Full Text NR-92-02
 
EXPLORATORY CENTERS FOR BIOBEHAVIORAL SYMPTOM MANAGEMENT
 
RFA:  NR-92-02
 
P.T. 04

Keywords: 
  Behavioral Medicine 
  Nursing 
  Behavioral/Social Studies/Service 
  Clinical Medicine, General 
  Biomedical Research, Multidiscipl 

 
National Center for Nursing Research
 
Letter of Intent Receipt Date:  March 31, 1992
Application Receipt Date:  May 7, 1992
 
PURPOSE
 
The National Center for Nursing Research (NCNR) invites the
submission of exploratory center (P20) applications for the
development of innovative clinical assessment and management
strategies for symptoms commonly experienced by acutely and
chronically ill patients.  These clinical assessment and management
strategies must address the biological and behavioral interface of
the selected symptom(s).  The center must have an interdisciplinary
approach with a focus on clinical research, basic research, or a
combination.
 
HEALTHY PEOPLE 2000
 
The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000,"
a PHS-led national activity for setting priority areas.  This Request
for Applications (RFA), Exploratory Centers for Biobehavioral Symptom
Management, is related to the priority areas of cancer, heart disease
and stroke, and diabetes and chronic disabling conditions.  Potential
applicants may obtain a copy of "Healthy People 2000" (Full Report:
Stock No. 017-001-00474-0 or Summary Report:  Stock No.
017-001-00473-1) through the Superintendent of Documents, Government
Printing Office, Washington, DC 20402-9325 (telephone 202-783-3238).
 
ELIGIBILITY REQUIREMENTS
 
Applications may be submitted from domestic, for-profit and non-
profit, public and private universities, colleges, hospitals, or
medical centers.  Applications from foreign institutions are
ineligible for the center program mechanism.  Although there are no
requirements for the presence of funded research grants, pilot
studies that are based on prior studies and an evolving program of
research will be more competitive.  Applicant institutions must
explain the appropriateness of the exploratory center mechanism for
their institution and how science will be advanced for the symptom(s)
selected.  Applications from minority individuals and women are
encouraged.
 
MECHANISM OF SUPPORT
 
The support mechanism for this RFA is the exploratory center grant
(P20).  The exploratory center grant must consist of (1) an
administrative and planning core providing administrative,
coordinating, planning, logistical, and/or methodological (e.g.,
research design, data analysis) support and (2) feasibility/pilot
studies.  The initial award period is for three years, and the award
may not be renewed.
 
Applicants for exploratory center grants may request up to three
years of support at a maximum of $125,000 total costs per year.
 
The majority of the funds under this RFA will be devoted to
small-scale studies.  The Administrative and Planning Core may not
exceed 20 percent of the direct costs.  The anticipated award date
for the grants will be September 30, 1992.
 
The Administrative and Planning Core
 
The Core manages the overall activities of the Center and must have a
specified Center Director, a discrete administrative structure, and
an Advisory Committee.  The Core may also include the administration
of shared resources, such as data sets, community or clinical
research facilities, or provide research design and data
analysis/statistical service.
 
Each applicant institution must name a Center Director who will be
the key figure in the scientific administration and management of the
exploratory center grant.  The Director must be an experienced
researcher with demonstrated leadership appropriate to the
coordination and development of the Center.
 
Although the final administrative structure of the Center will be
left up to the discretion of the applicant institution, experience
demonstrates that effective development of Center programs requires
interaction among the Director, the Principal Investigators of the
feasibility/pilot studies, appropriate institutional administrative
personnel, and the staff of the NCNR.  Like other interdisciplinary
grant programs, the success of the Center is dependent upon the
involvement of scientific and professional personnel representing a
variety of disciplines who must be willing to relate to and
collaborate with each other to facilitate the development of new
knowledge.  Moreover, it is important that a person with
institutional management expertise and experience be directly
involved with the fiscal aspects of the application and grant.
 
