Full Text HS-95-002


NIH GUIDE, Volume 23, Number 31, August 19, 1994

RFA:  HS-95-002

P.T. 34

  Health Services Delivery 
  Health Care Administration 

Agency for Health Care Policy and Research

Application Receipt Date:  January 24, 1995


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.  AHCPR urges
applicants to submit grant applications with relevance to the specific
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 APPLICATION PROCEDURES).

The applicant may be either the public or private nonprofit 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

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 a public or private nonprofit
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


This RFA will employ the small research 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 1995 to
support about 20 dissertation research projects.  The number of awards
will be contingent on the availability of funds and the quality of the


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, but are not limited to:

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


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.



It is the policy of AHCPR that women and members of minority groups
must be included in all AHCPR supported health services research
projects involving human subjects, unless a clear and compelling
rationale and justification are provided that inclusion is
inappropriate with respect to the health of the subjects or the purpose
of the research.

A new NIH policy resulting from the NIH Revitalization Act of 1993
(Section 492B of Public Law 103-43) supersedes and strengthens NIH's
previous policies (Concerning the Inclusion of Women in Study
Populations, and Concerning the Inclusion of Minorities in Study
Populations), which were in effect since 1990 and which AHCPR had
adopted.  The new NIH policy contains some provisions that are
substantially different from the 1990 policies.  AHCPR plans to publish
guidelines specific to AHCPR.  In the interim, AHCPR will follow the
NIH guidelines, as applicable.

All investigators proposing research involving human subjects should
read the "NIH Guidelines for Inclusion of Women and Minorities as
Subjects in Clinical Research," 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 NIH policy from the AHCPR
program staff listed under INQUIRIES.  AHCPR program staff may also
provide additional relevant information concerning this policy.


The application receipt date is January 24, 1995.  The research grant
application form PHS 398 (rev. 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, for AHCPR applications, from Global Exchange Inc.,
7910 Woodmont Avenue, Suite 400, Bethesda, MD 20814-3015, telephone
(301) 656-3100 (FAX 301-652-5264).

The RFA label available in the PHS 398 application form must be affixed
to the bottom of the face page of the original copy 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, type "RFA HS-95-002" in Section 2a on the face
page of the application form and the YES box 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**

Applications submitted under this RFA must be received in the Division
of Research Grants, NIH, by January 24, 1995.  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 form 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.

Applicants also should take careful note of the instructions on form
398, page 2, for preparing the description in the space designated.
This description should be carefully crafted because it serves a
variety of purposes and audiences.  Initially it is employed in the
application review process and serves as a significant criterion in the
initial evaluation of the competitiveness of the application.
Applicants are advised to have their faculty advisor(s) carefully
review the description.


Upon receipt, applications will be reviewed by the Referral Office,
Division of Research Grants, NIH, for completeness, and by AHCPR staff
for responsiveness to the RFA.  Incomplete and nonresponsive
applications will be returned to the applicant without further
consideration.  The determination of any application as nonresponsive
will be the sole responsibility of AHCPR.  The general review criteria
for AHCPR grant agreement applications are:  significance and
originality from a scientific and technical viewpoint; adequacy of the
proposed method(s); availability of data or proposed plan to collect
data required for the project; adequacy of the plan for organizing and
carrying out the project; qualifications and experience of the
principal investigator and proposed staff;  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 AHCPR 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 appropriateness.

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 arise.

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, 1995.


Those considering applying in response to this RFA are strongly
encouraged to discuss their project with AHCPR program administrators
before formal submission.  The AHCPR welcomes the opportunity to
clarify any issues or questions from potential applicants.

Direct inquiries regarding programmatic issues, including suitability
of their research topics and information on the policy of inclusion of
women and minorities in study populations, to:

Julius Pellegrino, Dissertation Program Coordinator
Center for General Health Services Extramural Research
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 502
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, Suite 601
Rockville, MD  20852
Telephone:  (301) 594-1447


This program is described in the Catalog of Federal Domestic
Assistance, No. 93.226.  Awards are made under authorization of the
Public Health Service Act, Title IX and Section 1142 of the Social
Security Act.  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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