[Federal Register: February 24, 2004 (Volume 69, Number 36)]
[Notices]
[Page 8460-8471]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr24fe04-93]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
[CFDA Number: 93.933]
Native American Research Centers for Health; New Request for
Application of Funds
Key Dates: Letter of Intent Deadline: May 1, 2004; Application
Deadline: June 18, 2004.
Overview
The Indian Health Service (IHS), with the National Institute of
General Medical Sciences (NIGMS) of the National Institutes of Health,
and the Agency for Healthcare Research and Quality (AHRQ) announces an
initiative to support the Native American Research Centers for Health
(NARCH) grant. This funding mechanism will develop opportunities for
conducting research and research training to meet the needs of American
Indian/Alaska Native (AI/AN) communities. Competing grant applications
for Fiscal Year (FY) 2005 will be accepted with a receipt date of June
18, 2004. There will be only one funding cycle for FY 2005. Awards will
be subject to the availability of funds and grants will be administered
in accordance with applicable Office of Management and Budget (OMB)
Circulars, Department of Health and Human Services grant regulations at
45 CFR parts 74 and 92, the Public Health Service Grants Policy
Statement, and other applicable Departmental, IHS, AHRQ and NIH
policies and procedures such as the regulations governing protection of
human subjects at 45 CFR part 46.
This initiative is described in the Catalog of Federal Domestic
Assistance
[[Page 8461]]
Nos. 93.933 and 93-375. Sections 301(a) and 405 of the Public Health
Service Act, as amended authorize these awards, and these are
administered under PHS grants policies and Federal Regulations 42 CFR
part 52c, 45 CFR part 74, and 45 CFR part 92. See also Senate
Appropriations Committee Report, No. 92-316, July 29, 1971, Executive
Order 12900, Educational Excellence for Hispanic Americans February 22,
1994, Executive Order 12876, Historically Black Colleges and
Universities, November 1, 1993, and Executive Order 13021, October 21,
1996, and Outline of Work Plan, August 18, 1998, White House Initiative
on Tribal Colleges and Universities. Applications are not subject to
the intergovernmental review requirements of Executive Order 12372 or
Health Systems Agency review.
The PHS strongly encourages all grant and contract recipients to
provide a smoke-free workplace and promote the non-use of all tobacco
products. In addition, Public Law 103-227, the Pro-Children Act of
1994, prohibits smoking in certain facilities (or in some cases, any
portion of a facility) in which regular or routine education, library,
day care, health care or early childhood development services are
provided to children. This is consistent with the PHS mission to
protect and advance the physical and mental health of the American
people.
I. Funding Opportunity Description
The NARCH initiative will support partnerships between AI/AN Tribes
or Tribally-based organizations such as the National Indian Health
Board and Area Health Boards, and institutions that conduct intensive
academic-level biomedical, behavioral and health services research.
These partnerships are called Native American Research Centers for
Health (NARCH). The purposes of the NARCH initiative are:
1. To develop a cadre of AI/AN scientists and health professionals
engaged in biomedical, clinical, behavioral and health services
research who will be competitive in securing NIH and AHRQ funding;
2. To increase the capacity of both research-intensive institutions
and AI/AN organizations to work in partnership to reduce distrust by
AI/AN communities and people toward research; and
3. To encourage competitive research linked to the health
priorities of the AI/AN organizations and to reducing health
disparities.
These purposes will be achieved by supporting student development
projects, faculty/researchers development projects, and research
projects (including pilot projects) developed by each NARCH
partnership.
II. Award Information
The estimated funds (total costs) available for the first year of
support for the entire initiative is expected to be over $ 2.2 million
in Fiscal Year 2005. The actual amount may vary, depending on the
response to the RFA and availability of funds.
An application may request a project period not to exceed four
years of support, and direct costs not to exceed $800,000 in the first
year. Direct costs to the applicant include the entire cost of each
subcontract--that is, each subcontract's direct cost plus the
subcontract's appropriate Facilities and Administration (F&A) cost.
Because it is anticipated that all budget requests will exceed
$250,000, the modular grant requirements would not apply to this RFA. A
minimum of 30 percent of the grant funds must remain with the applicant
organization.
