Department of Health and Human Services

Part 1. Overview Information

Participating Organization(s)

National Institutes of Health (NIH)

Components of Participating Organizations

National Institute of Mental Health (NIMH)

National Cancer Institute (NCI)

Funding Opportunity Title
Integrating Mental Health Care into Health Care Systems in Low- and Middle-Income Countries (R01 Clinical Trial Optional)
Activity Code

R01 Research Project Grant

Announcement Type
New
Related Notices
  • March 10, 2022 - Notice of Correction to Letters of Support Expectations for RFA-MH-22-130, "Integrating Mental Health Care into Health Care Systems in Low- and Middle-Income Countries (R01 Clinical Trial Optional)". See Notice NOT-MH-22-185
Funding Opportunity Announcement (FOA) Number
RFA-MH-22-130
Companion Funding Opportunity
None
Assistance Listing Number(s)
93.242, 93.393
Funding Opportunity Purpose

This Funding Opportunity Announcement (FOA) invites implementation research applications to develop, optimize, and test innovative theory-based strategies to integrate mental and physical health care within health care systems in low-and middle-income countries (LMICs). This FOA aims to support innovative research for implementing, scaling up, and financially sustaining integrated mental health care models to ultimately increase demand and utilization, quality, access, and availability of mental health care. This FOA is also expected to contribute to the long-term goals of strengthening the sustainable research capacity in LMICs and enhancing the potential for multidirectional knowledge and the exchange of research advancements. NIMH encourages partnerships between institutions in LMICs and high-income-countries (HICs).

Key Dates

Posted Date
February 10, 2022
Open Date (Earliest Submission Date)
May 22, 2022
Letter of Intent Due Date(s)

30 days prior to the application due date

Application Due Dates Review and Award Cycles
New Renewal / Resubmission / Revision (as allowed) AIDS Scientific Merit Review Advisory Council Review Earliest Start Date
June 22, 2022 Not Applicable August 04, 2022 November 2022 January 2023 April 2023

All applications are due by 5:00 PM local time of applicant organization. 

Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.

Expiration Date
August 05, 2022
Due Dates for E.O. 12372

Not Applicable

Required Application Instructions

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

There are several options available to submit your application through Grants.gov to NIH and Department of Health and Human Services partners. You must use one of these submission options to access the application forms for this opportunity.

  1. Use the NIH ASSIST system to prepare, submit and track your application online.
  2. Use an institutional system-to-system (S2S) solution to prepare and submit your application to Grants.gov and eRA Commons to track your application. Check with your institutional officials regarding availability.

  3. Use Grants.gov Workspace to prepare and submit your application and eRA Commons to track your application.


  4. Table of Contents

Part 2. Full Text of Announcement

Section I. Funding Opportunity Description

Background

Globally, more than 75% of people who need treatment, do not receive treatment for mental, neurological, and substance use disorders. Mental illnesses occur more commonly in people with other physical and chronic health conditions such as cardiovascular disease, diabetes, alcohol and substance use disorders, HIV, and more recently, people infected with COVID-19. Individuals with comorbidities have lower treatment adherence, poorer clinical outcomes, and a higher risk of disability and mortality. The relationship between mental illness and other chronic diseases is complex, bidirectional, and integrates multiple mechanisms, including biological, psychosocial, environmental, and economic factors. Understanding the potential mechanisms and interactions could help identify more efficacious strategies, interventions, and models of care to simultaneously address mental and co-occurring chronic illnesses.

Integrating mental health care into health care systems is a promising strategy to help expand access to mental health care and co-treat coexisting conditions. Integrated care may also increase accessibility, enhance continuity of care, and reduce cost. In addition, integrated care may produce efficiencies in health care delivery by providing care for multiple conditions. While there is evidence that some integrated care models significantly improve depression, anxiety, and other behavioral health conditions, it is unclear whether integrating mental health care into physical care can also improve other physical conditions. The service delivery infrastructure and other community care platforms such as primary care settings, community care centers, and platforms for chronic disease management also offer an opportunity to investigate models for integrating mental health care into health care systems in low-and middle-income countries (LMICs). Different integrated care models have been used in the outpatient management of mental disorders and other physical illnesses in high-income countries. Some integration models, such as the Collaborative Care Model and Stepped Care Model, have significantly improved mental health outcomes. However, while a variety of integrated care models have been tested in LMICs, considerably less is known about the optimal structure and implementation strategies necessary to scale up and sustain models of integration in LMICs.

Research Scope and Objectives

This FOA aims to support innovative implementation research to develop, optimize, and test innovative strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and financially sustaining integrated mental health care models to ultimately increase demand and utilization, quality, access, and availability of mental health care. This FOA is also expected to contribute to the long-term goals of strengthening the sustainable research capacity in LMICs and enhancing the potential for multidirectional knowledge and research advancements exchange.

Applications may propose new studies or secondary data analyses. All projects must describe the extent of researchers' significant involvement in LMIC settings and propose a research project element and a research capacity element. It will be essential for the proposed researchers to describe how the proposed research is relevant to the local context and aligns with NIMH's scientific priorities of transforming the prevention and treatment of mental illnesses and translating evidence into practice and policy. The potential for reciprocal learning will be considered an added value.

All applicants will be expected to substantially involve key personnel in the setting where the study will be conducted. For applications proposing a single PD/PI, the PD/PI will be required to have a primary academic appointment in an LMIC institution. Applications proposing MPIs will be required to include at least one PD/PI who has a primary academic appointment in an LMIC institution where the projects occur. The other PI(s) on the project can have an appointment at an LMIC-based institution or at a HIC-based institution. Research projects must be conducted in the LMIC in which the single PD/PI or at least one PD/PI has a primary appointment.

Applications to conduct secondary analyses must demonstrate the sufficiency of existing data sets in both quantity and quality to test hypothesized mediational pathways or to generate new hypotheses using computational and/or data science analytic approaches.

