reducing drug-related
transmission risks for HIV and other disease;
o The effectiveness of culturally appropriate HIV testing and counseling
interventions in reducing drug- and sex-related transmission risks among HIV-
positive and HIV-negative drug users in drug treatment settings;
o The effectiveness of cognitive-behavioral-affective skills building
interventions in reducing drug-related transmission risks for HIV and sex-
related transmission risks for HIV and other STIs, specifically tailored for
heterosexual adults or men who have sex with men;
o The effectiveness of developmentally appropriate cognitive-behavioral-
affective skills building interventions in reducing drug- and sex-related
disease transmission risks among adolescent drug users in treatment;
o The effectiveness of peer- or family-based interventions in reducing drug
abuse and drug-related transmission risks among adolescents in drug treatment
settings;
o The effectiveness of psychiatric treatment (e.g., for depression, anxiety,
PTSD, ADHD, conduct problems) in reducing drug- and sex-related transmission
risks among adolescent or adult substance abusers in drug treatment settings;
o The effectiveness of on-site, antiretroviral therapy adherence/compliance
counseling for HIV- or HCV-infected drug users in drug treatment;
o The effectiveness of providing comprehensive medical services, or linkage
to primary care, for HIV-, HCV- or STI-infected drug users in drug treatment.
Characteristics of the CTN
The CTN provides the Nation with a stable and broadly representative platform
for drug abuse treatment research through regional Nodes distributed
throughout the country. Each Node encompasses a substantial geographical
area and a variety of treatment settings, patient populations, and drug abuse
problems. The RRTC of each Node must have demonstrated expertise in
conducting drug abuse treatment research, clinical trials and clinical
training. Through its associated CTPs, each Node must demonstrate the
capacity to recruit and treat a broad range of patients, including
adolescents, women, patients with co-occurring mental disorders, those at
high risk for HIV infection, members of racial/ethnic groups, and those
abusing or addicted to various drugs of abuse. All Nodes must demonstrate the
capacity to deliver and test a variety of both pharmacological and behavioral
therapies. The term "behavioral therapy" is used here in the broadest sense
and is meant to include, for example, counseling, various aspects of
therapeutic community approaches, cognitive behavioral therapy, operant
behavioral therapy, and family therapy. For the CTN to be maximally
effective, the CTPs must be partners in the research enterprise by
participating in research decisions, including selection of research concepts
to be implemented and decisions concerning protocol design. The CTN has
completed several protocols, several are actively enrolling participants, and
more are preparing to initiate enrollment. See listing on the web at
http://www.nida.nih.gov/CTN/research.html.
As the CTN continues to develop, it is anticipated that CTN will be used as a
platform so that other topics could be studied such as:
o Techniques for transporting new behavioral therapies into community-based
treatment groups. For example, the effectiveness of various approaches to
therapist training could be compared within the clinical trial context. In
this fashion, information can be gained not only about whether a therapy
performs better than standard care, but also about how a therapy may be
transported.
o Optimizing access to and effectiveness of currently marketed
pharmacotherapies for treatment of drug abuse and addiction. Examples are
studies to determine the optimal approach for integrating medications with
behavioral therapies at optimal levels and doses, such as, naltrexone with
cognitive behavioral therapy or Buprenorphine with drug addiction counseling.
o Behavioral interventions aimed at improving compliance with medication
regimens in patients with co-morbid addictive and mental or physical
disorders. For example, studies could be done to determine the best
behavioral interventions to ensure antiviral medication compliance in drug
addicted individuals with AIDS, or to investigate the effectiveness of a new
behavioral intervention for patients with bipolar disorder.
o Effective therapies for treating marijuana abuse -- particularly in
adolescent populations.
o Models for integrating new behavioral interventions into existing clinical
practices.
In the area of HIV/AIDS research, examples are:
o Effective approaches to outreach and risk reduction counseling. Drug
addiction and the spread of HIV/AIDS are intertwined epidemics, and the CTN
will provide a vehicle to help facilitate reduction in risk behaviors given
that CTPs participating in the CTN must provide HIV risk reduction counseling
and offer HIV testing.
o Efficacy of drug abuse treatment on AIDS related outcomes, such as rate of
progression to AIDS. Studies could examine the effects of: 1) the early
treatment of HIV, Hepatitis B and C and Sexually Transmitted Diseases, or 2)
the prevention and early treatment of co-morbid medical and mental health
conditions associated with HIV/AIDS infection. Such studies may incorporate
the most current methodological advances for assessing a) biological and
mental health risks and HIV status, and b) adherence and compliance to
antiretroviral and other medical/mental health therapies.
The CTN, with its core of CTPs engaging diverse populations, is also designed
to provide a platform for health service research and a much needed vehicle
to recruit study subjects for such related topics as the genetic
vulnerability to addiction, which would be funded under separate research
grants.
In the area of genetics studies, examples are:
o Studies that better describe, disseminate, and predict the complex nature
and course of drug abuse and addiction to offer more precise phenotypic
indices for testing of hypothesized underlying genetic risk factors
associated with drug abuse.
o Pharmacogenetics into ongoing medications trials for response to treatment
and/or therapeutic outcome. Examples could include accurate and
comprehensive descriptions of phenotypes and associations with genotype to
disease (phenotype-to-genotype approach), or selection of appropriate
candidate gene variants to examine for association to a given drug response
or outcome (genotype-to-phenotype approach)
In the area of health service research, an example is:
o Studies to describe factors impacting transmission of knowledge, change of
treatment organizations, and adaptation of new treatments and their adoption
into widespread clinical practice. NIDA encourages researchers to study such
treatment issues at the organizational/program levels under separate research
project grants.
Although not all Nodes would be expected to have the capacity to conduct
studies in HIV/AIDS, genetics and health services, all Nodes will be expected
to collaborate in research focusing on such issues and to aid in recruitment
of appropriate subjects. Please reference the CTN policy on using the CTN as
a research platform. http://www.nida.nih.gov/CTN/policies.html.
Nodes with expertise in these special areas will be given priority when
making funding decisions.
MECHANISM OF SUPPORT
This RFA will use NIH U10 award mechanism(s). As an applicant you will be
solely responsible for planning, directing, and executing the proposed
project. This RFA is a one-time solicitation. The anticipated award date is
August 31, 2005.
The NIH (U10) is a cooperative agreement award mechanism. In the cooperative
agreement mechanism, the Principal Investigator retains the primary
responsibility and dominant role for planning, directing, and executing the
proposed project, with NIH staff being substantially involved as a partner
with the Principal Investigator, as described under the section "Cooperative
Agreement Terms and Conditions of Award"
FUNDS AVAILABLE
It is expected that each Node will have an operating budget of up to $2.2
million per year, comprised of grant awards of $1.25 million to pay for core
support with additional funds available for implementation of protocols.
There are also funds to support a separate contract which covers data
management, data analysis, and portions of quality assurance monitoring,
training and regulatory affairs. NIDA expects to make up to eleven awards
under this RFA for project periods of up to 5 years of support. It is
anticipated that there will be subsequent RFAs to sustain or expand the CTN.
It is projected that competing continuation applications will be invited upon
expiration of the initial funding period of awards made under this and
previous RFAs, subject to availability of funds.
For new applicants, in general, no more than $700,000 in direct costs should
be allocated to support first year operations. Therefore, the budgets for
ensuing years (year two through year five) should be increased to reflect
anticipated costs associated with maintaining the Node infrastructure and
performing research projects.
Because the role and function of a CTN Research Node is well established, it
is expected that the size of individual awards for core support will be
similar. Budget requests should be carefully justified and commensurate with
the complexity of the project. Although this program is provided for in the
financial plans of NIDA, awards pursuant to this RFA are contingent upon the
availability of funds for this purpose.
ELIGIBLE INSTITUTIONS
You may submit (an) application(s) if your institution has any of the
following characteristics:
o For-profit or non-profit organizations
o Public or private institutions, such as universities, colleges,
hospitals, and laboratories
o Units of State and local governments
o Eligible agencies of the Federal government
o Domestic institutions/organizations
o Foreign institutions are not eligible to apply
o Faith-based or community-based organizations
INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS
Any individual with the skills, knowledge, and resources necessary to carry
out the proposed research is invited to work with their institution to
develop an application for support. Individuals from underrepresented racial
and ethnic groups as well as individuals with disabilities are always
encouraged to apply for NIH programs.