Awards under this initiative will be administered using the
competing institutional grant mechanism of the IHS, and will be
reviewed using the NIH S06 mechanism. The responsibility for planning,
directing, and executing the program, as well as data acquisition and
analysis and evaluation of the proposed program, lies solely with the
applicant organization. The maximum grant period may not exceed four
years, with the opportunity for a competing renewal at the end of that
period.
III. Eligibility Information
The proposed NARCH must be a working partnership of the AI/AN
organization and of the research-intensive institution. Applicants
eligible to receive a NARCH award are the AI/AN organizations of the
partnerships. As the grantee, the AI/AN organizations will define
criteria and eligibility for participation in all aspects of the
partnership, consistent with this announcement. A minimum of 30 percent
of the grant funds must remain with that AI/AN organization, that is,
no more than 70 percent may be subcontracted to other institutions or
organizations.
1. Eligible Applicants
The AI/AN applicant must be one of the following:
A. A federally recognized Indian Tribe; or
B. A Tribally sanctioned non-profit Tribal organization; or
C. A non-profit national or area Indian health board; or
D. A consortium of two or more of those Tribes, Tribal
organizations, or health boards.
Applicants are strongly encouraged to establish eligibility of
their proposed applications prior to submission. Inquiries about
eligibility should be addressed to Phillip L. Smith, M.D., M.P.H., at
(301) 443-0222.
2. Cost Sharing or Matching
The proposed NARCH must have:
A. A Community and Scientific Advisory Council with more than 50
percent of its membership being appointed by the AI/AN applicant.
B. The proposed NARCH may include additional affiliated
organizations, e.g., Tribal colleges, additional colleges or
universities, additional Tribes, or other Indian communities or
organizations.
NARCH applicants are encouraged to have an affiliation with an
applicable component of the IHS for technical and other in-kind
support, such as linking data from IHS and others to understand better
the health status of the involved Tribes or communities.
3. Other (Required)
A. The Research-Intensive Partner must: be an accredited public or
private nonprofit university or other institution that has an
established record of conducting research into the health problems of
AI/AN; have demonstrated a commitment to enhancing the capability of
AI/AN faculty/researchers, students, investigators, and communities to
engage in biomedical, behavioral, clinical and health services
research; and have demonstrated a commitment to mentoring AI/AN
faculty/researchers, students, and investigators.
B. Principal Investigator: The Principal Investigator, the
individual responsible for the administration (including fiscal
management) of the overall project, must have his/her primary
appointment with the AI/AN applicant organization. Special arrangements
of employment, such as inter-organizational personnel agreements, are
permissible. The Principal Investigator may be, but is not required to
be, the NARCH Program Director or a Research Project Investigator.
C. NARCH Program Director: The NARCH Program Director is the
individual responsible for the day-to-day leadership and management of
the research and training programs within the proposed NARCH. The
Program Director may be, but is not required to be, the Student and
Faculty/Researcher Development Director or a Research Project
Investigator.
[[Page 8462]]
D. Student and Faculty/Researcher Development Director and
Participants: The NARCH initiative is an institutional developmental
grant mechanism that places an emphasis on the continual development of
students and faculty/researchers. In order to be included as the
Student and Faculty Development Director, the prospective director must
have a faculty/researcher appointment at the research-intensive
institution or equivalent appointment at the AI/AN organization or
other consortium partner, and must demonstrate that he/she has the
knowledge, skills, and capabilities to mentor students and faculty/
researchers and to generate and direct development and mentoring
programs. The Student and Faculty Development Director may be the NARCH
Program Director. Faculty/researchers and students should be supported
in research education activities that improve their skills and
abilities to be successful at the next stage of their professional
development. To be included as a participant for faculty/researcher
development in the proposed NARCH, the individual must have a faculty/
researcher appointment at the research-intensive institution or
equivalent appointment at the AI/AN organization or other consortium
partner.
E. Research Project Investigators: The NARCH initiative is an
institutional developmental grant mechanism that places an emphasis on
continual improvement of the research competitiveness of the research
investigators. In order to be included as a research project
investigator in the proposed NARCH, a prospective investigator must
have a faculty appointment at the research-intensive institution or
equivalent appointment at the AI/AN organization or other consortium
partner, and must show that he/she has the need, based on
institutional, departmental, and professional development plans, to
enhance his/her research knowledge, skills, and capabilities by
engaging in the proposed research program and associated activities.
