National Institutes of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
UG1 Clinical Research Cooperative Agreements - Single Project
- June 28, 2022 - Notice Announcing Frequently Asked Questions (FAQs) for the Maternal-Fetal Medicine Units Network and Neonatal Research Network Funding Opportunity Announcements. See Notice NOT-HD-22-025
- May 19, 2022 - Notice of Pre-Application Webinars for the Maternal-Fetal Medicine Units Network and Neonatal Research Network Funding Opportunity Announcements. See Notice NOT-HD-22-023
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) invites institutions to submit applications to participate in the Maternal-Fetal Medicine Units (MFMU) Network.
This Funding Opportunity Announcement (FOA) invites applications for MFMU Network Clinical Centers; a separate FOA invites applications for a MFMU Network Data Coordinating Center.
30 days prior to the application due date
| Application Due Dates | Review and Award Cycles | ||||
|---|---|---|---|---|---|
| New | Renewal / Resubmission / Revision (as allowed) | AIDS | Scientific Merit Review | Advisory Council Review | Earliest Start Date |
| August 11, 2022 | August 11, 2022 | Not Applicable | September 2022 | January 2023 | April 2023 |
All applications are due by 5:00 PM local time of applicant organization.
Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.
Not Applicable
It is critical that applicants follow the instructions in the Research (R) Instructions in the SF424 (R&R) Application Guide, except where instructed to do otherwise (in this FOA or in a Notice from NIH Guide for Grants and Contracts).
Conformance to all requirements (both in the Application Guide and the FOA) is required and strictly enforced. Applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV. When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions.
Applications that do not comply with these instructions may be delayed or not accepted for review.
PURPOSE AND OBJECTIVE OF THE NETWORK
The purpose of the Maternal-Fetal Medicine Units (MFMU) Network is to improve obstetric care, pregnancy health, and outcomes for pregnant and lactating people and their babies. This includes finding ways to: reduce maternal mortality, complications, and morbidities related to pregnancy, labor, and post-partum recovery; reduce prematurity, low-birth weight, infant mortality, and morbidities; and expand the evidence base about the safety and efficacy of therapeutic products used during pregnancy and lactation. NICHD expects the MFMU Network to be its primary and first-line infrastructure involved in implementing multi-site obstetric clinical trials.
As such, the MFMU Network helps address several Congressional and public health goals:
- The Prematurity Research Expansion and Education for Mothers Who Deliver Infants Early (PREEMIE) Act (Public Law 109-450) was passed originally in 2006 and reauthorized in 2018 (Public Law 115-328) to: (1) reduce rates of preterm labor and delivery, (2) work toward an evidence-based standard of care for pregnant people at risk of preterm labor or other serious complications, and for infants born preterm, and (3) reduce infant mortality and disabilities caused by premature birth.
- The Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC), established under the 21st Century Cures Act (Public Law No: 114-255), recommended that the Secretary of Health and Human Services increase the quantity, quality, and timeliness of research on safety and efficacy of therapeutic products used by pregnant women and lactating women.
- Ongoing and potential future public health crises that impact the health of pregnant people and/or their infants, such as the COVID epidemic, Zika epidemic, and the Opioids crisis.
The MFMU Network will also help NICHD address its Strategic Plan 2020, specifically for: Theme 3, Setting the Foundation for Healthy Pregnancies and Lifelong Wellness; Theme 4, Improving Child and Adolescent Health; and Theme 5, Advancing Safe and Effective Therapeutics and Devices for Pregnant and Lactating Women, Children, and People with Disabilities.
The objective of the MFMU Network, therefore, is to conduct definitive, rigorous, and reproducible, multi-site clinical trials and observational studies in pregnant and lactating people, providing evidence to guide obstetrics, obstetric pharmacology, and lactation clinical practice. This Network of research institutions will work collaboratively to implement common protocols to enroll and follow-up enough patients to achieve statistical power to answer protocol hypotheses more rapidly and definitively than individual centers acting alone.
Study designs may include, but are not limited to: investigational new drug or device, comparative effectiveness, and management trials; biomarker validation studies that are immediately preparatory to trials; and observational studies. Studies may assess both short-term (clinical) and long-term maternal and infant/child outcomes. The Network may conduct Phase 3 pharmacologic research to address gaps in knowledge for the use of drugs and therapeutics during pregnancy and lactation both therapeutics designed to treat pregnancy and lactation complications and therapeutics for other health issues that people may need to use during pregnancy and post-partum. Phase 1 and 2 trials will generally be conducted outside of this Network, but may be considered on a case-by-case basis (e.g., for trials in rare conditions). When relevant and appropriate, NICHD encourages the inclusion of genomic and proteomic studies, sub-studies, and/or collection of related biospecimens for such research. Examples of studies conducted in the Network can be found at: https://mfmunetwork.bsc.gwu.edu/PublicBSC/MFMU/MFMUPublic/research-projects.
The Network will also be uniquely poised to collaborate on studies and projects with other networks and initiatives such as the NICHD Neonatal Research Network, the NICHD Maternal and Pediatric Precision in Therapeutics (MPRINT) initiative, the NIH Helping to End Addiction Long-term (HEAL) Initiative, the NIH Researching COVID to Enhance Recovery (RECOVER) Initiative, the Foundation for the NIH, and other NIH institutes and Federal agencies, such as the Centers for Disease Control and Prevention.
GUIDING PRINCIPLES OF NICHD-SUPPORTED MULTI-SITE CLINICAL RESEARCH
In 2019 the Director of the NICHD, Dr. Diana Bianchi, outlined four guiding principles shaping the 21st century landscape of NICHD-supported multi-site clinical research (see NOT-HD-19-034, Infrastructure for NICHD Multisite Clinical Trials; NOT-HD-19-041, Request for Information on the NICHD Vision for Multisite Clinical Trials Infrastructure; a recorded webinar by Dr. Bianchi outlining NICHD's vision for multi-site clinical research infrastructure; a summary of the concept clearance to the National Advisory Child Health and Human Development Council; and the 2020 NICHD Strategic Plan):
- Enhancing rigor and reproducibility
- Promoting greater availability of multisite clinical trial infrastructure to support trials from a wider range of investigators
- Facilitating data sharing and access to biospecimens
- Facilitating greater involvement of diverse populations in multisite clinical trials.
All institutions participating in the Network will be expected to align with these goals as a condition of inclusion.
- Enhancing rigor and reproducibility
NICHD will develop new peer-reviewed protocol proposal and selection processes to increase transparency and rigor of Network study selection. With rare exceptions, all proposed trials to be conducted within the Network infrastructure will be submitted as individual NIH applications, will undergo NIH peer review, and funding decisions will be made by NICHD. During the next project period, the NICHD expects the Network will conduct approximately 5-10 trials. Studies may start and end at different times with some conducted simultaneously. The exact number of protocols supported will depend on the nature and extent of the investigations proposed and the availability of funds. The areas of study will be expanded to cover the research needs identified by Congress, the NICHD Strategic Plan, and the Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC) recommendations, as well as public health crises affecting pregnancy and lactation.
- Promoting greater availability of multisite clinical trial infrastructure to support trials from a wider range of investigators
To facilitate implementation of this guiding principle, investigators from outside the core Network will be encouraged to propose studies to be conducted in the Network. Investigators from Network Clinical Centers (CCs) will also propose studies via the new peer-reviewed proposal process. To be considered, these studies will need to align with the purpose and objectives of the Network and NICHD priorities and are dependent on funding availability. In addition, NICHD will develop new protocol proposal and selection processes to increase transparency and rigor of study selection. Network Policies and Procedures that govern Network structure and activities are posted on a public facing website. A Principal Investigator (PI) from outside investigator institutions that successfully competes for a trial award will become an adjunct PI, and they may also oversee an adjunct clinical center (adjunct CC) for the purposes of the awarded trial only.
- Facilitating data sharing and access to biospecimens
The Network, including all participating recruiting sites for each protocol, will be required to share data and any remaining biospecimens. The Network will abide by the NIH Policy for Data Management and Sharing, as amended, effective January 2023 that shared scientific data should be made accessible as soon as possible, and no later than the time of an associated publication, or the end of the award/support period, whichever comes first.
For Network studies and/or sub-studies that collect biospecimens, after completion and publication of the main analysis for which they are collected, any remaining biospecimens will be made available for sharing via the NICHD Data and Specimen Hub (DASH) or another NIH-approved system. These remaining specimens may be stored in the NICHD biospecimen repository, with the approval of NICHD, depending on funding availability.
Study consent forms must include appropriate language to allow broad sharing and future use of study data and biospecimens in alignment with Federal and local regulations and policies.
A major opportunity for the Network is to coordinate data across NICHD-funded perinatal research. This may incorporate new methods, including collecting patient-reported outcomes and/or electronic health record data in large, pragmatic clinical trials. In addition, comparison of results across similar studies in metadata analyses will increase the value of collected data and the contributions of participants. Finally, the use of Common Data Elements (CDEs) will be a priority of Network studies to ensure uniform collection of demographic, clinical, imaging, and biological data among studies inside and outside the Network, where appropriate. If relevant CDEs have not been developed, Network PIs may collaborate with NIH staff to develop them.
- Facilitating greater involvement of diverse populations in multisite clinical trials.
Large health disparities exist between different U.S. racial and ethnic groups, including in maternal and infant mortality and morbidity. Network trials will be expected to maximize inclusion of diverse study participants including underserved persons with disabilities, low socio-economic status, sexual/gender minorities (lesbian, gay, bisexual, and transgender populations, as well as those whose sexual orientation, gender identity and expressions, or reproductive development varies from traditional, societal, cultural, or physiological norms), and/or racial/ethnic minorities. Inclusion of these populations will help make Network study results more generalizable across racial/ethnic groups and support health equity for all persons. In addition, it is an NIH priority to develop diversity in the workforce (see Notice of NIH’s Interest in Diversity, NOT-OD-20-031); as such, NICHD encourages applications from Network Center and protocol PIs and Co-PIs from diverse populations. Ensuring diverse populations in multi-site clinical trials among both investigators and participants will be a high priority for Program staff.
To help with this, the Network and NICHD staff will consult with the NICHD Office of Health Equity, NICHD’s STrategies to enRich Inclusion and achieVe Equity (STRIVE) Initiative, and the NIH Tribal Health Research Office to facilitate greater involvement of these diverse populations in Network studies. Such consultations may be done Network-wide, for specific studies, and/or with specific recruiting sites, as needed.
NETWORK STRUCTURE, ROLES, AND RESPONSIBILITIES
The MFMU Network consists of perinatal Clinical Centers (CCs) and a Data Coordinating Center (DCC). The current MFMU Network includes 12 institution grants (the awardee institution is the main center; the CC refers to the entire set of sites under one award); the number of CCs awarded under this RFA will depend on the number of meritorious applications and available funding.
Each CC may partner with additional satellite sites (clinics, hospitals, and/or other academic institutions) that will recruit study participants and/or implement protocols (e.g., conduct follow-up examinations).
It is each institution’s responsibility to:
- Meet, and continue to meet, the requirements outlined in this RFA and the Notices of Grant Award. This includes having adequate and qualified staff, facilities, and equipment available, and supervision to oversee its staff and that of any satellite sites to conduct Network protocols in a safe and effective manner.
- Abide by Federal, state, and local laws and regulations, including those of the Common Rule and the U.S. Food and Drug Administration (FDA), as applicable.
- Participate in a cooperative and interactive manner with the other Network PIs, NICHD staff, and with non-network study investigators and recruiting sites.
- Follow all Network policies and procedures. By accepting the Notice of Grant Award, each successful Awardee agrees to abide by the Network’s Policies and Procedures and adhere to Network study protocols.
The Network operational structure includes the following groups:
- Steering Committee
- Data and Safety Monitoring Committee
- External Scientific Committee
- Community Engagement Board.
Steering Committee (SC)
The Steering Committee consists of:
- Principal investigators from each Clinical Center (one vote per center; multi-PI applications are allowed, but each award will only get one vote on the SC)
- Principal investigator from the Data Coordinating Center (voting member)
- NICHD Project Scientist (voting member)
- Adjunct principal investigator for any non-Network trial (one vote for that specific trial only)
- Steering Committee chairperson, appointed by the Director of NICHD (tie-breaking vote only).