The Principal Investigators must commit to and be actively involved in the
research and governance of the CTN at a minimum of 50 percent effort and
document a substantial history of leadership in clinical trials research and
an extensive research publication record.
SPECIAL REQUIREMENTS
To promote the development of a collaborative program among award recipients,
a number of issues need to be addressed in applications as discussed under
Application Procedures, below. Applicants should document their ability to
recruit a sufficient number of participants, and should demonstrate their
ability and willingness to work cooperatively with NIDA, other awardees, and
CTPs, and to follow common protocols. The Principal Investigator must commit
at least 50% effort to this project.
The following terms and conditions will be incorporated into the award
statement and are provided to the Principal Investigator(s) as well as the
institutional official at the time of award.
Cooperative Agreement Terms and Conditions of Award
These special Terms of Award are in addition to and not in lieu of otherwise
applicable OMB administrative guidelines, HHS Grant Administration
Regulations at 45 CFR Parts 74 and 92, and other HHS, and NIH Grant
Administration policy statements.
The administrative and funding instrument used for this program is a
cooperative agreement, an "assistance" mechanism (rather than an
"acquisition" mechanism) in which a substantial NIH scientific and/or
programmatic involvement with the Awardee is anticipated during the
performance of the activity. Under the cooperative agreement, the NIH purpose
is to support and/or coordinate the recipient’s activity by involvement and
otherwise working jointly with the award recipient in a partner role, but it
is not to assume direction, prime responsibility, or a dominant role in the
activity.
Consistent with this concept, the dominant role and prime responsibility for
the activity resides with the Awardee(s) for the project as a whole, although
specific tasks and activities in carrying out the studies will be shared
among the Awardees and NIDA and its contractors.
This cooperative agreement funding mechanism will require collaboration
between the Director of NIDA’s Center for Clinical Trials Network (CCTN) and
the Principal Investigators of the CTN Nodes. The NIDA CCTN will assist in
coordinating activities of the CTN as defined below and will facilitate the
exchange of information.
1. Awardee Rights and Responsibilities
Awardees will have primary responsibility for defining the details for the
project within the guidelines described in the Request for Applications and
for performing the scientific activity, and agree to accept close
coordination, cooperation, and participation of NIDA staff in those aspects
of scientific and technical management of the project described in these
terms and conditions. The awardee further agrees to accept close coordination
and to cooperate fully with NIDA designated coordinating centers that will be
responsible implementing approved protocols. Specifically, awardees have
primary responsibilities as described below.
a. Steering Committee:
Awardees participate in The National Drug Abuse Treatment Clinical Trials
Network (CTN) Steering Committee that serves as the governing body of the
CTN. The voting membership of the Steering Committee consists of the
Principal Investigator and a CTP Director representative of each RRTC, and
two representatives from NIDA, one of which is the NIDA CCTN Director. There
are also two representatives from the Clinical Coordinating Center and the
Data and Statistics Center. The Steering Committee reviews and approves the
research agenda, formulates and monitors policies and procedures guiding the
research activities, and oversees communications within the CTN as well as
with the greater scientific community and the public.
All major decisions are determined by majority vote of the Steering
Committee. All participating RRTCs must agree to abide by the study designs
and policies approved by the Steering Committee. Research undertaken within
the CTN is determined by the Steering Committee based on input from the Nodes
and subject to the approval of the Protocol Review Board and NIDA. Future
research must be within and consistent with the scientific objectives of the
RFA.
The Steering Committee policies and standard operating procedures govern all
aspects of the CTN including, but not limited to, protocol design and
development, protocol review and approval, study operations and standards,
data acquisition and management, and data analysis and publication. The
Steering Committee has established CTN performance goals and monitors
progress throughout the life of the CTN and its research projects. Standard
operating procedures and policies governing the CTN are available at
http://www.nida.nih.gov/CTN/policies.html.
b. Policies/Operating Procedures
The Steering Committee Chair will be responsible for ensuring that there are
well documented policies and operating procedures guiding all aspects of CTN
activities (e.g. protocol development, review, project initiation, conduct,
and closure, data collection and management, publication, etc.) and bylaws
delineating the requirements and expectations of collaborating institutions,
membership criteria, and standards of performance, and procedures for
removing institutions due to poor performance.
2. Responsibilities of the CTN Regional Research and Training Center (RRTC):
Generally, Awardees under this agreement have the following rights and
responsibilities as a National Drug Abuse Treatment Clinical Trials Network
(CTN) RRTC:
o The RRTC provides a core of administrative and study operations services,
as well as scientific leadership and management of clinical trials. The
RRTC, acting as the local operating center for a Node, has primary
responsibility for 1) establishing an infrastructure for core functions, 2)
generating a research agenda, 3) providing the Node with administration and
operations support, and 4) building partnerships with the CTPs.
o Infrastructure for core functions This includes but is not limited to 1)
arranging and managing the participation of at least five CTPs in the first
year, with possibility for expansion in subsequent years, 2) maintaining
scientific and technical personnel for protocol development and
implementation, 3) coordinating intra-Node activities, and 4) providing
resources for intra-Node activities, 5) collaborating with NIDA and other
Nodes to develop, implement, and disseminate findings from CTN research
projects 6)working with the CTN Clinical Coordinating Center and Data and
Statistics Center.
o Research Agenda/implementation - In partnership with its affiliated CTPs,
the RRTC develops and submits research concepts and protocols to the CTN
Steering Committee for review and approval. For each approved concept, a
protocol specific project team will be established to develop and implement
the research project. It is expected that a Lead Investigator will come from
the Node where the research concept and protocol originate. NIDA Staff may be
designated as scientific and programmatic collaborators on the project team.
The Lead Investigator will assume the leadership role for all aspects of that
specific protocol and serve as the primary liaison to CTN-wide
coordination/support centers as needed.
a. Protocol Development:
The Principal Investigator of a RRTC in collaboration with local CTPs, Co-
PIs, and other Network colleagues shall initiate the development of a
clinical trial concept and once that concept is approved by the Steering
Committee and NIDA, the Lead Investigator from that Node shall expeditiously
draft a research protocol according to Steering Committee guidelines for
protocol content and format. The Steering Committee will review and approve
RRTC initiated protocols. Such review will include provisions for NIDA
scientific review and comment, including review by an independent CTN
Protocol Review Board. The RRTC will be responsible for providing ancillary
information about the protocol to permit review of the proposed project’s
scientific rationale, feasibility, costs, and compatibility with NIDA
research priorities and existing clinical research programs.
The Principal Investigators of RRTCs agree to cooperate with NIDA’s
contracted Data and Statistical Center with regard to CTN-wide standards for
collection and analysis of data generated under the CTN, and enabling the
Data and Statistics Center to provide timely, accurate, and complete data for
purposes of monitoring the safety and progress of research projects conducted
within the CTN, as well as final study data according to schedules developed
and approved by the Steering Committee for individual research projects
conducted through the CTN.
b. Data Rights:
The NIH expects investigators supported by NIH funding to make their research
data available to the scientific community for subsequent analysis based on a
data sharing plan approved as part of the award; see the NIH data sharing
policy website at http://grants.nih.gov/grants/policy/data_sharing The CTN is
intended as a national resource for the advancement of treatment for addicted
individuals and other affected persons. The Awardee of this agreement
acknowledges that NIH has access to any and all data generated under this
cooperative agreement and the Awardee agrees to provide royalty-free,
nonexclusive, and irrevocable license for the government to reproduce,
publish, or otherwise use the material and data derived from research
conducted under this cooperative agreement. Data collected or derived under
this cooperative agreement must be shared upon request with the Steering
Committee, or its designee, for external monitoring pursuant to NIDA
responsibilities under agreements with other government agencies (e.g. Food
and Drug Administration) or commercial pharmaceutical companies where NIDA
may co-develop investigational agents. At the conclusion of each protocol,
the Lead Investigator will be required to direct the data coordinating center
to produce a public use file of all related study data. The format and
documentation of the data should be complete enough to replicate the studies
outcomes and ensure its broader utilization by the drug abuse treatment
community while maintaining subject confidentiality.
c. Quality Assurance and Monitoring:
All clinical trials are subject to quality control and monitoring as stated
by CTN Quality Assurance (QA) and Monitoring policies and procedures. The
Lead Investigator of each trial is primarily responsible for design of study
QA monitoring plan according to the CTN policies and procedures. In addition,
NIDA or its representative, the Clinical Coordinating Center, will provide
periodic oversight and Quality Assurance monitoring of all clinical trial
sites following the Good Clinical Practice (GCP) standards. Awardee agrees
to permit on site monitoring for all of its community treatment provider
sites.