F. Tribal Approval of the Application: It is the policy of the IHS
that all research involving AI/AN Tribes be approved by the Tribal
governments with jurisdiction. Therefore, the following documentation
is required as part of the application:
For a federally recognized Indian Tribe--a
resolution of support from the Tribal government must be part of the
application. Applications that involve more than one Indian Tribe must
include resolutions of support from all participating Tribes.
For an eligible consortium of Tribes--a resolution
of support from each Tribe of the consortium must be included.
For a Tribally sanctioned non-profit Tribal
organization--specific Tribal resolution(s) of support will not be
required if the current Tribal resolution(s) under which the
organization operates encompasses the proposed application. (A copy of
the current operational resolution(s) must be submitted with the
application.) An official signed resolution must be received by the
Grants Management Branch, IHS, no later than June 18, 2004 at the Reyes
Building, 801 Thompson Avenue, Rockville, MD 20852-1627. A grant will
not be awarded unless the signed resolution is received by this date.
For a non-profit national or area Indian health
board, or a consortium of those eligible Indian health boards--a
resolution is not required. However, the applicant organization must
submit a letter of support signed by the executive director of each
health board involved, specifically citing the research project
proposed. Each AI/AN organization that derives benefit from the grant
must also submit such a letter.
G. Mechanism of Support: Awards under this initiative will be
administered using the competing institutional grant mechanism of the
IHS, and will be reviewed using the NIH S06 mechanism. The
responsibility for planning, directing, and executing the program, as
well as data acquisition and analysis and evaluation of the proposed
program, lies solely with the applicant organization. The maximum grant
period may not exceed four years, with the opportunity for a competing
renewal at the end of that period.
IV. Application and Submission Information
1. Address To Request Application Package
NARCH Program Director,
801 Reyes Building, TMP Suite 450,
Rockville, MD 20852.
2. Content and Form of Application Submission
A. The purposes of the NARCH initiative must include:
To develop a cadre of AI/AN scientists and
health professionals engaged in biomedical, clinical, behavioral and
health services research that is competitive to NIH funding;
To increase the capacity of both research-
intensive institutions and AI/AN organizations to work in partnership
to reduce distrust by AI/AN communities and people toward research; and
To encourage competitive research linked to the
health priorities of the AI/AN partner and to reducing health
disparities.
B. A proposed NARCH, therefore, may include any or all of the
following components: student development projects; faculty/researcher
development projects; research projects (including pilot projects); and
``core'' administrative facility.
C. The content of the application should explain the components of
the application, and how they help meet the purposes of the NARCH
initiative.
A description should be provided of the current
state of the research and research training enterprise at the proposed
NARCH and its institutional and community partners, including faculty/
researcher and student profiles.
A clear statement should be presented of the overall
goals, specific measurable objectives, and anticipated milestones.
These elements should be presented in the context of needed
improvements in the partners' organizational infrastructure and
environment for research.
Documentation should be provided to establish that
the research-intensive partner is an institution with a record of
conducting research into the health of AI/ANs, and that it has a
demonstrated commitment to the special encouragement of, and assistance
to, AI/AN faculty/researchers, students, investigators, and communities
for enhancing their capacity to engage in biomedical, behavioral and
health services research.
Documentation about the nature of the partnership
itself should be included, such as: the process to develop the
application and proposed NARCH itself, the past and future efforts to
increase the capacity of the partners to improve their partnership, and
to contribute to the success of the NARCH.
A plan for assessment of the benefits of the
activities by the proposed NARCH on specific, measurable outcomes
identified in the application should be provided. IHS and NIGMS
recognize that Tribes, Tribally-based organizations, and research-
intensive institutions are diverse in their missions, their health and
economic
[[Page 8463]]
statuses, and their cultures. Such an assessment could include a self-
study by the proposed NARCH and its partners, which focuses on fact-
finding, program evaluation, and recommendations for improvement in key
areas.
Strategies for determining the initial and ongoing
success of their efforts for organizational development should also be
presented. It is expected that each proposed NARCH will develop its own
set of strategies that best match its circumstances.
