Full Text HD-96-002
NIH GUIDE, Volume 25, Number 11, April 5, 1996
RFA:  HD-96-002
P.T. 34, II

  Health Promotion 
  Handicapped Education 

National Institute of Child Health and Human Development 
Office of Research for Women's Health
Letter of Intent Receipt Date:  April 15, 1996
Application Receipt Date:  May 16, 1996
The National Institute of Child Health and Human Development (NICHD)
and the Office of Research on Women's Health (ORWH) invite
applications for research project grants (R01s) that will develop and
test the effectiveness of interventions that will lead to the
improved health and well-being of women with physical disabilities.
It is anticipated that studies resulting from this initiative will
augment the knowledge needed to enable women with disabilities to
achieve optimal health and, as a corollary, contribute to preventing
or reducing the incidence or severity of secondary diseases or
The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This Request
for Application (RFA), Health Promotion for Women With Physical
Disabilities, is related to the priority area of chronic and
disabling conditions and the goal to reduce health disparities among
Americans.  Potential applicants may obtain a copy of "Healthy People
2000" (Full Report:  Stock No. 017-001-00474-0 or Summary Report:
Stock No. 017-001-00473-1) through the Superintendent of Documents,
Government Printing Office, Washington, DC 20402-9325 (telephone
Applications may be submitted by domestic and foreign, for-profit and
non-profit organizations, public and private, such as universities,
colleges, hospitals, laboratories, units of state and local
governments, and eligible agencies of the Federal government.
Racial/ethnic minority individuals, women, and persons with
disabilities are encouraged to apply as Principal Investigators.
This RFA will use the National Institutes of Health (NIH) research
project grant (R01) mechanism.  The total project period for an
application submitted in response to the present RFA may not exceed
three years and the total direct costs for the first year may not
exceed $100,000 with a maximum of $350,000 for three years.
Responsibility for the planning, direction, and execution of the
proposed project will be solely that of the applicant.  The
anticipated award date is September 30, 1995.
This RFA is a one-time solicitation.  Future unsolicited competing
continuation applications will compete with all unsolicited
investigator-initiated applications and be reviewed according to the
customary peer review procedures.
Applications submitted in response to this RFA will compete for
direct costs of approximately $600,000 that have been made available
from the NICHD and $100,000 from the ORWH for the first year of
support for the program.  It is expected that approximately seven
awards will be made.  The number of awards depends on the overall
scientific merit of the applications, their relevance to the stated
goal of the RFA, and the availability of funds.
Currently, there are approximately 36 million women living with
chronic physical impairments and disabilities in the United States.
With improvements in medical care, individuals born with birth
defects or experiencing serious injury are surviving and living
longer.  As a consequence, issues associated with the quality of life
and reduction in the incidence of secondary conditions of persons
with disabilities have become increasingly prominent.
With enactment of the Americans with Disabilities Act, the need has
been recognized for the development of effective interventions for
promoting the health of persons with disabilities.  Few such
interventions have been validated systematically and research on
health promotion practices that meet the particular needs of women
with disabilities has been especially neglected.
To identify the unique health needs of women with disabilities, the
NIH sponsored a conference on "The Health of Women with Physical
Disabilities" in May, 1994.  The conference focused on four areas of
women's health that served to establish a research agenda for
improving health of women with disabilities.  A common thread
throughout the proceedings was the need to identify effective health
promotion and wellness programs for women with disabilities and to
evaluate the outcomes of these programs.
Health has been defined by the World Health Organizations as being "a
state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity."  Thus, health promotion
programs should reflect a comprehensive approach to health that
includes physiological functioning, emotional and social functioning,
as well as life style behaviors.  Such programs should emphasize
self-responsibility, nutritional awareness, health related physical
fitness and stress management.  They must  take into account that the
health status of women with disabilities is not static, but dynamic,
and that health programs should lead to enhanced useful functioning,
the prevention of secondary disabling conditions, and an increased
quality of life.
Physically active life styles have been shown to be effective in
reducing morbidity due to all causes in able-bodied populations.
Prolonged exposure to stressors has been linked to suppression of the
immune response and an increase in autoimmune disease.  Known
benefits of exercise for women include improved aerobic capacity,
improved performance, weight control, modified aging responses, and
possible prevention of osteoporosis.  In addition, improvement in
psychological health and quality of life are also reported.  Low
levels of fitness associated with physical inactivity have commonly
been reported for general populations of individuals with physical
disabilities.  Further, women with disabilities contend with multiple
stressors including major life changes and frequent daily hassles.