The Advisory Committee assists the Director in making the scientific
and administrative decisions relating to the Center.  With the
Director, the Advisory Committee will have the responsibility of
evaluating the feasibility/pilot studies proposed in the initial
application and to be developed during subsequent years.  (This does
not preclude the applicant institution from developing a separate
external review process to evaluate the scientific merit of the
individual feasibility/pilot studies developed during subsequent
years.  The final evaluation of the feasibility/pilot studies,
however, will rest with the Advisory Committee and the Center
Director).  The Advisory Committee may perform other duties as deemed
appropriate by the applicant institution.  The Advisory Committee
must be composed of scientists and administrators with expertise and
experience relevant to the scientific program of the center.  Members
may be employees of the applicant institution or of other
institutions.  However, at least two members of this committee must
be from outside the Center (i.e., either at the applicant institution
or another institution).
 
Feasibility/Pilot Studies
 
Specific feasibility/pilot studies may focus on only one symptom or
they may focus on two or more symptoms depending on the expertise of
the scientists and theoretical basis selected to guide the research.
The biological and behavioral interface of each symptom needs to be
explicated in feasibility/pilot studies and must include an
interdisciplinary approach.  The P20 funding mechanism is intended to
furnish modest support that will allow an institution the opportunity
to develop preliminary data sufficient to provide the basis for
applications for independent research through conventional granting
mechanisms.  Feasibility/pilot studies are typically limited to a
nonrenewable period of one to two years.  Applications submitted in
response to this RFA must propose a minimum of three, (but four are
encouraged) feasibility/pilot studies to be supported during at least
the first year of the award.  Subsequent preliminary research
projects (a minimum of two ongoing each year) may be developed during
the course of the award and must be submitted to the Advisory
Committee for approval and discussed as part of the annual progress
report.  Results of each feasibility/pilot study must be reported in
the Center's annual progress reports to the NCNR.
 
Institutions with General Clinical Research Centers
 
Applicants from institutions that have a General Clinical Research
Center (GCRC) funded by the NIH National Center for Research
Resources may wish to identify the GCRC as a resource for conducting
the proposed research.  Details of the interaction of the exploratory
center staff and feasibility/pilot study team members with the GCRC
staff and research personnel may be provided in a statement
describing the collaborative linkages being developed.  A letter of
agreement from the GCRC Program Director must be included with the
application.
 
FUNDS AVAILABLE
 
Approximately $300,000 for the first year will be committed to fund
applications submitted in response to this RFA.  It is anticipated
that a minimum of two applications will be funded.  This level of
support is dependent on the receipt of a sufficient number of
applications of high scientific merit.  Although this program is
provided for in the financial plans of the NCNR, the award of grants
pursuant to this RFA is also contingent upon the availability of
funds for this purpose.
 
RESEARCH OBJECTIVES
 
This initiative directly builds on the ongoing work of a panel of
scientific experts on symptom management convened as part of the
development of the National Nursing Research Agenda.  There has been
a great deal of interest in the assessment and management of symptoms
experienced by patients both in clinical settings and in home
settings.
 
The goal of this RFA is to stimulate the development of innovative
clinical assessment and management strategies to more effectively
handle their commonly experienced symptoms of acutely and chronically
ill patients.  These innovative clinical assessment and management
strategies may focus on the prevention of the symptom(s), the
amelioration of the symptom(s), or the attenuation of the symptom(s)
and continuing occurrence if total alleviation is not possible.
These innovative clinical assessment and management strategies must
address the biological and behavioral interface of the symptom(s)
being considered.  Specific behavioral and/or psychosocial strategies
need to be matched with specific state-of-the-art biological,
chemical, and immunological measurements and techniques to provide a
comprehensive picture of the symptom(s) being explored.  For example,
depression and fatigue are two biological and psychological stress
responses during the recovery of a myocardial infarction.
Immunological, chemical, and biological indices of recovery might
include hematological parameters, lymphocytic levels, and
electrocardiographic readings.  Understanding the biological
processes undergirding the symptom(s) manifested by acutely and
chronically ill patients will increase the scientific knowledge base
for these symptoms and promote the development of behavioral
strategies that could be generalized across a variety of patient
populations in the future.
 