The Steering Committee has the primary responsibility for implementing the objectives of the Network, including identifying areas of potential research, developing and implementing Network protocols, and analyzing and publishing study results. The SC meets 4 times per year and has monthly teleconferences. All SC members or their designees are expected to attend these meetings. At least two meetings per year are expected to be face-to-face (weather and public health permitting), usually in the Washington, DC metro area. In general, SC meetings last for 2-3 days each, and are scheduled 12-18 months in advance. Network PIs and coordinators are expected to attend the quarterly meetings.
The Steering Committee may create subcommittees to manage specific Network functions. These include, but are not limited to:
- Protocol Development Subcommittee
- Publications Subcommittee
- Concurrent Research Subcommittee
- Protocol subcommittees and/or working groups for each study being implemented and/or under development.
Data and Safety Monitoring Board (DSMB)
A Data and Safety Monitoring Board (DSMB) will be established in accordance with the NICHD DSMB Policy for Clinical Trials to monitor all Network clinical trials, as well as observational studies or sub-studies that involve more than minimal risk to participants. Full members of the DSMB cannot be from any of the Network CCs, their satellite-sites, or the DCC; the DCC PI is an ex officio member, providing statistical reports for DSMB review and logistical support for DSMC meetings. The DSMB is responsible for safeguarding the interests of study participants and protecting study participants from unacceptable risk. The DSMB provides recommendations to the NICHD Director and Network investigators on research design, data quality, and analysis issues, as well as conducting interim monitoring of trials for safety, efficacy, feasibility, and ethical conduct.
External Scientific Committee
An External Scientific Committee, a group of outside experts who provide feedback on protocols, feasibility assessments, and prioritization of protocols to the Network investigators and to the NICHD, as needed, will be established. They may also review applications from external sites that apply to join Network studies as single-trial sites. This committee will be formed as a collaborative effort with NICHD staff who will ultimately approve its membership.
Community Engagement Board
The Network will be expected to interact with a Community Engagement Board. This will be a group of lay community members who have interest and/or experience in maternal-fetal medicine conditions. The objective is to assure that Network research is relevant and sensitive to the needs and concerns of the communities served. Examples of services that may be provided by this Board include, but are not limited to, providing input on maternal-fetal research outcomes of most interest to patients and families, as well as sharing feedback on consent forms and processes. This Board will be formed as a collaborative effort with NICHD staff who will ultimately approve its membership.
Single Investigational Review Board (sIRB)
Per NIH policy, all new Network studies will use a single Investigational Review Board (sIRB). This sIRB can either be at a Network Clinical Center (e.g., via a SMART IRB), the DCC, or via a commercial IRB. sIRB costs will be covered via protocol study funding, and do not need to be included in the budget for this RFA. Ideally, the same IRB will be used for all/most studies to maximize efficiency and consistency of protocol implementation. The DCC will have a central role in establishing, coordinating with, and providing logistical support to the sIRB.
Clinical Centers (CCs)
The CCs are expected to participate collaboratively on the Steering Committee to achieve the Network’s objectives. The CC’s specific objective is to develop and implement Network protocols even those approved, but proposed by non-Network investigators, including recruiting study participants, implementing study interventions, conducting required follow-up examinations, and working together to publish study results. CC's may also be able to engage in training opportunities.
As such, CCs are responsible for:
- Identifying areas for potential Network research.
- Collaborating with study investigators both within and outside the Network in developing Network protocols and budgets for NIH grant submission and/or funding approval.
- Participating in the development and implementation of Network protocols, whether the PI is from within the Network or a non-Network PI.
- Implementing funded Network studies, including meeting recruitment goals based on information provided at the time of application, with minimal protocol violations/deviations, and completing any protocol follow-up activities.
- Collecting and transmitting study data to the Data Coordinating Center in an accurate and timely manner.
- Overseeing and monitoring the participation of any satellite sites within the CC. The productivity of the satellite sites will be considered part of the CC’s contribution to the Network.
- Collaborating in data analyses and publication of results.
A typical CC in the Network is generally a regional academic medical center or tertiary care facility, capable of providing research support and supervision for any satellite sites. CCs may choose to partner with additional geographically or organizationally linked satellite sites, particularly to access participant populations not traditionally cared for at the CC. Single, large volume, delivery centers are preferred over multi-site arrangements with smaller centers. CCs are expected to have a minimum of 3,000 deliveries per year, at least 30 percent of which must be high-risk pregnancies.
CCs are expected to participate in all approved Network studies, (including those proposed by non-Network PIs), unless they do not have the relevant eligible population (e.g., opioid-addicted patients), or have an ongoing local study that conflicts with a Network study that is identified in its application. Centers agree to prioritize Network studies over other studies, including other NIH-funded studies, for subject recruitment.
Each CCs will be required to set up appropriate master agreements (memoranda of understanding, subcontracts, data use agreements, etc.) with the DCC and/or adjunct CCs to enable transfer of earned capitation funds and study data for all Network protocols between the CC and those entities. CCs are responsible for setting up similar agreements and/or mechanisms with each of their satellite sites, as needed.
Each CC will have the following Network staff:
- Principal Investigator (PI)
- Co-PI/Alternate PI
- Research Coordinator
- Data entry personnel
CC Principal Investigator
The PI participates, with the other CC PIs, the DCC PI, and the NICHD Project Scientist as a member of the Network Steering Committee, with each CCgetting one vote. If a CC proposes multiple PIs, it will need to designate which PI will be the attending and voting member on the Steering Committee.
The PI’s responsibilities include:
- Ensuring that the research is conducted in accordance with all applicable federal regulations and guidelines, such as from the NIH, FDA, and Office for Human Research Protections (OHRP).
- Obtaining and maintaining required IRB approvals and reliance agreements. Ensuring that the necessary financial arrangements and federal assurances are in place before participation and during study implementation. This includes submitting required documentation for IRB approvals/renewals to the DCC, and notifying NICHD and the DCC in a timely manner of any suspensions, changes, and other activities affecting study integrity and recruitment.
- Reporting serious adverse events and/or protocol deviations to the DCC, medical monitor, and/or NICHD Project Scientist within required timeframes.
- Ensuring collection and transmission of accurate data to the DCC in a timely manner.
- Participating in Network quality assurance efforts, including cooperating during site visits and responding promptly to DCC inquiries.
- Hiring and supervising qualified study personnel, verifying staff qualifications and required training certifications, and reporting these to the DCC, as needed for protocol implementation. Notifying NICHD and the DCC of any staff changes in a timely manner.
- Securing the cooperation of his/her/their institution and colleagues in Network research efforts. Communicating with CC and satellite site staff on ongoing and upcoming protocols and opportunities to build buy-in, identify potential feasibility issues, and manage issues related to protocol equipoise.
- Communicating Network activities and issues to CC research staff, and any satellite sites, in a timely fashion, including issues affecting day-to-day operations of Network protocols.
- Attending, or designating another CC staff member to attend, all Steering Committee meetings and teleconferences and the subcommittee meetings of which they are a member.
- For sites that are also members of the NICHD Neonatal Research Network (NRN), communicating with the NRN PI, reviewing ongoing and planned research of the two Networks to alert staff to potential conflicts, collaborating on areas of common interest, and offering advice within the primary areas of expertise.
Co-Principal Investigator
Each institution must also designate a Co-Principal Investigator (Co-PI) or Alternate PI to act as the CC PI whenever he/she/they is not available. As acting, the Co-PI should have full authority and ability to act in the PI’s stead, including attending required Network meetings and/or teleconferences, voting on Steering Committee and subcommittee issues, and having full access to Network records. Ideally, the Co-PI is a partner to the PI and is designated to take on some of the PI’s responsibilities, in whole or in part.
Research Coordinator
Each CC will also appoint one research coordinator to oversee the conduct of Network clinical trials. Under the direction of the PI, the Research Coordinator is responsible for ensuring the successful conduct and coordination of Network protocols.
The Research Coordinator is responsible for:
- Assisting in the day-to-day operations of implementing Network protocols, including adhering to protocols, collecting data, supervising data transmission, monitoring data quality, training staff, procuring study equipment and supplies, and liaising with follow-up clinic staff to ensure appropriate study participant follow-up.
- Maintaining routine data quality assurance methods for staff under his/her/their supervision and assisting the PI with quality assurance at the CC and all of its satellite sites.
- Supervising data entry activities, including instructing and certifying data entry personnel in software and hardware usage.
- Maintaining a central file of protocols, manuals, data forms, regulatory documents, network correspondence, and performance reports in accordance with Good Clinical Practice (GCP).
- Collaborating with the PIs (including non-Network PIs) and DCC in developing protocols, manuals of operation, and data collection forms. Assisting in answering Network queries for information, such as those needed to inform protocol development and improve protocol implementation.
- Attending at least two Steering Committee meetings per year, the monthly Coordinator conference call, and the meetings of any subcommittees of which they are a member.
The Research Coordinator supervisory duties should require no more than half time; the remainder of efforts should be devoted to Network subject recruitment and day-to-day site needs and administrative issues, including IRB submissions and renewals, SC attendance, site visits, training sessions, protocol development, participation in conference calls, etc., as well as CC data collection as required.
Data entry personnel
Data entry personnel are responsible for entering data and preparing and uploading documentation into Network data management system(s) in a timely manner.
Personnel conducting data abstracts from the medical records should have relevant medical expertise and training in the Network protocols, manuals, and forms and in the hospital medical records (electronic and hard copy). Appropriate supervision and oversight are required to ensure high data quality.
Data Coordinating Center (DCC)
The DCC is expected to participate collaboratively on the Steering Committee to achieve the Network’s objectives. As such, the DCC’s specific objective is to develop, implement, and analyze results for Network protocols, especially providing biostatistical expertise, computer programming, and project management to design protocols, develop statistical analysis plans, develop data management systems, manage study funds, monitor data integrity and study safety, and work with study investigators to analyze and publish study results. The DCC is responsible for:
- Collaborating with study investigators both within and outside the Network in developing Network protocols and budgets for NIH grant submission and/or funding approval.
- Supporting Network protocol design, training, implementation, and study monitoring. The DCC works with study investigators to design protocols, including developing statistical analysis plans, power analyses, and study budgets. As part of this, the DCC and the study team will review available NIH Common Data Elements (CDEs) and include them in Network studies, as appropriate, to ensure data harmonization with uniform collection of demographic, clinical, imaging, and biological data to the extent feasible. If relevant CDEs have not been developed, the DCC and study investigators may collaborate with NIH staff to develop them. In addition, the DCC may coordinate external services, including procuring study drugs, equipment, and other supplies, implementing masking and randomization methods, and executing subcontracts, such as for additional recruiting sites, vendor services for diagnostic tests, specimen analyses, etc., and consultancy agreements with outside experts.
- Coordinating closely with and/or managing the Network sIRB(s) to obtain and maintain IRB approvals and continuing renewals for all studies and ensure all recruiting sites have appropriate reliance agreements in place.
- Providing data management, including developing protocol manuals and forms, programming data management systems, and preparing reports for the DSMB, the FDA, the SC, Network subcommittees, CCs, and NICHD/NIH.
- Conducting statistical analyses of study data for interim monitoring, final results, and secondary data analyses, and collaborating with study investigators to publish results of Network trials and studies in a timely and accurate manner.
- Sponsoring (or sharing sponsorship obligations with NICHD and/or other institutions for) FDA Investigational New Drug (IND) and Investigational Device Exemption (IDE) applications on behalf of the Network, as needed, such as submitting and/or providing support for FDA-required reports.
- Managing study ( capitation ) funds, disbursing payments to CCs and non-Network recruiting sites based on enrolled patients and other study-specific milestone triggers specified in the study protocols and budgets. Working with NICHD Program Staff to develop a detailed financial reporting system, reporting at least quarterly and/or as needed on capitation budget expenditures and projections through the anticipated protocol end dates.
- Managing Network-wide reporting and data and specimen sharing requirements, including, but not limited to: submitting annual data to the NIH Human Subject System; creating and updating ClinicalTrials.gov records for all Network studies, including reporting study results within required timeframes; fulfilling Network Data Sharing requirements by preparing and submitting study data and documentation to NIH-approved data repositories; and submitting, or managing the submission of, remaining biospecimens to a NIH-approved specimen repository.
