Full Text HS-94-001


NIH GUIDE, Volume 22, Number 31, August 27, 1993

RFA:  HS-94-001

P.T. 34

  Health Services Delivery 

Agency for Health Care Policy and Research

Application Receipt Date:  January 24, 1994


The Agency for Health Care Policy and Research (AHCPR) announces the
availability of a Request for Applications (RFA) for grants for
health services dissertation research.  The AHCPR conducts and
supports research that will enhance the quality, appropriateness, and
effectiveness of health care services, and access to such services.
The provision of dissertation grant support is part of AHCPR's effort
to stimulate the development of innovative and timely research on
issues related to the delivery of health care services.  Grant
support is designed to aid the career development of new health
services researchers and to encourage individuals from a variety of
academic disciplines and programs to study complex issues with
respect to health care services.


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.  The AHCPR
urges applicants to submit grant applications with relevance to the
specific health services research objectives of this initiative.
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 202-783-3238).


A student applying for a dissertation research grant (the Principal
Investigator) must be enrolled in an accredited doctoral degree
program in the social, management, medical, or health sciences.  The
student also must be conducting or intending to conduct dissertation
research on issues related to the delivery of health care services as
described below.  The proposed principal investigator must be a
registered doctoral candidate in resident or nonresident status.  All
requirements for the doctoral degree other than the dissertation must
be completed by the time of the award.  Prior to submission of the
application, the dissertation proposal must be approved by the
dissertation faculty committee and certified by the faculty advisor.
This information must be verified in a letter of certification from
the thesis chairperson and submitted with the grant application (see

The applicant may be either the institution that will administer the
grant on behalf of the proposed Principal Investigator or the
proposed Principal Investigator applying as an individual.
Applications from minority and women investigators are encouraged.

A proposed Principal Investigator for dissertation research grant
support need not be a citizen of the United States.  However, an
investigator who is not a U.S. citizen and does not have a permanent
resident visa must apply through an institution.  Also, an
application from a student enrolled in a foreign institution will be
accepted if the application is in English and the investigator
applies through an institution.

The proposed investigator who receives support for dissertation
research under a grant from the AHCPR may not at the same time
receive support under a predoctoral training grant or fellowship
grant awarded by any other agency of the U.S. Department of Health
and Human Services.


This RFA will use the small grant (R03) mechanism.  Responsibility
for the planning, direction, and execution of the proposed project
will be solely that of the proposed principal investigator.  The
total direct costs must not exceed $20,000 for the entire project
period.  An application that exceeds this amount will be returned to
the applicant.  The proposed principal investigator may request
support only for the amount of time necessary to complete the
dissertation.  A dissertation research grant usually is awarded for a
period of 12 months or less, but may be awarded for up to 17 months.


The AHCPR expects to award up to $500,000 in fiscal year 1994 to
support about 20 dissertation research projects.  The number of
awards will be contingent on the availability of funds and the
quality of the applications.


Only applications that propose studies in areas identified in section
902 of the Public Health Service Act are eligible for support.  Areas
of health services research authorized under section 902 in which
AHCPR is interested in dissertation grants include:

o  Effectiveness, efficiency, and quality of health care services;

o  Outcomes of health care services and procedures;

o  Clinical practice, including primary care and practice-oriented

o  Health care costs, productivity, and market forces;

o  Health care technologies, facilities, and equipment;

o  Health promotion and disease prevention;

o  Medical liability;

o  AIDS/HIV infection with respect to issues of access and delivery
of health care services;

o  Rural health services; and

o  Health of low-income, minority, elderly, and other underserved

Applicants are encouraged to discuss the general policy priority of
their research topics by letter or by telephone with AHCPR staff
listed under INQUIRIES.


Allowable Costs

Expenses usually allowed under PHS research grants will be covered by
AHCPR dissertation research grants.  Allowable costs include:  the
investigator's salary; direct project expenses such as travel, data
processing, and supplies; and, for institutional applicants only,
indirect costs.  Fees for maintaining matriculation or other fees
imposed on those preparing dissertations are allowable costs,
provided the fees are required of all students of similar standing,
regardless of the source of funding.  Applicants are expected to work
full time on the project.  Any level of effort that is less than full
time must be fully justified.

For the purpose of calculating indirect costs, dissertation research
grants are considered to be training grants.  Therefore, in
accordance with PHS policy, indirect costs, payable only when the
applicant is an institution, are limited to eight percent of total
allowable direct costs exclusive of tuition and related fees and
expenditures for equipment, or at the institution's actual indirect
cost rate, whichever results in a lesser dollar amount.

