Full Text HS-98-002
NIH GUIDE, Volume 26, Number 20, June 13, 1997
RFA:  HS-98-002
P.T. 44

  Biomedical Research Training 
  Health Services Delivery 

Agency for Health Care Policy and Research
Letter of Intent Receipt Date:  July 10, 1997
Application Receipt Date:  September 23, 1997
The Agency for Health Care Policy and Research (AHCPR) invites
applications for incentive awards for innovative approaches to health
services research training that are responsive to the research and
analytic needs of the evolving health care delivery system.  The
intent of the awards is to support the design and implementation of
new models for training health services researchers in order to
address emerging issues in health care policy and delivery and to
respond to the changing analytic needs of health care providers,
payers, and policymakers.  The awards represent seed money to support
developmental efforts not readily supported by existing training
mechanisms.  They are aimed at developing and sustaining novel and
unique educational approaches geared to enhancing established health
services research training programs.
Applications may address a wide spectrum of activities, including
seminars, structured short-term research experiences designed to
motivate and acquaint students with alternative career opportunities
in health services research, hands-on research experiences in
non-academic settings, cross-institutional collaboration to develop
training curricula or other innovative strategies to advance areas
where current capacity is limited, comprehensive and integrated
curriculum and faculty development within and between academic
institutions or between academic and non- academic settings, and the
development of model programs to strengthen the recruitment and
retention of minority health services research trainees. Applicants
are encouraged to develop partnerships with traditionally minority
academic institutions and health professional organizations to foster
collaboration and experiential training.  The overall intent is to
maintain the solid academic base of existing training programs, while
broadening that base to include an enhanced appreciation of the
changing health care delivery system and related analytic and
research needs.
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 high priority areas.  AHCPR
encourages applicants to address these objectives.  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 202-512-1800.
Applications may be submitted by domestic non-profit private and
public institutions with established programs in predoctoral and/or
postdoctoral health services research training.
The mechanism of support will be the Education Projects (R25), which
is designed for the development and/or implementation of programs
related to education.  The total project period for each application
submitted in response to the RFA may not exceed 5 years.  The
earliest anticipated award date is May 1, 1998.
AHCPR expects to award up to $1 million in Fiscal Year 1998,
depending on the overall availability of funds to support the first
year for approximately 20 projects under this RFA. Awards will
reflect a balance between short- and longer-term projects.
The number of awards is dependent on the number of high- quality
applications and their individual budget requirements; it is not the
intent of AHCPR that the awards be of equal size, but it is expected
that the average annual award will approximate $50,000 in direct
costs.  For longer- term projects, funding beyond the initial budget
period will depend upon annual progress reviews by AHCPR and the
availability of funds.
AHCPR currently supports institutional training programs through the
National Research Service Award (NRSA) program. The purpose of these
training programs is to help ensure that adequate numbers of highly
trained individuals are available to carry out the Nation's health
services research agenda.  However, NRSA funds can be used only for a
limited set of activities.  This program provides support not readily
available through other mechanisms for the development and/or
implementation of innovative models for training health services
researchers.  The program will help ensure that health services
research training programs reflect and address the restructuring
occurring in the broader health care system, as discussed in the
recent report by the Institute of Medicine, entitled Health Services
Research:  Work Force and Educational Issues, and by a 1996 expert
meeting of researchers, providers, and payers, convened by AHCPR to
address emerging issues in training.
Areas of Training
Traditionally, AHCPR has supported research that examines the
availability, quality, appropriateness, effectiveness, and costs of
health care services.  AHCPR further seeks to address these issues
specifically within the context of the current, rapidly evolving
health care delivery system in order to meet the needs of patients,
providers, plans, purchasers, and/or policy makers.  Thus, a goal of
this educational initiative is to equip students with the necessary
knowledge, skills, and experiences to conduct future research which
will address these needs.  This will be accomplished by supporting
the development and implementation of innovative training models
which will enhance the existing substantive and methodological bases
of established health services research training programs by
providing students with the conceptual, methodological, and practical
foundations to conduct research to:
o  Help consumers make more informed choices;
o  Determine what works best in clinical care;
o  Measure and improve quality of care;
o  Monitor and evaluate health care delivery;
o  Improve the cost-effective use of health care resources;
o  Provide health care policymakers with the information needed to
make informed decisions;
o  Address issues of relevance to priority populations, including
women, children, persons with chronic diseases or disabilities, the
elderly, and minority populations; and
o  Build and sustain the health services research infrastructure
Types of Projects
Existing health services research training programs with established
track records are eligible to compete for these innovative awards.