Applications that propose primary data collection must specify the models, variables, and measures used to identify and test potential pathways and mechanisms that may account for changes in key outcomes. Proposed studies should be consistent with the NIMH experimental therapeutics approach. Valid and reliable measures will provide useful Information about pathways and mechanisms that may account for intervention effects. Accordingly, applicants should plan to use the most direct and objective measures possible in the study setting, including validated measures of mental and psychical health beyond self-reports and other subjective measures, where possible, and include measures that span more than one level of assessment if possible and appropriate. NIMH encourages applicants to consider RDoC or RDoC-like constructs when defining intervention targets and outcomes, as feasible in the setting (see the RDoC webpage for more details)

For researchers proposing a new study, NIMH strongly encourages the employment of person-centric, multidisciplinary, and multilevel approaches, as well as multi-component interventions that potentially impact mental and physical health outcomes and quality of life. Of specific interest is research that uses task-sharing, innovative digital health technologies, and syndemic frameworks, where appropriate. The use of competency-based training approaches and competency assessments is strongly encouraged in order to improve the quality of care and reach (accurate detection).

For applications proposing a syndemic approach to implement integrated health care, applicants should operationalize the framework proposed based on appropriate methodological techniques to develop (e.g., epidemiological data, mixed methods, qualitative and ethnographic research) and evaluate (e.g., appropriated statistic methods) the impact of the syndemic model to improve mental and other clinical health outcomes. For applications proposing multi-component interventions or applying a syndemic approach, applicants should examine how different components contribute to and/or interact synergistically to produce the observed mental and other clinical health outcomes. This may involve advanced data analytic approaches, modeling; structuring, harmonizing, and extracting meaningful features from multiple data streams; and advanced computational and statistical approaches.

Applications with data collection plans that involve multiple respondent groups (e.g., clients/patients, therapists/providers, supervisors, administrators) should address provisions for human subject protections and consenting procedures for all participant groups, accordingly.

Research capacity element

Researchers are expected to describe a plan and activities between the partner country institutions and/or between the LMICs institutions, to strengthen research capacity at local and regional levels in LMICs and enhance the potential for multidirectional knowledge and research advancements exchange.

Activities may include but are not limited to:

  • Sharing education platforms to strengthen and develop expertise across research team members in different institutions and countries.
  • Engaging students and early investigators from the partner country institutions in bilateral training and exchanging knowledge on topics relevant to the research project.
  • Providing opportunities for obtaining relevant qualifications and expertise in research (e.g., Master’s and Ph.D. degrees).
  • Developing and disseminating implementation science programs to support the development of future studies.
  • Training in writing and submitting grants to NIH, written and publishing manuscripts.
  • Professional development in grants administration to foster proficiency in the management of scientific and administrative aspects of the grant.
  • Contributing to inform and disseminate common measures/data elements, evidence-based treatment, prevention, and health system policies where the study is taking place.
  • Making efficient use of local/regional oversight bodies such as International Review Boards (IRB) and Data and Safety Monitoring Boards (DSMBs)

Examples of relevant research topics include but are not limited to:

This FOA aims to support innovative implementation research to develop, optimize, and test innovative strategies for implementing, scaling up and financially sustaining integrated mental health care models in LMICs.

The general scope of the research includes, but is not limited to:

  • Identify and implement an optimal integration model to ensure scalability and sustainability.
  • Identify the necessary core elements of integrated mental health care models (e.g., routine screening, training/hiring case manager and consulting, disease registry)to enable the model’s implementation, scale-up, and sustainability.
  • Develop and test implementation strategies and innovative health technologies to improve health system-, patient-, and family-level outcomes and ensure the quality of integration.
  • Develop and test models and strategies for training, supervising, and supporting providers, including identifying the optimal functions, roles, and composition of integrated care teams to deliver integrated care with fidelity and high quality.
  • Test mechanisms of actions/ target mediators of implementation strategies for overcoming barriers to the adoption, adaptation, integration, scale-up, and sustainability of integrated care models.
  • Develop and test models and strategies for linking integrated care with other community-based services.
  • Develop and test behavioral economic strategies, financing models (payment mechanisms), and health policies that influence the success of scaling up and sustaining the provision of integrated care; by including an integrated care model on the universal health system and a cost-effective bundle of service.
  • Determine how an integrated care model can best engage local communities to enhance service user participation (e.g., demand and utilization).
  • Examine the independent and complementary or synergistic effects on the mental and physical health outcome of integrated care models with multilevel interventions targeting modifiable conditions (e.g., the structure of the health system, health policies, and other social drivers of mental illness).
  • Test strategies that target health system arrangements, such as incentives, regulations, and policies, which may facilitate or deter the availability (supply), accessibility, scalability, and sustainability of integrated care model and test relevant approaches to measure and extract existing data regarding these arrangements.

For applications involving clinical trials:

Consistent with the NIMH experimental therapeutics approach, this FOA is intended to support research trials that not only test the intervention effects on outcomes of interest but also explicitly inform understanding regarding whether the intervention engages associated change mechanisms that were previously identified under more controlled, efficacy conditions, thereby reconfirming the intervention targets and testing whether previously identified change mechanisms are operative in the effectiveness context (see NIMH webpage on Clinical Trials). In this manner, the effectiveness trial results will advance knowledge regarding therapeutic change mechanisms and have utility regardless of trial outcomes (e.g., in the event of negative results, Information about whether the intervention was successful at engaging its targets can facilitate interpretation).

NIMH encourages projects to test the effectiveness of preventive, therapeutic, or services interventions designed as hybrid effectiveness-implementation trials, as appropriate, depending on the level of pre-existing effectiveness evidence and implementation readiness.

This FOA encourages effectiveness research that simultaneously tests strategies to promote successful implementation (i.e., as Hybrid Type II trials). Likewise, studies primarily aimed at testing an implementation or dissemination strategy should also be designed to assess the outcomes and effectiveness of the intervention/approach that is being implemented, as appropriate and feasible (i.e., as Hybrid Type III trials).

NIMH encourages studies that test intervention and service delivery strategies that incorporate features specifically designed to prevent threats to intervention fidelity and implementation strategy fidelity, as appropriate. Strategies that might be used to enhance scalability and sustained implementation include but are not limited to consumer-facing technology (e.g., self-administered content) and provider-facing technology (e.g., technology to support provider training and sustained implementation fidelity); expert consultation via existing resources or other sustainable means (e.g., telehealth, collaborative care approaches); or other robust design features that promote provider competence and sustained implementation fidelity.