Other Conditions

The following conditions apply to dissertation grants:

o  A Principal Investigator who discontinues or suspends a project
during the grant period must inform the AHCPR immediately in writing.
The AHCPR may suspend or terminate the grant as requested by the
Principal Investigator or on its own initiative.

o  The dissertation constitutes the final report of the grant.  The
dissertation must be officially accepted by the faculty committee or
university official responsible for the candidate's dissertation and
must be signed by the responsible officials.  Three copies of the
dissertation must be submitted to the AHCPR.

o  The dissertation and all financial status reports must be
submitted in English.



The AHCPR requires all applicants for research grants to include
minorities and women in study populations so that research findings
can be of benefit to all persons at risk of the disease, disorder, or
condition under study.  Special emphasis must be placed on including
minorities and women in studies of diseases, disorders, and
conditions which disproportionately affect them.  This policy applies
to males and females of all ages.  If women or minorities are
excluded or inadequately represented in research, a clear and
compelling rationale must be provided.

This policy applies to all AHCPR research grants.  The AHCPR will not
award grants for applications which do not comply.  If the
application does not contain the required information, it will be
returned without review.

The composition of the proposed study population must be described in
terms of gender and racial/ethnic group.  In addition, gender and
racial/ethnic issues should be addressed in developing a research
design and sample size appropriate for the scientific objectives of
the study.  This information should be included in the form PHS 398
in Sections 1 to 4 of the Research Plan and summarized in Section 5,
Human Subjects.

Applicants are urged to assess carefully the feasibility of including
the broadest possible representation of minority groups.  However,
AHCPR recognizes that it may not be feasible or appropriate in all
research projects to include representation of the full array of
United States racial/ethnic minority populations (i.e., American
Indians/Alaskan Natives, Asian/Pacific Islanders, African Americans,
Hispanics).  Where appropriate, the applicant must provide the
rationale for studies on single minority population groups.

For foreign awards, the policy on inclusion of women applies fully.
Since the definition of minority differs in other countries, the
applicant must discuss the relevance of research involving foreign
population groups to the United States' populations, including

Peer reviewers will address specifically whether the applicant's
research plan conforms to these policies.  If the representation of
women or minorities in a study design is inadequate to answer the
scientific question(s) addressed and the justification for the
selected study population is inadequate, it will be considered a
scientific weakness or deficiency in the study design and will be
reflected in the priority score assigned to the application.


The application receipt date is January 24, 1994.  The research grant
application form PHS 398 (revised 9/91) is to be used in applying for
these grants, in accordance with the instructions described here and
the instructions in the application.  These forms are available at
most institutional offices of sponsored research; the Office of
Grants Information, Division of Research Grants, National Institutes
of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone
301-710-0267; and the Scientific Review Branch, Agency for Health
Care Policy and Research, 2101 East Jefferson Street, Suite 602,
Rockville, MD 20852, telephone 301-594-1449.

In addition, a packet containing both a Grant Announcement based upon
this RFA and the research grant application form PHS 398 will be
available after September 15 from:

AHCPR Publications Clearinghouse/DISS
P.O. Box 8547
Silver Spring, MD  20907
Telephone:  1-800-358-9295

The RFA label available in the PHS 398 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 2a of the face page of the application form and the YES box in
2a must be marked.

The completed, signed, original application and five legible copies
of form PHS 398 and the letter from the faculty committee must be
sent or delivered to:

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

Completed applications must be received by the Division of Research
Grants by January 24, 1994.  If an application is received after that
date, it will be returned to the applicant.

An application that does not conform to the instructions in this RFA
will be returned.  Resubmitted applications are seldom funded.
Therefore, individuals considering resubmissions are strongly
encouraged to contact the Dissertation Program Coordinator, at the
address listed in INQUIRIES below, prior to resubmitting revised

Special Instructions

Whenever feasible, the proposed Principal Investigator for a
dissertation grant is encouraged to have the application administered
through an institution.  This may be either the degree-granting
institution or another non-profit institution with which the proposed
Principal Investigator is professionally affiliated.  In determining
which institution is more appropriate, the student must consider the
extent to which the resources of the designated institution are
capable of supporting the proposed research effort.

A letter from the faculty committee or university official directly
responsible for supervising the development and progress of the
dissertation research must be submitted with the application.  The
letter must (1) certify approval of the dissertation proposal, (2)
certify that all requirements for the doctoral degree except the
dissertation are completed (or will be completed by the time of the
grant award), and (3) note that the faculty committee expects the
doctoral candidate to proceed with the approved dissertation proposal
with or without AHCPR support.  The application must identify all
members of the faculty advisory committee, by listing the information
in form 398, page 2, and providing a brief separate biographical
sketch for each on form 398, page 6.

Applicants for a dissertation grant should take special care in
reading the instructions in the research grant application form PHS
398.  Special care should be taken to thoroughly understand and
carefully address the matters of human subject certifications and
assurances, including issues related to gender and minority
representation, as described in the application form PHS 398
(especially pages 11-13, 21-23, and 25-26).  In the instructions for
the PHS 398, "human subject" is defined by regulations as "a living
individual about whom an investigator (whether professional or
student) conducting research obtains (1) data through intervention or
interaction with the individual or (2) identifiable private
information."  The human subject regulations encompass graphic,
written, or recorded information derived from individually
identifiable human subjects.