Applicants are encouraged to address activities, such as the
o  Curriculum and/or faculty development.  These initiatives would
enhance the infrastructure to support training. Applications could
focus on the administrative and programmatic needs required to put
together worthy training initiatives.  For example, this type of
program would allow an institution and its faculty to: design and
implement a new curriculum of critical importance to the education of
health services researchers and responsive to the needs of the
changing health care delivery system; to develop course content in
areas of identified need (such as outcomes/health status measurement,
quality of health care, evidence-based research findings,
effectiveness research, biostatistics, epidemiology, health
economics, decision analysis, cost- effectiveness analysis, and
health policy); or to foster faculty development through such avenues
as research experiences in nonacademic settings that would provide a
direct benefit to students.
o  Development of partnerships with non-academic organizations and
community health care providers.  These partnerships would be
designed to provide experience in applied research focused on
identified delivery system needs that would translate into improved
training.  A variety of partnership arrangements are anticipated,
including participation in curriculum development, the inclusion of
highly-qualified, non-academic personnel in the training experiences
of students; development of health services research student
internships or practicums in non-academic research settings; and the
leveraging of resources to expand the capacity for health services
research training.
o Facilitating recruitment and retention of minority trainees.
Partnerships, as those noted above, would be developed with
traditionally minority academic institutions and health professional
o  Short-Term Training.  These programs can range from one day to
several weeks and would focus on state-of-the-art research techniques
and methodology needed in conducting applied HSR.  They can take on
many forms, such  as seminars offered within or outside of the
existing grantee institution, workshops, summer institutes, or short
courses. They can be designed for a variety of purposes including,
but not limited to, exposing students to careers in health services
research, affording mid-career personnel exposure to new creative
educational opportunities and technologies, or introducing and
integrating community providers to health services research.
Proposed activities of this nature need to be related to the basic
thrust of existing training programs.
Budget Preparation and Allowable Costs
In general, allowable costs must be consistent with PHS policy.
These costs include, but are not limited to: supplies, personnel
costs, consultant costs, equipment, travel (excluding foreign travel
except where foreign travel is critical to achieving the objectives
of the grant), sub- contractual costs, and other expenses.  These
awards are made to institutions and not students.  Stipends and other
routine student training expenses, such as tuition and fees, are not
Faculty members participating in the design and implementation of
education programs can request with proper justification the percent
of their time devoted to curriculum design and specialized
organizational, coordinating, and implementation activities which are
essential to achieving the goals of their proposed educational
program.  Faculty-student preceptor-type interactions and activities,
however, will be considered as a regular, nonreimbursable part of
one's academic duties. In all cases, faculty compensation should not
exceed levels commensurate with the institution's policy for similar
Applicants receive indirect costs in addition to the direct costs of
the project.  For the purpose of calculating indirect costs,
education project grants are considered to be training grants.
Therefore, in accordance with PHS policy, indirect costs are limited
to eight percent of total allowable direct costs exclusive of
expenditures for equipment, or at the institution's actual indirect
cost rate, whichever results in a lesser dollar amount.
Rights in Data
AHCPR grantees may copyright or seek patents, as appropriate, for
final and interim products and materials including, but not limited
to, methodological tools, measures, software with documentation,
literature searches, and analyses, which are developed in whole or in
part with AHCPR funds.  Such copyrights and patents are subject to a
Federal Government license to use these products and materials for
AHCPR purposes.  AHCPR purposes may include, subject to statutory
confidentiality protections, making research materials, data bases,
and algorithms available for verification or replication by other
researchers; and subject to AHCPR budget constraints, final products
may be made available to the health care community and the public by
AHCPR, or its agents, if such distribution would significantly
increase access to a product and thereby produce public health
benefits.  Ordinarily, to accomplish distribution, AHCPR publishes
research findings but relies on grantee efforts to market
grant-supported products.  In keeping with AHCPR's legislative
mandates to make both research results and data available, copies of
all products and materials developed under a grant supported in whole
or in part by AHCPR funds are to be made available to AHCPR promptly
and without restriction, upon request by AHCPR.
