Department of Health and Human Services

Part 1. Overview Information

Key Dates

Required Application Instructions

It is critical that applicants follow the instructions in the SF424 (R&R) Application Guide, except where instructed to do otherwise (in this FOA or in a Notice from the 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.

Table of Contents

1. Part 1. Overview Information
2. Part 2. Full Text of the Announcement
   1. Section I. Funding Opportunity Description
   2. Section II. Award Information
   3. Section III. Eligibility Information
   4. Section IV. Application and Submission Information
   5. Section V. Application Review Information
   6. Section VI. Award Administration Information
   7. Section VII. Agency Contacts
   8. Section VIII. Other Information

Part 2. Full Text of Announcement

Section I. Funding Opportunity Description

Purpose

While some interventions have been successful in improving the care of children with asthma, disparities in asthma outcomes persist. In 2012, after representatives from nearly 20 Federal organizations reviewed prior, available, and projected efforts to reduce disparities in asthma, they created a Coordinated Federal Action Plan to Reduce Racial and Ethnic Asthma Disparities (http://www.epa.gov/childrenstaskforce/federal_asthma_disparities_action_plan.pdf ), concluding that multiple risk factors contribute to the persistence of disparities. The Action Plan, a key activity of the President’s Task Force on Children’s Environmental Health Risks and Safety Risks, advises that substantial progress in reducing disparities will require research to design, execute and evaluate implementation programs that maximize synergies among all key sectors to create a system of care that focuses on children most in need and reaches them where they live, learn and play.

This FOA will support research that addresses the Federal Coordinated Action Plan. Investigators who participate in this Cooperative Agreement must have collaborations within their communities to create an Asthma Care Implementation Program (ACIP) that integrates interventions from at least four different sectors that contribute to the care of children with asthma: medical care, families, home environment, and the community. For the purposes of this FOA, community refers to organizations/institutions whose primary purpose is not medical care (e.g., school, library). The interventions must have demonstrated efficacy based on prior research and be well integrated. Nevertheless the design and analysis plan for the study must account for the relative contributions of the components of care that impact asthma outcomes as well as the importance of specific components of the process of implementation. By evaluating the implementation process in the ACIP, investigators should define the determinants of implementation outcomes that might be modified, if needed, to meet other communities' needs. The metrics for the implementation process that will be used by all ACIPs that participate in this Cooperative Agreement will be determined by a Steering Committee composed of the Program Directors/Principal Investigators PD(s)/PI(s). The Steering Committee will also create a report of Best Practices that incorporates the results of their research with respect to implementation and the potential for dissemination in other settings.

To ensure the initial design of the ACIP addresses the needs of relevant stakeholders, investigators must have performed a recent (within 24 months prior to the receipt date) formal community needs assessment either through an NHLBI funding opportunity (RFA-HL-15-028 ; U34) or any other alternative source of support. Because this FOA will support research to address disparities in asthma outcomes, investigators' ability to identify and engage children at highest risk for poor asthma outcomes and follow them will be essential. Given the importance of engaging collaborators to make the multi-sector interventions possible, investigators must also have obtained a commitment of resources (including in-kind resources) from each of the four sectors who will participate in the ACIP. It is anticipated that the commitments of the collaborators may affect the sustainability of the program which will also be evaluated within this FOA.

Supported Research Activities

This FOA will support the evaluation of community based ACIPs. Therefore, prior to application, PD(s)/PI(s) must have conducted a recent (within the 24 months prior to the application receipt date) needs assessment for the community in which the interventions and clinical trial are planned. The implementation strategy for the ACIP and its evaluation should be based on an overall conceptual framework as well as the entire protocol for the proposed clinical trial.

PD(s)/PI(s) may use up to one year of the U01 project period to complete all activities needed to enroll the first patient in the clinical trial. Completion of the integration of ACIP collaborators with one another, procurement of study related materials (e.g., case report forms, manuals) and any protocol specific activities necessary prior to enrollment of the first subject can occur in year 1.

After investigators have confirmed completion of their pre-enrollment activities with the NHLBI Program Official, the "active" treatment/intervention phase of the clinical trial will begin and continue for no longer than the end of the fourth year of funding. The completion of the trial will be followed by a one year (year 5 of funding) inactive phase when the investigator will not be able to participate in any of the ACIP interventions with study participants nor can funding from this Cooperative Agreement support the ACIP interventions. During this "inactive" phase of the award, analyses and dissemination of the research findings can be conducted. In the final year of funding, the sustainability of the ACIP will be assessed after 12 months of inactivity. The sustainability assessment can then be analyzed and, as part of the Steering Committee activities, the report on Best Practices will be written and further dissemination may continue.