The theoretical basis for the planned feasibility/pilot studies must
be clearly explicated for the behavioral, psychosocial, and
biological strategies used in the exploratory center grant
application.  The symptom(s) selected for exploration is open to the
applicants and may include, but is not limited to, the high priority
symptoms of pain, fatigue, dyspnea, nausea, vomiting, cognitive
impairment, altered sleep or rest patterns, and depression or anxiety
secondary to a physical illness.  However, symptoms specific to
psychiatric disorders are not included in the scope of this RFA.  One
or more symptoms may be selected by the applicants depending on the
scientific expertise available at the applicant institution or
clinical setting and the theoretical basis of the research.  An
interdisciplinary approach should be utilized to promote the
collaboration of scientists with expertise in nursing with scientists
of other disciplines.  Although feasibility/pilot studies addressing
only pharmacological interventions are not acceptable, the inclusion
of pharmacological strategies in combination with nonpharmacologic
strategies is appropriate for a multimodal management approach.
 
BACKGROUND
 
Selected symptoms are highlighted below to reflect the critical need
to develop innovative clinical assessment and management of symptoms
commonly experienced by acutely and chronically ill patients.
Although specific research needs are identified, they are provided
only to stimulate creative research ideas and not to be considered as
all inclusive or limiting in scope.  The expert panel on symptom
management, as part of the National Nursing Research Agenda,
considered these selected symptoms, but no specific symptom (or its
underlying disease or life event) will be given preferential
treatment during the review and funding processes.  The scientific
merit of the entire exploratory grant application is the crucial
element to be considered in the review and funding processes.
 
Acute pain is a human condition experienced by patients in clinical
and home settings resulting from such events as medical illnesses,
surgery, and diagnostic procedures.  Behavioral strategies, such as
biofeedback and relaxation techniques, and sensory preparation
strategies have demonstrated efficacy in management of acute pain in
the populations in which they have been used.  Few research studies
have used behavioral and sensory strategies in combination with
pharmacologic treatment protocols to manage acute pain.  Behavioral
and sensory strategies could be used in conjunction with
pharmacologic analgesics, such as endogenous endorphins and
enkephalins.  Therefore, more research studies are needed to explore
the effectiveness of the multimodal treatment approach with specific
populations, such as in acute pain management of patients with sickle
cell disease.  Additionally, it is known that ethical and legal
constraints relating to medication usage by children, women, and
older adults and the preferences of health care providers for certain
medications make it difficult to implement experimental studies to
assess the efficacy of specific medications to manage acute pain in
these populations.  Usage of patient controlled analgesia dispensed
by oral and intravenous methods for effective pain management has
received limited research attention in these specific populations as
well.  Since the pain threshold is known to be influenced by an
individual's perception of pain and mood state, internal and external
sensors to monitor the severity, type, and time of pain could be
explored.  Research studies are needed to delineate appropriate pain
management parameters for children, women, and older adults.
Research findings to date have limited details concerning racial and
gender preferences in pain management in these patient populations.
Therefore, clearly designed research studies addressing pain
assessment and the preferences of management in these selected
populations are especially needed.
 
Fatigue is a universal symptom of almost all acute and chronic
illnesses.  Fatigue can be distinguished in the clinical setting as
normal fatigue, pathophysiologic fatigue, or psychological fatigue.
When assessed during patient history-taking, fatigue is described as
the perception of tiredness, lack of energy, and an inability to
continue.  It is manifested through slow movement, flat affect,
irritability, and tearfulness.  Four instruments (Symptom Distress
Scale, Yoshitaka's Fatigue Scale, Rhoten's Fatigue Scale, and Pearson
and Byar's Fatigue Feeling Tone Scale) are commonly cited as
measuring fatigue through changes within the symptomatology of
specific diseases or as aspects of general mood states or functional
status.  Quantitative and qualitative indices of blood cells, the
rate of oxygen consumption, and release of peptides throughout the
body are biological parameters measured in fatigue.  Review of the
professional literature indicates the need to develop instruments
that characterize the unique fatigue experienced by patients with
specific illnesses or life events.  Biological changes in sleep
patterns and other circadian rhythms, in tissue oxygenation, and in
activity levels (including metabolic and cardiorespiratory responses)
have been noted in specific research studies focusing on fatigue.
Research is needed to explore the correlation of how biological and
behavioral measures can be combined with subjective measures of
fatigue to assess and manage fatigue in specific illnesses or life
events.
 