- Providing the logistical support necessary to run an efficient and productive network, including video/teleconference support, meeting facilitation, and taking meeting minutes. The DCC also creates and maintains a Network website that includes both public-facing pages about the Network and its studies, and private/investigator-only pages to facilitate Network communication (i.e., to distribute study documents to the Network).
As with the CCs, the DCC will be required to set up appropriate master agreements (memoranda of understanding, subcontracts, data use agreements, etc.) with each CC, adjunct CC, and/or single-trial sites to enable transfer of earned capitation funds and study data for all Network protocols between the DCC and each site.
The DCC will have the following categories of personnel:
- Principal Investigator
- Co-PI/Alternate PI
- Statisticians
- Research Coordinators and/or Project Assistants
- Programming staff
- Logistics and support staff
The DCC should have some degree of flexibility in staffing to be able to respond to changing work effort needs (i.e., changing number and complexity of protocols in various stages of development and implementation, submission deadlines for major conferences, etc.).
Additional details about the DCC can be found in RFA-HD-23-017 Maternal-Fetal Medicine Units (MFMU) Network: Data Coordinating Center.
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
NICHD provides funding to each CC and the DCC through Clinical Research Cooperative Agreements. NICHD uses this assistance mechanism when it anticipates its scientific and/or programmatic staff will need to have substantial involvement with the awardee(s) during performance of clinical research. The NICHD Program Staff will assist Network PIs in identifying research topics of high priority and in designing and implementing protocols in the areas targeted for research.
The NICHD’s Office of Clinical Research (OCR) staff, Program Official, and Grants Management will be responsible for overall grant stewardship. The Program Official, or his/her/their designee, will serve as the NICHD representative on the Network’s DSMB in the manner delineated in the NICHD Data and Safety Monitoring Policy. A NICHD Project Scientist will be involved substantially with the awardees, serving as NICHD’s voting representative on the Steering Committee, and working with investigators to design and implement protocols and analyze results. A Clinical Trials Specialist or Program Analyst will work with the Program Official and Project Scientist to help coordinate Network management. The NICHD’s Office of Clinical Research (OCR) will work with NICHD Program Staff to develop efficiencies, support Network stewardship, and provide policy guidance. OCR staff may attend SC and subcommittee/working group meetings as observers.
Independent of the governance above, the NICHD Director retains responsibility for all NICHD funded research. The NICHD Director receives the DSMB’s recommendations on whether Network studies should be continued or terminated and can make an independent decision on how to proceed. The NICHD Director can override the decisions of the Steering Committee when it is in the strategic interest of the NIH/NICHD, human subject protection, and/or dependent on funding availability.
NETWORK PROTOCOL SELECTION PROCESS
Funds to implement individual protocols in the Network will be awarded via applications under separate funding opportunity announcements and/or administrative supplements in certain cases at NICHD discretion. For any issued FOAs, protocol proposals may be submitted from investigators inside or outside the Network and/or from small businesses or industry (with appropriate agreements in place between all parties). Network investigators are strongly encouraged to submit protocols.
As part of this process, Network investigators will be expected to collaborate with investigative teams from outside institutions both in a pre-application process to assess feasibility and design protocols for submission to NICHD/NIH peer review, and post-award to develop final protocols, manuals, and forms and conduct the awarded protocols in the Network. Clinical Centers will be expected to collaborate with investigator teams from outside institutions (adjunct CCs) who have successfully competed for NIH-funded clinical trial awards to be conducted in the Network.
Funding for protocol implementation costs (capitation and study-specific costs) will be distributed via master agreements for capitation earned and study implementation costs to the CCs and non-Network recruiting sites, generally on a per-patient basis, according to protocol budgets and submission of protocol data.
Additional external single-trial sites may be added as recruiting sites to Network protocols, when needed, for instance, for studies of rare diseases or conditions. To the extent practicable, single-trial sites will undergo a competitive peer-reviewed process (i.e., solicited by a Request for Proposals via the DCC). Such sites may be added as subcontractors/sub-grantees to the DCC.
INITIAL NETWORK ACTIVITIES POST AWARD
Year One activities may include refining Network policies and procedures, establishing committees and committee membership, and developing protocols for submission to the anticipated Protocol FOA or other funding opportunity announcements. New procedures for collaborating with non-Network investigators may need to be developed. Any changes to the policies and procedures must comply with current NIH policies and guidance and may require NICHD approval.
Ongoing studies in the MFMU Network
The following ongoing Network studies are still recruiting new participants as of the issuance of this RFA. Successful CC's awarded through this FOA may be asked to join these studies if they are still recruiting at the time of grant award (NOTE: capitation costs for these studies should not be included in this budget they will be awarded to the DCC award separately, as needed):
- Pessary and Progesterone for Preterm Prevention in Twin Gestation with a Short Cervix (PROSPECT) (NCT02518594). A randomized controlled trial of 630 women with a twin gestation and ultrasound evidence of short cervical length, randomized to one of three arms: (1) 200mg micronized progesterone daily; (2) placebo; or (3) Arabin cervical pessary.
- Activity in Women At Risk for Early delivery (AWARE). A secondary protocol to the TOPS trial evaluating if activity level is associated with prolonging of gestational duration.
- Continuous Positive Airway Pressure (CPAP) for Sleep Apnea in Pregnancy (SLEEP) (NCT03487185). A randomized controlled trial of 2,700 women to assess whether treatment of obstructive sleep apnea with CPAP in pregnancy will result in a reduction in the rate of hypertensive disorders of pregnancy.
- Post-Acute Sequelae of SARS-CoV-2 in Pregnant Patients and Their Offspring (PASC-PREG). This study will conduct longitudinal follow-up of GRAVID participants to determine the prevalence and natural history of Post-Acute Sequelae of SARS-CoV-2 in Pregnant Patients and Their Offspring.
See Section VIII. Other Information for award authorities and regulations.
Cooperative Agreement: A support mechanism used when there will be substantial Federal scientific or programmatic involvement. Substantial involvement means that, after award, NIH scientific or program staff will assist, guide, coordinate, or participate in project activities. See Section VI.2 for additional information about the substantial involvement for this FOA.
Renewal
The OER Glossary and the SF424 (R&R) Application Guide provide details on these application types. Only those application types listed here are allowed for this FOA.
Optional: Accepting applications that either propose or do not propose clinical trial(s).
The number of awards is contingent upon NIH appropriations and the submission of a sufficient number of meritorious applications. NIH intends to fund Clinical Center awards, corresponding up to a total of $5,200,000, for fiscal year 2023. Future year amounts will depend on annual appropriations.
A maximum of $220,000 per year in direct costs may be requested.
The maximum project period is 7 years
NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made from this FOA.
1. Eligible Applicants
Higher Education Institutions
- Public/State Controlled Institutions of Higher Education
- Private Institutions of Higher Education
The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education:
- Hispanic-serving Institutions
- Historically Black Colleges and Universities (HBCUs)
- Tribally Controlled Colleges and Universities (TCCUs)
- Alaska Native and Native Hawaiian Serving Institutions
- Asian American Native American Pacific Islander Serving Institutions (AANAPISIs)
Nonprofits Other Than Institutions of Higher Education
- Nonprofits with 501(c)(3) IRS Status (Other than Institutions of Higher Education)
- Nonprofits without 501(c)(3) IRS Status (Other than Institutions of Higher Education)
For-Profit Organizations
- Small Businesses
- For-Profit Organizations (Other than Small Businesses)
Local Governments
- State Governments
- County Governments
- City or Township Governments
- Special District Governments
- Indian/Native American Tribal Governments (Federally Recognized)
- Indian/Native American Tribal Governments (Other than Federally Recognized)
Federal Government
- Eligible Agencies of the Federal Government
- U.S. Territory or Possession
Other
- Independent School Districts
- Public Housing Authorities/Indian Housing Authorities
- Native American Tribal Organizations (other than Federally recognized tribal governments)
- Faith-based or Community-based Organizations
- Regional Organizations
Non-domestic (non-U.S.) Entities (Foreign Institutions) are not eligible to apply.
Non-domestic (non-U.S.) components of U.S. Organizations are not eligible to apply.
Foreign components, as defined in the NIH Grants Policy Statement, are not allowed.
Applicant organizations
Applicant organizations must complete and maintain the following registrations as described in the SF 424 (R&R) Application Guide to be eligible to apply for or receive an award. All registrations must be completed prior to the application being submitted. Registration can take 6 weeks or more, so applicants should begin the registration process as soon as possible. The NIH Policy on Late Submission of Grant Applications states that failure to complete registrations in advance of a due date is not a valid reason for a late submission.
- System for Award Management (SAM) Applicants must complete and maintain an active registration, which requires renewal at least annually. The renewal process may require as much time as the initial registration. SAM registration includes the assignment of a Commercial and Government Entity (CAGE) Code for domestic organizations which have not already been assigned a CAGE Code.
- NATO Commercial and Government Entity (NCAGE) Code Foreign organizations must obtain an NCAGE code (in lieu of a CAGE code) in order to register in SAM.
- Unique Entity Identifier (UEI)- A UEI is issued as part of the SAM.gov registration process. SAM registrations prior to fall 2021 were updated to include a UEI. For applications due on or after January 25, 2022, the UEI must be provided on the application forms (e.g., FORMS-G); the same UEI must be used for all registrations, as well as on the grant application.
- Dun and Bradstreet Universal Numbering System (DUNS) Organization registrations prior to April 2022 require applicants to obtain a DUNS prior to registering in SAM. By April 2022, the federal government will stop using the DUNS number as an entity identifier and will transition to the Unique Entity Identifier (UEI) issued by SAM. Prior to April 2022, after obtaining a DUNS number, applicants can begin both SAM and eRA Commons registrations. The same DUNS number must be used for all registrations, as well as on the grant application.
- eRA Commons - Once the unique organization identifier (DUNS prior to April 2022; UEI after April 2022) is established, organizations can register with eRA Commons in tandem with completing their full SAM and Grants.gov registrations; all registrations must be in place by time of submission. eRA Commons requires organizations to identify at least one Signing Official (SO) and at least one Program Director/Principal Investigator (PD/PI) account in order to submit an application.
- Grants.gov Applicants must have an active SAM registration in order to complete the Grants.gov registration.
Program Directors/Principal Investigators (PD(s)/PI(s))
All PD(s)/PI(s) must have an eRA Commons account. PD(s)/PI(s) should work with their organizational officials to either create a new account or to affiliate their existing account with the applicant organization in eRA Commons. If the PD/PI is also the organizational Signing Official, they must have two distinct eRA Commons accounts, one for each role. Obtaining an eRA Commons account can take up to 2 weeks.
Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the Program Director(s)/Principal Investigator(s) (PD(s)/PI(s)) is invited to work with his/her organization 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 support. See Notice of NIH’s Interest in Diversity, NOT-OD-20-031. See, Reminder: Notice of NIH's Encouragement of Applications Supporting Individuals from Underrepresented Ethnic and Racial Groups as well as Individuals with Disabilities, NOT-OD-22-019.
For institutions/organizations proposing multiple PDs/PIs, visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the SF424 (R&R) Application Guide.
2. Cost Sharing
This FOA does not require cost sharing as defined in the NIH Grants Policy Statement.
3. Additional Information on Eligibility
Number of Applications
Only one application per institution (normally identified by having a unique DUNS number or NIH IPF number) is allowed.
The NIH will not accept duplicate or highly overlapping applications under review at the same time, per 2.3.7.4 Submission of Resubmission Application. This means that the NIH will not accept:
- A new (A0) application that is submitted before issuance of the summary statement from the review of an overlapping new (A0) or resubmission (A1) application.
- A resubmission (A1) application that is submitted before issuance of the summary statement from the review of the previous new (A0) application.
- An application that has substantial overlap with another application pending appeal of initial peer review (see 2.3.9.4 Similar, Essentially Identical, or Identical Applications).
1. Requesting an Application Package
The application forms package specific to this opportunity must be accessed through ASSIST, Grants.gov Workspace or an institutional system-to-system solution. Links to apply using ASSIST or Grants.gov Workspace are available in Part 1 of this FOA. See your administrative office for instructions if you plan to use an institutional system-to-system solution.