For medication trials, NIDA, when necessary, will be the holder of the
Investigational New Drug application (IND). When there is an IND, NIDA will
be primarily responsible for study control and monitoring as defined by FDA
rules and regulations. When NIDA holds the IND, the RRTCs will be subject to
review by NIDA to ensure adherence to GCP. The Awardee agrees to provide
material and documentation needed to assure GCP compliance.
d. Training:
A Training Tracking System has been developed by the CTN to track the
required training of staff throughout the network. The system tracks two
components, staff training requirements and training attendance. The purpose
of the system is to identify the training delivered and document that the
training requirements have been satisfied. Reports are available to the CTN
community via its secured web-based document repository (Livelink). Awardees
agree to enter training information into this CTN wide system.
e. Subject Safety/Oversight
The RRTC will develop protocol-specific measures to assure the safety and
protection of the rights of volunteers involved in the clinical studies, and
other research projects, to be conducted under this cooperative agreement.
The Principal Investigator assumes and accepts the primary responsibility for
ensuring CTN studies are conducted in compliance with all federal regulations
and NIDA policies and procedures. These include, but are not limited to,
Title 21 CFR Parts 11, 50, 56, 312, and Title 45 CFR 46. The RRTC must be
able to demonstrate that each institution and CTP has a current, approved,
Institutional Assurance of Protection for Human Subjects on file with the
Department of Health and Human Services Office for Human Research
Protections; that each protocol and informed consent is approved by the
recognized Institutional Review Board (IRB) prior to the enrollment of
subjects in any study; and that each subject (or legal representative) has
given necessary written informed consent prior to admission to any study
conducted under this cooperative agreement. The Principal Investigator
agrees and assures that adequate records will be maintained, and that access
to these records will be available, to enable outside monitors to assess
compliance with applicable federal laws and regulations.
f. Unexpected Adverse Experience Reporting:
The Principal Investigator of the RRTC agrees to implement and adhere to an
adverse event tracking system operated by NIDA and adopted by the Steering
Committee.
g. Reporting Requirements:
In addition to periodic financial and administrative reports required by NIH
for administration of this cooperative agreement, the Awardee agrees to
furnish the following reports according to the schedule indicated:
CTN Node Operations Reports: Awardees are required and agree to provide
quarterly reports of program activities to NIDA by the 10th day of the month
following the end of programmatic quarters (90 days from the date of award).
These reports include: 1) a quarterly progress report of the activities of
the Node within the reporting period and 2) quarterly financial reports
showing a breakdown of the costs incurred for both the RRTC and CTPs for the
reporting period. The quarterly financial report shall include a total of all
costs spent in previous quarters for that year as well as the current
reporting period. This report is in addition to the yearly Federal Status
Report (FSR) required by NIH. The CCTN/NIDA will define a recommended format
and specify minimum content for these Program Operations Reports.
CTN Research Project Reports: Awardees are required and agree to provide
periodic reports of the research projects undertaken in the CTN. At minimum
the Lead Investigator must provide timely information on the tasks, schedule,
and costs associated with the development and implementation of a CTN
research project. Enrollment information in a format and according to a
schedule defined by NIDA and the Steering Committee are required for each CTN
clinical research project. Other protocol-specific reports, such as those
needed to monitor the safety and clinical effectiveness of drugs or other
interventions under investigation will be required to allow the Steering
Committee and Data and Safety Monitoring Board to monitor the research
projects undertaken in the CTN. The Steering Committee will determine the
nature, frequency, and content of reports as part of the protocol review and
approval process
Investigational New Drug (IND) Reports: Awardees are required and agree to
provide reports according to regulations and guidelines established by the
Food and Drug Administration (FDA). Data and other reports required of IND
sponsors will be provided to the Steering Committee prior to dates
established by the Steering Committee.
Final Study Report: Lead Investigators are required to provide the Director,
CCTN and the Steering Committee with a Final Study Report within 120 days of
data lock upon completion of the protocol. The Final Study Report is a brief
accounting of the history, participants, and milestones in the completion of
the trial. The content and format are approved by the Steering Committee.
h. Publication of Data:
Prompt and timely presentation and publication in the scientific literature
of findings resulting from research undertaken in the CTN is required. It is
expected that the Lead Investigator will have an initial outcome paper
completed and submitted to an appropriate peer-reviewed scientific journal
within 180 days of data lock for the protocol. The Awardee agrees to
acknowledge NIDA support in the publications and oral presentations resulting
from research conducted under cooperative agreement. Prior to the submission
of manuscripts for publication Awardees agree to provide preprint copies to
the Steering Committee according to policies and procedures the Steering
Committee may establish to monitor the presentation and publication of CTN
results.
i. Progress Review
The CTN Steering Committee has established and will continue to elaborate
procedures for monitoring the performance of the RRTCs and the CTPs
participating in research under this cooperative agreement. Performance
metrics, such as budget execution, subject enrollment, data acquisition and
transmission, and study analysis and reports have been defined to permit NIDA
and the CTN Steering Committee a means to assess progress of the Node and
provide information needed to support future funding decisions.
The inability of an RRTC to meet performance requirements and
responsibilities defined in these Terms and Conditions, and further
elaborated by the Steering Committee may result in an adjustment of funding,
withholding of support, restriction of funds already awarded, or suspension
or termination of the award.
j. National Meetings:
The Steering Committee may meet up to four (4) times each year. The Principal
Investigator agrees to provide adequate support for participation in CTN
meetings as required by the Steering Committee and its various operating sub-
committees. The Principal Investigator agrees to support participation by CTP
personnel as required by CTN projects.
k. Conflict of Interest:
Awardees are required to comply with 42 CRF part 50, subpart F
Responsibility of Applicants for promoting Objectivity in Research for Which
PHS Funding is Sought. In addition, the CTN Steering Committee has
developed policies on Conflict of Interest and monitors compliance to that
policy. The Conflict of Interest Policy addresses issues that may arise
through financial ties between RRTC and CTP participants and the private
sectors. Awardees will abide by the CTN Conflict of Interest Policy and
ensure staff identified in the policy provide disclosure to the CCTN as
required. This policy can be found at:
http://grants.nih.gov/grants/policy/coi/index.htm or
http://www.nida.nih.gov/CTN/policies.html
l. Protocol Closure:
Throughout the term of the cooperative agreement NIDA may request that a
research project be terminated for reasons including: 1) insufficient subject
accrual; 2) accrual goal for the protocol is met; 3) poor performance in
conducting the protocol; 4) safety of the subjects in the study; 5)
achievement of conclusive study results; and, 6) emergence of new information
that diminishes the scientific importance of the study question. Financial
support from NIDA through this cooperative agreement will cease upon project
closure, except that funds may remain available for patients already enrolled
in the study.
3. RRTC and CTPs:
a. The RRTC agrees to negotiate and establish subcontracts with at least five
community treatment programs (CTPs) to conduct research and training projects
under this cooperative agreement.
Each CTP must:
-- Agree to participate in controlled clinical trials, including
randomization methods for assignment of patients to experimental or control
groups or randomization of therapists to different conditions;
-- Screen and recruit adequate numbers of patients required to meet the
expectation of specific protocols. This frequently requires recruiting one
patient per week.