National Cancer Institute (NCI)

The National Cancer Institute seeks implementation science projects integrating mental health services across the cancer care continuum including during cancer prevention, detection, diagnosis, treatment including palliative care, and survivorship. Examples include (but are not limited to) studies that seek to understand and evaluate sustainable approaches to integrating mental health services into cancer diagnosis and treatment; optimizing mental health care for survivors seeing oncology and non-oncology providers; and adapting or developing and testing mental health care interventions to settings with underdeveloped infrastructure.

Applications Not Responsive to this FOA (all applications)

The following will be considered nonresponsive to this FOA and will not be reviewed:

  • Applications that propose research to be conducted primarily in HICs, including but not limited to the US.
  • Research focused on including services for chronic conditions care into specialized mental health programs.
  • Studies examining the efficacy and effectiveness of new pharmacologic therapies.
  • Studies limited to descriptive analyses of disease prevalence and health systems.
  • Studies conducted exclusively in academic research laboratories as opposed to effectiveness studies in community practice clinics/settings (e.g., studies in research clinics that involve research therapists or other features that are not representative of typical practice settings and substantially impact generalizability).

For the purposes of this FOA, use the following definitions:

LMICs: are defined according to the fiscal year 2022 World Bank designations of low- and middle-income countries (LMICs) (see World Bank Data Helpdesk webpage).

Reciprocal learning: in the field of global mental health, reciprocal learning is a multidirectional exchange of research advancements requiring sharing of ideas and collaboration. This process expands the benefit of research innovations to diverse contexts, communities, and populations, equitably improving mental health and shaping future research worldwide.

Chronic conditions: refer to non-communicable and communicable conditions that last at least three months, remitting and recurring symptoms, and often slow progression.

Person-centric approach: the management and delivery of health services so that clients receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health system (WHO)

Syndemic: is the aggregation of two or more concurrent or sequential disease clusters, interacting synergistically at both the population and individual levels, contributing to excess burden of disease and prognosis.

Implementation research: is defined as the scientific study of strategies to adopt and integrate evidence-based health interventions into clinical and community settings to improve individual outcomes and benefit population health.

Dissemination research: is defined as the scientific study of the targeted distribution of information and intervention materials to a specific public health or clinical practice audience. The intent is to understand how best to communicate and integrate knowledge and the associated evidence-based interventions.

Technical Assistance Teleconference

A Technical Assistance teleconference will be held via Zoom (Webinar ID 161 812 3252) for potential applicants on March 16, 2022 at 9:00 AM ET. Click here to register. Please check the NIMH Center for Global Mental Health website for webinar updates.

The NIMH has published updated policies and guidance for investigators regarding human research protection and clinical research data and safety monitoring (NOT-MH-19-027). The application’s PHS Human Subjects and Clinical Trials Information, including the Data and Safety Monitoring Plan, should reflect the policies and guidance in this notice. Plans for the protection of research participants and data and safety monitoring will be reviewed by the NIMH for consistency with NIMH and NIH policies and federal regulations.

See Section VIII. Other Information for award authorities and regulations.

Section II. Award Information

Funding Instrument

Grant: A support mechanism providing money, property, or both to an eligible entity to carry out an approved project or activity.

Application Types Allowed
New

The OER Glossary and the SF424 (R&R) Application Guide provide details on these application types. Only those application types listed here are allowed for this FOA.

Clinical Trial?

Optional: Accepting applications that either propose or do not propose clinical trial(s).

Need help determining whether you are doing a clinical trial?

Funds Available and Anticipated Number of Awards

NIMH and NCI intend to commit $3M in FY 2023 to fund 6-7 awards.

Award Budget

Application budgets are not limited but need to reflect the actual needs of the proposed project. .

Award Project Period

The scope of the proposed project should determine the project period. The maximum project period is 5 years.

NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made from 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)

Local 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)

Federal Government

  • 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
  • Non-domestic (non-U.S.) Entities (Foreign Institutions)
Foreign Institutions

Non-domestic (non-U.S.) Entities (Foreign Institutions) are eligible to apply.

Non-domestic (non-U.S.) components of U.S. Organizations are 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.

  • System for Award Management (SAM) – 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.
    • Unique Entity Identifier (UEI)- A UEI is issued as part of the SAM.gov registration process. SAM registrations prior to fall 2021 were updated to include a UEI. For applications due on or after January 25, 2022, the UEI must be provided on the application forms (e.g., FORMS-G); the same UEI must be used for all registrations, as well as on the grant application.
    • Dun and Bradstreet Universal Numbering System (DUNS) – Organization registrations prior to April 2022 require applicants to obtain a DUNS prior to registering in SAM. By April 2022, the federal government will stop using the DUNS number as an entity identifier and will transition to the Unique Entity Identifier (UEI) issued by SAM. Prior to April 2022, 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.
  • eRA Commons - Once the unique organization identifier (DUNS prior to April 2022; UEI after April 2022) is established, organizations can register with eRA Commons in tandem with completing their full SAM and Grants.gov registrations; all registrations must be in place by time of submission. 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 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.

For institutions/organizations proposing a single PD/PI will be required to have a primary academic appointment in an LMIC institution.

Applications proposing MPIs will be required to include at least one PD/PI who has a primary academic appointment in an LMIC institution where the projects occur. Applications proposing MPIs can have a contact PI in either institution.

NIMH encourages partnerships between institutions in LMICs and HICs.

Research projects must be conducted in the LMIC in which the single PD/PI or at least one PD/PI has a primary appointment.

LMICs are defined according to the fiscal year 2022 World Bank designations of low- and middle-income countries (LMICs) (see World Bank Data Helpdesk webpage).

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, per 2.3.7.4 Submission of Resubmission Application. 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 2.3.9.4 Similar, Essentially Identical, or Identical Applications)

Section IV. Application and Submission Information

1. Requesting an Application Package

The application forms package specific to this opportunity must be accessed through ASSIST, Grants.gov Workspace or an institutional system-to-system solution. Links to apply using ASSIST or Grants.gov Workspace are available in Part 1 of this FOA. See your administrative office for instructions if you plan to use an institutional system-to-system solution.

2. Content and Form of Application Submission

It is critical that applicants follow the instructions in the Research (R) Instructions in the SF424 (R&R) Application Guide 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.

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:

Email: nimhpeerreview@mail.nih.gov

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.