2. Content and Form of Application Submission
It is critical that applicants follow the instructions in the Research (R) Instructions in the SF424 (R&R) Application Guide except where instructed in this funding opportunity announcement to do otherwise. Conformance to the requirements in the Application Guide is required and strictly enforced. Applications that are out of compliance with these instructions may be delayed or not accepted for review.Letter of Intent
Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows IC staff to estimate the potential review workload and plan the review.
By the date listed in Part 1. Overview Information, prospective applicants are asked to submit a letter of intent that includes the following information:
- Descriptive title of proposed activity
- Name(s), address(es), and telephone number(s) of the PD(s)/PI(s)
- Names of other key personnel
- Participating institution(s)
- Number and title of this funding opportunity
The letter of intent should be sent to:
Nahida Chakhtoura, M.D.
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-435-6872
Email: [email protected]
All page limitations described in the SF424 Application Guide and the Table of Page Limits must be followed.
The following section supplements the instructions found in the SF424 (R&R) Application Guide and should be used for preparing an application to this FOA.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
Other Attachments
Attachment 1. Populations Available for Network Studies
Provide a summary of the CC’s obstetric patient population as a pdf attachment using the filename Attachment 1. Populations Available for Network Studies . Successful applicants (the main CC institution plus any satellite sites combined) are required to have a minimum of 3,000 deliveries per year, at least 30 percent of which must be high-risk pregnancies. A large majority of patients with obstetric complications must also receive prenatal care at the sites. Single, large volume, delivery centers are preferred over multi-site arrangements with smaller centers.
In the attachment, the applicant must:
- Include a completed copy of Table 1 below, detailing its patient population that may be eligible and available for Network protocol recruitment for calendar years 2020 and 2021. For CCs with more than one hospital and/or satellite site, please include separate columns for each site and year.
-
Describe whether the CC and/or satellite sites anticipate an increase or decrease in the pregnancy and/or birth rate for the upcoming calendar year (2023).
-
Include a completed copy of Table 2 below with a breakdown of the total number of deliveries for 2021 by race and Hispanic origin of mother.
Table 1. Populations Available for Study
| Description | 2020 | 2021 |
| Total number of deliveries, N | ||
| Number of deliveries from mothers outside of the hospital system, N | ||
| High-risk pregnancies, N (%) | ||
| Obstetric outpatient visits, N | ||
| Ultrasounds performed, N | ||
| Obstetrical patients who receive prenatal care within the CC sites, N (%) | ||
| Obstetrical patients who receive prenatal care within the CC sites who initiate care in the first trimester, N (%) | ||
| Obstetrical patients who receive prenatal care within the CC sites who initiate care in the second trimester, N (%) | ||
| High-risk obstetric patients who receive prenatal care within CC sites, N (%) | ||
| Antepartum admissions, N | ||
| Obstetrical admissions, N | ||
| Cesarean deliveries, N (%) | ||
| Multiple gestations, N | ||
| Cardiac disease in pregnancy, N | ||
| Chronic hypertensive, N | ||
| Preeclampsia and hypertensive disease in pregnancy, N | ||
| Diabetes, Pregestational (Type I and Type II), N | ||
| Diabetes, Gestational, N | ||
| Preterm premature rupture of membranes, N | ||
| Preterm births <29 weeks gestational age, N | ||
| Preterm births 29 0/7 34 6/7 weeks gestational age, N | ||
| Follow-up clinic visits at 24-months corrected age, N |
Table 2. Inclusion Report for Total Number of Deliveries for 2021
| Ethnic Categories | Total | ||||
| Not Hispanic or Latino | Hispanic or Latino | ||||
| Race | Female | Male | Female | Male | |
| American Indian/Alaska Native, N |
NA |
NA | |||
| Asian, N | NA | NA | |||
| Native Hawaiian or Other Pacific Islander, N | NA | NA | |||
| Black or African American, N | NA | NA | |||
| White, N | NA | NA | |||
| More than one race, N | NA | NA | |||
| Total | |||||
Attachment 2. Ongoing Concurrent Research
Centers are expected to participate in all Network studies (including those proposed by non-Network PIs), unless they do not have the relevant eligible population (e.g., opioid-addicted patients), or have ongoing local studies that conflict with a Network study. The applicant must identify any ongoing trials or studies at the CC and any satellite sites that may affect recruitment of participants from the Populations Available for Network Studies listed in the table above.
Provide a table of the CC’s and each satellite sites ongoing studies as a pdf attachment using the filename Attachment 2. Ongoing Concurrent Research . The table should include each study’s title, ClinicalTrials.gov ID number, a description of any interventions, and the eligibility criteria.
Attachment 3. Special Strengths
Provide a summary of the CC’s special strengths as a pdf attachment using the filename Attachment 3. Special Strengths . Applicants are encouraged to describe special or unique strengths that may be relevant to research in the Network. This can include, but is not limited to, state-of-the art scientific capabilities that may be available for Network research, such as imaging, proteomics, genomics, placental function assessment, or clinical pharmacology capabilities. It may also include experience with innovative trial designs and analyses.
Special administrative strengths or experience related to clinical trial research (e.g., central institutional review boards, data and safety monitoring boards, advisory boards for clinical research, clinical research committees) can be highlighted, including level and support of clinical trials.
Examples of Special Strengths include, but are not limited to:
- Obstetric Pharmacology Resources. Given the Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC) recommendations and the Network’s purpose, describe the Center's capability to conduct pharmacokinetic or pharmacodynamic studies and available pharmacology expertise.
- Lactation Support Program and Research. To address PRGLAC’s recommendations to increase the quantity, quality, and timeliness of research on safety and efficacy of therapeutic products used by pregnant women and lactating women, the Network will need to work with CC lactation support programs. Describe the CC’s lactation support program and any ongoing research in this area.
- Programs that manage substance use or mental health in pregnant people.
- Expertise in infectious diseases during pregnancy
- NIH Clinical and Translational Science Award (CTSA) Support. If the main CC site and/or any satellite site(s) have a NIH CTSA grant, describe how that grant will support Network activities (study coordination and recruitment assistance, protocol development support, training and mentoring, etc.).
Attachment 4. Clinical Research Experience
Provide a table summarizing research productivity of completed studies at the CC and its satellite sites in pregnant and lactating people and their infants from 2016 to present as an attachment using the filename Attachment 4. Clinical Research Experience.pdf . The table format must include:
Column A: Study Title
Column B: Brief Description
Column C: Funding Source(s)
Column D: Days from IRB approval to first patient enrolled
Column E: Site Planned Average Monthly Enrollment
Column F: Site Actual Average Monthly Enrollment
Also provide a list of publications (and total number of publications) for studies completed in pregnant and lactating people and their infants over the same time period.
Attachment 5. Clinical Center Facilities
Submit a pdf attachment named Attachment 5. Clinical Center Facilities that describes the Center’s and satellite sites facilities for:
- Ultrasound/fetal assessment unit(s), including: the number, model, and locations of ultrasound machines; the number of faculty and sonographers (obstetrics, radiology and other) who perform fetal imaging and their level of training
- Imaging capabilities for imaging pregnant people (e.g., MRIs) for evaluating placental and fetal pathology
- Investigational Drug Service/research pharmacy (including hours and days of operation)
- Antenatal fetal testing
- Perinatal pathology
- Level III medical and surgical subspecialists
- Ambulatory facilities for prenatal and postpartum care
- Blood and biological specimen processing and storage facilities.?
All instructions in the SF424 (R&R) Application Guide must be followed.
The CC PI must demonstrate clinical science excellence, specialized expertise in pregnancy management and maternal-fetal medicine (MFM), a strong background in perinatal research, and a proven ability to recruit participants from various racial and ethnic groups. Each CC must include MFM clinicians and neonatologists. In addition, CCs are expected to have clinical pharmacologists and lactation scientists/specialists available to participate in trials as needed.
Please include descriptions and biosketches for each of the individuals filling the roles below. Describe the qualifications and experience of each person, specifically documenting their respective abilities to organize, manage, and/or coordinate a CC in the Network and to implement clinical trials.
The PI(s) and Alternate/Co-PI will be considered Key Personnel on any resulting awards.
The applicants are encouraged to assemble a diverse team that includes women and minorities.
Principal Investigator(s)
Applicants must include a biosketch for a PI; multi-PI applications are allowed. PI(s) for the Clinical Centers should be maternal-fetal medicine specialists, certified either by the American Board of Obstetrics and Gynecology with a Maternal-Fetal Medicine subspecialty, or by a similar non-United States certifying entity.
Due to the demands and nature of the Network, the identified PI(s) should not have extensive departmental duties (e.g., as Department Chair); rather, he/she/they should be able to devote the required time to the development, implementation, and management of the Network Center. The biosketch of the PI should include a track record demonstrating successful implementation of perinatal clinical trials. For Centers that propose multiple sites, the PI must have the management experience to monitor and oversee Network activities at non-contiguous sites, including those at other institutions.
Alternate/Co-Principal Investigator
Applicants must include a biosketch for an alternate or Co-PI candidate to assure continuity of operations in the event the PI is unavailable. The person designated as the Alternate/Co-PI should meet the same qualification criteria as the PI. As such, the biosketch of the Co-PI should include a track record demonstrating successful implementation of perinatal clinical trials. The Alternate PI may be one of the named PI(s) on a multiple PI application.
Research Coordinator(s)
Applicants must include a biosketch for a full-time clinical Research Coordinator, who has medical expertise and/or extensive clinical research experience in conducting clinical trials in MFM/obstetric inpatient and outpatient settings and/or Labor and Delivery Units.
While a data entry clerk does not need to be specifically identified in the application, please note that any personnel conducting data abstraction from the medical records should have relevant medical experience to ensure data integrity.
Additional Specialists
The application must propose a committed group of multidisciplinary professionals to conduct clinical trials and studies successfully in pregnancy and perinatology. Please include at least two additional maternal-fetal medicine specialists and one neonatologist who will be working with the Network team to implement protocols.
In addition, Network studies may require the involvement of and collaboration with other medical specialties, such as: Neonatology, Clinical Pharmacology, Lactation, Surgery, and other relevant disciplines. Applicants may include descriptions and biosketches of additional relevant collaborators.
R&R Budget
All instructions in the SF424 (R&R) Application Guide must be followed.
BASE BUDGET
Each applicant should submit Base Budget estimates for all years. The budget at the time of application will be limited to annual maximums of:
- PI: 1.2 person-months (10%) effort
- Alternate/Co-PI, additional investigator, or additional PI support: up to 1.2 person-months (10%) effort
- Research Coordinator: 12 person-months (100%) effort
- Data Entry Clerk: 6 person-months (50%) effort
- Supplies and small equipment (itemized and justified): Not to exceed $5,000/year
- Travel: Up to 8 trips generally to the Washington, DC metro area. The PI (or designee) and Research Coordinator are required to attend in-person Steering Committee meetings (in their entirety) up to 2 times per year. Additional study investigators may need to attend these meetings to propose/present new protocols and updates on protocol implementation and study results.
- Other costs (itemized and individually justified): Not to exceed $3,000/year.
Total funding for CCs includes both the base awards (via this RFA) and reimbursements for approved study-related expenses (via the DCC and/or adjunct CCs) and is dependent on the availability of funding. In general, the NIH does not have a policy on salary escalation submitted in an application. We advise applicants to request in the application the actual costs needed for the budget period and to request cost escalations only if the escalation is consistent with the Awardee’s institutional policy. See https://grants.nih.gov/grants/policy/salcap_summary.htm and https://grants.nih.gov/grants/policy/fy2012_salary_cap_faqs.htm.
Protocol Costs
For successful trial proposals that are submitted under future FOA(s), the DCC and/or adjunct CC will be awarded Capitation funds to cover study expenses. The DCC and/or adjunct CC will then be responsible for issuing payments for approved and funded protocol expenses to the CCs, DCC, and/or non-Network recruiting sites. The protocol budgets will cover study-related costs, generally funded at fixed rates on a per-subject enrolled or per-site basis, as appropriate. Capitation funds can be utilized to support Network operations and protocols, for instance, supporting additional personnel time for study screening, recruitment, and implementation or covering other allowable costs that are Network-related. Capitation funds are generally distributed based on milestone achievements (e.g., recruiting and/or randomizing a subject and/or transmitting specific study data to the DCC).