Dyspnea is the subjective sensation of uncomfortable breathing
experienced by patients with pulmonary diseases, cardiovascular
diseases, and neuromuscular disorders affecting the respiratory
muscles.  Dyspnea involves both the actual sensation of difficult or
labored breathing and the perception of that sensation by the
patient.  Reporting of the symptom of dyspnea often is influenced by
societal norms, whereas the distress and the response to dyspnea is
influenced by the patient's psychological characteristics and coping
styles and strategies.  Until recently there has been limited
research on the therapies and techniques to decrease the symptom of
dyspnea.  Measurement issues persist in accurately assessing the
symptom; activity scales and self-report scales currently are
utilized.  Therefore, more effective assessment and management
strategies are needed to comprehensively treat patients experiencing
dyspnea.  The autonomic nervous system is intricately involved in
respiration and can be cognitively modified via biofeedback and
relaxation.  These techniques can be coupled with biological
measurements of adequate oxygenation and respiratory muscle activity
in the management of dyspnea.  Detailing the biological responses of
the patients to the various combination therapies would provide
valuable data for the development of effective treatment of the
symptom across specific diseases and specific populations.
 
SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING IMPLEMENTATION OF NIH
POLICIES CONCERNING INCLUSION OF WOMEN AND MINORITIES IN CLINICAL
RESEARCH STUDY POPULATIONS
 
NIH and ADAMHA policy is that applicants for NIH/ADAMHA clinical
research grants and cooperative agreements will be required to
include minorities and women in study populations so that research
findings can be of benefit to all persons at risk of the disease,
disorder or condition under study; special emphasis should be placed
on the need for inclusion of minorities and women in studies of
diseases, disorders and conditions which disproportionately affect
them.  This policy is intended to apply to males and females of all
ages.  If women or minorities are excluded or inadequately
represented in clinical research, particularly in proposed
population-based studies, a clear compelling rationale should be
provided.
 
The composition of the proposed study population must be described in
terms of gender and racial/ethnic group.  In addition, gender and
racial/ethnic issues should be addressed in developing a research
design and sample size appropriate for the scientific objectives of
the study.  This information should be included in the form PHS 398
in Section 2, A-D of the Research Plan AND summarized in Section 2,
E, Human Subjects.  Applicants are urged to assess carefully the
feasibility of including the broadest possible representation of
minority groups.  However, NIH recognizes that it may not be feasible
or appropriate in all research projects to include representation of
the full array of United States racial/ethnic minority populations,
i.e., Native Americans (including American Indians or Alaskan
Natives), Asian/Pacific Islanders, Blacks, Hispanics.
 
The rationale for studies on single minority population groups should
be provided.
 
For the purpose of this policy, clinical research includes human
biomedical and behavioral studies of etiology, epidemiology,
prevention (and preventive strategies), diagnosis, or treatment of
disease, disorders or conditions, including but not limited to
clinical trials.
 
The usual NIH policies concerning research on human subjects also
apply.  Basic research or clinical studies in which human tissues
cannot be identified or linked to individuals are excluded.  However,
every effort should be made to include human tissues from women and
racial/ethnic minorities when it is important to apply the results of
the study broadly, and this should be addressed by applicants.
 
If the required information is not contained within the application,
the application will be returned.
 
Peer reviewers will address specifically whether the research plan in
the application conforms to these policies.  If the representation of
women or minorities in a study design is inadequate to answer the
scientific question(s) addressed AND the justification for the
selected study population is inadequate, it will be considered a
scientific weakness or deficiency in the study design and will be
reflected in assigning the priority score to the application.
 
All applications for clinical research submitted to NIH are required
to address these policies.  NIH funding components will not award
grants or cooperative agreements that do not comply with these
policies.
 
LETTER OF INTENT
 
Prospective applicants are asked to submit by March 31, 1992, a
letter of intent that includes a descriptive title of the proposed
research, the name, address, and telephone number of the Principal
Investigator, the identities of other key personnel and participating
institutions, and the number and title of the RFA in response to
which an application may be submitted.
 