SF424(R&R) Other Project Information

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

SF424(R&R) Senior/Key Person Profile

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

Biographical Sketch

  • Describe the extent of involvement of researchers in LMICs.
  • Describe the team's expertise and knowledge of the social and cultural contexts of the LMIC setting with appropriate participation and leadership by LMIC investigators, key personnel, and stakeholders.

R&R or Modular Budget

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

The PD/PI is encouraged to budget travel costs to present the research results at high-caliber technical meetings, at least one of which is devoted directly to global health research. A portion of the budget could include costs for external members of the advisory committee to meet, if possible by teleconference and or in-person.

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:

Significance

  • Address the degree to which the proposed integrated model is relevant to the local context and could be disseminated into practice and policy given: (i) the current health system function (e.g., current available financial and non-financial resources); (ii) service delivery arrangements or payment mechanisms; (iii) typical service structures (e.g., health policies) and use patterns; and (iv) public health impact.
  • Detail how the proposed research will lead to new knowledge about an optimal and effective integration model to ensure scalability and sustainability.

For studies that involve clinical trials:

  • Justify the practical effect of the integrated model in terms of the estimated hypothesized effect size (e.g., in terms of mental and physical health outcomes, and implementation outcomes).
  • Address the potential impact of the integrated model in terms of:
  1. the empirical basis for the anticipated effect size (e.g., citing data regarding the magnitude of the association between the target and the clinical endpoint of interest and/or effect sizes obtained in prior efficacy studies),
  2. the clinical meaningfulness of the anticipated increment in effects compared to existing approaches, and
  3. public health impact.

Innovation

As relevant and appropriate, describe how application of digital technologies, big data, or other innovative approaches or frameworks are leveraged to implement, scale up, and sustain accessible and effective integrated mental health care models to ultimately increase demand and utilization, quality, access, and availability of mental health care.

Approach

  • Projects must propose a research project and a research capacity element in collaboration between multiple investigators/institutions.
  • Provide evidence that outcome measures are valid and reliable for the proposed population(s).
  • Detail the procedures that will be used to identify and systematically quantify the resources necessary to implement and scale-up the intervention.
  • As relevant, address how the study contributes to advancing the personalization of mental health care and describe the collection of clinical and biological variables (e.g., blood for genetic analysis, other potential biomarkers) that might be used to examine moderators or inform/test algorithms for more prescriptive approaches. Address plans to examine moderators and/or the potential to contribute information regarding potential moderators to larger databases.
  • Describe plans to establish or develop research partnerships with local decision-makers such as representatives from government agencies, non-government organizations, provider organizations where the study will take place, such as Ministry/Department of Health, Education, Social Welfare, and Finance. Partnerships with global health organizations and /or developmental agencies (e.g., WHO, USAID, World Bank) are encouraged.

Applications that will involve the acquisition of new data must:

  • Propose implementation research that applies implementation science theories, models, and frameworks to inform research design and utilize a broader range of implementation outcomes.
  • Propose integration of mental health services into existing health care systems or other existing platforms of care for physical conditions such as primary care settings, community care centers, platforms for chronic disease management, and those used to support mobile populations to improve care coordination and patient-family and fitness system-level outcomes.
  • Describe plans to test strategies to overcome barriers on the structure of the health system, external influences, such as policies and regulations, that may affect the supply and accessibility of effective integrated mental health care models to facilitate its scaling up and sustainability.
  • Propose a culturally appropriate and feasible evidence-based mental health intervention (or a combination of evidence-based interventions), as part of the mental health service provided in integrated care.
  • As appropriate, propose implementation science measures that are applicable in diverse global settings and incorporate outcome measures that are validated and generally accepted by the field, including stakeholder-relevant outcomes (e.g., functioning, health services use).
  • Target and assess outcomes from more than one mental illness (e.g., depression, bipolar disorder, generalized anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorders, and/or schizophrenia AND one or more physical or chronic diseases which could include but are not limited to: alcohol and substance use disorders, diabetes, obesity, metabolic disease, hypertension, cardiovascular disease, chronic respiratory disease, cancer or stroke, HIV, tuberculosis, neglected tropical diseases, and COVID. The use of the transdiagnostic approach is also strongly encouraged. Implementation outcomes are also required.
  • Propose methods to assess more than one level of assessment, assess the quality of integration and competency for delivering care.
  • Propose research design and methods according to the following:
    • Address whether the intervention engages the mechanism that is presumed to underlie the intervention effects (the mechanism that accounts for changes in clinical/functional outcomes, changes in provider behavior, etc.) so that the results will inform understanding of change mechanisms and inform decisions about whether further effectiveness testing is warranted.
    • Address whether the intervention engages the mechanism that is presumed to underlie the intervention effects.
    • Propose a well-supported conceptual framework that clearly identifies the target(s)/mechanism(s) and the empirical evidence linking the target(s)/mechanism(s) to study outcomes.
    • Present justified plans for assessing engagement, including the specific measures, the assessment schedule, and the justification for the assessment strategy (e.g., evidence regarding the validity and feasibility of the proposed measures in the effectiveness context).
    • Present analytic strategies that will be used to examine target engagement and associations with clinical benefit (mental and physical conditions).
  • Propose an economic evaluation and budgetary impact analysis.

Applications proposing multi-component intervention and or syndemic approach studies must:

  • Describe how different intervention components contribute to and/or interact synergistically to produce the observed outcome (mental and physical health outcomes, implementation outcome).
  • Describe how the application applies appropriate methodological techniques to operationalize the syndemic framework to develop and evaluate the impact on mental and other clinical health outcomes.

For applications proposing research involving secondary analyses of existing data sets must:

  • Demonstrate the sufficiency of existing data sets in both quantity and quality to test hypothesized mediational pathways or to generate new hypotheses using computational and/or data science analytic approaches.
  • Demonstrated that the data are available and accessible.

Timeline:

Provide a timeline for the proposed research that does not overlap the Study Timeline submitted on the Human Subjects-Clinical Trial Information form, if applicable.