Guidance and suggestions for program evaluation of a proposed NARCH
can be obtained from http://www.the-aps.org/education/promote/promote.html
.
Applicants are strongly urged to contact NARCH initiative staff at
an early stage to request the specific supplementary instructions for
the PHS 398 for the NARCH grants. Application kits and supplementary
instructions may be obtained from the initiative contacts listed under
VII. Agency Contacts.
The PHS 398 (updated 9/09/03) research grant
application instructions and forms at http://grants.nih.gov/grants/funding/phs398/phs398.html
are to be used in applying for these grants.
This version of the PHS 398 is available in an interactive, searchable,
PDF format. The NIH will return applications that are not submitted in
the 09/09/03 updated format. For further assistance contact Grants
Info, telephone (301) 435-0714, e-mail: GrantsInfo@nih.gov.
``DUNS'' number
Applications must be prepared using the PHS 398 research grant
application instructions and forms (updated 09/09/03). As of October 1,
2003, applications must have a Dun and Bradstreet (D&B) Data Universal
Numbering System (DUNS) number as the Universal Identifier when
applying for Federal grants or cooperative agreements. The DUNS number
can be obtained by calling (866) 705-5711 or through the Web site at
http://www.dunandbradstreet.com/. The DUNS number should be entered on
line 11 of the face page of the PHS 398 form. The PHS 398 document is
available at http://grants.nih.gov/grants/funding/phs398/phs398.html in
an interactive format. For further assistance contact Grants Info,
Telephone (301) 435-0714, e-mail: GrantsInfo@nih.gov.
Internet applications for a DUNS number can take up to 30 days and
this could cause organizations to lose opportunities to apply, or delay
them until the next round. It is significantly faster to obtain one by
phone.
You will need the following information to request a DUNS number:
Organization name
Organization address
Organization telephone number
Name of CEO, Executive Director, President, etc.
(The person in charge)
Legal structure of the organization
Year organization started
Primary business (activity) line
Total number of employees.
D. The RFA label available at http://grants1.nih.gov/grants/funding/phs398/label-bk.pdf
in the PDF format, must be affixed to the
bottom-face page of the application. Type this RFA number: ``NOT GM-04-
107'' on the label. Failure to use this label could delay processing
the application and it may not reach the review committee in time for
review. In addition, the ``Native American Research Centers for
Health'' and the RFA number must be typed on line 2 of the face page of
the application form and the YES box must be marked.
E. Student Development Projects: If student development projects
are proposed, the NARCH application should describe new programs,
modifications, or additions, to existing programs of the partners that
encourage and facilitate AI/AN students to enter, advance, and remain
in research careers. Such projects might include, but are not limited
to, providing employment as research assistants in research projects of
research-active mentors with an explicit mentoring plan, providing
other mentoring with an explicit mentoring plan, providing workshops to
improve technical or communication skills, providing motivating
seminars or journal clubs highlighting problems of interest to
students, providing contact with role models, and providing
opportunities to travel to present results at national scientific
meetings.
If research mentorships or apprenticeships are proposed, the
application should clearly document the experience, proposed
commitment, and quality of the mentors in providing guidance and advice
to students (including responsible conduct of research and research
integrity, teaching, and protection of human subjects), and in
fostering the development of academic and/or community-based AI/AN
researchers.
The application should describe how the development plans for the
student will meet both the individual's professional development goals,
and one purpose of the NARCH initiative: to develop a cadre of AI/AN
scientists and health professionals.
The application must have an evaluation plan for the project(s)
that indicates the anticipated outcomes relative to the current
baseline data. For example, one outcome might be the improved retention
of students in science majors. The application should indicate the
anticipated (quantitative) improvement relative to the current
retention rate.
A student in a NARCH Student Development Project must be a full-
time or part-time student officially enrolled in an educational program
leading to an undergraduate or graduate degree, or in a post-doctoral
educational program, or (if well justified) in late high school. A
helpful book about mentoring science students is found at http://books.nap.edu/catalog/5789.html
.
F. Faculty/Researcher Development Projects: If faculty/researcher
development projects are proposed, the NARCH application should
describe the need, proposed activity, and anticipated outcomes.