Applications will be reviewed initially by the Referral Office at the
Division of Research Grants, NIH, for completeness and by AHCPR for
responsiveness to the RFA.  Incomplete and nonresponsive applications
will be returned to applicants without further consideration.  Review
criteria for AHCPR grant applications are significance and
originality from a scientific and technical viewpoint; adequacy of
the methodology to carry out the proposed project; availability of
data or proposed plan to collect data required for the project;
qualifications and experience of the Principal Investigator and
proposed staff; adequacy of the plan for organizing and carrying out
the project; reasonableness of the proposed budget; and adequacy of
the facilities and resources available to the applicant.

Dissertation research grant applications will be reviewed under AHCPR
review procedures by non-Federal or Federal experts.  Reviewers will
be selected on the basis of their health services research
accomplishments and knowledge and their experience in research career
development.  Because reviews are rigorous, considerable
methodological detail is important in the narrative of the
application.  All elements of the application will be considered in
the review process.  Primary emphasis will be given to the
significance, scientific merit, and feasibility of the project.

Applications may be subject to triage to determine their scientific
merit relative to other applications received in response to this
RFA.  The AHCPR will withdraw from further competition those
applications judged by triage to be noncompetitive for award and
notify the Principal Investigator and institutional official.  Those
applications judged to be competitive will undergo further scientific
merit review.  Review results and funding decisions will be announced
approximately six months after the submission date.  Special review
criteria, funding decisions, and continuation of support are
described below.

Applications will be evaluated in accordance with the criteria stated
above for scientific/technical merit and the special review criteria
listed below by an appropriate peer review group.

Special Review Criteria

Applications are reviewed to determine their suitability in four
major areas:  problem or policy significance, research design,
investigator's qualifications and support structure, and budgetary

Problem Significance

o  The project is focused on a significant problem or policy in the
delivery of health care.

o  The methodology or anticipated results of the project have
national interest, provide a basis for generalized conclusions, or
have important practical applicability.

Research Design

o  The problem to be addressed by the research is clearly defined.

o  The application reflects an adequate knowledge of other research
related to the problem.

o  Questions to be answered or hypotheses to be tested are well
formulated and clearly stated.

o  Research methodology is fully described, including, where
applicable, explanation of sampling procedures, description of types
and sources of data to be gathered, discussion of methodological
problems expected to be encountered, and description of specific
analyses to be undertaken.

o  The application adequately describes the plans for managing the
project, including a tentative schedule for the main steps of the
investigation within the project period requested.

Investigator's Qualifications and Support Structure

o  The applicant shows promise as a health services research

o  The applicant's experience and training are sufficient to carry
out the research.

o  The available facilities and organizational arrangements are
appropriate to the research.

o  Faculty advice, composition of dissertation committee, and support
are suitable to the research being undertaken, as evidenced by the
letter of support.

Budgetary Appropriateness

o  The allocation of time and money reflects an understanding of the
research tasks to be accomplished and of the problems likely to

o  Where appropriate and feasible, the proposed approach uses data
available or being collected through government and other sources.


Applications will compete for available funds with all other
applications for this RFA.  The following will be considered in
making funding decisions:  quality of the proposed project as
determined by peer review, and availability of funds.  The earliest
anticipated date of award for applications will be August 1, 1994.


Written and telephone inquiries concerning this RFA are encouraged.
Applicants are encouraged to discuss programmatic issues, such as the
suitability of their research topics, with and request the RFA by
letter or telephone from:

Julius Pellegrino, M.B.A., M.P.H.
Center for General Health Services Extramural Research
Agency for Health Care Policy and Research
Executive Office Center, Suite 502
2101 East Jefferson Street
Rockville, MD  20852
Telephone:  (301) 594-1357 ext.138

Direct inquiries regarding fiscal and administrative matters to:

Ralph L. Sloat, Grants Management Officer
Agency for Health Care Policy and Research
2101 East Jefferson Street
Rockville, MD  20852
Telephone:  (301) 594-1447


This program is described in the Catalog of Federal Domestic
Assistance, No. 93.180.  Awards are made under authorization of the
Public Health Service Act, Title IX, as amended by Public Laws
101-239 and 102-410, (42 U.S.C. 299-299c-6) and Section 1142 of the
Social Security Act (42 U.S.C. 1320b-12).  Awards are administered
under the PHS Grants Policy Statement; and Federal Regulations 42 CFR
Part 67, Subpart A, and 45 CFR Part 74 (45 CFR Part 92 for State and
local governments).  This program is not subject to the
intergovernmental review requirements of Executive Order 12372.


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