Advisory Board:

Propose an Advisory Board and an appropriate plan (e.g., advisory board structure, roles, and budget justification) to ensure engagement of relevant stakeholders throughout the project - from design to dissemination- to inform research and ensure findings will have utility for end-users. Advisory committee members could include but are not limited to patients, family, community members, advocates, peers, health care providers, policymakers, and members of the research partnership. An appropriate plan with a description of advisory board structure, roles, and budget justification to secure the members to complete the research aims and support regular meetings should be provided. A schedule for the Advisory committee meetings should be included in the timeline. During the project period, the PD/PI will be expected to describe the proceedings of the advisory committee in annual progress reports

The PD/PI is expected to include the establishment of a to-be-named external advisory committee. It is essential that potential advisory board members are not contacted or identified in advance (i.e., in the application) to minimize conflicts during the review process. If an application is selected for funding, NIMH will request the names of advisory committee members as part of the Just-in-Time process. The application should indicate the areas of scientific expertise, anticipated input, and any critical considerations in selecting potential members. Advisory committee members cannot be collaborators or consultants on the proposed project. The Advisory Committee is expected to provide an ongoing assessment of the research's progress, discuss future research goals, aims, and ideas, and provide research career guidance to the awardee during the five years of the grant.

Letters of Support:

The Chair of the Department where the PD/PI holds the primary academic appointment must provide a letter describing any tangible research support committed to the PD/PI. This may include start-up packages provided to the investigator, salary commitment, protected time for research, space and equipment allocations, core facilities made available without charge-back, specialized training, mini-sabbatical experiences to promote career enhancement, etc. In addition, the letter should discuss the departmental commitment to protected research time for the applicant. The strength of the institutional support will be considered a factor in the review of the application.

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.

The following modifications also apply:

All applications, regardless of the amount of direct costs requested for any one year, must address a Data Sharing Plan.

To advance the goal of advancing research through widespread data sharing among researchers, investigators funded under this FOA are expected to share those data via the National Institute of Mental Health Data Archive (NDA; see NOT-MH-19-033). Established by the NIH, NDA is a secure informatics platform for scientific collaboration and data-sharing that enables the effective communication of detailed research data, tools, and supporting documentation. NDA links data across research projects through its Global Unique Identifier (GUID) and Data Dictionary technology. Investigators funded under this FOA are expected to use these technologies to submit data to NDA.

To accomplish this objective, it will be important to formulate a) an enrollment strategy that will obtain the information necessary to generate a GUID for each participant, and b) a budget strategy that will cover the costs of data submission. The NDA web site provides two tools to help investigators develop appropriate strategies: 1) the NDA Data Submission Cost Model which offers a customizable Excel worksheet that includes tasks and hours for the Program Director/Principal Investigator and Data Manager to budget for data sharing; and 2) plain language text to be considered in your informed consent available from the NDA's Data Contribution page. Investigators are expected to certify the quality of all data generated by grants funded under this FOA prior to submission to NDA and review their data for accuracy after submission. Submission of descriptive/raw data is expected semi-annually (every January 15 and July 15); submission of all other data is expected at the time of publication, or prior to the end of the grant, whichever occurs first (see NDA Sharing Regimen for more information); Investigators are expected to share results, positive and negative, specific to the cohorts and outcome measures studied. The NDA Data Sharing Plan is available for review on the NDA website. NDA staff will work with investigators to help them submit data types not yet defined in the NDA Data Dictionary.

Appendix:
Only limited Appendix materials are allowed. Follow all instructions for the Appendix as described in the SF424 (R&R) Application Guide.
PHS Human Subjects and Clinical Trials Information

When involving human subjects research, clinical research, and/or NIH-defined clinical trials (and when applicable, clinical trials research experience) follow all instructions for the PHS Human Subjects and Clinical Trials Information form in the SF424 (R&R) Application Guide, with the following additional instructions:

If you answered “Yes” to the question “Are Human Subjects Involved?” on the R&R Other Project Information form, you must include at least one human subjects study record using the Study Record: PHS Human Subjects and Clinical Trials Information form or Delayed Onset Study record.

Study Record: PHS Human Subjects and Clinical Trials Information

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

Delayed Onset Study

Note: Delayed onset does NOT apply to a study that can be described but will not start immediately (i.e., delayed start).All instructions in the SF424 (R&R) Application Guide must be followed.

PHS Assignment Request Form

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

Foreign Institutions

Foreign (non-U.S.) institutions must follow policies described in the NIH Grants Policy Statement, and procedures for foreign institutions described throughout the SF424 (R&R) Application Guide.

3. Unique Entity Identifier and System for Award Management (SAM)

See Part 1. Section III.1 for information regarding the requirement for obtaining a unique entity identifier and for completing and maintaining active registrations in System for Award Management (SAM), NATO Commercial and Government Entity (NCAGE) Code (if applicable), eRA Commons, and Grants.gov

4. Submission Dates and Times

Part I. Overview Information contains information about Key Dates and times. 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. When a submission date falls on a weekend or Federal holiday, the application deadline is automatically extended to the next business day.

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 and time.  If a Changed/Corrected application is submitted after the deadline, the application will be considered late. Applications that miss the due date and time are subjected to the NIH Policy on Late Application Submission.

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.

5. Intergovernmental Review (E.O. 12372)

This initiative is not subject to intergovernmental review.

6. 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.

7. 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 How to Apply – Application Guide. If you encounter a system issue beyond your control that threatens your ability to complete the submission process on-time, you must follow the Dealing with System Issues guidance. For assistance with application submission, contact the Application Submission Contacts in Section VII.

Important reminders:

All PD(s)/PI(s) must include their eRA Commons ID in the Credential fieldof the Senior/Key Person Profile form. 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 unique entity identifier (DUNS number or UEI as required) provided 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 components of participating organizations, NIH. Applications that are incomplete, non-compliant and/or nonresponsive will not be reviewed.

Use of Common Data Elements in NIH-funded Research

Many NIH ICs encourage the use of common data elements (CDEs) in basic, clinical, and applied research, patient registries, and other human subject research to facilitate broader and more effective use of data and advance research across studies. CDEs are data elements that have been identified and defined for use in multiple data sets across different studies. Use of CDEs can facilitate data sharing and standardization to improve data quality and enable data integration from multiple studies and sources, including electronic health records. NIH ICs have identified CDEs for many clinical domains (e.g., neurological disease), types of studies (e.g. genome-wide association studies (GWAS)), types of outcomes (e.g., patient-reported outcomes), and patient registries (e.g., the Global Rare Diseases Patient Registry and Data Repository). NIH has established a “Common Data Element (CDE) Resource Portal" (http://cde.nih.gov/) to assist investigators in identifying NIH-supported CDEs when developing protocols, case report forms, and other instruments for data collection. The Portal provides guidance about and access to NIH-supported CDE initiatives and other tools and resources for the appropriate use of CDEs and data standards in NIH-funded research. Investigators are encouraged to consult the Portal and describe in their applications any use they will make of NIH-supported CDEs in their projects.