-- Agree to provide routine clinical care to patients participating in
protocols;
-- Agree to provide experimental/standard care in accord with approved
research protocols;
-- Provide HIV risk reduction counseling and access to HIV testing;
-- Provide HCV education and referral for testing and treatment;
-- Maintain patient records and other source documents required for each
protocol;
--Collect clinical and laboratory data, including biological specimens when
indicated;
-- Cooperate with quality assurance activities of the CTN and adhere to
guidelines set by the RRTC, the Steering Committee, and NIDA;
-- Cooperate with NIDA’s Clinical Coordinating Center and Data and Statistics
Center
-- Participate in the development of research concepts and protocols for
trials to be conducted in the CTN;
-- Agree not to report data prior to collaborative reporting;
-- Agree to periodic on-site audits by representatives of its RRTC, NIDA, or
a NIDA designee to ensure appropriate use of investigational drugs;
compliance with regulations for FDA, IRB approval or informed consent
(compliance with 45 CFR 46); misconduct in science inquires; compliance with
protocol specifications; quality assurance and accuracy of data recording;
and completeness of reporting of adverse drug reactions.
CTPs are not expected to participate in every CTN research project, but must
adhere to the above terms when they choose to participate in a CTN research
project.
b. The RRTC shall establish agreements with CTPs that include, at minimum: 1)
a statement of work defining the goals and objectives of the research
projects to be undertaken under this cooperative agreement; 2) a budget for
support of the research projects that clearly identifies the personnel,
equipment, materials, and other costs required to successfully conduct high
quality research in the community treatment program according to the
requirements of specific protocols approved for implementation by the CTN
Steering Committee; and 3) a financial and program reporting requirement,
including access to data and materials, to facilitate CTN program operation
and research project oversight and monitoring.
4. NIDA Staff Responsibilities
NIDA staff do have and will have substantial scientific and programmatic
involvement throughout the life of this cooperative agreement through
technical assistance, and advice and coordination extending beyond normal
program stewardship for grants, as described in these terms and conditions.
The role of the NIDA staff as described throughout these Terms and Conditions
is to assist and facilitate, but not to direct the research activities.
Communication and interaction will occur primarily with the scientific
leadership of the RRTC; however, NIDA may also interact directly with the
Directors of any of the collaborating CTPs as needed.
NIDA maintains a Logistic Support Center (LSC) through contract. These
central resources support certain administrative coordinating functions of
the CTN. These include: 1) Logistical support for meetings of the Network,
e.g., CTN Steering Committee, subcommittees, workgroups and other Boards (the
Advisory Board, the DSMB, etc.), 2) Reproduction and distribution of research
and educational materials, including treatment protocols, training manuals,
and instrumentation, 3) Development, reproduction, and distribution of
materials publicizing the activities of the CTN.
a. NIDA’s Scientific Role
NIDA Collaborating Scientists (CSs) with expertise in behavioral therapies,
medications development, and practice research may participate in the
development of study plans and protocols, quality assurance and control
activities, and in coordinating projects across scientific disciplines and
CTN Nodes. NIDA CSs may initiate or participate in publications in accordance
with established professional and NIH guidelines for authorship. The NIDA CSs
will not, however, have a direct role in assessment, testing, or treatment of
human subjects participating in studies under this cooperative agreement. A
collaborating scientist is assigned such responsibility only with the
approval of the Director, CCTN.
The NIDA CCTN Director, and/or designated staff, will work closely with the
CTN Steering Committee to assure that the research efforts are consistent
with NIDA’s research objectives and complement other clinical trial
activities supported by NIDA under other means.
NIDA will serve as a resource, and will disseminate information regarding
promising new therapies. NIDA staff will advise the clinical investigators,
as requested or needed, of results from other trials (e.g., adverse
experiences and study termination) that could influence the design,
development, or conduct of clinical trials under this cooperative agreement.
The following Boards will have approval authorities as indicated:
NIDA Protocol Review Board: An expert board authorized by the NIDA Director
that will review the final draft of the protocol submitted by the Lead
Investigator and the Protocol Development Team for scientific and regulatory
approval.
Data and Safety Monitoring Board (DSMB). The DSMB is an independent expert
board appointed by and reporting to the Director of NIDA that will review
study plans and oversee and monitor the conduct of the clinical trials to
ensure the safety of participants and the validity and integrity of the data.
The DSMB will also make an independent assessment of the effectiveness of
interventions under investigation and whether a trial will continue. One or
more NIDA staff will serve as non-voting members on the DSMB.
b. NIDA’s Role in Protocol Review and Approval
In order for a CTN research project to be initiated, the study proposal must
be mutually approved by the CTN Steering Committee and NIDA. Once notified
that a clinical trial is under consideration, NIDA will evaluate the proposed
trial according to NIDA’s treatment research agenda, its likelihood of timely
completion; patient safety; compliance with Federal regulatory requirements;
plans for interim monitoring and final analysis of results; and resource
requirements. The Lead Investigator for the protocol is required to provide
the CCTN with a cost projection and rationale for the resource requirements
for protocol implementation.
Prior to protocol approval as defined above, NIDA will provide no trial
materials or permit expenditure of CTN funds to implement the research
project unless and until the proposed protocol is approved.
Disagreements arising during the protocol approval process may be submitted
to an arbitration panel for resolution. A panel composed of one CTN
designee, one NIDA designee, and a third member with drug abuse clinical
trials expertise chosen by the other two members will be formed to review the
NIDA decision and recommend an appropriate course of action to the Director,
NIDA. These special arbitration procedures in no way affect the Awardee’s
right to appeal an adverse determination in accordance with PHS regulations
at 42 CFR Part 50, Subpart D, and HHS regulations at 45 CFR Part 16.
c. NIDA Approval to Enroll Study Participants
CTN research projects may proceed upon the Lead Investigator receiving
approval from the NIDA CCTN Director that enrollment may begin. The Lead
Investigator is responsible for providing all necessary documentation of the
readiness of each participating site to initiate participant enrollment. Such
documentation will include 1) evidence of IRB approval for each clinical
site, 2) evidence of data system readiness based on the successful test and
certification by NIDA’s Data and Statistics Center, 3) evidence that all
participating project personnel both at the CTP and the RRTC have received
the training needed to conduct the research according to the protocol and
that this information has been documented in the CTN Training Tracking Data
Base and 4) evidence that the protocol quality assurance plans are in place
to monitor the research project at participating clinical sites.
d. NIDA’s Role During Protocol Conduct
For ongoing research projects NIDA personnel and its contractors will monitor
the safety of study participants through review of incremental case report
form. For all clinical trials, NIDA will assign a Medical Officer who will
be responsible for the review and disposition of adverse events that may
arise in the course of a study. NIDA will prepare periodic reports profiling
the conduct of the study including the safety of study participants for
review by the CTN Data and Safety Monitoring Board (DSMB).
e. NIDA’s Role in Protocol Closure
The NIDA CCTN Director, and/or designated staff, will monitor the progress of
CTN studies by reviewing data and other reports periodically submitted to
NIDA. The independent NIDA Data and Safety Monitoring Board, consisting of
experts from several disciplines, may determine a need to alter, suspend, or
close an ongoing trial due to safety concerns or study performance issues.
Additionally, NIDA may deem it necessary to deny access to further
investigational drug supplies and deny the expenditure of additional NIDA
funds (except where volunteers are already enrolled) if any of the following
reasons apply: (1) scientific question no longer relevant, (2) slow accrual,
(3) study will not answer questions intended in the proposed study plan, or
(4) misuse of federal funds. Appeal of such a decision by the RRTC would
proceed in the same manner as an appeal regarding the disapproval of a
protocol prior to opening.
f. NIDA Access to Data
The NIDA CCTN Director, and/or designated staff, shall have access to all
data generated under this cooperative agreement and may periodically review
data recorded on clinical source documents, case report forms, or in
electronic form. Data must be available for external checking against
original source documents as required by NIDA, and Federal regulations
pertaining to the responsibility of NIDA as an IND sponsor. The awardees
will retain custody and primary rights to the data consistent with current
HHS, PHS, and NIH policies, including a policy to provide public access to
selected, significant data sets generated with the use of public funds,
within a reasonable period of time after primary analysis and publication by
the CTN.
g. Clinical Trials Agreements
It is expected that for some clinical trials proposed by the CTN Steering
Committee, a pharmaceutical company collaborator will provide investigational
agents for the trials. In order for the CTN, NIDA and the company to
understand their respective responsibilities and rights, a Clinical Trials
Agreement (CTA) will be negotiated and signed by NIDA and the company.