Requirements

To be considered responsive, applications must include a proposed community based ACIP. As indicated above, community refers to organizations or institutions whose primary purpose is not medical care. The PD(s)/PI(s) may be involved in medical care and employed by a medical institution, but the ACIP cannot be based in the PD(s)/PI(s) workplace (if a hospital, for example).

Applications that do not meet these requirements will not be reviewed.

Examples of Research Programs:

Because the research programs must be evidence based, the individual interventions will not be novel. The listed examples of interventions or groups of interventions could be elements of a proposed program of care, though these would need to be integrated to form a comprehensive program. The innovation in applications is expected to be in the integration of interventions and the ways interventions are used to meet the needs of the community. Examples of interventions would include but are not limited to the following:

• A school based program that includes asthma education and family outreach to facilitate changes to the home environment.
• Health literacy-sensitive disease management training for parents.
• Adherence programs in the community for children with asthma or parents of children with asthma that not only remind them of the need for monitoring and medication but identify hot spots to avoid based on known asthma triggers
• A medical home that is responsive to the needs of a high risk community including electronic communication between the family and medical care provider and addresses system wide changes. For example, there could be policy changes such as reimbursement for home remediation to reduce triggers if the family agrees with the changes and they are recommended by the physician on the basis of a community health worker's home assessment. The community health worker's assessment could be incorporated into the medical record and alert the physician to the issues in the home environment. If the physician recognizes the need for remediation, the organization that will do the remediation as well as the reimbursement system would be coordinated.

Potential resources that could be used to identify interventions or collaborators may be found on the following websites:

http://www.asthmacommunitynetwork.org/resources

http://portal.hud.gov/hudportal/HUD?src=/program_offices/healthy_homes/hhi

http://www.cdc.gov/asthma/children.htm

http://www.cdc.gov/Asthma/contacts/default.htm

http://www.ahrq.gov/research/findings/factsheets/children/chastria/index.html

http://www.childhoodasthma.org/

http://www.rampasthma.org/

Organization and Operation:

This cooperative agreement allows up to 6 years of funding with four distinct, sequential activities:

1. Preparation for the clinical trial (maximum one year in duration). Based on the protocol submitted, milestones describing the necessary preparations to enable enrollment of patients will be negotiated as part of the award.

2. Clinical trial (active intervention, up to 3 years). The trial cannot begin until the preparation milestones have been met. The intervention must be completed (last subject completes study) by the end of the fourth year of funding.

3. Analysis and initial dissemination (one year duration). The active interventions in the clinical trial must have been completed. Support will only be provided for analysis of results, collaborations with other investigators, and dissemination of results.

4. Sustainability assessment (maximum one year duration). Following a 12 month period with no active intervention(s), the investigator must assess whether the interventions themselves and the associated effects have been continued, modified, or stopped. Any modifications and barriers to continuation should be assessed.

Section II. Award Information

NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made in response to this FOA.

Section III. Eligibility Information

1. Eligible Applicants

Eligible Organizations

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)

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)
• 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

Foreign Institutions

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 allowed.

Required Registrations

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.

• Dun and Bradstreet Universal Numbering System (DUNS) - All registrations require that applicants be issued a DUNS number. 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.
• System for Award Management (SAM) (formerly CCR) 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.
• eRA Commons - Applicants must have an active DUNS number and SAM registration in order to complete the eRA Commons registration. Organizations can register with the eRA Commons as they are working through their SAM or Grants.gov registration. 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 DUNS number and 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.

Eligible Individuals (Program Director/Principal Investigator)

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.

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

Applicant organizations may submit more than one application, provided that each application is scientifically distinct.

The NIH will not accept duplicate or highly overlapping applications under review at the same time. 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 NOT-OD-11-101).

In addition, the NIH will not accept a resubmission (A1) application that is submitted later than 37 months after submission of the new (A0) application that it follows. The NIH will accept submission:

• To an RFA of an application that was submitted previously as an investigator-initiated application but not paid;
• Of an investigator-initiated application that was originally submitted to an RFA but not paid; or
• Of an application with a changed grant activity code.