The special terms of award described above are in addition to and not
in lieu of otherwise applicable PHS grant policies and Federal
Prospective applicants are asked to submit, by July 10, 1997, a
letter of intent that includes a descriptive title of the proposed
project; the names, addresses, and telephone numbers of the proposed
Training Program Director and other key personnel; and the number and
title of the RFA. Although a letter of intent is not required, is not
binding, and does not enter into the consideration of any subsequent
application, the information allows AHCPR staff to estimate the
potential review workload and avoid conflicts of interest in the
review.  AHCPR will not provide responses to letters of intent.
The letters of intent is to be addressed to:
Karen Rudzinski, Ph.D.
NRSA Project Officer
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 400
Rockville, MD  20852-4908
Email:  training@ahcpr.gov
The research grant application form PHS 398 (rev. 5/95) is to be used
in applying for these grants.  State and local government applicants
may use form PHS 5161-1, "Application for Federal Assistance" (rev.
5/96), and follow those requirements for copy submission.  Applicants
are reminded that the 25-page limit on the narrative section must be
In completing the PHS 398 form, designed primarily for research
grants, applicants should make reasonable accommodations so that the
requirements outlined in this RFA for an education grant are
appropriately addressed.  In particular, applicant should ensure that
the substantive content of the application addresses the issues under
Review Considerations.
Application kits are available at most institutional offices of
sponsored research and may be obtained from the Division of
Extramural Outreach and Information Resources, Office of Extramural
Research, National Institutes of Health, 6701 Rockledge Drive MSC
7910, Bethesda, MD 20892-7910, Telephone: 301-710-0267, E-mail,
AHCPR applicants should obtain application materials from the AHCPR
contractor: 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 form PHS 398 (rev. 5/96) must be
affixed to the bottom of  the face page of the original application.
Failure to do so could result in delayed processing of the
application such that it may not reach the review committee in time
for review.  In addition, the RFA title and number must be typed on
line 2 of the face page of the application form and the YES must be
Submit a signed, typewritten original of the application, including
the checklist, and three signed photocopies, in one package to:
BETHESDA, MD  20892-7710
BETHESDA, MD  20817 (for express/carrier service)
At the time of submission, two additional copies of the application
must be sent to:
Karen Rudzinski, Ph.D.
NRSA Project Officer
Office of Scientific Affairs
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 400
Rockville, MD  20852-4908
Applications submitted under this RFA must be received in the
Division of Research Grants, NIH, by September 23, 1997. If an
application is received after that date, it will be returned to the
applicant without review.
Applications that are complete and responsive will be evaluated for
technical and educational merit by an appropriate peer review group
in accordance with AHCPR peer review procedures.
Review Criteria
Grant applications should be characterized by innovation,
scholarship, and responsiveness to the special and/or changing needs
of and demands for health services researchers.  To ensure these
objectives, educational program applicants will be evaluated using
the following criteria:
Project Characteristics
o  The novelty, significance, and rationale of the proposed project
to health services research training and its responsiveness to the
evolving needs of payers, providers, and/or policy makers; the manner
in which the initiative logically builds upon and enhances the
existing health services research training program.
o  The quality and adequacy of the design of the innovation proposed
-- including the probability of achieving stated short- and long-term
o  Substantive and methodological content of the proposed project and
its relevance to the Program Objectives noted above, including
relevant descriptions of courses and experiential opportunities
offered and/or required.
o  The significance, quality, feasibility, and likely outcome of the
unique, new dimension being proposed to enhance the basic training
Program Leadership and Organizational Plans and Support
o  The institutional training environment, including criteria such as
the level of institutional commitment, quality of the facilities,
availability of appropriate courses, and availability of research
o  Program leadership in terms of past records of achievement and
qualifications of the Training Program Director and key personnel to
implement plans as proposed.