NIMH has released expectations for collecting common data elements when an application involves human research participants. Details can be found at NOT-MH-20-067 and the NIMH webpage on Data Sharing for Applicants and Awardees.

Post Submission Materials

Applicants are required to follow the instructions for post-submission materials, as described in the policy. Any instructions provided here are in addition to the instructions in the policy.

Section V. Application Review Information

1. Criteria

Only the review criteria described below will be considered in the review process.  Applications submitted to the NIH in support of the NIH mission are evaluated for scientific and technical merit through the NIH peer review system.

A proposed Clinical Trial application may include study design, methods, and intervention that are not by themselves innovative but address important questions or unmet needs. Additionally, the results of the clinical trial may indicate that further clinical development of the intervention is unwarranted or lead to new avenues of scientific investigation.

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? Is the prior research that serves as the key support for the proposed project rigorous? 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?

Specific for this FOA:

  • Evaluate the team's proposal of an integrated model that is relevant to the local context and can be disseminated into practice and policy
  • To what extent will the proposed research lead to new knowledge about an optimal and effective integration model that addresses scalability and sustainability?

In addition, for applications involving clinical trials

Are the scientific rationale and need for a clinical trial to test the proposed hypothesis or intervention well supported by preliminary data, clinical and/or preclinical studies, or information in the literature or knowledge of biological mechanisms? For trials focusing on clinical or public health endpoints, is this clinical trial necessary for testing the safety, efficacy or effectiveness of an intervention that could lead to a change in clinical practice, community behaviors or health care policy? For trials focusing on mechanistic, behavioral, physiological, biochemical, or other biomedical endpoints, is this trial needed to advance scientific understanding?

Investigator(s)

Are the PD(s)/PI(s), collaborators, and other researchers well suited to the project? If Early Stage Investigators or those 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?

Specific for this FOA:

  • How well does the team's expertise highlights sufficient knowledge of the social and cultural contexts of the LMIC setting with appropriate participation of researchers and leadership by LMICs investigators, key personnel, and stakeholders?

In addition, for applications involving clinical trials

With regard to the proposed leadership for the project, do the PD/PI(s) and key personnel have the expertise, experience, and ability to organize, manage and implement the proposed clinical trial and meet milestones and timelines? Do they have appropriate expertise in study coordination, data management and statistics? For a multicenter trial, is the organizational structure appropriate and does the application identify a core of potential center investigators and staffing for a coordinating center?

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?

As relevant and appropriate, how well does the application apply digital technologies, big data, or other innovative approaches or frameworks to implement, scale up, and sustain accessible and effective integrated mental health care models to ultimately increase demand and utilization, quality, access, and availability of mental health care?

In addition, for applications involving clinical trials

Does the design/research plan include innovative elements, as appropriate, that enhance its sensitivity, potential for information or potential to advance scientific knowledge or clinical practice?

Approach

Are the overall strategy, methodology, and analyses well-reasoned and appropriate to accomplish the specific aims of the project? Have the investigators included plans to address weaknesses in the rigor of prior research that serves as the key support for the proposed project? Have the investigators presented strategies to ensure a robust and unbiased approach, as appropriate for the work proposed? 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? Have the investigators presented adequate plans to address relevant biological variables, such as sex, for studies in vertebrate animals or human subjects?

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 individuals of all ages (including children and older adults), justified in terms of the scientific goals and research strategy proposed?

Specific for this FOA:

  • How well does the application propose a research project and a research capacity element in collaboration with the investigators/institutions involved?
  • To what degree does the application propose to generate new information concerning the structure of the health system and test strategies to overcome barriers in the supply of effective integrated mental health care models to facilitate its scaling up and sustainability?
  • How well does the application propose a culturally appropriate and feasible evidence-based mental health intervention (or a combination of evidence-based interventions) as part of the mental health service provided on the integrated care and employ implementation science measures relevant for the proposed setting.
  • As appropriate, to what extent does the application employ measures that span more than one level of assessment, assess multi-disease treatment outcomes (more than one mental illness AND one or more comorbid physical conditions), assess the quality of integration, and competency for delivering care?
  • If the application proposed multi-component intervention and or syndemic approach, how well does the application describe how different components contribute to and/or interact synergistically to produce the observed outcome (mental and physical health outcomes; implementation outcome); and how well it applies appropriate methodological techniques to operationalize the syndemic framework to develop and evaluate the impact on mental and other clinical health outcomes.
  • For Applications that will involve the acquisition of new data:
    • Are the proposed research design and methods appropriate? How well does the study design explicitly address whether the intervention engages the mechanism that is presumed to underlie the intervention effects (the mechanism that accounts for changes in clinical/functional outcomes, changes in provider behavior, etc.) so that the results will inform understanding of change mechanisms and inform decisions about whether further effectiveness testing is warranted? To what extent does the application include (1) a well-supported conceptual framework that clearly identifies the target(s)/mechanism(s) and the empirical evidence linking the target(s)/mechanism(s) to study outcomes; (2) well-justified plans for assessing engagement, including the specific measures, the assessment schedule, and the justification for the assessment strategy (e.g., evidence regarding the validity and feasibility of the proposed measures in the effectiveness context); and (3) appropriate analytic strategies that will be used to examine target engagement and associations with clinical benefit (mental and physical conditions).
  • Is the proposed research partnership with local decision-makers where the study will take place appropriate?
  • Is the Advisory Board plan adequate (e.g., advisory board structure, roles, and budget justification) to ensure engagement of relevant stakeholders throughout the project to inform research and ensure findings will have utility for end-users?
  • If the proposed research will conduct secondary analyses of existing data sets, to what extent has the application demonstrated the sufficiency of existing data sets in both quantity and quality to test hypothesized mediational pathways or to generate new hypotheses using computational and/or data science analytic approaches?
  • Is the data sharing plan appropriate?