Participating sites will be required to accept protocol budgets for approved and funded Network studies. For this reason, PIs and Coordinators are required to assist in the development and review of protocol budgets prior to approval and funding. Awards may be restricted at sites unable to successfully participate in Network protocols, including timely start-up of studies, adequate participant enrollment, and achievement of other milestones.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed, with the following additional instructions:
Research Strategy: Applicants must provide a description of the center's capabilities in multi-center collaborative research. This should demonstrate detailed knowledge of the conduct of multi-center clinical trials and observational studies in pregnant and lactating people.
NOTE: For this FOA, applicants are not required or expected to include a research plan or protocol.
When developing applications for this FOA, please follow the headings and subheadings outlined in this section to ensure that all requested information is included and to streamline the study section review process.
Enrollment of Diverse Populations
Without duplicating information requested in the Other Attachments requested (e.g., Population Available for Studies), describe how the CC will recruit diverse populations into Network studies. CCs are expected to document a proven ability to recruit participants from diverse racial and ethnic groups. For each ongoing Network studies mentioned in Section I, applicants must provide an estimate of eligible populations.
Staffing and Management
Being a successful Network CC is challenging and requires close coordination between all members of the CC and satellite site research team to start-up and implement multiple protocols simultaneously. Applicants must describe the following:
- Describe the research team’s experience in designing and conducting multi-site maternal-fetal medicine clinical trials and studies.
- Describe the organization and supervisory structure of the team at the CC and each satellite site, and their experience implementing multiple studies simultaneously with high-quality data collection. Capabilities for patient recruitment on nights and weekends must be addressed.
- Describe how clinical staff receive in-service training for new studies, including any required special certifications.
- Provide a plan for data management (collection, entry, transmission) and quality assurance (timing and handling of edits and audits).
Management Plan (for multi-site applications only)
If a multi-site center has a long-standing, well-documented, collaboration and interaction between the institutions, clearly state this in the application. For Centers with more than one recruiting site, it is preferred that they provide evidence of collaboration among MFM subspecialists on recent trials. In addition, please provide a management plan for how supervision, communications, training, and data quality monitoring will be handled between each satellite site and the main Center. For each proposed satellite site, identify which investigator (PI, Co-PI, or others) will be responsible for managing Network activities at that site.
Integration of Research Programs
If the applicant’s institution is also submitting an application for the NICHD Neonatal Research Network: Clinical Centers RFA (RFA-HD-23-002), the applicant must describe how the MFMU and NRN Network programs will streamline processes and promote interdisciplinary teamwork.
Experience in Conducting Clinical Trials
Without duplicating information requested in Other Project Information, provide evidence of research productivity at the CC in pregnant and lactating people and their babies. Describe previous, recent, and/or ongoing clinical studies and trials, especially those of a cooperative or multi-site design. Describe how it handled up to three trials/studies that struggled with recruitment and/or retention of subjects and up to three that succeeded, with a particular focus on key challenges, successes, and lessons learned. Provide evidence of recruitment and retention success, describing their eligible populations versus actual enrolled study subjects. Centers with smaller populations but high enrollment rates may be preferred over those with large eligible populations but low trial enrollment rates. Include contributions in key areas of research development and design, patient recruitment, retention and study completion, data collection and statistical analysis, and study implementation leadership (lead study investigator, trial subcommittee membership, etc.).
Approach for Recruiting, Retaining, and Following-up Mothers and Infants
Describe the CC’s plans and approach to recruit participants at different gestational ages and retain participants throughout pregnancy, potentially for multiple prenatal visits. Some, but not all, MFMU trials may require recruiting participants while in labor and delivery; CCs that can recruit participants 24 hours per day, 7 days per week are preferred.
Describe the procedures in place to track post-partum mothers and infants to maintain contact with families, schedule appointments, actions taken for missed appointments, home visit appointment options, and other creative measures to increase follow-up compliance. Priority will be given to sites that have done this successfully for clinical trials.
Clinical Center Facilities
Describe the Clinical Center’s facilities. CCs must have research-oriented divisions of perinatal medicine. Funded CCs will have both clinical science excellence and specialized expertise in the management of perinatal complications, a strong background in clinical research in pregnancy and postpartum, and a proven ability to recruit patients into intervention trials and follow mothers and babies up after birth. Each CC will also have strong collaborative relationships between the MFM department and neonatology. The clinical center(s) should be in an institution with a Level III or higher Neonatal Intensive Care Unit (NICU) for the care of high-risk neonates. In addition, to better address the Task Force on Research Specific to Pregnant Women and Lactating Women (PRGLAC) recommendations, CCs will need to collaborate with their clinical pharmacology and lactation support departments.
Provide a detailed description of the clinical attributes of the perinatal program and its facilities and its ability to recruit participants. The CC is expected to have a full range of perinatal subspecialists, clinical capabilities, and support staff.
Neonatal Intensive Care Unit
CC neonatologists should be active in clinical research. Provide details on the Maternal-Fetal Medicine and Neonatology Divisions collaborations on clinical research and to improve clinical care. Describe any history of collaboration between the Neonatology and Perinatology units toward improving clinical care, database accessibility, and research productivity.
Neonatal Follow-up Program
Describe the CC’s neonatal follow-up program for seeing infants at 24 months corrected age (required) and at 5-6 years of age (preferred). Describe the current system of follow-up assessment, including data collection, population demographics, compliance rates, schedule of follow-up visits, funding sources, and policies and procedures for conducting research in the follow-up setting. Many Network studies require follow-up of study infants at 24 months corrected age, and some require follow-up at 5-6 years of age. For studies requiring 24-month follow up, a follow-up rate of 80% is required; a rate of 90% or higher is desirable. A designated facility for follow-up must be in place at the CC. Detail the neonatal follow-up facilities, including the number of clinics, the main reasons for follow-up (e.g., low birth weight, extremely low birth weight, neurological issues, ECMO, etc.), and the age(s) at which children are seen in the clinic(s). Provide details on follow-up examiner expertise in performing Bayley Scales of Infant and Toddler Development 4th Edition assessments, neurological examinations, and hearing and vision assessments.
Culture of Clinical Research
Please describe the CC’s environment and approach to team science and creating a culture that encourages clinical research. Successful CCsinvolve their entire teams, including nurses and coordinators, in Network research, helping to recruit and implement studies. These teams may also be involved in proposing secondary analyses of studies and/or proposing new studies or secondary studies. This promotes team science and helps mentor and train more junior staff and new investigators.
In addition, CCs must participate collaboratively with the Steering Committee, the other Network investigators, and potentially with investigative teams outside of the Network. CCs are expected to participate in all Network studies, unless they do not have the relevant eligible population or have an ongoing local study identified in its application that conflicts with a Network study. Centers agree to prioritize Network studies over other studies, including other NIH-funded studies, for subject recruitment at their centers. Finally, all CCs will be required to set up appropriate master agreements (memoranda of understanding, subcontracts, data use agreements, etc.) with the DCC and/or adjunct CCs to enable transfer of earned capitation funds and study data for all Network protocols. CCs are responsible for setting up similar agreements and/or mechanisms with each of their satellite sites, as needed. In the submitted Letters of Support, please confirm that the Institution agrees to these requirements.
Multiple PD/PI Leadership Plan:
If a multi-site center has a long-standing, well-documented, collaboration and interaction between the institutions, clearly state this in the application. For CCs with more than one recruiting site it is preferred that they provide evidence of collaboration among MFM subspecialists on recent trials. In addition provide a management plan for how supervision, communications, training, and data quality monitoring will be handled between each satellite site and the main Center. For each proposed satellite site, identify which investigator (PI, Co-PI, or others) will be responsible for managing Network activities at that site.
Letters of Support:
Clinical Center Institution
Because this program requires a team effort across an Institution’s MFM and Neonatal Departments to be successful, departmental and institutional commitments to participate in MFMU Network research should be clearly documented. Please provide letters of support from appropriate individuals at the CC detailing:
- Institutional support in areas of grants management, personnel provision and management, space allocation, procurement, and equipment, as well as general support of the research. Evidence of past support can also be cited.
- Clearly expressed intent to:
- Participate in a cooperative manner with other Network clinical centers, adjunct clinical centers, the data coordinating center, and NICHD staff in all aspects of research as outlined in this FOA;
- Participate in all Network trials, unless they describe trials that currently conflict with ongoing Network trials as part of their application for this FOA;
- Prioritize MFMU Network research at awarded clinical sites, including committing to safeguard staff time for the satisfactory conduct of the studies. Awards may be restricted at sites unable to successfully participate in Network protocols, including timely start-up of studies, adequate participant enrollment, and achievement of other milestones;
- Cooperate with the policy for capitation of research costs in this FOA and in the Network policy manual;
- Comply with the Network Data Sharing Plans as outlined in this FOA and in the Network policy manual; and
- Keep confidential and do not disclose any confidential or proprietary information when working with Network and non-Network investigators and/or industry partners other than to employees, agents, subcontractors, consultants, vendors, or affiliates who have a need to know that information, and/or to make use of it, only for the purpose of discussing, evaluating, and assisting in the development of potential studies for conduct in the Network, and subsequently to conduct approved and funded studies in the Network.
Satellite Site Institutions
If any satellite sites are included in this application, provide similar Letters of Support from each such institution.
Institutions with Clinical and Translational Science Awards (CTSA)
Applications from institutions that have a NIH Clinical and Translational Science Award (CTSA) are expected to provide a letter of agreement from the CTSA PI that identifies the level and type of support that will be provided for this grant, should it be awarded.
Resource Sharing Plan: Individuals are required to comply with the instructions for the Resource Sharing Plans as provided in the SF424 (R&R) Application Guide.
All applications, regardless of the amount of direct costs requested for any one year, must address a Data Sharing Plan.
NICHD Plans for Sharing Human and Non-Human Data and/or Biospecimens
NICHD expects that data, biospecimens, and results of NICHD-funded research will be shared with the wider scientific community to the extent feasible and in a timely manner, per NIH Policy, as amended. .
NIH Data Management and Sharing Policy expects the timely release and sharing of data to be no later than the time of an associated publication, or the end of the award/support period, whichever comes first. Per the Policy, all applications, regardless of the amount of direct costs requested for any one year, are required to include a Data Management and Sharing Plan ( the Plan ) outlining how scientific data and any accompanying metadata will be managed and shared, regardless of whether the data are used to support scholarly publication. For this cooperative agreement clinical trials research Network, protocols submitted via future protocol funding opportunity announcements or other NIH FOAs will include a detailed Plan that will be approved by NIH; a detailed Plan must be submitted and approved by NIH for each study conducted in the Network. Each Plan should describe data types, file formats, submission timelines, standards used in collecting or processing the data and other elements described in Supplemental Information to the NIH Policy for Data Management and Sharing: Elements of an NIH Data Management and Sharing Plan (NOT-OD-21-014). The Plan will be subject to assessment and approval by NIH Program Staff prior to funding. The approved Plan may be incorporated into the Terms & Conditions of each protocol award, and awardees are required to comply with the approved Plan and any approved updates to the Plan. The Plan should be included with the final protocol for IRB approval as well.
For sharing human and non-human data, unless stipulated otherwise in each protocol’s approved Plan, the Network’s DCC is responsible for preparing and submitting protocol datasets to the NICHD Data and Specimen Hub (DASH https://dash.nichd.nih.gov/) and/or other NIH-approved repositories on behalf of the Network. For protocols that generate large-scale human genetic data, recruiting sites will have to provide a Provisional or Institutional Certification specifying whether the individual-level data can be shared through an NIH-approved repository, such as dbGaP, in line with the NIH Genomic Data Sharing Policy (https://grants.nih.gov/grants/guide/notice-files/NOT-OD-14-124.html). This will be done on a protocol-by-protocol basis. If any ongoing Network protocols require this, it will be requested before the Awardee can start recruiting into the study.
For sharing biospecimens, the Network’s DCC is responsible for maintaining an inventory of biospecimens managed across the Network and, upon NICHD approval, coordinating submission of any remaining biospecimens to an NIH-approved repository on behalf of the Network.