Although a letter of intent is not required, is not binding, and does
not enter into the review of subsequent applications, the information
that it contains is helpful in planning for the review of
applications.  It allows NCNR staff to estimate the potential review
workload and to avoid possible conflict of interest in the review.
 
The letter of intent is to be sent to:
 
Ethel Jackson, D.D.S.
Chief and Scientific Review Administrator
National Center for Nursing Research
Building 31, Room 5B19
9000 Rockville Pike
Bethesda, MD  20892
 
APPLICATION PROCEDURES
 
The research grant application form PHS 398 (revised 9/91) must be
used in applying for these grants.  These forms are available at most
institutional business offices and from the Office of Grants
Inquiries, Division of Research Grants, National Institutes of
Health, 5333 Westbard Avenue, Room 449, Bethesda, MD 20892 (telephone
301-496-7441).
 
Special application instructions apply to the exploratory centers
program RFA; these instructions are provided in detail in the section
below.
 
Submit a signed, typewritten original of the application, including
the checklist, and four signed, exact photocopies, in one package to:
 
DIVISION OF RESEARCH GRANTS
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892
 
At the time of submission, two additional copies of the application
must also be sent to:
 
Ethel Jackson, D.D.S.
Chief and Scientific Review Administrator
National Center for Nursing Research
Building 31, Room 5B19
9000 Rockville Pike
Bethesda, MD  20892
 
Applications must be received by May 7, 1992.  If an application is
received after that date, it will be returned to the applicant.
Also, the Division Research Grants (DRG) will not accept any
application in response to this announcement that is essentially the
same as one currently pending initial review, unless the applicant
withdraws the pending application.  Nor will the DRG accept any
application that is essentially the same as one already reviewed.
This does not preclude the submission of substantial revisions of
applications already reviewed, but such applications must include an
introduction addressing the previous critique.
 
SPECIAL APPLICATION INSTRUCTIONS
 
The written application is the basis for the merit review.
Particular attention must be given to the format of the application.
The standard instructions provided with form PHS 398 are designed
primarily for applications for single research projects.  Exploratory
center grant applications require additional information as outlined
below.  Page limitations presented in the Form 398 instructions must
be followed closely unless otherwise noted.
 
Face Page (PHS 398, page 1)
 
The RFA label available in the 9/91 revision of PHS 398 application
form must be affixed to the bottom of the face page. Failure to use
this label could result in delayed processing of the application such
that it may not reach the review committee in time for review.  In
addition, the RFA title and number, "Exploratory Centers for
Biobehavioral Symptom Management, NR-92-02" must be typed on line 2
of the face page of the application form; check the YES box.
 
This is page 1 of the application; all succeeding pages must be
numbered consecutively.
 
Description and Key Personnel (PHS 398, page 2)
 
This section must concisely state the overall goals of the entire
exploratory center and clearly state the contribution of each
component to the overall goals.  Key personnel for the entire
exploratory center, including consultants must be listed
alphabetically.
 
Detailed Budget for First 12-Month Period (PHS 398, page 4)
 
Present a detailed composite budget for all requested support for the
first year.  In addition, provide separate budgets in the same format
and budget justifications for each component of the Center. The
annual budget for the first year of requested support may not exceed
$125,000 total costs (direct plus indirect costs). Consultation with
NCNR grants management staff listed in INQUIRIES is strongly
encouraged during the development of the exploratory center grant
budget.
 
Budget Estimate for Each Year of Requested Support (PHS 398, page 5)
Generally, future years should be limited to increments of four
percent.  Include estimates for future feasibility/pilot studies.
 
Biographical Sketches (PHS 398, Form Page "Biographical Sketch" and
Continuation Page)
 
A biographical sketch for each professional, as per PHS 398
instructions, may not exceed two pages.  Therefore, cite only the
most relevant publications.  A sketch is required for each
professional participating in the Administrative and Planning Core
and the feasibility/pilot studies and for all consultants.
Biographical sketches must clearly indicate whether the professional
personnel are scientists in the schools of nursing or departments of
nursing or from collaborating departments and colleges.
 