Important terms of the agreement include IND sponsorship, safety and data
monitoring, and access to trial data. Concurrence with the RRTC Principal
Investigator will normally be obtained prior to execution of any final
agreement that deviates significantly from the standard NIDA CTA. In
general, terms in the CTA covering data access and sharing will conform to
policies developed jointly by the CTN Steering Committee and NIDA.
h. NIDA Review of CTN Compliance with Federally Mandated Regulatory
Requirements
The NIDA CCTN staff will review applicable regulatory requirements and advise
CTN members of mechanisms to meet; (1) FDA regulations for studies involving
investigational agents, and (2) the DHHS Office for Human Research
Protections regulations for the protection of human volunteers in clinical
research studies.
i. Review of Performance
The NIDA CCTN Director will review the performance of the CTN as a whole and
of individual RRTCs. at least once every two years. Such reviews will
include periodic reviews of the RRTC and its CTP sites for compliance with
clinical and regulatory guidelines and success in achieving the performance
standards established by the CTN Steering Committee. The review will be based
on information provided in periodic progress reports defined elsewhere in
these Terms and Conditions, and evaluations of site performance conducted by
the CCTN staff. Insufficient patient accrual, substandard data quality,
inadequate progress in executing the research agenda, or noncompliance with
the Terms and Conditions of Award may result in a reduction in budget,
withholding support, suspension, or termination of award.
5. Arbitration
When agreement between an awardee and NIDA staff cannot be reached on
scientific/programmatic issues that may arise after the award, an arbitration
panel will be formed. A panel composed of one CTN designee, one NIDA
designee, and a third member with drug abuse clinical trials expertise chosen
by the other two members will be formed to review the NIDA decision and
recommend an appropriate course of action to the Director, NIDA. These
special arbitration procedures in no way affect the Awardee’s right to appeal
an adverse determination in accordance with PHS regulations at 42 CFR Part
50, Subpart D, and HHS regulations at 45 CFR Part 16.
WHERE TO SEND INQUIRIES
We encourage inquiries concerning this RFA and welcome the opportunity to
answer questions from potential applicants. Inquiries may fall into three
areas: scientific/research, peer review, and financial or grants management
issues:
o Direct your questions about scientific/research issues to:
Betty Tai, Ph.D.
Center for the Clinical Trials Network
National Institute on Drug Abuse, NIH, DHHS
6001 Executive Boulevard, Room 3103, MSC 9557
Bethesda, MD 20892-9557
Telephone: (301) 443-6697
FAX: (301) 443-2317
Email: btai@nida.nih.gov
o Direct your questions about peer review issues to:
Teresa Levitin, Ph.D.
Office of Extramural Affairs
National Institute on Drug Abuse, NIH, DHHS
6101 Executive Boulevard, Suite 234, MSC 8401
Bethesda, Maryland 20892-8401
Telephone: (301) 443-2755
FAX: (301) 443-0538
Email: tlevitin@mail.nih.gov
o Direct your questions about financial or grants management matters to:
Dr. Gary Fleming
Chief, Grants Management Branch
National Institute on Drug Abuse, NIH, DHHS
6101 Executive Boulevard, Room 270, MSC 8403
Bethesda, Maryland 20892-8403
Rockville, MD 20852 (for express/courier service)
Telephone: 301-443-6710
Fax: 301-594-6849
E-mail: GF6S@NIH.GOV
LETTER OF INTENT
Prospective applicants are asked to submit a letter of intent that includes
the following information:
o Descriptive title of the proposed research
o Name, address, and telephone number of the Principal Investigator
o Names of other key personnel
o Participating institutions
o Number and title of this RFA
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.
The letter of intent is to be sent by the date listed at the beginning of
this document. The letter of intent should be sent to:
DA05-001
Director
Office of Extramural Affairs
National Institute on Drug Abuse, NIH, DHHS
6101 Executive Boulevard, Suite 220, MSC 8401
Bethesda, Maryland 20892-8401
Telephone: (301) 443-2755
FAX: (301) 443-0538
Email: tlevitin@mail.nih.gov
SUBMITTING AN APPLICATION
Applications must be prepared using the PHS 398 research grant application
instructions and forms (rev. 5/2001). Applications must have a DUN and
Bradstreet (D&B) Data Universal Numbering System (DUNS) number as the
Universal Identifier when applying for Federal grants or cooperative
agreements. The DUNS number can be obtained by calling (866) 705-5711 or
through the web site at http://www.dunandbradstreet.com/. The DUNS number
should be entered on line 11 of the face page of the PHS 398 form. The PHS
398 document is available at
http://grants.nih.gov/grants/funding/phs398/phs398.html in an interactive
format. For further assistance contact GrantsInfo, Telephone (301) 710-0267,
Email: GrantsInfo@nih.gov.
USING THE RFA LABEL: The RFA label available in the PHS 398 (rev. 5/2001)
application form must be affixed to the bottom of the face page of the
application. Type the RFA number on the label. 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 title
and number must be typed on line 2 of the face page of the application form
and the YES box must be marked. The RFA label is also available at:
http://grants.nih.gov/grants/funding/phs398/labels.pdf.
SENDING AN APPLICATION TO THE NIH: Submit a signed, typewritten original of
the application, including the Checklist, and three signed, photocopies, in
one package to:
Center for Scientific Review
National Institutes of Health, DHHS
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD 20892-7710
Bethesda, MD 20817 (for express/courier service)
At the time of submission, two additional copies of the application and all
copies of the appendix material must be sent to:
DA05-001
Director
Office of Extramural Affairs
National Institute on Drug Abuse, NIH, DHHS
6101 Executive Boulevard, Suite 220, MSC 8401
Bethesda, Maryland 20892-8401
Telephone: (301) 443-2755
FAX: (301) 443-0538
Email: tlevitin@mail.nih.gov
APPLICATION PROCESSING: Applications must be received on or before the
application receipt date listed in the heading of this RFA. If an
application is received after that date, it will be returned to the applicant
without review.
Although there is no immediate acknowledgement of the receipt of an
application, applicants are generally notified of the review and funding
assignment within 8 weeks.
The Center for Scientific Review (CSR) will not accept any application in
response to this RFA that is essentially the same as one currently pending
initial review, unless the applicant withdraws the pending application.
However, when a previously unfunded application, originally submitted as an
investigator-initiated application, is to be submitted in response to an RFA,
it is to be prepared as a NEW application. That is, the application for the
RFA must not include an Introduction describing the changes and improvements
made, and the text must not be marked to indicate the changes from the
previous unfunded version of the application.
SUPPLEMENTARY INSTRUCTIONS
Specific content must be present in the application to document the technical
and scientific merit of the applicant's plan for a Node that will addresses
the fundamental goals and collaborative nature of the CTN.
The use of tables, diagrams, and organizational and flow charts is strongly
encouraged.
APPLICATION PACKAGE
The application should conform to the general instructions and requirements
of the PHS 398 (rev. 5/2001) with the exceptions noted below.
Sections a-d need not be organized according to Specific Aims, Background and
Significance, etc. as stated in the PHS 398 application kit. It is suggested
that sections a-d be replaced with the following sections. Note, also the
page limits described in a subsequent section of this announcement.
SPECIFIC REQUIREMENTS FOR COMPETING CONTINUATION APPLICATIONS
Progress Report Section
An application from a currently funded Node will be a competing continuation.
It is recognized that each competing continuation application will present
both unique features and activities carried out in common with other CTN
Nodes. Applications are expected to provide evidence of their contributions
to shared CTN activities as well as to provide evidence of their unique
strengths and accomplishments. A competing continuation application must
include a progress report which at minimum consists of:
1. Evidence of efficient administrative structure/personnel in managing
multi-site trials, ability to participate in multi-site trials;
2. A summary of research activities/accomplishments during the prior funding
period, including a clear presentation of annual accrual to all
participating protocols, and the gender/ethnic minority composition of
recruited study populations, from affiliated CTPs and how well accrual
met CTN accrual goals, and scientific publications and presentations;
3. Status of any concepts developed by the applicants, i.e., concepts
developed and submitted by the Node and any concepts accepted for
development CTN-wide;
4. Progress in developing and implementing research protocols, including the
details of the process and organizational structure for protocol
development and implementation, efficient and extensive Node training
activities to ensure efficiency in performing protocols, QA to ensure
adherence to protocol requirements and patient well being and safety,
quality data management, etc.;
5. Evidence of ability to engage community treatment programs in bi-
directional communications to bridge the research to practice gap;
6. Evidence of participation and leadership in CTN research and
administrative activities;
7. Summary of unique contributions of the Node to CTN-wide activities in the
prior funding period.