Each CC, adjunct CC, and/or recruiting site is responsible for ensuring that each study’s informed consent forms contain language allowing broad sharing and future use of study data and biospecimens in alignment with federal and local regulations and policies. Consent forms must notify participants that their data and, when relevant, imaging data and biospecimens (potentially for both maternal and child) may be shared with other Network investigators, the study sponsor(s), applicable federal agencies, and, when relevant, industry partners. In addition, de-identified data, imaging data, and remaining biospecimens from each study may be shared with researchers outside of the Network, including depositing them in NIH-approved public repositories. CCs, adjunct CCs, and/or recruiting sites may also be required to obtain approval(s) from appropriate regulatory authorities (e.g., IRB) for sharing that data, particularly for studies conducted under a waiver of consent.
For this FOA, applicants must indicate in their institution’s (and any satellite site s) Letter of Support their agreement to comply with the Network Data and Specimen Sharing Plans, including abiding by the negotiated Data Management and Sharing Plans for studies conducted in the Network, and cooperate with network procedures needed to finalize and share study data per these Plans.
When involving human subjects research, clinical research, and/or NIH-defined clinical trials (and when applicable, clinical trials research experience) follow all instructions for the PHS Human Subjects and Clinical Trials Information form in the SF424 (R&R) Application Guide, with the following additional instructions:
If you answered Yes to the question Are Human Subjects Involved? on the R&R Other Project Information form, you must include at least one human subjects study record using the Study Record: PHS Human Subjects and Clinical Trials Information form or Delayed Onset Study record.
Study Record: PHS Human Subjects and Clinical Trials Information
All instructions in the SF424 (R&R) Application Guide must be followed.
Delayed Onset Study
Note: Delayed onset does NOT apply to a study that can be described but will not start immediately (i.e., delayed start).All instructions in the SF424 (R&R) Application Guide must be followed.
All instructions in the SF424 (R&R) Application Guide must be followed.
3. Unique Entity Identifier and System for Award Management (SAM)
See Part 1. Section III.1 for information regarding the requirement for obtaining a unique entity identifier and for completing and maintaining active registrations in System for Award Management (SAM), NATO Commercial and Government Entity (NCAGE) Code (if applicable), eRA Commons, and Grants.gov.
Part I. Overview Information contains information about Key Dates and times. Applicants are encouraged to submit applications before the due date to ensure they have time to make any application corrections that might be necessary for successful submission. When a submission date falls on a weekend or Federal holiday, the application deadline is automatically extended to the next business day.
Organizations must submit applications to Grants.gov (the online portal to find and apply for grants across all Federal agencies). Applicants must then complete the submission process by tracking the status of the application in the eRA Commons, NIH’s electronic system for grants administration. NIH and Grants.gov systems check the application against many of the application instructions upon submission. Errors must be corrected and a changed/corrected application must be submitted to Grants.gov on or before the application due date and time. If a Changed/Corrected application is submitted after the deadline, the application will be considered late. Applications that miss the due date and time are subjected to the NIH Policy on Late Application Submission.
Applicants are responsible for viewing their application before the due date in the eRA Commons to ensure accurate and successful submission.
Information on the submission process and a definition of on-time submission are provided in the SF424 (R&R) Application Guide.
5. Intergovernmental Review (E.O. 12372)
This initiative is not subject to intergovernmental review.
All NIH awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Pre-award costs are allowable only as described in the NIH Grants Policy Statement.
Applications must be submitted electronically following the instructions described in the SF424 (R&R) Application Guide. Paper applications will not be accepted.
Applicants must complete all required registrations before the application due date. Section III. Eligibility Information contains information about registration.
For assistance with your electronic application or for more information on the electronic submission process, visit How to Apply Application Guide. If you encounter a system issue beyond your control that threatens your ability to complete the submission process on-time, you must follow the Dealing with System Issues guidance. For assistance with application submission, contact the Application Submission Contacts in Section VII.
Important reminders:
All PD(s)/PI(s) must include their eRA Commons ID in the Credential fieldof the Senior/Key Person Profile form. Failure to register in the Commons and to include a valid PD/PI Commons ID in the credential field will prevent the successful submission of an electronic application to NIH. See Section III of this FOA for information on registration requirements.
The applicant organization must ensure that the unique entity identifier (DUNS number or UEI as required) provided on the application is the same number used in the organization’s profile in the eRA Commons and for the System for Award Management. Additional information may be found in the SF424 (R&R) Application Guide.
See more tips for avoiding common errors.
Upon receipt, applications will be evaluated for completeness and compliance with application instructions by the Center for Scientific Review and responsiveness by components of participating organizations, NIH. Applications that are incomplete, non-compliant and/or nonresponsive will not be reviewed.
Applicants are required to follow the instructions for post-submission materials, as described in the policy. Any instructions provided here are in addition to the instructions in the policy.
1. Criteria
Only the review criteria described below will be considered in the review process. Applications submitted to the NIH in support of the NIH mission are evaluated for scientific and technical merit through the NIH peer review system.
For this FOA, as NICHD’s primary infrastructure for implementing multi-site obstetric clinical trials, awarded Centers will participate in clinical trials and observational studies conducted by the MFMU Network. The review of this application will emphasize the overall research environment, capabilities, and experience of the applicant and its personnel. In addition to the review criteria below, the merit of the application will include how well the applicant can carry out such studies, with particular emphasis on the population available for research, recruitment, retention, and follow up in clinical trials, as well as collaboration with other Centers in the Network.
NOTE: For this FOA, applicants are not required or expected to include a research plan or protocol.
A proposed Clinical Trial application may include study design, methods, and intervention that are not by themselves innovative but address important questions or unmet needs. Additionally, the results of the clinical trial may indicate that further clinical development of the intervention is unwarranted or lead to new avenues of scientific investigation.
Overall Impact
Reviewers will provide an overall impact score to reflect their assessment of the likelihood for the project to exert a sustained, powerful influence on the research field(s) involved, in consideration of the following review criteria and additional review criteria (as applicable for the project proposed).
Scored Review Criteria
Reviewers will consider each of the review criteria below in the determination of scientific merit, and give a separate score for each. An application does not need to be strong in all categories to be judged likely to have major scientific impact. For example, a project that by its nature is not innovative may be essential to advance a field.
Significance
Does the project address an important problem or a critical barrier to progress in the field? Is the prior research that serves as the key support for the proposed project rigorous? If the aims of the project are achieved, how will scientific knowledge, technical capability, and/or clinical practice be improved? How will successful completion of the aims change the concepts, methods, technologies, treatments, services, or preventative interventions that drive this field?
Specific to this FOA:
To meet the MFMU Network’s purpose and objectives, how adequately does the application:
- Meet the requirements for Populations Available for Network Studies? Does it have access to adequate numbers of patients with the conditions and/or patient care requirements needed to fully to participate in Network studies?
- Demonstrate the ability to recruit and retain participants from racial and ethnic minorities for research studies?
In addition, for applications involving clinical trials
Are the scientific rationale and need for a clinical trial to test the proposed hypothesis or intervention well supported by preliminary data, clinical and/or preclinical studies, or information in the literature or knowledge of biological mechanisms? For trials focusing on clinical or public health endpoints, is this clinical trial necessary for testing the safety, efficacy or effectiveness of an intervention that could lead to a change in clinical practice, community behaviors or health care policy? For trials focusing on mechanistic, behavioral, physiological, biochemical, or other biomedical endpoints, is this trial needed to advance scientific understanding?
Investigator(s)
Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or those in the early stages of independent careers, do they have appropriate experience and training? If established, have they demonstrated an ongoing record of accomplishments that have advanced their field(s)? If the project is collaborative or multi-PD/PI, do the investigators have complementary and integrated expertise; are their leadership approach, governance and organizational structure appropriate for the project?
Specific to this FOA:
To meet the MFMU Network’s purpose and objectives, how adequately does the application demonstrate:
- Adequate and qualified staff and supervision to oversee this staff to conduct Network protocols in a safe and effective manner?
- Key personnel with knowledge and experience to conduct collaborative clinical research, especially experience with randomized clinical trials and research design in maternal-fetal medicine?
- A research team that is qualified and experienced enough to manage multiple studies conducted simultaneously and to ensure high quality data collection and protocol implementation?
In addition, for applications involving clinical trials
With regard to the proposed leadership for the project, do the PD/PI(s) and key personnel have the expertise, experience, and ability to organize, manage and implement the proposed clinical trial and meet milestones and timelines? Do they have appropriate expertise in study coordination, data management and statistics? For a multicenter trial, is the organizational structure appropriate and does the application identify a core of potential center investigators and staffing for a coordinating center?
Innovation
Does the application challenge and seek to shift current research or clinical practice paradigms by utilizing novel theoretical concepts, approaches or methodologies, instrumentation, or interventions? Are the concepts, approaches or methodologies, instrumentation, or interventions novel to one field of research or novel in a broad sense? Is a refinement, improvement, or new application of theoretical concepts, approaches or methodologies, instrumentation, or interventions proposed?
Specific to this FOA:
To help further the MFMU Network’s purpose and objectives, how significant are the application's innovations for:
- Special strengths or capabilities that will enhance the success of the Center and Network?
- Innovative trial designs or statistical analyses in recent clinical trials or observational studies?
- If the applicant’s institution is also submitting an application for the NICHD Neonatal Research Network Clinical Center FOA (RFA-HD-23-002 NICHD Neonatal Research Network (NRN), Clinical Centers (UG1)), how well will the two research programs work together?
In addition, for applications involving clinical trials
Does the design/research plan include innovative elements, as appropriate, that enhance its sensitivity, potential for information or potential to advance scientific knowledge or clinical practice?
Approach
Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? Have the investigators included plans to address weaknesses in the rigor of prior research that serves as the key support for the proposed project? Have the investigators presented strategies to ensure a robust and unbiased approach, as appropriate for the work proposed? Are potential problems, alternative strategies, and benchmarks for success presented? If the project is in the early stages of development, will the strategy establish feasibility and will particularly risky aspects be managed? Have the investigators presented adequate plans to address relevant biological variables, such as sex, for studies in vertebrate animals or human subjects?
If the project involves human subjects and/or NIH-defined clinical research, are the plans to address 1) the protection of human subjects from research risks, and 2) inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion or exclusion of individuals of all ages (including children and older adults), justified in terms of the scientific goals and research strategy proposed?
Specific to this FOA:
To further the MFMU Network’s purpose and objectives, how adequately does the application describe:
- A recent track record in conducting clinical trials and studies by the investigators and the clinical team?
- A strong approach for recruiting, retaining, and following up mothers and infants in maternal-fetal medicine and obstetric studies?
- For Centers that propose multiple sites, does the applicant have the management experience to monitor and oversee Network activities at non-contiguous sites, including those at other institutions? Does the applicant’s proposed management plan address these issues sufficiently?
Environment
Will the scientific environment in which the work will be done contribute to the probability of success? Are the institutional support, equipment and other physical resources available to the investigators adequate for the project proposed? Will the project benefit from unique features of the scientific environment, subject populations, or collaborative arrangements?
Specific to this FOA:
To further the MFMU Network’s purpose and objectives, how well does the application describe:
- Adequate facilities and equipment available at the CC and any satellite sites to conduct Network protocols in a safe and effective manner?
- The corporate capabilities, facilities, and resources to recruit, retain, and follow up mothers and infants in clinical trials and observational studies?
- A culture of clinical research, as demonstrated by staff and institutional commitment to recruit, retain, and follow up women and infants enrolled in clinical trials and studies?
- A strong commitment to prioritizing MFMU studies?
- A willingness to work and cooperate with other MFMU Centers, adjunct Centers, the DCC, and the NICHD in a manner summarized in this FOA?
- Institutional assurances and commitments to support the Network, in such areas as fiscal administration, personnel management, space allocation, procurement, planning, and budgeting?
In addition, for applications involving clinical trials
If proposed, are the administrative, data coordinating, enrollment and laboratory/testing centers, appropriate for the trial proposed?
Does the application adequately address the capability and ability to conduct the trial at the proposed site(s) or centers? Are the plans to add or drop enrollment centers, as needed, appropriate?
If international site(s) is/are proposed, does the application adequately address the complexity of executing the clinical trial?
If multi-sites/centers, is there evidence of the ability of the individual site or center to: (1) enroll the proposed numbers; (2) adhere to the protocol; (3) collect and transmit data in an accurate and timely fashion; and, (4) operate within the proposed organizational structure?