Section IV. Application and Submission Information

1. Requesting an Application Package

Applicants must download the SF424 (R&R) application package associated with this funding opportunity using the "Apply for Grant Electronically" button in this FOA or following the directions provided at Grants.gov.

2. Content and Form of Application Submission

It is critical that applicants follow the instructions in the SF424 (R&R) Application Guide, including Supplemental Grant Application Instructions 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.

For information on Application Submission and Receipt, visit Frequently Asked Questions Application Guide, Electronic Submission of Grant Applications.

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:

Director, Office of Scientific Review
National Heart, Lung, and Blood Institute
6701 Rockledge Drive, Room 7214
Bethesda, MD 20892-7924 (Express Mail ZIP: 20817)
Telephone: 301-435-0270
Fax: 301-435-0730
Email: [email protected]

Page Limitations

All page limitations described in the SF424 Application Guide and the Table of Page Limits must be followed.

Instructions for Application Submission

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.

SF424(R&R) Cover

All instructions in the SF424 (R&R) Application Guide must be followed.

SF424(R&R) Project/Performance Site Locations

All instructions in the SF424 (R&R) Application Guide must be followed. Include the following:

Describe how the research infrastructure can support the implementation of the ACIP and provide access to, engagement of, and follow-up of children at high risk of poor asthma outcomes.

SF424(R&R) Other Project Information

All instructions in the SF424 (R&R) Application Guide must be followed.

Facilities and Other Resources. Investigators who receive funding from or will collaborate with a local Clinical and Translational Science Award (CTSA) funded by the National Institutes of Health should identify the roles and resources that are be available to support the proposed ACIP, commenting particularly on those aspects that will enhance their programmatic and scientific efficiency

SF424(R&R) Senior/Key Person Profile

All instructions in the SF424 (R&R) Application Guide must be followed. Include the following:

Describe experience with leading a community based effort or building the necessary collaborations for research. Describe multi-disciplinary expertise.

R&R or Modular Budget

All instructions in the SF424 (R&R) Application Guide must be followed.

R&R Subaward Budget

All instructions in the SF424 (R&R) Application Guide must be followed.

PHS 398 Cover Page Supplement

All instructions in the SF424 (R&R) Application Guide must be followed.

PHS 398 Research Plan

All instructions in the SF424 (R&R) Application Guide must be followed, with the following additional instructions:

Research Strategy:

The Research Strategy section must include:

1. Results of a recently completed (within 24 months prior to the receipt date) community needs assessment for the community in which the trial will be done:
   1. Applications should indicate when and how the community needs assessment was done.
   2. It should be explicitly stated how the identified community needs will be addressed by the ACIP.
2. Conceptual framework(s) or model(s) used to develop the research program, the implementation strategy, and evaluation of the program.
   1. Examples include but are not limited to those reviewed in Am J Prev Med. 2012 Sep;43(3):337-50. doi: 10.1016/j.amepre.2012.05.024.
3. A description of the integration of interventions and the ways interventions will be used to meet the needs of the community. The plan for integration should be novel so that the system of care in the ACIP represents a change from traditional approaches to care.
4. A multi-disciplinary team that implements the ACIP as well as the evaluation of it. Applications must describe:
   1. How stakeholders will be engaged throughout the conduct of the trial
   2. Evidence of the research team's commitment and ability to collaborate
   3. Who will provide direct care to children, the associated resources for care, and evidence of expertise and experience
5. A recruitment plan that specifies how children at high risk of poor asthma outcomes will be identified and engaged in the trial.
   1. The plan should also identify how children will be tracked as they participate in interventions across the sectors involved in their care and keep providers up to date on other providers' care.
6. A clinical trial that includes all of the following elements:
   1. Interventions to be implemented for a maximum of three years and that can be completed by the end of the 4th year of funding.
   2. Evidence based interventions that involve all of the following sectors:
      1. Medical care (e.g., address practitioners adherence to asthma clinical practice guidelines)
      2. Family and child (e.g. address asthma self-management behaviors; the social context of family and cultural perceptions of disease and health care seeking; family support; psychosocial factors such as depression and stress)
      3. Homes (e.g., address exposures to allergens, irritants and pollutants
      4. Community (e.g., school and child care environments; address peer and community levels of health literacy, asthma education, and programs/policies that support asthma self-management).
      NOTE: A single intervention may involve more than one sector. For example, a community health worker may be involved in a home environment assessment. Therefore, while multiple interventions are required, there may be fewer than four.
   3. Protocol sections (the full protocol must be in the Appendix) must include:
      1. Clinical trial design: Numerous study designs are responsive to this initiative, e.g., group randomized (or "cluster") trials, quasi-experimental research designs, mixed-methods research design, pragmatic trials, sampling, or systems analyses
      2. An appropriate comparator group
      3. Asthma outcomes such as asthma control, exacerbation, or pulmonary physiology.
      4. Outcomes that measure the impact of the intervention(s) on disparities
      5. Implementation outcomes (from Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., Griffey, R., and Hensley, M. Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health (2011) 38: 65-76):
         1. Acceptability is the perception among implementation stakeholders that a given treatment, service, practice, or innovation is agreeable, palatable, or satisfactory.
         2. Adoption is defined as the intention, initial decision, or action to try or employ an innovation or evidence-based practice.
         3. Appropriateness is the perceived fit, relevance, or compatibility of the innovation or evidence based practice for a given practice setting, provider, or consumer; and/or perceived fit of the innovation to address a particular issue or problem.
         4. Cost (incremental or implementation cost) is defined as the cost impact of an implementation effort.
         5. Feasibility is defined as the extent to which a new treatment, or an innovation, can be successfully used or carried out within a given agency or setting.
         6. Fidelity is defined as the degree to which an intervention was implemented as it was prescribed in the original protocol or as it was intended by the program developers.
         7. Penetration is defined as the integration of a practice within a service setting and its subsystems.
         8. Sustainability is defined as the extent to which a newly implemented treatment is maintained or institutionalized within a service setting’s ongoing, stable operations.
      6. Prospectively planned quality assessments and mechanisms to obtain stakeholder feedback during the intervention period as well as the adjustments to the trial that may be made on the basis of that data.
7. Describe how the proposed interventions adequately represent care provided by the medical profession, the family, the home environment, and the community. Include a description of how the interventions fulfill the identified needs of the U.S. community in which the study will be done. Include plans for measuring sustainability.
8. An analysis plan to be completed in the fifth year of funding or the 12 months after the active intervention ends
   1. The analysis plan should define how best practices from the interventions will be selected.
   2. Planned analyses should address the generalizability of the findings in alternative settings and any potential barriers to implementing the interventions on a larger scale.
   3. The analysis plan should include assumptions including but not limited to the following: sample size, effect size, and expected power.
9. A plan for data management must be included, particularly if information technology is used to integrate care providers and patient/family communication.
10. Investigators who receive funding from or will collaborate with a local Clinical and Translational Science Award (CTSA) funded by the National Institutes of Health should clearly delineated how any duplication of resources or overlap in activities will be identified and managed.

Letters of Support

Each collaborator must provide a Letter of Support indicating the resources (including in-kind resources) they intend to contribute to the ACIP.

Consortium/Contractual Arrangements

Provide a list of collaborators who represent the following four sectors: medical care, family, home environment, and community. The PD/PI may be one of these collaborators. If available, the third party agreements with the collaborator must include a description of the timeframe for completing all third party agreements, which will be a condition of the award. Collaborations that have not been completely established at the time of the application must be initiated with the expectation to complete the third party agreement within 90 days of the award.

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, with the following modification:

• All applications submitted for the January 25, 2015, due date or after are expected to comply with the NIH Genomic Data Sharing Policy as detailed in NOT-OD-14-111, as applicable.
• All applications, regardless of the amount of direct costs requested for any one year, should address a Data Sharing Plan.
• All applications must include a robust plan for dissemination of the implementation process as well as interventions, consistent with achieving the goals of this program; the plans for dissemination must include methods for dissemination that are not limited to publications and presentations.

Appendix: Do not use the Appendix to circumvent page limits. Follow all instructions for the Appendix as described in the SF424 (R&R) Application Guide. Include the protocol description.

Planned Enrollment Report

When conducting clinical research, follow all instructions for completing Planned Enrollment Reports as described in the SF424 (R&R) Application Guide.

PHS 398 Cumulative Inclusion Enrollment Report

When conducting clinical research, follow all instructions for completing Cumulative Inclusion Enrollment Report as described in the SF424 (R&R) Application Guide.

3. Submission Dates and Times

Part I. Overview Information contains information about Key Dates. 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.

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. If a Changed/Corrected application is submitted after the deadline, the application will be considered late.