Faculty/researcher development projects might include, but are not
limited to, short-term mentored research experiences in the lab of an
active NIH-extramurally-funded researcher with an explicit mentoring
plan, long-term general mentoring under an explicit mentoring plan, or
attendance at workshops or courses or national meetings needed for
acquiring specific skills or methodologies needed for prospective
research.
As with student development projects, the application should
document the experience, proposed commitment, and quality of the
mentors, teachers, or experience in providing guidance and advice to
faculty/researcher, and in fostering the development of academic and
community-based AI/AN research.
The application must also describe the evaluation plan for the
faculty/researcher development project.
The application must clearly describe how the development plans for
faculty/researcher will meet both the individual's professional
development goals, and two purposes of the NARCH initiative: to develop
a cadre of AI/AN scientists and health professionals, and to enhance
the partnership of the proposed NARCH.
G. Research Projects: NARCH applications may include a maximum of
five (5) regular research projects and a maximum of five (5) pilot
research projects. Unlike regular research projects, a pilot research
project is limited in scope and is not expected to have preliminary
data. It is also limited to a budget of no more than $50,000 direct
costs per year for four years. The pilot research project is intended
for
[[Page 8464]]
faculty/researchers without current research support. Support for
faculty/researchers participating in pilot research projects is
preparatory to seeking more substantial funding from NIH research grant
programs (e.g., Academic Research Enhancement Award [AREA], K, and R01
awards), as well as funding from other agencies and private sources.
Funds received from the proposed NARCH to support pilot research
projects may not be used to supplement ongoing research projects. A
NARCH application need not include both research projects and pilot
research projects. Applications for only pilot research projects or for
only research projects may be submitted. Individual project
investigators may propose either a research project or a pilot research
project, but not both.
Research projects (including pilot research projects) proposed
under this initiative must be in research areas normally funded by any
of the National Institutes of Health or the Agency for Healthcare
Research and Quality (AHRQ). Research projects addressing health
disparities and the health priorities of the AI/AN partner are
especially encouraged.
A listing of grants recently funded by NIH may be found at CRISP
(Computer Retrieval of Information on Scientific Projects), a
searchable database of federally funded biomedical research projects
conducted at universities, hospitals, and other research institutions.
It may be accessed at (http:/crisp.cit.nih.gov/). Grants funded by AHRQ
can also be found on CRISP as well as on GOLD (Grants On-Line Database)
which can be found at (http://www.gold.ahrq.gov/).
Each research project or pilot research project should follow the
instructions provided in PHS 398 (updated 09/09/03) for preparing
research grant applications. The professional development goals must
clearly describe specific objectives and milestones which should
include, but are not limited to, improving competitiveness in acquiring
grant support. The applicant should describe how successful completion
of the proposed research project will improve the research skills, and
will help develop the students and faculty/researcher, thus
contributing to the overall goals and specific measurable objectives of
the proposed NARCH.
Each research project or pilot research project must follow the IHS
policy concerning Tribal approval, that all research involving AI/AN
Tribes be approved by the Tribal governments with jurisdiction. That
is, each grantee must include a resolution of approval from the Tribal
government[s], or (if applicable) a letter of support signed by the
director of the eligible AI/AN organization, or both (if applicable)
for projects that involve people or community[ies] of an AI/AN Tribe,
or an eligible non-profit organization.
3. Submission Dates and Times
A. Letter of Intent Deadline: May 1, 2004.
Prospective applicants are asked to submit a letter of intent that
includes the title of the proposed NARCH, the name, address, and
telephone number of the Principal Investigator and its Program
Director, the identities of the partners and of key personnel, and the
number and title of this RFA. The letter of intent must be received by
Dr. Michael R. Martin at the Center for Scientific Review, MSC 7892,
Room 6160, 6701 Rockledge Drive, Bethesda, MD 20892-7892, telephone:
(301) 594-7945, Fax: (301) 480-2065, e-mail: mm72k@nih.gov, before 6
p.m. EST on May 1, 2004. Letters may be submitted by mail, fax or e-
mail.
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 the IHS and NIH Center for
Scientific Review (CSR) staffs to estimate the potential review
workload and avoid conflict of interest in the review.