Additional Review Criteria
As applicable for the project proposed, reviewers will evaluate the following additional items while determining scientific and technical merit, and in providing an overall impact score, but will not give separate scores for these items.
Study Timeline
Specific to applications involving clinical trials
Is the study timeline described in detail, taking into account start-up activities, the anticipated rate of enrollment, and planned follow-up assessment? Is the projected timeline feasible and well justified? Does the project incorporate efficiencies and utilize existing resources (e.g., CTSAs, practice-based research networks, electronic medical records, administrative database, or patient registries) to increase the efficiency of participant enrollment and data collection, as appropriate?
Are potential challenges and corresponding solutions discussed (e.g., strategies that can be implemented in the event of enrollment shortfalls)?
Protections for Human Subjects
For research that involves human subjects but does not involve one of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate the justification for involvement of human subjects and the proposed protections from research risk relating to their participation according to the following five review criteria: 1) risk to subjects, 2) adequacy of protection against risks, 3) potential benefits to the subjects and others, 4) importance of the knowledge to be gained, and 5) data and safety monitoring for clinical trials.
For research that involves human subjects and meets the criteria for one or more of the categories of research that are exempt under 45 CFR Part 46, the committee will evaluate: 1) the justification for the exemption, 2) human subjects involvement and characteristics, and 3) sources of materials. For additional information on review of the Human Subjects section, please refer to the Guidelines for the Review of Human Subjects.
Inclusion of Women, Minorities, and Individuals Across the Lifespan
When the proposed project involves human subjects and/or NIH-defined clinical research, the committee will evaluate the proposed plans for the inclusion (or exclusion) of individuals on the basis of sex/gender, race, and ethnicity, as well as the inclusion (or exclusion) of individuals of all ages (including children and older adults) to determine if it is justified in terms of the scientific goals and research strategy proposed. For additional information on review of the Inclusion section, please refer to the Guidelines for the Review of Inclusion in Clinical Research.
Vertebrate Animals
The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following criteria: (1) description of proposed procedures involving animals, including species, strains, ages, sex, and total number to be used; (2) justifications for the use of animals versus alternative models and for the appropriateness of the species proposed; (3) interventions to minimize discomfort, distress, pain and injury; and (4) justification for euthanasia method if NOT consistent with the AVMA Guidelines for the Euthanasia of Animals. Reviewers will assess the use of chimpanzees as they would any other application proposing the use of vertebrate animals. For additional information on review of the Vertebrate Animals section, please refer to the Worksheet for Review of the Vertebrate Animal Section.
Biohazards
Reviewers will assess whether materials or procedures proposed are potentially hazardous to research personnel and/or the environment, and if needed, determine whether adequate protection is proposed.
Resubmissions
Not Applicable
Renewals
For Renewals, the committee will consider the progress made in the last funding period.
Revisions
Not Applicable
As applicable for the project proposed, reviewers will consider each of the following items, but will not give scores for these items, and should not consider them in providing an overall impact score.
Applications from Foreign Organizations
Not Applicable.
Select Agent Research
Reviewers will assess the information provided in this section of the application, including 1) the Select Agent(s) to be used in the proposed research, 2) the registration status of all entities where Select Agent(s) will be used, 3) the procedures that will be used to monitor possession use and transfer of Select Agent(s), and 4) plans for appropriate biosafety, biocontainment, and security of the Select Agent(s).
Resource Sharing Plans
Reviewers will comment on whether the following Resource Sharing Plans, or the rationale for not sharing the following types of resources, are reasonable: (1) Data Sharing Plan; (2) Sharing Model Organisms; and (3) Genomic Data Sharing Plan (GDS).
Authentication of Key Biological and/or Chemical Resources:
For projects involving key biological and/or chemical resources, reviewers will comment on the brief plans proposed for identifying and ensuring the validity of those resources.
Budget and Period of Support
Reviewers will consider whether the budget and the requested period of support are fully justified and reasonable in relation to the proposed research.
2. Review and Selection Process
Applications will be evaluated for scientific and technical merit by (an) appropriate Scientific Review Group(s) convened by the NICHD, in accordance with NIH peer review policy and procedures, using the stated review criteria. Assignment to a Scientific Review Group will be shown in the eRA Commons.
As part of the scientific peer review, all applications will receive a written critique.
Applications may undergo a selection process in which only those applications deemed to have the highest scientific and technical merit (generally the top half of applications under review) will be discussed and assigned an overall impact score.
Appeals of initial peer review will not be accepted for applications submitted in response to this FOA.
Applications will be assigned to the appropriate NIH Institute or Center. Applications will compete for available funds with all other recommended applications submitted in response to this FOA. Following initial peer review, recommended applications will receive a second level of review by the National Advisory Child Health and Human Development Council (NACHHD). The following will be considered in making funding decisions:
- Scientific and technical merit of the proposed project as determined by scientific peer review.
- Availability of funds.
- Relevance of the proposed project to program priorities.
- Geographic distribution of Centers
3. Anticipated Announcement and Award Dates
After the peer review of the application is completed, the PD/PI will be able to access his or her Summary Statement (written critique) via the eRA Commons. Refer to Part 1 for dates for peer review, advisory council review, and earliest start date.
Information regarding the disposition of applications is available in the NIH Grants Policy Statement.
1. Award Notices
If the application is under consideration for funding, NIH will request "just-in-time" information from the applicant as described in the NIH Grants Policy Statement.
A formal notification in the form of a Notice of Award (NoA) will be provided to the applicant organization for successful applications. The NoA signed by the grants management officer is the authorizing document and will be sent via email to the recipient's business official.
Recipients must comply with any funding restrictions described in Section IV.5. Funding Restrictions. Selection of an application for award is not an authorization to begin performance. Any costs incurred before receipt of the NoA are at the recipient's risk. These costs may be reimbursed only to the extent considered allowable pre-award costs.
Any application awarded in response to this FOA will be subject to terms and conditions found on the Award Conditions and Information for NIH Grants website. This includes any recent legislation and policy applicable to awards that is highlighted on this website.
Individual awards are based on the application submitted to, and as approved by, the NIH and are subject to the IC-specific terms and conditions identified in the NoA.
ClinicalTrials.gov: If an award provides for one or more clinical trials. By law (Title VIII, Section 801 of Public Law 110-85), the "responsible party" must register and submit results information for certain applicable clinical trials on the ClinicalTrials.gov Protocol Registration and Results System Information Website (https://register.clinicaltrials.gov). NIH expects registration and results reporting of all trials whether required under the law or not. For more information, see https://grants.nih.gov/policy/clinical-trials/reporting/index.htm
Institutional Review Board or Independent Ethics Committee Approval: Recipient institutions must ensure that all protocols are reviewed by their IRB or IEC. To help ensure the safety of participants enrolled in NIH-funded studies, the recipient must provide NIH copies of documents related to all major changes in the status of ongoing protocols.
Data and Safety Monitoring Requirements: The NIH policy for data and safety monitoring requires oversight and monitoring of all NIH-conducted or -supported human biomedical and behavioral intervention studies (clinical trials) to ensure the safety of participants and the validity and integrity of the data. Further information concerning these requirements is found at http://grants.nih.gov/grants/policy/hs/data_safety.htm and in the application instructions (SF424 (R&R) and PHS 398).
Investigational New Drug or Investigational Device Exemption Requirements: Consistent with federal regulations, clinical research projects involving the use of investigational therapeutics, vaccines, or other medical interventions (including licensed products and devices for a purpose other than that for which they were licensed) in humans under a research protocol must be performed under a Food and Drug Administration (FDA) investigational new drug (IND) or investigational device exemption (IDE).
2. Administrative and National Policy Requirements
All NIH grant and cooperative agreement awards include the NIH Grants Policy Statement as part of the NoA. For these terms of award, see the NIH Grants Policy Statement Part II: Terms and Conditions of NIH Grant Awards, Subpart A: General and Part II: Terms and Conditions of NIH Grant Awards, Subpart B: Terms and Conditions for Specific Types of Grants, Recipients, and Activities, including of note, but not limited to:
- Federalwide Research Terms and Conditions
- Prohibition on Certain Telecommunications and Video Surveillance Services or Equipment
- Acknowledgment of Federal Funding
If a recipient is successful and receives a Notice of Award, in accepting the award, the recipient agrees that any activities under the award are subject to all provisions currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.
Should the applicant organization successfully compete for an award, recipients of federal financial assistance (FFA) from HHS must administer their programs in compliance with federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, disability, age and, in some circumstances, religion, conscience, and sex (including gender identity , sexual orientation, and pregnancy). This includes ensuring programs are accessible to persons with limited English proficiency and persons with disabilities. The HHS Office for Civil Rights provides guidance on complying with civil rights laws enforced by HHS. Please see https://www.hhs.gov/civil-rights/for-providers/provider-obligations/index.html and https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/index.html
HHS recognizes that research projects are often limited in scope for many reasons that are nondiscriminatory, such as the principal investigator’s scientific interest, funding limitations, recruitment requirements, and other considerations. Thus, criteria in research protocols that target or exclude certain populations are warranted where nondiscriminatory justifications establish that such criteria are appropriate with respect to the health or safety of the subjects, the scientific study design, or the purpose of the research. For additional guidance regarding how the provisions apply to NIH grant programs, please contact the Scientific/Research Contact that is identified in Section VII under Agency Contacts of this FOA.
- Recipients of FFA must ensure that their programs are accessible to persons with limited English proficiency. For guidance on meeting the legal obligation to take reasonable steps to ensure meaningful access to programs or activities by limited English proficient individuals see https://www.hhs.gov/civil-rights/for-individuals/special-topics/limited-english-proficiency/fact-sheet-guidance/index.htmlandhttps://www.lep.gov.
- For information on an institution’s specific legal obligations for serving qualified individuals with disabilities, including reasonable accommodations and making services accessible to them, see http://www.hhs.gov/ocr/civilrights/understanding/disability/index.html.
- HHS funded health and education programs must be administered in an environment free of sexual harassment, see https://www.hhs.gov/civil-rights/for-individuals/sex-discrimination/index.html. For information about NIH's commitment to supporting a safe and respectful work environment, who to contact with questions or concerns, and what NIH's expectations are for institutions and the individuals supported on NIH-funded awards, please see https://grants.nih.gov/grants/policy/harassment.htm.
- For guidance on administering programs in compliance with applicable federal conscience protection and associated anti-discrimination laws see https://www.hhs.gov/conscience/conscience-protections/index.html and https://www.hhs.gov/conscience/religious-freedom/index.html.
Please contact the HHS Office for Civil Rights for more information about obligations and prohibitions under federal civil rights laws at https://www.hhs.gov/ocr/about-us/contact-us/index.html or call 1-800-368-1019 or TDD 1-800-537-7697.
In accordance with the statutory provisions contained in Section 872 of the Duncan Hunter National Defense Authorization Act of Fiscal Year 2009 (Public Law 110-417), NIH awards will be subject to the Federal Awardee Performance and Integrity Information System (FAPIIS) requirements. FAPIIS requires Federal award making officials to review and consider information about an applicant in the designated integrity and performance system (currently FAPIIS) prior to making an award. An applicant, at its option, may review information in the designated integrity and performance systems accessible through FAPIIS and comment on any information about itself that a Federal agency previously entered and is currently in FAPIIS. The Federal awarding agency will consider any comments by the applicant, in addition to other information in FAPIIS, in making a judgement about the applicant’s integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 45 CFR Part 75.205and 2 CFR Part 200.206 Federal awarding agency review of risk posed by applicants. This provision will apply to all NIH grants and cooperative agreements except fellowships.
The administrative and funding instrument used for this program will be the cooperative agreement, an "assistance" mechanism (rather than an "acquisition" mechanism), in which substantial NIH programmatic involvement with the recipients is anticipated during the performance of the activities. Under the cooperative agreement, the NIH purpose is to support and stimulate the recipients' activities by involvement in and otherwise working jointly with the recipients in a partnership role; it is not to assume direction, prime responsibility, or a dominant role in the activities. Consistent with this concept, the dominant role and prime responsibility resides with the recipients for the project as a whole, although specific tasks and activities may be shared among the recipients and the NIH as defined below.
The PD(s)/PI(s) will have the primary responsibility for:
- Staffing
- Obtaining prior written approval of the NICHD Grants Management Specialist, in consultation with the Program Official for any change in any of the key personnel identified in the Notice of Grant Award.