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.

4. Intergovernmental Review (E.O. 12372)

This initiative is not subject to intergovernmental review.

5. Funding Restrictions

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.

6. Other Submission Requirements and Information

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 Applying Electronically. If you encounter a system issue beyond your control that threatens your ability to complete the submission process on-time, you must follow the Guidelines for Applicants Experiencing System Issues.

Important reminders:

All PD(s)/PI(s) must include their eRA Commons ID in the Credential field of the Senior/Key Person Profile Component of the SF424(R&R) Application Package. 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 DUNS number it provides 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 NHLBI, NIH. Applications that are incomplete, non-compliant and/or nonresponsive will not be reviewed.

Post Submission Materials

Applicants are required to follow the instructions for post-submission materials, as described in NOT-OD-13-030.

Section V. Application Review Information

Important Update: See NOT-OD-16-006 and NOT-OD-16-011 for updated review language for applications for due dates on or after January 25, 2016.

1. Criteria

Only the review criteria described below will be considered in the review process. As part of the NIH mission, all applications submitted to the NIH in support of biomedical and behavioral research are evaluated for scientific and technical merit through the NIH peer review system.

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? 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? How strongly would this research reduce disparities in asthma outcomes?

Investigator(s)

Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or New Investigators, or 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? How likely is the PD/PI or multi-PD/PI team to be successful in leading a community based effort or building the necessary collaborations for this research? Do the proposed investigator(s) have the necessary multi-disciplinary expertise?

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? Given that the interventions must be evidence based (and, therefore, not novel), is the plan to integrate the interventions in the ACIP novel? Would implementation of the ACIP represent a substantial change from current practices in the care of children at high risk of poor asthma outcomes? Will the plan for dissemination create opportunities to expand the reach of the interventions?

Approach

Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? 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? Is the comparator group or condition appropriate? Is the described conceptual implementation framework effectively used to develop the research plan? Do the proposed interventions adequately represent care provided by the medical profession, the family, the home environment, and the community? Is the plan to measure sustainability adequate? Are the selected interventions responsive to the identified needs of the U.S. community in which the study will be done?

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 children, justified in terms of the scientific goals and research strategy proposed?

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? Will the research infrastructure support the implementation of the ACIP and provide access to, engagement of, and follow up of children at high risk of poor asthma outcomes?

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.

Protections for Human Subjects

For research that involves human subjects but does not involve one of the six 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 six 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 Children

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 children 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

Not Applicable

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

Not Applicable

Revisions

Not Applicable

Additional Review Considerations

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 Wide Association Studies (GWAS) /Genomic Data Sharing Plan.

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 NHLBI 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:

• 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.
• Will receive a written critique.

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 Heart, Lung, and Blood Advisory Council. 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.

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.

Information regarding the disposition of applications is available in the NIH Grants Policy Statement.

Section VI. Award Administration Information

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 grantee’s business official.

Awardees 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.

Permission of the Institute will be required for any no cost extension.

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, Grantees, and Activities. More information is provided at Award Conditions and Information for NIH Grants.

Cooperative Agreement Terms and Conditions of Award

The following special terms of award are in addition to, and not in lieu of, otherwise applicable U.S. Office of Management and Budget (OMB) administrative guidelines, U.S. Department of Health and Human Services (DHHS) grant administration regulations at 45 CFR Parts 74 and 92 (Part 92 is applicable when State and local Governments are eligible to apply), and other HHS, PHS, and NIH grant administration policies.

The administrative and funding instrument used for this program will be the cooperative agreement, an "assistance" mechanism (rather than an "acquisition" mechanism), in which substantial NIH programmatic involvement with the awardees 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 award 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 awardees for the project as a whole, although specific tasks and activities may be shared among the awardees and the NIH as defined below.

The PD(s)/PI(s) will have the primary responsibility for:

• Creation of the programs of care for children at high risk of poor outcomes in asthma
• Engaging collaborators representative of four sectors (one of which may be their own) and obtaining commitments of resources from them. The awardee shall provide evidence of executed 3rd party agreements within 90 days of the award issuance date to the Grants Management Specialist listed on the Award. Failure to provide this evidence may result in enforcement action as described in the NIH GPS.
• Designing and performing their proposed clinical trial in compliance with the requirements of this FOA.
• Reporting on study conduct, safety measures, data collection and analysis to the NHLBI-appointed DSMB.
• Regular conference calls with the Program Official to engage NHLBI Staff for the needs of the program.
• Participation in the Asthma Empowerment Steering Committee calls and activities. (See additional information in Joint Responsibility.) The PD(s)/PI(s) will serve as a voting member of the Steering Committee.
• Awardees will retain custody of and have primary rights to the data and software developed under these awards, subject to Government rights of access consistent with current DHHS, PHS, and NIH policies.