The goal of this RFA is to encourage the development of health
promotion programs for women with disabilities.  Such programs can
include the development and evaluation of specific interventions that
will lead to increased fitness and well-being as well as stress
reduction and health maintenance.  Applications leading to improved
methodology for assessing the effectiveness of these interventions
are encouraged.
The following items provide examples of subject areas that are within
the scope of the RFA.  This list is not exhaustive and applicants are
encouraged to communicate with program staff regarding the
responsiveness of other topics that may be related to this RFA.
o  Develop comprehensive wellness programs that can provide women
with opportunities to access fitness, nutrition, and stress reduction
programs at one site, and evaluate their effectiveness in maintaining
health and preventing secondary conditions.
o  Identify the barriers to greater participation in wellness
programs by women with disabilities, either as a consequence of
women's perceptions of the need for such programs or the attitudes of
health care providers about the health maintenance and wellness of
women with disabilities.  Develop and evaluate interventions that
will encourage greater utilization of such programs by women with
o  Develop methodology for measuring the health promoting behaviors
of women with disabilities.
o  Develop assessment tools for measuring the activity of women with
o  Develop improved measures that differentiate the components of
fitness and functioning, including strength, endurance, and
o  Develop methods to promote the fitness of women with severely
restricted mobility.
o  Examine the role of stress in fitness and well-being, examining
its potential positive role as well as unwanted sequelae.  For
instance, can stress in women with severe motor impairments be
utilized to improve cardiovascular fitness?
o  Characterize behaviors that integrate fitness strategies into
other aspects of life, work, and family.
o  Characterize the positive impact of fitness and its effects on
reducing secondary conditions, and other co-morbidity.
o  Evaluate the effectiveness of interventions over the life-span of
women with disabilities, paying particular attention to differences
in effectiveness based not only on age but also on duration after
It is the policy of the NIH that women and members of minority groups
and their subpopulations must be included in all NIH supported
biomedical and behavioral research projects involving human subjects,
unless a clear and compelling rationale and justification is provided
that inclusion is inappropriate with respect to the health of the
subjects or the purpose of the research.  This new policy results
from the NIH Revitalization Act of 1993 (Section 492B of Public Law
103-43) and supersedes and strengthens the previous policies
(Concerning the Inclusion of Women in Study Populations, and
Concerning the Inclusion of Minorities in Study Populations), which
have been in effect since 1990.  The new policy contains some
provisions that are substantially different from the 1990 policies.
All investigators proposing research involving human subjects should
read the "NIH Guidelines For Inclusion of Women and Minorities as
Subjects in Clinical Research," which have been published in the
Federal Register of March 28, 1994 (FR 59 14508-14513) and reprinted
in the NIH Guide for Grants and Contracts, Volume 23, Number 11,
March 18, 1994.
Investigators also may obtain copies of the policy from the program
staff listed under INQUIRIES.  Program staff may also provide
additional relevant information concerning the policy.
Prospective applicants are asked to submit, by April 15, 1996, a
letter of intent that includes a descriptive title of the proposed
research, the name, address, and telephone number of the Principal
Investigator, the identities of other key personnel and participating
institutions, and the number and title of the RFA in response to
which the application may be submitted.  Although a letter of intent
is not required, is not binding, and does not enter into the review
of a subsequent application, the information that it contains allows
NICHD staff to estimate the potential review workload and avoid
conflict of interest in the review.
The letter of intent is to be sent to:
Danuta Krotoski, Ph.D.
National Center for Medical Rehabilitation Research
National Institute of Child Health and Human Development Building
6100, Room 2A03
6100 Executive Boulevard
Bethesda, MD  20892
Telephone:  (301) 402-2242
FAX:  (301) 402-0832
Email:  krotoskd@hd01.nichd.nih.gov
The research grant application form PHS 398 (rev. 5/95) is to be used
in applying for these grants.  Applications kits are available at
most institutional offices of sponsored research and may be obtained
from the Grants Information Office, Office of Extramural Outreach and
Information Resources, National Institutes of Health, 6701 Rockledge
Drive, MSC 7910, Bethesda, MD 20892-7910, telephone 301/710-0267,
email:  ASKNIH@odrockm1.od.nih.gov; and from the program
administrator listed under INQUIRIES.
The RFA label available in the PHS 398 (rev. 5/95) application form
must be affixed to the bottom of the face page of the application.
Failure to use this label could result in delayed processing of the
application such that it may not reach the review committee in time
for review.  In addition, the RFA title and number must be typed on
line 2 of the face page of the application form and the YES box must
be marked.