- For multi-PI awards, designating a PI to be its voting representative on the Network Steering Committee.
- Protocol Development and Implementation
- Providing input and subject matter expertise for study development, data analysis and interpretation, preparation of publications, and collaboration with other investigators. This may require working with outside non-Network investigators to develop protocols and/or grant applications for potential studies to be conducted in the Network. When working with Network and non-Network investigators and/or industry partners, recipients will keep confidential and not disclose any confidential or proprietary information other than to employees, agents, subcontractors, consultants, vendors, or affiliates who have a need to know that information, and/or make use of it, only for the purpose of discussing, evaluating, and assisting in the development of potential studies for conduct in the Network, and subsequently to conduct approved and funded studies in the Network.
- Participating in all Network studies at all recipient recruiting sites and prioritizing Network studies over other studies, including other NIH-funded studies for subject recruitment, unless it is known before start-up that the institution does not have the relevant eligible population or has an ongoing local study that conflicts with a Network study that was identified in its application.
- Meeting recruitment and follow-up targets. The individual awardees may be required to project patient enrollment for specific studies; continuation and level of funding will be based on actual recruitment. For specific studies, recipient(s), either individually or collectively as the Network, who do not accomplish negotiated milestones may be required to submit a milestone report which will discuss why the milestones were not met in the agreed upon timeframe and propose a corrective action plan. The corrective action plan shall include: amended milestones, plans to achieve the amended milestones, and any additional items required by NICHD Program staff. The plan must be approved and signed by the Institutional Officials and the PD(s)/PI(s) listed on the awards prior to submission.
- Maintaining quality control measures to ensure protocol adherence and collection and transmission of accurate data within required timeframes to the Network Data Coordinating Center and/or other coordinating centers identified in protocol awards.
- Protocol Results Reporting and Data and Specimen Sharing
- Publishing, and/or assisting in the publishing and publicly disseminating study results, in accordance with Network and NIH policies, including publishing results on ClinicalTrials.gov and submitting study publications to the PubMed Central within the required timeframes.
- Complying with Network data and specimen sharing plans, including ensuring the appropriate language is included in study informed consent forms.
- Acknowledging NIH funding support in all relevant publications and presentations of work performed under this agreement.
NIH staff have substantial programmatic involvement that is above and beyond the normal stewardship role in awards, as described below:
NICHD’s Office of Clinical Research staff, a Program Official, and a Grants Manager will be responsible for overall grant stewardship. A NICHD Project Scientist will provide scientific input to the Network. A Clinical Trials Specialist or Program Analyst will work with the Program Official and Project Scientist to help coordinate Network management.
NICHD Office of Clinical Research
NICHD’s Office of Clinical Research will work with NICHD Program Staff to develop efficiencies, support Network stewardship, and provide policy guidance. Staff from the NICHD Office of Clinical Research (OCR) may attend SC and subcommittee/working group meetings as observers.
NICHD Program Official
In addition to general grant stewardship, a NICHD Program Official will:
- Monitor progress of study milestones to ensure that the objectives are being met and that all regulatory, fiscal, and administrative matters are handled according to NIH guidelines. Continuation of funding will be dependent upon the awardee’s ability to show adequate progress towards milestone accomplishment.
- Conduct site visits, as needed, to review/on-board new sites and monitor study implementation at existing sites. In conjunction with the Grants Manager, the Program Official may withhold support of a recipient if technical performance requirements such as protocol compliance, enrollment targets, or randomization and/or follow-up of subjects are not met.
- Serve as the NICHD representative, or designate a NICHD representative, on the Network’s Data and Safety Monitoring Board (DSMB) in the manner delineated in the NICHD Data and Safety Monitoring Policy.
- Monitor Network base budget and study funding and developing annual budget projections for outyears with assistance from the NICHD Program Analyst/Clinical Trials Specialist.
NICHD Project Scientist
A NICHD Project Scientist will have substantial programmatic involvement that is above and beyond the typical stewardship role in other awards. As described below, the Project Scientist will:
- Serve as the NICHD’s voting representative on the Steering Committee and all Network subcommittees.
- Provide scientific/programmatic support and input for study design, implementation, results analysis, publication, study closeout, and development of solutions to major problems, such as insufficient participant enrollment. He/she/they will work with investigators, both within and outside of the Network, to design protocols, manage study implementation, and analyze and publish results.
- Assist in the development and review of study budgets, including the identification of capitation costs and special institutional needs.
- Have access to study data and may periodically review the data and administrative progress reports. For these purposes, any individual-level data should be de-identified, and data from ongoing trials should be blinded until it is time to analyze study results. Program staff may use information obtained from the data for the preparation of internal reports on the activities of the study.
- Oversee the adequacy of adverse event management and reporting.
- Monitor study progress, of each participating facility and of the Network as a whole, through receipient's annual reports, Network study reports, site visits, screening logs, etc. This review may include, but is not limited to, compliance with the study protocol, meeting enrollment and participant follow-up targets, adherence to uniform data collection procedures, and the timeliness and quality of data reporting.
Director of the NICHD
NICHD reserves the right to terminate or curtail a study (or an individual award) under a range of scenarios including but not limited to: (a) failure to implement the study protocol; (b) a substantial shortfall in subject recruitment, follow-up, data reporting and dissemination, quality control, or other major breach of the protocol; (c) substantive changes in the agreed-upon protocol with which NIH does not concur; (d) reaching a major study objective substantially ahead of schedule with persuasive statistical evidence; (e) human subject safety or ethical issues that may dictate a premature termination; or (f) a change in the state of science that changes equipoise or has other significant impact on the relevance of the question under study. Studies in which recruitment and/or participant follow-up milestones are not met, or for which regulatory approval has not been met within one year, and are unlikely to improve sufficiently to bring the study to completion within an acceptable budget or timeframe, may be closed for lack of progress. If NIH or the awardee concludes that the study is no longer feasible, the Network shall submit a close-out plan to NIH within 2 months.
Independent of the governance above, the NICHD Director retains responsibility for all NICHD-funded research. The NICHD Director receives the DSMB’s recommendations on whether Network studies should be continued or terminated and can make an independent decision on how to proceed. The NICHD Director can override the decisions of the Steering Committee when it is in the strategic interest of the NIH/NICHD, human subject protection, and/or dependent on funding availability.
Areas of Joint Responsibility include:
- All parties will agree to accept the coordinating role of the group and the participatory and cooperative nature of the group process. As part of this, all parties will form a joint Steering Committee to govern the Network, consisting of:
- One PI from each recipient Clinical Center (one vote per center)
- One PI from the recipient Data Coordinating Center (voting member)
- NICHD Project Scientist (voting member)
- One Adjunct PI from any non-Network trial (one vote for that specific trial only)
- Steering Committee chairperson, appointed by the Director of NICHD (tie-breaking vote only).
- The Steering Committee has primary responsibility for implementing the objectives of the Network, including:
- Identifying areas of potential research
- Working with investigators within and outside of the Network to develop protocols. As part of this process, the Steering Committee, PIs (both Network and non-Network), and their involved staff must keep protocol development materials (drafts, unpublished data, and other intellectual property) from investigators and potential industry partners confidential.
- After NIH peer review and funding approval of studies to be conducted in the Network, overseeing the organization and execution of the studies
- Analyzing and publishing study results
- Depositing results in ClinicalTrials.gov
- Complying with NIH requirements for data and specimen sharing and software development, subject to Government rights of access consistent with current HHS, PHS, and NIH policies, including for data and specimen sharing.
- As part of its governance responsibilities, the Steering Committee will develop a Network Policies and Procedures Manual that delineates the structure and function of the Network, its standard operating procedures, and general rules (e.g., publication authorship). The NICHD Program Staff will help ensure that these policies follow NIH and other Federal guidelines and appropriately address the strategic interests and stewardship responsibilities of the NIH. The Steering Committee will vote on the overall Network Policies and Procedures Manual and any amendments; the NICHD Program Official will have approval authority for this Manual.
Dispute Resolution:
Any disagreements that may arise in scientific or programmatic matters (within the scope of the award) between recipients and the NIH may be brought to Dispute Resolution. A Dispute Resolution Panel composed of three members will be convened. It will have three members: a designee of the Steering Committee chosen without NIH staff voting, one NIH designee, and a third designee with expertise in the relevant area who is chosen by the other two; in the case of individual disagreement, the first member may be chosen by the individual awardee. This special dispute resolution procedure does not alter the awardee's right to appeal an adverse action that is otherwise appealable in accordance with PHS regulation 42 CFR Part 50, Subpart D and DHHS regulation 45 CFR Part 16.
Multiple PD/PI Dispute Resolution
If a conflict develops between PD(s)/PI(s) in a multiple PD/PI application, the following procedures will apply:
The Departmental administrators representing the PD(s)/PI(s) shall meet and attempt in good faith to settle any dispute, claim or controversy arising out of or relating to the interpretation, performance or breach of this disagreement. However, if the Departmental administrators fail to reach resolution in 30 days then the NIH may invoke dispute resolution procedures as described in the above paragraph.
3. Reporting
When multiple years are involved, recipients will be required to submit the Research Performance Progress Report (RPPR) annually and financial statements as required in the NIH Grants Policy Statement.
A final RPPR, invention statement, and the expenditure data portion of the Federal Financial Report are required for closeout of an award, as described in the NIH Grants Policy Statement. NIH FOAs outline intended research goals and objectives. Post award, NIH will review and measure performance based on the details and outcomes that are shared within the RPPR, as described at 45 CFR Part 75.301 and 2 CFR Part 200.301.
The Federal Funding Accountability and Transparency Act of 2006 (Transparency Act), includes a requirement for recipients of Federal grants to report information about first-tier subawards and executive compensation under Federal assistance awards issued in FY2011 or later. All recipients of applicable NIH grants and cooperative agreements are required to report to the Federal Subaward Reporting System (FSRS) available at www.fsrs.gov on all subawards over $25,000. See the NIH Grants Policy Statement for additional information on this reporting requirement.
In accordance with the regulatory requirements provided at 45 CFR 75.113 and Appendix XII to 45 CFR Part 75, recipients that have currently active Federal grants, cooperative agreements, and procurement contracts from all Federal awarding agencies with a cumulative total value greater than $10,000,000 for any period of time during the period of performance of a Federal award, must report and maintain the currency of information reported in the System for Award Management (SAM) about civil, criminal, and administrative proceedings in connection with the award or performance of a Federal award that reached final disposition within the most recent five-year period. The recipient must also make semiannual disclosures regarding such proceedings. Proceedings information will be made publicly available in the designated integrity and performance system (currently FAPIIS). This is a statutory requirement under section 872 of Public Law 110-417, as amended (41 U.S.C. 2313). As required by section 3010 of Public Law 111-212, all information posted in the designated integrity and performance system on or after April 15, 2011, except past performance reviews required for Federal procurement contracts, will be publicly available. Full reporting requirements and procedures are found in Appendix XII to 45 CFR Part 75 Award Term and Conditions for Recipient Integrity and Performance Matters.
We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants.
eRA Service Desk (Questions regarding ASSIST, eRA Commons, application errors and warnings, documenting system problems that threaten submission by the due date, and post-submission issues)
Finding Help Online: http://grants.nih.gov/support/ (preferred method of contact)
Telephone: 301-402-7469 or 866-504-9552 (Toll Free)
General Grants Information (Questions regarding application instructions, application processes, and NIH grant resources)
Email: [email protected] (preferred method of contact)
Telephone: 301-480-7075
Grants.gov Customer Support (Questions regarding Grants.gov registration and Workspace)
Contact Center Telephone: 800-518-4726
Email: [email protected]
Nahida Chakhtoura, M.D.
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-435-6872
Email: [email protected]
Sherry Dupere, PhD
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-496-1485
Email: [email protected]
Ryan Talesnik
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Telephone: 301-435-6976
Email: [email protected]
Recently issued trans-NIH policy notices may affect your application submission. A full list of policy notices published by NIH is provided in the NIH Guide for Grants and Contracts. All awards are subject to the terms and conditions, cost principles, and other considerations described in the NIH Grants Policy Statement.
Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 2 CFR 200, 42 CFR Part 52 and 45 CFR Part 75.
and Human Services (HHS)