REQUIREMENTS FOR ALL APPLICATIONS: The following sections are to be used by
all applicants, both for new and competing continuation applications.
1. Understanding of and Ability to Contribute to the Mission of the CTN:
This section should consist of a few pages to establish the applicant’s
understanding of the CTN and describe how the proposed Node contributes to
the CTN goals.
2. Administrative and Management Plans:
The qualifications and experience of the Principal Investigator must be
described. An individual should be designated as the coordinator for intra-
Node research activities. His or her qualifications and experience should
also be described. Each application must also demonstrate the ability to
access professionals with the appropriate expertise to design and implement
the proposed interventions and controlled clinical trials. Evidence of
participation in multi-site clinical trials is desirable.
It is important to demonstrate the Principal Investigator’s ability to
contribute to the scientific agenda and commit a minimum of 50 percent of
time to provide protocol mandated leadership for the clinical trial. The
accrual of geographically diverse CTPs should be evident. Evidence of
current or previous successful collaborations with community treatment
programs and of participation in successful multi-site trials in
collaboration with other research centers would be desirable.
Plans for intra-Node communications encompassing all of the Node's CTPs
should be specified. Diagrams and descriptions of proposed intra-Node
committee structures should be given.
Each applicant must demonstrate the ability to train and maintain the
proficiency of RRTC and CTP personnel to successfully manage treatment and
clinical trials research.
3. Research and Clinical Infrastructures:
The plans should document the availability of appropriate expertise within
the RRTC to design, implement, and analyze the results of proposed trials.
The plans should describe the infrastructure for core functions, which
include but are not limited to managing the participation of CTPs in CTN
activities, staffing technical personnel for protocol design, development and
implementation, and providing resources for and coordination of intra-Node
activities. The plans should also elaborate on the infrastructure
capabilities in research administration, project management, protocol design
and development, quality assurance and regulatory affairs. The plans should
describe the framework and procedures for training and supervision of
treatment providers in the experimental and standard interventions that will
be utilized in the CTN.
Applicants must demonstrate access to diverse racial and ethnic populations
through the aggregate of their proposed community treatment providers.
4. Collaborations between the RRTC and CTPs:
The application should describe the relationships between the CTPs and RRTC.
It should provide detailed descriptions of CTPs that will participate, with
detailed descriptions of each CTP’s characteristics, including patient
population characteristics, patient throughput, types of treatment currently
delivered, and staff number, characteristics, and structure. See outline that
follows this paragraph. Each CTP’s description is limited to two pages of
text. It will be critical for the Node to recruit and retain sufficient CTPs
to participate in multiple simultaneous trials. The possibility of expanding
the number of CTPs should be addressed. The appendix should contain letters
of agreement from CTP directors and tables, as needed, to describe the CTPs.
For each Community Treatment Program (CTP)
1. Name of Organization
2. Address
3. Telephone
4. Fax Number
5. Director/Contact (person who will work with the CTN, serve on
committees, etc.)
6. E-Mail Address of Director/Contact
Characteristics of each CTP to include:
1. Number of clinical sites in organization
2. Static capacity -- at any one time, what is the CTP’s total patient
census?
3. Annual patient admissions by treatment modality
4. Rural or urban -- is the CTP located in a rural or urban community?
5. Clinic patient characteristics:
o Percent Black, African-American
o Percent Hispanic, Latino
o Percent White, Caucasian
o Percent American Indian or Alaskan Native
o Percent Asian or Pacific Islander
6. Gender breakdown of patients -- percent male, percent female
7. Age breakdown of patients -- percent adolescent (under 21), percent
over 65 if known (Medicare)
8. Does this agency serve pregnant women, families with children, etc?
Percent of clients who fall into these categories.
9. What kinds of HIV/HCV services are currently offered? 1) Education and
prevention; 2) testing and counseling; and/or 3) treatment for HIV/HCV
10. Classify the CTP as either ( Drug-Free ) Psychosocial, Methadone (and
Buprenorphine), or both
11. Does the CTP offer behavioral treatment? If so, what types of
treatment are offered? Is treatment provided in individual or group
sessions, or both?
12. Categorize setting as: 1) Outpatient; 2) Residential; 3) Post-
residential; 4) IOP (Intensive Outpatient Treatment); 5) TC
(Therapeutic Community) -- treatment beyond the standard 6-8 week
program; 6) Day care -- all day 8-5, 5 days per week; or 7) Half-way
House
13. Does the CTP treat patients who are classified as co-morbid? (Dually
diagnosed)
14. Are faith-based treatment services part of the program? Please
describe.
15. Primary source of program funding: Patient Fees, Public Insurance,
Public grant or contracts, Private Insurance
16. Any other pertinent characteristics of the CTPs proposed in your grant
An organizational chart to describe the functional structure of RRTC and CTP
personnel in the design and implementation of a variety of clinical research
projects should be provided in the body of the application (i.e., within the
45 pages). An organizational chart and a description of the RRTC operation
should describe the relationship between the research and administrative
functional units within the Node. Evidence of current or previous successful
collaborations with the community treatment programs would be desirable.
In each of these areas, it is crucial that the applicant describe how the
treatment providers will function in true partnership with the RRTC in terms
of research concept origination, protocol design, research project
implementation, and administrative support services. Applicants should
anticipate potential problems and challenges that may arise in this process
and propose mechanisms for collaborative resolution among the Node
participants. The NIH policy regarding consortium agreements must be
considered in describing the relationship between the RRTC and the CTPs.
5. Research Concept:
Applicants should not propose a detailed research protocol, but rather should
provide a specific example of a research concept and an abbreviated plan that
could be undertaken and is consistent with the RFA to take advantage of the
unique capabilities of the CTN, including collaboration across Nodes. The
concept should present a discussion of the types of research questions that
could be addressed, research methods that might be used, and patient
populations that might be employed. Particular emphasis should be placed on
how the applicant proposes to ensure that the RRTC and the CTPs of the Node
will work collaboratively at all levels, and that the Node will be able to
work collaboratively with other Nodes and NIDA in multi-site clinical trials.
It should be understood that the concept example may not necessarily be
implemented in the CTN.
The research plans for the proposed concept should include descriptions of
research study design, interventions, outcome measures, and statistical
considerations; access to appropriate patients; procedures for data
management, a training plan, quality control and follow-up; procedures for
monitoring and reporting adverse events; and information on human subjects
protections. Finally, there should be a cost estimate displayed as a
protocol budget. This concept must include details according to the SOPs
detailed in the following web site. http://www.nida.nih.gov/CTN/policies.html
6. Human Subjects Research (research plan section e):
The application should describe plans for human subject protections, data and
safety monitoring as well as gender and minority information about patient
populations for the CTN Node as a whole.
7. Other:
There should be information on literature cited, contractual arrangements,
etc. as specified in the PHS 398.
Budget
The budget and accompanying justification are not part of the 45 page limit.
Applicants should include budget estimates and plans for participating in the
CTN, organized around the areas of research planning, core functions, RRTC
and CTP collaboration, and administrative and management plans.
The applicant should prepare a separate detailed budget for 1) infrastructure
to enable the RRTC to provide core functions for the Node (e.g., personnel,
facilities, equipment, supplies, training costs, logistic support, travel,
etc.); 2) CTP support to conduct clinical trials; 3) Lead Node
responsibilities for the scientific leadership of research projects. As
noted elsewhere in this RFA, funds for Node travel should be included to
provide for participation in CTN related meetings.
Page Limits
To summarize the guidance above, the total length of the Research Plan,
including the CTP descriptions and research concept and administrative and
management plan should not exceed 45 pages. Descriptions of CTPs should not
exceed 2 pages per program. Descriptions of research concept should not
exceed 10 pages. Literature Cited and Consortium/Contractual Arrangements
sections should be provided following the 45 pages and in total should not
exceed 15 pages.