Submit a signed, typewritten original of the application, including
the Checklist, and three signed photocopies, in one package to:
6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express/courier service)
At the time of submission, two additional copies of the application
must be sent to:
Susan Streufert, Ph.D.
Division of Scientific Review
National Institute of Child Health and Human Development Building
6100, Room 5E03H
6100 Executive Boulevard
Bethesda, MD  20892-7510
Rockville, MD  20852 (for express/courier service)
Applications must be received by May 16, 1996.  If an application is
received after that date, it will be returned to the applicant
without review.  The Division of Research Grants (DRG) will not
accept any application in response to this RFA that is essentially
the same as one currently pending initial review, unless the
applicant withdraws the pending application.  The DRG will not accept
any application that is essentially the same as one already reviewed.
This does not preclude the submission of substantial revisions of
applications already reviewed, but such applications must include an
introduction addressing the previous critique.
Upon receipt, applications will be reviewed for completeness by DRG
and responsiveness by the NICHD.  Incomplete applications will be
returned to the applicant without further consideration.  If the
application is not responsive to the RFA, NICHD staff may contact the
applicant to determine whether to return the application to the
applicant or submit it for review in competition with unsolicited
applications at the next review cycle.  Applications that are
complete and responsive to the RFA will be evaluated for scientific
and technical merit by an appropriate peer review group convened by
the NICHD in accordance with the review criteria stated below.
As part of the initial merit review, a process may be used by the
initial review group in which applications will be determined to be
competitive or non-competitive based on their scientific merit
relative to other applications received in response to the RFA.
Applications judged to be competitive will be discussed and be
assigned a priority score.  Applications determined to be non-
competitive will be withdrawn from further consideration and the
Principal Investigator and the official signing for the applicant
organization will be notified.  Principal Investigators of
applications judged to be non-competitive will receive summary
statements containing reviewers' comments.
Review Criteria
o  scientific, technical, or medical significance and originality of
the proposed research;
o  appropriateness and adequacy of the experimental approach and
methodology proposed to carry out the research;
o  qualifications and research experience of the Principal
Investigator and staff, particularly, but not exclusively, in the
area of the proposed research;
o  inclusion of women with disabilities as part of the research team,
either as principal investigator, co-investigators, or consultants;
o  availability of the resources necessary to perform the research;
o  appropriateness of the proposed budget and duration in relation to
the proposed research;
o  adequacy of plans to include minorities and their subgroups as
appropriate for the scientific goals of the research.  Plans for the
recruitment and retention of subjects will also be evaluated.
The initial review group will also examine the provisions for the
protection of human and animal subjects and the safety of the
research environment.
Applications will be selected based on scientific merit of the
proposal, the availability of funds, inclusion of women with
disabilities as investigators or co-investigators on the grants and
its responsiveness to the RFA.
Inquiries concerning this RFA are encouraged.  The opportunity to
clarify any issues or questions from potential applicants is welcome.
Direct inquiries regarding programmatic issues to:
Danuta Krotoski, Ph.D.
National Center for Medical Rehabilitation Research
National Institute of Child Health and Human Development Building
61E, Room 2A03
Bethesda, MD  20892-7510
Telephone:  (301) 402-2242
FAX:  (301) 402-0832
Email:  krotoskd@hd01.nichd.nih.gov
Direct inquiries regarding fiscal matters to:
Mary Ellen Colvin
Grants Management Branch
National Institute of Child Health and Human Development Building
61E, Room 8A07
Bethesda, MD  20892-7510
Telephone:  (301) 493-1303
FAX:  (301) 496-0915
Email:  colvinm@hd01.nichd.nih
This program is described in the Catalog of Federal Domestic
Assistance No. 93.929-Medical Rehabilitation Research.  Awards are
made under authorization of the Public Health Service Act, Title IV,
Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC
241 and 285) and administered under PHS grants policies and Federal
Regulations 42 CFR 52 and 45 CFR Part 74.  This program is not
subject to the intergovernmental review requirements of Executive
Order 12372 or Health Systems Agency review.
The PHS strongly encourages all grant and contract recipients to
provide a smoke-free workplace and promote the non-use of all tobacco
products.  In addition, Public Law 103-227, the Pro-Children Act of
1994, prohibits smoking in certain facilities (or in some cases, any
portion of a facility) in which regular or routine education,
library, day care, health care or early childhood development
services are provided to children.  This is consistent with the PHS
mission to protect and advance the physical and mental health of the
American people.

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