Summary of Other Sources of Support (PHS 398, Other Support) Follow
instructions of PHS 398.
 
Program Narrative (PHS 398, Continuation Pages)
 
The narrative must provide a description and plan of the exploratory
center grant application.  The narrative must include an overall
description of the symptom(s) and plans for the Center as well as a
description of each of the Center components.  The narrative must
describe (a) the Administrative and Planning Core, including the
Advisory Committee (ten pages maximum); (b) the symptom(s) and how
each symptom contributes and integrates into the overall framework of
the Center (5 pages maximum); and (c) the feasibility/pilot studies
proposed for the first year--at least three, four is recommended (10
pages per study, 40 pages maximum).
 
Resources and Environment
 
Briefly describe the institutional environment and resources that are
relevant to effective implementation of the Center.  This may include
statements about clinical, laboratory, field, and survey facilities,
participating and affiliated units, patient and other subject
populations, geographic distribution of space and personnel,
consultative resources, and computation facilities.
 
Appendices
 
Follow instructions on page 23 of PHS 398.
 
Budgetary Considerations  -  Allowable Costs
 
Unless otherwise indicated, allowable costs and policies governing
the research grant program of the NIH will prevail.  Overlapping
support between the exploratory center grant and other NIH grants and
contracts to the applicant institution will be administratively
reviewed and, if appropriate, will be adjusted to avoid duplication
of funding.
 
Support may be requested for salaries of professional, technical, and
support personnel within the Center who contribute to allowable
activities of the Center.  The salaries derived from the Center grant
will depend on the effort provided and institutional salary policies.
Salaries of personnel engaged in research activities supported by
feasibility/pilot funds are allowable cost items as are salaries of
personnel in the Administrative and Planning Core.  Stipends for
research fellows/trainees are not allowable.  No overlap of time or
effort between the Center and other separately funded projects is
permitted.
 
Support for secretarial and administrative staff may be provided to
the extent that their activities relate to administrative management
of the Center's activities, providing these costs have not been
included in the institution's indirect cost pool.
 
Expenditures for major equipment under this RFA will be considered
only under exceptional circumstances.  The application must document
what is already available and provide clear justification in terms of
use by investigators in more than one feasibility/pilot study.
General purpose equipment needs may be included and justified only
after surveying the availability of such items within the
institution.
 
Consumable supplies directly related to the operation of the Center
are allowed.  These supplies include office materials (if not
included in the indirect cost pool) and scientific supplies, but must
not provide supplements to the general supply category of separately
funded individual projects.
 
Research patient care costs (both inpatient and outpatient expenses)
will be considered in the context of other existing institutional
clinical resources.  Attempts must be made by the applicant
institution to utilize existing clinical facilities such as GCRC and
individually supported beds.  The Center is not intended to be a
facility for health care delivery.  Only those research patient costs
directly related to research activities may be charged to the Center.
 
While funds for alteration and renovation of an existing structure to
provide suitable core facilities for the Center are allowable under
current PHS guidelines, such requests are not encouraged due to the
overall budgetary level of support available.
 
Domestic and foreign travel of Center personnel directly related to
the activities of the Center is allowable.  In addition to travel
expenses associated with administrative, planning, and research
activities, travel plans must include one trip for two people to the
NCNR for a meeting with NCNR program staff and the staff of the other
participating exploratory centers to share research experiences and
scientific ideas.
 
Costs for consultant services (consultation fees, per diem, travel)
may be included.  Costs associated with consultation or scientific or
technical assistance, evaluation of Center activities, and review of
feasibility/pilot studies are allowable.  Costs for long-distance
telephone calls, photocopying, computer time, publication, and other
expenses that are related to the activities of the Center, including
the feasibility/pilot studies, are permitted.
 
REVIEW CONSIDERATIONS
 
Upon receipt, applications will be reviewed by NIH staff for
completeness and responsiveness.  Incomplete and unresponsive
applications will be returned to the applicant without further
consideration.
 