o  Organizational structure of the proposed training project,
including delineation of administrative responsibilities for
planning, oversight, and evaluation.
o  Demonstration of cooperation by any proposed collaborating
facilities, institutions, or departments in providing research
experiences and/or sites for trainees, including (where applicable)
documentation of mechanisms by which trainees will be integrated into
the ongoing health services research activities of other entities.
o  Evidence of the institution's commitment and plans to continue the
project or output from the project once grant support ends,
particularly when the innovative component involves curricula
development aimed at strengthening the educational capability of the
overall training program or when the project consists of educational
activities directed toward or involving the larger community.
o  For projects involving students, the qualifications and experience
of preceptors and their research support to impart specialized
research skills.
Project Institutionalization, Evaluation, and Dissemination Plans
o  Proposed methods for monitoring and evaluating performance of the
project, particularly in reference to achieving Program Objectives
noted above.
o  Demonstration of extent to which and ways in which AHCPR support
will be leveraged to maximize the potential for innovation in health
services research training.
o  Where appropriate, the adequacy of plans to diffuse or disseminate
knowledge gained from the project to the health services research
and/or health care delivery system community through appropriate
publication in professional periodicals and journals, presentations
at national meetings, and other vehicles.
o  Reasonableness and value of the proposed budget relative to goals
Combining the above factors, as appropriate, peer reviewers will
determine an overall level of merit for the application, which will
be reflected in a priority score.
Funding decisions for these innovative awards to health services
research training programs will be based on peer review, AHCPR
research program priorities, the need for research personnel in
specified program areas, balance among types of research training
supported by AHCPR, and the availability of funds.
Written and telephone inquiries concerning this RFA are encouraged.
Copies of the RFA and related materials are available from:
Global Exchange, Inc.
7910 Woodmont Avenue, Suite 400
Bethesda, MD 20814-3015
Telephone: 301-656-3100
Fax: 301-652-5264
This RFA is available through the AHCPR's website:
http:\\www.ahcpr.gov and through AHCPR InstantFAX at 301- 594-2800.
To use InstantFAX, you must call from a facsimile (FAX) machine with
a telephone handset.  Follow the voice prompt in order to obtain a
copy of the table of contents which has the document order number
(not the same as the RFA number).  The RFA will be sent at the end of
the ordering process.  AHCPR InstantFAX operates 24 hours a day, 7
days a week.  For questions about this service, call AHCPR's Division
of Communications at 301-594-1364, ext. 1389.
Direct inquiries regarding programmatic issues to:
Karen Rudzinski, Ph.D.
NRSA Project Officer
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 400
Rockville, MD  20852-4908
Telephone: 301-594-1452, ext. 1610
E-mail: training@ahcpr.gov
Direct fiscal and administrative inquiries to:
Mable L. Lam
Grants Management Officer
Agency for Health Care Policy and Research
2101 East Jefferson Street, Suite 601
Rockville, MD  20852
Telephone: 301-594-1447, ext. 1165
Fax: 301-594-3210
Email: mlam@ahcpr.gov
This program is described in the Catalog of Federal Domestic
Assistance, No. 93.226.  Awards are made under authorization of Title
IX of the Public Health Services Act (42 U.S.C. 299-299c-6).  Awards
are administered under HHS and PHS Grant Policies and Federal
regulations 42 CFR 67, Subpart A; and 45 CFR, Parts 74 and 92.  The
program is not subject to the intergovernmental review requirements
of Executive Order 12372 or Health Systems Agency review.
The Public Health Service strongly encourages all grant and contract
recipients to provide a smoke-free workplace and promote the non-use
of all tobacco products.  In addition, Public Law 103-227, The
Pro-Children act of 1994, prohibits smoking in certain facilities (or
in some cases, any portion of a facility) in which regular or routine
education, library, day care, health care, or early childhood
development services are provided to children.  This is consistent
with the PHS mission to protect and advance the physical and mental
health of the American people.

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