NIH staff have substantial programmatic involvement that is above and beyond the normal stewardship role in awards, as described below:

• A Program Official will be a voting member of the Steering Committee.
• NHLBI will be responsible for providing oversight of the monitoring of clinical trials through an NHLBI Data Safety and Monitoring Board (DSMB).
• An independent DSMB will be appointed by the Director, NHLBI to provide overall monitoring of interim data and safety issues. Meetings of the DSMB will be held regularly by teleconference. An NHLBI scientist other than the NHLBI Program Official will serve as Executive Secretary to the Board. Because the DSMB serves as an independent group advisory to the NHLBI, study investigators shall not communicate with DSMB members regarding study issues, except as authorized by the Board's Executive Secretary.
• Given the need for timely completion of the clinical trials to allow for the 12 month lapse in interventions before performing the sustainability assessment, Program Staff will monitor the clinical trials throughout each project year with the expectation that research plans will be modified if needed.
• Additionally, the Program Official will be responsible for the normal scientific and programmatic stewardship of the award and will be named in the award notice.

Areas of Joint Responsibility include:

• Milestones will be negotiated prior to the first year award to serve as indicators of adequate preparation for the clinical trial. The milestones will be based on the clinical trial protocol submitted with the application and any modifications that are considered necessary by Program Staff and the PD/PI. Criteria for successful achievement of the milestones will be included in the grant award. The clinical trial cannot begin enrolling subjects and no further funding will be provided until the milestones have been met.
• Attending conference calls as part of an Asthma Empowerment Steering Committee with other awardees and Program Staff to meet the following requirements:
  1. Define the metrics to evaluate the implementation of their program. The same metrics will be used for all programs.
  2. Determine the criteria for inclusion of specific interventions in a guide of best practices for the care of children with high risk of poor outcomes in asthma. Create a report to document these Best Practices.
  3. Reporting (at least annually) the results of quality assessments and stakeholder feedback as well as the trial modifications to be undertaken to address the data.
  4. Define the metrics to assess sustainability in the final year of the program.
• Any changes to the interventions or the collaborators in the program of care must be submitted to the Program Official for approval before implementation.

Dispute Resolution:

Any disagreements that may arise in scientific or programmatic matters (within the scope of the award) between award 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 grantee, one NIH designee, and a third designee with expertise in the relevant area who is chosen by the other two. 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.

3. Reporting

When multiple years are involved, awardees 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 progress report, 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.

The Federal Funding Accountability and Transparency Act of 2006 (Transparency Act), includes a requirement for awardees of Federal grants to report information about first-tier subawards and executive compensation under Federal assistance awards issued in FY2011 or later. All awardees 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.

Section VII. Agency Contacts

We encourage inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants.

Application Submission Contacts

eRA Service Desk (Questions regarding ASSIST, eRA Commons registration, submitting and tracking an application, documenting system problems that threaten submission by the due date, post submission issues)
Telephone: 301-402-7469 or 866-504-9552 (Toll Free)
Finding Help Online: https://grants.nih.gov/support/index.html
Email: [email protected]

Grants.gov Customer Support (Questions regarding Grants.gov registration and submission, downloading forms and application packages)
Contact CenterTelephone: 800-518-4726
Email: [email protected]

GrantsInfo (Questions regarding application instructions and process, finding NIH grant resources)
Telephone: 301-945-7573
Email: [email protected]

Scientific/Research Contact(s)

Michelle M. Freemer, M.D.
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-435-0202
Email: [email protected]

Peer Review Contact(s)

Director, Office of Scientific Review
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-435-0270
Email: [email protected]

Financial/Grants Management Contact(s)

Catherine Sanchez
National Heart, Lung, and Blood Institute (NHLBI)
Telephone: 301-402-3839
Email: [email protected]

Section VIII. Other Information

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.

Authority and Regulations

Awards are made under the authorization of Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284) and under Federal Regulations 42 CFR Part 52 and 45 CFR Parts 74 and 92.