In addition, for applications involving clinical trials

Does the application adequately address the following, if applicable

Study Design

Is the study design justified and appropriate to address primary and secondary outcome variable(s)/endpoints that will be clear, informative and relevant to the hypothesis being tested? Is the scientific rationale/premise of the study based on previously well-designed preclinical and/or clinical research? Given the methods used to assign participants and deliver interventions, is the study design adequately powered to answer the research question(s), test the proposed hypothesis/hypotheses, and provide interpretable results? Is the trial appropriately designed to conduct the research efficiently? Are the study populations (size, gender, age, demographic group), proposed intervention arms/dose, and duration of the trial, appropriate and well justified?

Are potential ethical issues adequately addressed? Is the process for obtaining informed consent or assent appropriate? Is the eligible population available? Are the plans for recruitment outreach, enrollment, retention, handling dropouts, missed visits, and losses to follow-up appropriate to ensure robust data collection? Are the planned recruitment timelines feasible and is the plan to monitor accrual adequate? Has the need for randomization (or not), masking (if appropriate), controls, and inclusion/exclusion criteria been addressed? Are differences addressed, if applicable, in the intervention effect due to sex/gender and race/ethnicity?

Are the plans to standardize, assure quality of, and monitor adherence to, the trial protocol and data collection or distribution guidelines appropriate? Is there a plan to obtain required study agent(s)? Does the application propose to use existing available resources, as applicable?

Data Management and Statistical Analysis

Are planned analyses and statistical approach appropriate for the proposed study design and methods used to assign participants and deliver interventions? Are the procedures for data management and quality control of data adequate at clinical site(s) or at center laboratories, as applicable? Have the methods for standardization of procedures for data management to assess the effect of the intervention and quality control been addressed? Is there a plan to complete data analysis within the proposed period of the award?

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?

In addition, for applications involving clinical trials

If proposed, are the administrative, data coordinating, enrollment and laboratory/testing centers, appropriate for the trial proposed?

Does the application adequately address the capability and ability to conduct the trial at the proposed site(s) or centers? Are the plans to add or drop enrollment centers, as needed, appropriate?

If international site(s) is/are proposed, does the application adequately address the complexity of executing the clinical trial?

If multi-sites/centers, is there evidence of the ability of the individual site or center to: (1) enroll the proposed numbers; (2) adhere to the protocol; (3) collect and transmit data in an accurate and timely fashion; and, (4) operate within the proposed organizational structure?

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.

Study Timeline

Specific to applications involving clinical trials

Is the study timeline described in detail, taking into account start-up activities, the anticipated rate of enrollment, and planned follow-up assessment? Is the projected timeline feasible and well justified? Does the project incorporate efficiencies and utilize existing resources (e.g., CTSAs, practice-based research networks, electronic medical records, administrative database, or patient registries) to increase the efficiency of participant enrollment and data collection, as appropriate?

Are potential challenges and corresponding solutions discussed (e.g., strategies that can be implemented in the event of enrollment shortfalls)?

Protections for Human Subjects

For research that involves human subjects but does not involve one of the 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 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 Individuals Across the Lifespan

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 individuals of all ages (including children and older adults) 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

The committee will evaluate the involvement of live vertebrate animals as part of the scientific assessment according to the following criteria: (1) description of proposed procedures involving animals, including species, strains, ages, sex, and total number to be used; (2) justifications for the use of animals versus alternative models and for the appropriateness of the species proposed; (3) interventions to minimize discomfort, distress, pain and injury; and (4) justification for euthanasia method if NOT consistent with the AVMA Guidelines for the Euthanasia of Animals. Reviewers will assess the use of chimpanzees as they would any other application proposing the use of vertebrate animals. For additional information on review of the Vertebrate Animals section, please refer to the Worksheet for Review of the Vertebrate Animal Section.

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

Reviewers will assess whether the project presents special opportunities for furthering research programs through the use of unusual talent, resources, populations, or environmental conditions that exist in other countries and either are not readily available in the United States or augment existing U.S. resources.

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) Sharing Model Organisms and (2) Genomic Data Sharing Plan (GDS).

Authentication of Key Biological and/or Chemical Resources:

For projects involving key biological and/or chemical resources, reviewers will comment on the brief plans proposed for identifying and ensuring the validity of those resources.

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 NIMH, 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 will receive a written critique.

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.

Appeals of initial peer review will not be accepted for applications submitted in response to this FOA.

Applications will be assigned on the basis of established PHS referral guidelines 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 appropriate national Advisory Council or Board. 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. Refer to Part 1 for dates for peer review, advisory council review, and earliest start date.

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 recipient's business official.

Recipients 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.

The NIMH has published policies and guidance for investigators regarding human research protection, data and safety monitoring, Independent Safety Monitors and Data and Safety Monitoring Boards, reportable events, and participant recruitment monitoring (NOT-MH-19-027). The application’s PHS Human Subjects and Clinical Trials Information should reflect the manner in which these policies will be implemented for each study record. These plans will be reviewed by the NIMH for consistency with NIMH and NIH policies and federal regulations. The NIMH will expect clinical trials to be conducted in accordance with these policies including, but not limited to: timely registration to ClinicalTrials.gov, submission of review determinations from the clinical trial’s data and safety monitoring entity (at least annually), timely submission of reportable events as prescribed, and establishment of recruitment milestones and progress reporting.

Individual awards are based on the application submitted to, and as approved by, the NIH and are subject to the IC-specific terms and conditions identified in the NoA.

ClinicalTrials.gov: If an award provides for one or more clinical trials. By law (Title VIII, Section 801 of Public Law 110-85), the "responsible party" must register and submit results information for certain “applicable clinical trials” on the ClinicalTrials.gov Protocol Registration and Results System Information Website (https://register.clinicaltrials.gov). NIH expects registration and results reporting of all trials whether required under the law or not. For more information, see https://grants.nih.gov/policy/clinical-trials/reporting/index.htm

Institutional Review Board or Independent Ethics Committee Approval: Recipient institutions must ensure that all protocols are reviewed by their IRB or IEC. To help ensure the safety of participants enrolled in NIH-funded studies, the recipient must provide NIH copies of documents related to all major changes in the status of ongoing protocols.