B. Application and Resolution Deadline: June 18, 2004.
The applications must be received before 6 p.m. EST on June 18,
2004. If an application is received after that date, it will be
returned to the applicant without review. To be considered timely, an
application must be sent on or before the deadline date. If sent timely
(with documented proof of mailing) but received after the deadline, an
application will be accepted for review only if it is received in time
for orderly processing. Competing applications not meeting the deadline
date specified in the announcement are considered late applications and
will not be considered for funding under that announcement.
The Center for Scientific Review (CSR) will not accept any
application in response to this RFA that is essentially the same as one
currently pending initial review, unless the applicant withdraws the
pending application. The CSR will not 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.
4. Intergovernmental Review
This funding opportunity is not subject to Executive Order 12372,
``Intergovernmental Review of Federal Programs.'' A State approval is
not required.
5. Funding Restrictions
Grantees are allowed a reasonable period of time in which to submit
required financial and performance reports.
Failure to submit required reports within the time allowed may
result in suspension or termination of an active grant, withholding of
additional awards for the project, or other enforcement actions such as
withholding of payments or converting to the reimbursement method of
payment. Continued failure to submit required reports may result in the
imposition of special award provisions, or cause other eligible
projects or activities involving that grantee organization, or the
individual responsible for the delinquency to not be funded.
Failure to obtain prior approval for change in Scope, Principal
Investigator, Grantee Institutions, Successor in Interest, or Recipient
Institute Name, undertaking any activities disapproved or restricted as
a condition of the award, may result in fund restrictions.
Allowable Administrative Cost
Certain administrative costs for managing a comprehensive program
are allowable and may vary, depending upon the size and complexity of
the program's activities. The costs budgeted for NARCH grants and
subcontracts may not duplicate items already budgeted in other cost
centers of the AI/AN, research-intensive, and subcontracted
organizations and institutions, such as accounts which make up the
Facilities and Administration (F&A) cost pool. The grantee organization
receiving the award must be prepared to provide documentation showing
the direct relationship of proposed costs to the program, and that
costs of this type are charged in a uniform manner to all other grants
at all institutions and organizations participating in the award.
Salary (up to 25 percent effort, although it should
generally be less) for the NARCH Program Director is allowable for that
portion of time or effort specifically employed in directing the
proposed NARCH. (The 25 percent limit does not include salary for being
a research investigator.) Limited salary support for secretarial or
clerical help is
[[Page 8465]]
allowable only when in direct support of the proposed NARCH. For
guidance, applicants should refer to the OMB Circular appropriate for
them, A-87 (Cost Principles for State, local, and Indian Tribal
Governments), at http://www.whitehouse.gov/omb/circulars or A-122 (Cost Principles for Non-Profit Organizations), http://www.whitehouse.gov/
.gov/
INQUIRIES.
Costs for evaluation activities are allowable, as
are costs for the Community and Scientific Advisory Council. All
applications must include costs associated with one annual meeting per
year in Rockville, MD, of NARCH directors and their key scientific
personnel.
Student Development Costs. Student (graduate,
undergraduate, and high school, if well justified) remuneration through
salary/wages for participation in research experiences may be
requested, provided all the following conditions are met:
The student is performing necessary work
involved in the research.
There is an employer-employee relationship
between the student and the proposed NARCH or its partners. The total
compensation is reasonable for the work performed.
It is the practice of the proposed NARCH or its
partners to provide compensation for all students in similar
circumstances, regardless of the source of support for the activity.
Graduate students, but not undergraduate students, are allowed
tuition costs as part of a compensation package. When requesting
support for a graduate student, the NARCH application should provide,
in the budget justification section of the application, the basis for
the compensation level. The IHS staff will review the requested
compensation level and, if it is reasonable and justified, will provide
compensation up to a maximum of $45,000 (http://grants.nih.gov/grants/guide/notice-files/not98-168.html
). Post-doctoral students should be
compensated at a rate commensurate with that of other post-doctoral
employees with similar degrees and experience at the research-intensive
institution.
It is the expectation of the IHS, NIGMS and AHRQ that students who
are enrolled in an accredited graduate program, as part of a proposed
NARCH, will not be excluded from support from other non-federal or
federal graduate training sources (such as loans and assistance under
the Veterans' Adjustment Benefit Act or Pell Grants) for which they are
eligible. Graduate and post-doctoral students cannot concurrently hold
another federally-sponsored stipend or fellowship or any other federal
award that duplicates the NARCH support.