PEER REVIEW PROCESS
Upon receipt, applications will be reviewed for completeness by the CSR and
responsiveness by NIDA. Incomplete and/or nonresponsive applications will not
be reviewed.
Applications that are complete and responsive to the RFA will be evaluated
for scientific and technical merit by an appropriate peer review group
convened by NIDA in accordance with the review criteria stated below. As
part of the initial merit review, all applications will:
o Undergo a process in which only those applications deemed to have the
highest scientific merit, generally the top half of the applications under
review, will be discussed and assigned a priority score
o Receive a written critique
o Receive a second level review by the National Advisory Council on Drug
Abuse.
REVIEW CRITERIA
The goals of NIH-supported research are to advance our understanding of
biological systems, improve the control of disease, and enhance health. In
the written comments, reviewers will be asked to evaluate the application in
order to judge the likelihood that the proposed research will have a
substantial impact on the pursuit of these goals. The scientific review group
will address and consider each of the following criteria in assigning the
application’s overall score, weighting them as appropriate for each
application.
o Significance
o Approach
o Innovation
o Investigator
o Environment
The application does not need to be strong in all categories to be judged
likely to have major scientific impact and thus deserve a high priority
score. For example, an investigator may propose to carry out important work
that by its nature is not innovative but is essential to move a field
forward.
1. UNDERSTANDING THE CTN
o How well does the proposed Node (i.e., the applicant RRTC and its
affiliated community treatment programs) demonstrate an understanding of the
scientific agenda of the Clinical Trials Network (CTN)?
o To what extent would the proposed Node likely contribute or continue to
contribute to the goals and enhance the capability of a nationwide CTN?
2. ADMINISTRATIVE AND MANAGEMENT PLANS
o How strong are the plans for overall Node management and operations,
including the structure and mechanisms for effective intra-Node communication
and collaboration and involving appropriate personnel in the design and
implementation of protocols?
o How strong are the applicant's previous experience and plans for training
RRTC and community treatment personnel, including therapists and research
associates, in implementing multi-site clinical trials?
o How strong are the plans for effective interaction and coordination with
other Nodes and NIDA?
3. RESEARCH AND CLINICAL INFRASTRUCTURE
o Is there sufficient evidence that the proposed Principal Investigator (PI)
will be (or has devoted) adequate time to carry out the work of the CTN?
(Must be a minimum of 50%)
o How strong are the previous research experience and other qualifications of
the PI and other key staff in design, administration, and management of
multi-site clinical trials, including quality control, quality assurance, and
data management procedures?
o How strong are the qualifications of key personnel and scientific staff in
the areas of the proposed research concept and in the more general skills
needed to develop, conduct, and analyze clinical trials?
o How good are the available resources and proposed personnel for
administering Node participation in clinical trials, including adequacy of
procedures to collect, monitor, and analyze the data and assure the safety of
patients/participants?
o How strong is the evidence of infrastructure capabilities in project
management, protocol development, and knowledge of regulatory affairs?
o How strong is the Node’s capacity to include appropriate representation of
gender, minorities and their subgroups, and subjects with a range of ages
appropriate for the scientific goals of the research?
o How strong is the Node’s capacity to conduct research on HIV/AIDS and
substance abuse?
4. COLLABORATION BETWEEN RRTC AND CTPs
o Is there a record of previous RRTC-CTP collaboration, including orienting
community personnel to protocol requirements, organizing scientific and
educational meetings for those participating in the clinical trials, and
participating in inter-group clinical trials.?
o What is the quality of plans for involving CTPs in the research and
organizational activities of the CTN?
o How well developed are the RRTC's criteria for selecting CTPs with diverse
geographic and population representation (as balanced by constraints of
reasonable management)?
o How good are the quality of the proposed CTPs and the experience of their
program directors?
o To what extent do the proposed CTPs vary programmatically? To what extent
are they able to accrue a demographically diverse patient population?
o How feasible are CTP plans for patient enrollment and retention? How well
do the CTPs demonstrate their ability to accrue patients at an adequate rate
to support multi-site clinical trials?
5. RESEARCH PLANS
o How well does the proposed research concept demonstrate knowledge of state-
of-the-art research designs, methodologies, and operations?
o Does the plan have the potential to produce a major improvement in the
quality and effectiveness of drug treatment?
6. PROGRESS (For competing continuation applications):
Evaluate the adequacy of progress in:
o developing and implementing protocols
o subject accrual and retention
o data management
o evaluation/monitoring of Node activities
o publication/presentation of research findings, and other dissemination of
findings
o level of participation and leadership in CTN-wide protocols
o level of participation and leadership in CTN-wide committees
o assess unique strengths and limitations this node brings to the CTN as a
whole
7. OTHER
In addition to the above criteria, in accordance with NIH policy, all
applications will also be reviewed with respect to the following:
o The adequacy of plans to include both genders, minorities and their
subgroups, and children as appropriate for the scientific goals of the
research.
o Plans for the recruitment and retention of subjects will also be evaluated.
o The adequacy of the proposed protection for humans, animals or the
environment, to the extent they may be adversely affected by the project
proposed in the application.
o The plans for data and safety monitoring will be assessed.
8. BUDGET
o The reasonableness of the proposed budget and duration in relation to the
proposed research.
o How appropriate are the budget estimates for infrastructure to enable the
RRTC to provide core functions for the Node (e.g., personnel, facilities,
equipment, supplies, logistic support, travel)?
o How appropriate are budget estimates for CTP support to conduct the
clinical trials?
o How adequate are plans for budgetary control and oversight?
ADDITIONAL REVIEW CRITERIA: In addition to the above criteria, the following
items will be considered in the determination of scientific merit and the
priority score:
PROTECTION OF HUMAN SUBJECTS FROM RESEARCH RISK: The involvement of human
subjects and protections from research risk relating to their participation
in the proposed research will be assessed. (See criteria included in the
section on Federal Citations, below).
INCLUSION OF WOMEN, MINORITIES AND CHILDREN IN RESEARCH: The adequacy of
plans to include subjects from both genders, all racial and ethnic groups
(and subgroups), and children as appropriate for the scientific goals of the
research. Plans for the recruitment and retention of subjects will also be
evaluated. (See Inclusion Criteria in the sections on Federal Citations,
below).
CARE AND USE OF VERTEBRATE ANIMALS IN RESEARCH: If vertebrate animals are to
be used in the project, the five items described under Section f of the PHS
398 research grant application instructions (rev. 5/2001) will be assessed.
ADDITIONAL REVIEW CONSIDERATIONS
Sharing Research Data:
Applicants requesting more than $500,000 in direct costs in any year of the
proposed research must include a data sharing plan in their application. The
reasonableness of the data sharing plan or the rationale for not sharing
research data will be assessed by the reviewers. However, reviewers will not
factor the proposed data sharing plan into the determination of scientific
merit or priority score.
BUDGET: The reasonableness of the proposed budget and the requested period
of support in relation to the proposed research.
RECEIPT AND REVIEW SCHEDULE
Letter of Intent Receipt Date: September 14, 2004
Application Receipt Date: October 14, 2004
Peer Review Date: December 2004-January 2005
Council Review: May 2005
Earliest Anticipated Start Date: July 2005
AWARD CRITERIA
Award criteria that will be used to make award decisions include:
o Scientific merit (as determined by peer review)
o Availability of funds
o Programmatic priorities, including program balance, ability to use the CTN
as a platform for training clinical researchers and as a platform for other
research (e.g., health services, genetics, and HIV/AIDS), and geographic
representation.
REQUIRED FEDERAL CITATIONS
ANIMAL WELFARE PROTECTION: Recipients of PHS support for activities
involving live, vertebrate animals must comply with PHS Policy on Humane Care
and Use of Laboratory Animals
(http://grants.nih.gov/grants/olaw/references/PHSPolicyLabAnimals.pdf), as
mandated by the Health Research Extension Act of 1985
(http://grants.nih.gov/grants/olaw/references/hrea1985.htm), and the USDA
Animal Welfare Regulations
(http://www.nal.usda.gov/awic/legislat/usdaleg1.htm), as applicable.