Data and Safety Monitoring Requirements: The NIH policy for data and safety monitoring requires oversight and monitoring of all NIH-conducted or -supported human biomedical and behavioral intervention studies (clinical trials) to ensure the safety of participants and the validity and integrity of the data. Further information concerning these requirements is found at http://grants.nih.gov/grants/policy/hs/data_safety.htm and in the application instructions (SF424 (R&R) and PHS 398).

Investigational New Drug or Investigational Device Exemption Requirements: Consistent with federal regulations, clinical research projects involving the use of investigational therapeutics, vaccines, or other medical interventions (including licensed products and devices for a purpose other than that for which they were licensed) in humans under a research protocol must be performed under a Food and Drug Administration (FDA) investigational new drug (IND) or investigational device exemption (IDE).

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, Recipients, and Activities, including of note, but not limited to:

If a recipient is successful and receives a Notice of Award, in accepting the award, the recipient agrees that any activities under the award are subject to all provisions currently in effect or implemented during the period of the award, other Department regulations and policies in effect at the time of the award, and applicable statutory provisions.

Should the applicant organization successfully compete for an award, recipients of federal financial assistance (FFA) from HHS must administer their programs in compliance with federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, disability, age and, in some circumstances, religion, conscience, and sex (including gender identify, sexual orientation, and pregnancy). This includes ensuring programs are accessible to persons with limited English proficiency and persons with disabilities. The HHS Office for Civil Rights provides guidance on complying with civil rights laws enforced by HHS. Please see https://www.hhs.gov/civil-rights/for-providers/provider-obligations/index.html and https://www.hhs.gov/civil-rights/for-individuals/nondiscrimination/index.html

HHS recognizes that research projects are often limited in scope for many reasons that are nondiscriminatory, such as the principal investigator’s scientific interest, funding limitations, recruitment requirements, and other considerations. Thus, criteria in research protocols that target or exclude certain populations are warranted where nondiscriminatory justifications establish that such criteria are appropriate with respect to the health or safety of the subjects, the scientific study design, or the purpose of the research. For additional guidance regarding how the provisions apply to NIH grant programs, please contact the Scientific/Research Contact that is identified in Section VII under Agency Contacts of this FOA.

Please contact the HHS Office for Civil Rights for more information about obligations and prohibitions under federal civil rights laws at https://www.hhs.gov/ocr/about-us/contact-us/index.html or call 1-800-368-1019 or TDD 1-800-537-7697.

In accordance with the statutory provisions contained in Section 872 of the Duncan Hunter National Defense Authorization Act of Fiscal Year 2009 (Public Law 110-417), NIH awards will be subject to the Federal Awardee Performance and Integrity Information System (FAPIIS) requirements. FAPIIS requires Federal award making officials to review and consider information about an applicant in the designated integrity and performance system (currently FAPIIS) prior to making an award. An applicant, at its option, may review information in the designated integrity and performance systems accessible through FAPIIS and comment on any information about itself that a Federal agency previously entered and is currently in FAPIIS. The Federal awarding agency will consider any comments by the applicant, in addition to other information in FAPIIS, in making a judgement about the applicant’s integrity, business ethics, and record of performance under Federal awards when completing the review of risk posed by applicants as described in 45 CFR Part 75.205 and 2 CFR Part 200.206 “Federal awarding agency review of risk posed by applicants.” This provision will apply to all NIH grants and cooperative agreements except fellowships.

Cooperative Agreement Terms and Conditions of Award

Not Applicable

3. Reporting

When multiple years are involved, recipients 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 RPPR, 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. NIH FOAs outline intended research goals and objectives. Post award, NIH will review and measure performance based on the details and outcomes that are shared within the RPPR, as described at 45 CFR Part 75.301 and 2 CFR Part 200.301.

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

In accordance with the regulatory requirements provided at 45 CFR 75.113 and Appendix XII to 45 CFR Part 75, recipients that have currently active Federal grants, cooperative agreements, and procurement contracts from all Federal awarding agencies with a cumulative total value greater than $10,000,000 for any period of time during the period of performance of a Federal award, must report and maintain the currency of information reported in the System for Award Management (SAM) about civil, criminal, and administrative proceedings in connection with the award or performance of a Federal award that reached final disposition within the most recent five-year period.  The recipient must also make semiannual disclosures regarding such proceedings. Proceedings information will be made publicly available in the designated integrity and performance system (currently FAPIIS).  This is a statutory requirement under section 872 of Public Law 110-417, as amended (41 U.S.C. 2313).  As required by section 3010 of Public Law 111-212, all information posted in the designated integrity and performance system on or after April 15, 2011, except past performance reviews required for Federal procurement contracts, will be publicly available.  Full reporting requirements and procedures are found in Appendix XII to 45 CFR Part 75 – Award Term and Conditions for Recipient Integrity and Performance Matters.

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, application errors and warnings, documenting system problems that threaten submission by the due date, and post-submission issues)

Finding Help Online: http://grants.nih.gov/support/ (preferred method of contact)
Telephone: 301-402-7469 or 866-504-9552 (Toll Free)

General Grants Information (Questions regarding application instructions, application processes, and NIH grant resources)
Email: GrantsInfo@nih.gov (preferred method of contact)
Telephone: 301-945-7573

Grants.gov Customer Support (Questions regarding Grants.gov registration and Workspace)
Contact Center Telephone: 800-518-4726
Email: support@grants.gov

Scientific/Research Contact(s)

Andrea Horvath Marques, M.D., MPH, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-646-7320
Email: andrea.horvathmarques@nih.gov

Mark Parascandola, PhD, MPH 
National Cancer Institute (NCI)
Telephone: 240-276-6871
Email: paramark@mail.nih.gov 

Peer Review Contact(s)

Nick Gaiano, Ph.D.
National Institute of Mental Health (NIMH)
Telephone: 301-827-3420
Email: nick.gaiano@nih.gov

Financial/Grants Management Contact(s)

Tamara Kees
National Institute of Mental Health (NIMH)
Telephone: 301-443-811
Email: tkees@mail.nih.gov

Dawn M. Mitchum
National Cancer Institute (NCI)
Telephone: 202-430-2997
Email: dawn.mitchum@nih.gov

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 Part 75.

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