Faculty/Researcher Development Costs. Costs to
support faculty/researcher development activities, such as workshops or
courses, national meetings, or short-term research experiences in the
laboratory of an active NIH-extramurally-funded researcher needed for
acquiring specific skills or methodologies needed for prospective
research, are allowable. Such costs might include tuition, travel and
per diem costs, as well as salary support appropriate to the percent
effort needed for the activity. Also, allowable are costs such as
travel and per diem associated with short-term research experiences in
the laboratory of an active extramurally funded researcher.
Research Project Costs. Direct costs associated with
research and pilot research projects are allowable when adequate
justification is provided. These include faculty/researcher salaries,
reimbursed according to percent effort. Summer salary support can be
paid provided the institution's academic schedule permits such release
and when the institution approves. The maximum summer-salary support
provided by the program cannot exceed the equivalent of three months at
100 percent effort, or time specified by the institution as its policy.
Grant funds may not be used to increase or supplement faculty/
researcher academic year salaries. Salary support for technical
assistance and costs for consultants, if justified, are allowable.
Costs for equipment to be used to carry out the proposed research are
allowable.
Costs for Core Scientific Services. Costs for core
scientific services to support two or more projects are allowable.
Costs for multi-user research equipment are also allowable. A plan for
access to the multi-user equipment, its maintenance, management and use
must be included. To aid in the review, it is suggested that a tabular
summary show the estimated or actual proportional use of this equipment
by each project, and other investigators and students. Justify this
core component by discussing ways in which these centralized services
improve quality, bring about an economy of effort, and/or save overall
costs as compared to their inclusion as part of each research project.
Personnel costs to maintain and service the equipment are an allowable
cost. Support for very large pieces of equipment, however, may be
restricted by the NARCH budget. Plans to maintain the shared core
scientific services and facility beyond the grant period should be
discussed.
Cost for Supplies. Costs for supplies, including
costs for animals, necessary to carry out the proposed research may be
included. Travel costs for the investigator(s) are permitted when
direct benefits to the program are expected, and when adequate
justification is provided. Alterations and Renovations costs (up to
$40,000) are allowable only when essential for conduct of the proposed
research. Other permitted costs include animal maintenance (unit care
costs and number of care days), donor fees, publication costs, computer
charges, rentals and leases, equipment maintenance, and service
contracts.
Consortium and Contract Arrangements. Consortium
arrangements that may involve personnel costs, supplies, and other
allowable costs, including F & A costs; contractual costs for support
services, such as the laboratory testing of biological materials,
clinical services, data processing, or core administrative services,
are allowable expenses. Consortia and contractual costs with Native
health organizations, tribes and/or research institutions in Canada are
allowable expenses.
Pilot Research Projects. The intent of pilot
research projects is to lead to regular research projects funded as
part of the center grant or as freestanding grants. For pilot research
projects, applications may request support for up to $50,000 (direct
costs) per year. This support is non-renewable.
Subcontracts. The grant recipient may issue
subcontracts to other organizations (such as the research-intensive
institution of the partnership), as long as at least 30 percent of the
grant remains with the AI/AN organization; that is, no more than 70
percent may be subcontracted.
F. Unallowable Costs: Unallowable costs for research projects
(including for pilots projects) include costs for student development,
textbooks, journals, memberships, and Internet subscription costs, as
well as other costs prohibited by OMB Circulars A-87 or A-122 as
applicable. Employees of the applicant organization may not serve as
paid consultants but may be paid.
[[Page 8466]]
The pilot research project is intended for faculty/researcher
without current research support. Therefore, investigators with
significant current support from other mechanisms such as the R01 and
research funding from other extramural sources are not eligible, and
the costs therefore are not allowable. Release time for preparing
proposals or mini-research projects, not submitted, as pilot projects,
is not allowed.
6. Other Submission Requirement
The administrative personnel, facilities, and programs of the
overall NARCH should be described. It is permissible, but not necessary
to have a set of core support programs that provide common scientific
services to two or more NARCH projects.