Those applications that are complete and responsive will be evaluated
in accordance with the criteria stated below for scientific/technical
merit by an appropriate peer review group convened by the NCNR.
Applications may be subjected to triage by a peer review group to
determine their competitiveness relative to other applications
received in response to this RFA.  The review criteria for triage are
identified below.  The NIH will withdraw from further competition
those applications judged by triage to be noncompetitive for award
and notify the applicant and institutional official.  Those
applications judged to be competitive will undergo further scientific
merit review.  The second level of review will be provided by the
National Advisory Council for Nursing Research.
 
The review of the exploratory center applications will focus on the
scientific merit of the feasibility/pilot studies.  Additionally, the
component parts of the exploratory center will be reviewed for
synergism and contribution to the development of the science.  The
evaluation will include the following review criteria:
 
1.  Overall Program
 
o  The scientific merit of the program as a whole.  The significance
of the overall program goals and the development of a well-defined
central focus.
 
o  The potential of the identified participants to develop
interdisciplinary research programs of high merit as evidenced by
previous accomplishments.
 
o  The balance of administrative and planning expenses in comparison
to those for conducting the small-scale studies.
 
2.  Administration and Planning Core
 
o  The scientific and administrative leadership ability and
experience of the Center Director and his/her commitment and ability
to devote adequate time to the effective management of the Center.
 
o  Maintenance of internal communication and cooperation among the
investigators involved in the Center.
 
o  Adequacy of the Advisory Committee to assess the scientific merit
of the proposed feasibility/pilot studies.
 
o  Mechanism for reviewing the use of funds for small-scale studies.
 
o  Appropriateness and adequacy of collaboration of the
interdisciplinary team with members of the Center.
 
o  The appropriateness of the Center budget for the various
components of the Center.
 
3.  Feasibility/Pilot Studies
 
o  The balance in scientific coverage of the specific symptom(s)
selected.  Competitive applications will clearly explicate the
biological and behavioral interface of the symptoms selected and
explored by an interdisciplinary team.
 
o  The scientific and technical quality of the initial
feasibility/pilot studies.  (Note:  Unlike a program project
application, reviewers will not vote on the merit of each study. The
overall quality of the proposed feasibility/pilot studies will be
taken into account in arriving at an evaluation of the application.)
 
4.  Institutional Commitment
 
o  The institutional commitment to the program, including lines of
responsibility for the Center, and the institution's contribution to
the management capabilities of the Center.
 
o  The degree of institutional contributions towards the
Administrative and Planning Core and/or to the feasibility/pilot
studies.
 
o  The academic research environment and resources in which the
activities will be conducted, including the availability of space,
equipment, and facilities, and the potential for interaction with
scientists from other departments and schools besides the ones
identified in the application.
 
o  The institutional commitment to newly recruited individuals
responsible for conducting essential Center functions and activities.
 
AWARD CRITERIA
 
Applications selected for funding will be from schools of nursing,
departments of nursing, or other programs that have appropriately
prepared individuals for research.  In order to expand the number of
researchers conducting research and additional nursing research
programs, institutions whose schools of nursing or departmental
components have been selected for funding under previous NCNR Centers
program RFAs (P50, P20) will not be selected for funding under this
RFA.
 
INQUIRIES
 
Written and telephone inquiries concerning this RFA are encouraged.
The opportunity to clarify any issues or questions from potential
applicants is welcome.
 
Direct inquiries regarding programmatic issues to:
 
Laura A. James,  Ph.D, R.N.
Nurse Scientist Administrator
Acute and Chronic Illness Branch
National Center for Nursing Research
Building 31, Room 5B03
Bethesda, MD  20892
Telephone:  (301) 496-0523
 
Direct inquiries regarding fiscal matters to:
 
Sally Nichols
Grants Management Officer
National Center for Nursing Research
Building 31, Room 5B06
Bethesda, MD  20892
Telephone:  (301) 496-0237
 
AUTHORITY AND REGULATIONS
 
This program is described in the Catalog of Federal Domestic
Assistance No. 93.336, Nursing Research.  Awards are made under
authorization of the Public Health Service Act, Title IV, Part A
(Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and
285) and administered under PHS grants policies and Federal
Regulations 42 CFR 52 and 45 CFR Part 74.  This program is not
subject to the intergovernmental review requirements of Executive
Order 12372 or Health Systems Agency review, April 6, 1988.
 
.

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