HUMAN SUBJECTS PROTECTION: Federal regulations (45CFR46) require that
applications and proposals involving human subjects must be evaluated with
reference to the risks to the subjects, the adequacy of protection against
these risks, the potential benefits of the research to the subjects and
others, and the importance of the knowledge gained or to be gained.
http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm
DATA AND SAFETY MONITORING PLAN: Data and safety monitoring is required for
all types of clinical trials, including physiologic, toxicity, and dose-
finding studies (phase I); efficacy studies (phase II); efficacy,
effectiveness and comparative trials (phase III). The establishment of data
and safety monitoring boards (DSMBs) is required for multi-site clinical
trials involving interventions that entail potential risk to the
participants. (NIH Policy for Data and Safety Monitoring, NIH Guide for
Grants and Contracts, June 12, 1998:
http://grants.nih.gov/grants/guide/notice-files/not98-084.html).
SHARING RESEARCH DATA: Investigators submitting an NIH application seeking
$500,000 or more in direct costs in any single year are expected to include a
plan for data sharing or state why this is not possible.
http://grants.nih.gov/grants/policy/data_sharing Investigators should seek
guidance from their institutions, on issues related to institutional
policies, local IRB rules, as well as local, state and Federal laws and
regulations, including the Privacy Rule. Reviewers will consider the data
sharing plan but will not factor the plan into the determination of the
scientific merit or the priority score.
INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH: It is the policy of
the NIH that women and members of minority groups and their sub-populations
must be included in all NIH-supported clinical research projects unless a
clear and compelling justification is provided indicating that inclusion is
inappropriate with respect to the health of the subjects or the purpose of
the research. This policy results from the NIH Revitalization Act of 1993
(Section 492B of Public Law 103-43).
All investigators proposing clinical research should read the "NIH Guidelines
for Inclusion of Women and Minorities as Subjects in Clinical Research -
Amended, October, 2001," published in the NIH Guide for Grants and Contracts
on October 9, 2001
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html);
a complete copy of the updated Guidelines are available at
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.
The amended policy incorporates: the use of an NIH definition of clinical
research; updated racial and ethnic categories in compliance with the new OMB
standards; clarification of language governing NIH-defined Phase III clinical
trials consistent with the new PHS Form 398; and updated roles and
responsibilities of NIH staff and the extramural community. The policy
continues to require for all NIH-defined Phase III clinical trials that: a)
all applications or proposals and/or protocols must provide a description of
plans to conduct analyses, as appropriate, to address differences by
sex/gender and/or racial/ethnic groups, including subgroups if applicable; and
b) investigators must report annual accrual and progress in conducting
analyses, as appropriate, by sex/gender and/or racial/ethnic group
differences.
INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS:
The NIH maintains a policy that children (i.e., individuals under the age of
21) must be included in all human subjects research, conducted or supported
by the NIH, unless there are scientific and ethical reasons not to include
them.
All investigators proposing research involving human subjects should read the
"NIH Policy and Guidelines" on the inclusion of children as participants in
research involving human subjects that is available at
http://grants.nih.gov/grants/funding/children/children.htm
REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS: NIH
policy requires education on the protection of human subject participants for
all investigators submitting NIH proposals for research involving human
subjects. You will find this policy announcement in the NIH Guide for Grants
and Contracts Announcement, dated June 5, 2000, at
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.
HUMAN EMBRYONIC STEM CELLS (hESC): Criteria for federal funding of research
on hESCs can be found at http://stemcells.nih.gov/index.asp and at
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-005.html. Only
research using hESC lines that are registered in the NIH Human Embryonic Stem
Cell Registry will be eligible for Federal funding (see http://escr.nih.gov).
It is the responsibility of the applicant to provide, in the project
description and elsewhere in the application as appropriate, the official NIH
identifier(s) for the hESC line(s)to be used in the proposed research.
Applications that do not provide this information will be returned without
review.
HIV/AIDS COUNSELING AND TESTING POLICY FOR THE NATIONAL INSTITUTE ON DRUG
ABUSE: Researchers funded by NIDA who are conducting research in community
outreach settings, clinical, hospital settings, or clinical laboratories and
have ongoing contact with clients at risk for HIV infection, are strongly
encouraged to provide HIV risk reduction education and counseling. HIV
counseling should include offering HIV testing available on-site or by
referral to other HIV testing service for persons at risk for HIV infection
including injecting drug users, crack cocaine users, and sexually active drug
users and their sexual partners. For more information see
http://grants.nih.gov/grants/guide/notice-files/NOT-DA-01-001.html.
NATIONAL ADVISORY COUNCIL ON DRUG ABUSE RECOMMENDED GUIDELINES FOR THE
ADMINISTRATION OF DRUGS TO HUMAN SUBJECTS: The National Advisory Council on
Drug Abuse recognizes the importance of research involving the administration
of drugs to human subjects and has developed guidelines relevant to such
research. Potential applicants are encouraged to obtain and review these
recommendations of Council before submitting an application that will
administer compounds to human subjects. The guidelines are available on
NIDA's Home Page at http://www.nida.nih.gov under the Funding, or may be obtained by
calling (301) 443-2755.
PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT: The
Office of Management and Budget (OMB) Circular A-110 has been revised to
provide public access to research data through the Freedom of Information Act
(FOIA) under some circumstances. Data that are (1) first produced in a
project that is supported in whole or in part with Federal funds and (2)
cited publicly and officially by a Federal agency in support of an action
that has the force and effect of law (i.e., a regulation) may be accessed
through FOIA. It is important for applicants to understand the basic scope
of this amendment. NIH has provided guidance at
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.
Applicants may wish to place data collected under this PA in a public
archive, which can provide protections for the data and manage the
distribution for an indefinite period of time. If so, the application should
include a description of the archiving plan in the study design and include
information about this in the budget justification section of the
application. In addition, applicants should think about how to structure
informed consent statements and other human subjects procedures given the
potential for wider use of data collected under this award.
STANDARDS FOR PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION: The
Department of Health and Human Services (DHHS) issued final modification to
the Standards for Privacy of Individually Identifiable Health Information ,
the Privacy Rule, on August 14, 2002. The Privacy Rule is a federal
regulation under the Health Insurance Portability and Accountability Act
(HIPAA) of 1996 that governs the protection of individually identifiable
health information, and is administered and enforced by the DHHS Office for
Civil Rights (OCR).
Decisions about applicability and implementation of the Privacy Rule reside
with the researcher and his/her institution. The OCR website
(http://www.hhs.gov/ocr/) provides information on the Privacy Rule, including
a complete Regulation Text and a set of decision tools on Am I a covered
entity? Information on the impact of the HIPAA Privacy Rule on NIH
processes involving the review, funding, and progress monitoring of grants,
cooperative agreements, and research contracts can be found at
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-03-025.html.
URLs IN NIH GRANT APPLICATIONS OR APPENDICES: All applications and proposals
for NIH funding must be self-contained within specified page limitations.
Unless otherwise specified in an NIH solicitation, Internet addresses (URLs)
should not be used to provide information necessary to the review because
reviewers are under no obligation to view the Internet sites. Furthermore,
we caution reviewers that their anonymity may be compromised when they
directly access an Internet site.
HEALTHY PEOPLE 2010: The Public Health Service (PHS) is committed to
achieving the health promotion and disease prevention objectives of "Healthy
People 2010," a PHS-led national activity for setting priority areas. This
RFA is related to one or more of the priority areas. Potential applicants may
obtain a copy of "Healthy People 2010" at http://www.healthypeople.gov/.
AUTHORITY AND REGULATIONS: This program is described in the Catalog of
Federal Domestic Assistance at http://www.cfda.gov/ and is not subject to the
intergovernmental review requirements of Executive Order 12372 or Health
Systems Agency review. 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 52 and 45 CFR Parts 74 and 92). All
awards are subject to the terms and conditions, cost principles, and other
considerations described in the NIH Grants Policy Statement. The NIH Grants
Policy Statement can be found at
http://grants.nih.gov/grants/policy/policy.htm.
The PHS strongly encourages all grant recipients to provide a smoke-free
workplace and discourage the use of all tobacco products. In addition,
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in
certain facilities (or in some cases, any portion of a facility) in which
regular or routine education, library, day care, health care, or early
childhood development services are provided to children. This is consistent
with the PHS mission to protect and advance the physical and mental health of
the American people.
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