Submit a typed and signed original application, including the
Checklist, and one (1) single-sided photocopy of the entire application
(including Appendices and supporting documents) in one package to:
Grants Management Branch, Indian Health Service, Reyes Building, 801
Thompson Avenue, Rockville, MD 20852-1627 (zip code is unchanged for
express/courier services), Telephone: (301) 443-5204.
Also, at the time of submission, send four (4) additional single-
sided photocopied and signed applications, including the Checklist,
Appendices, and supporting documentation to: Center for Scientific
Review, National Institutes of Health, 6701 Rockledge Drive, Room 6160-
-MSC 7892, Bethesda, MD 20892-7720, Bethesda, MD 20817 (for express or
courier service). Telephone: (301) 594-7945.
V. Application Review Information
Upon receipt, IHS and NIH staff will administratively review
applications for completeness and responsiveness. Applications that are
incomplete, non-responsive to this RFA, or do not follow the guidelines
of the PHS form 398 (updated 09/09/03) or of the supplementary
instructions for NARCH grants, will be returned to the applicant
without further consideration.
Applications will be evaluated in accordance with the criteria
stated below for scientific and technical merit by appropriate peer
review groups convened by the CSR. The National Advisory General
Medical Sciences Council will conduct the second level of review.
1. Criteria
Priorities for funding will be based on the scientific and
technical merit of the application, the assessed potential of
investigators in the developmental stages of their careers, and the
likelihood that the proposed NARCH can further the purposes of the
NARCH initiative. Awards will be made only to organizations with
financial management systems and management capabilities that are
acceptable under PHS policy. Awards will be administered under the PHS
Grants Policy Statement.
2. Review and Selection Process
A. Review of Student and Faculty/Researcher Development Plans: The
anticipated effectiveness of the proposed NARCH in making a difference
relative to the current base-line data (based in part on previous
experience of the partners) will be assessed. Factors to be considered
include:
The appropriateness of the content, phasing,
quality, and duration of the student or faculty/researcher development
plans in the NARCH application to achieve the scientific development of
the faculty/researcher, post-doctoral, pre-doctoral, undergraduate, and
(if well justified) high school students; and
The experience, proposed commitment, and quality of
the mentoring plan and of individual mentors of the partners in
providing mentoring, guidance, and advice to candidates (including
training in responsible conduct of research and research integrity,
teaching, and protection of human subjects), and in fostering the
development of academic and community-based AI/AN researchers.
B. Review of Research Projects: The NIH has announced procedures to
be used for the review of research grant applications (NIH Guide,
Volume 26, Number 22, June 27, 1997 or see http://grants. nih. gov/
grants/guide/notice-files/not97-010. html). For NARCH applications, the
five criteria listed in this announcement will be used for the
scientific review of research projects and pilot research projects. The
review of research projects and pilot research projects will be the
same except that applications for pilot studies may be smaller in scope
and would not be expected to have preliminary data.
The purposes of the NARCH initiative are:
To develop a cadre of AI/AN scientists and health
professionals engaged in biomedical, behavioral and health services
research;
To increase the formation of partnerships between
AI/AN and research-intensive institutions; and
To encourage competitive research that address the
health priorities and health disparities in the AI/AN population.
In the written comments, reviewers will be asked to discuss the
following aspects of the application in order to judge the likelihood
that the proposed research will have a substantial impact on the
pursuit of these purposes. Each of these criteria will be addressed and
considered in assigning the overall score, weighting them as
appropriate for each application.
Significance: Does this study address an important
problem? If the aims of the application are achieved, how will
scientific knowledge be advanced? What will be the effect of these
studies on the concepts or methods that drive this field?
Approach: Are the conceptual framework, design,
methods, and analyses adequately developed, well-integrated, and
appropriate to the aims of the project? Does the application
acknowledge potential problem areas and consider alternative tactics?
For pilot research projects, are the proposed aims reasonable, and is
there potential to lead to more substantial funding?
Innovation: Does the project employ novel concepts,
approaches, or methods? Are the aims original and innovative? Does the
project challenge existing paradigms or develop new methodologies or
technologies?
Investigator: Is the investigator appropriately
trained and well suited to carry out this work? Is the work proposed
appropriate to the experience level of the principal investigator and
other researchers (if any)?
Environment: Does the scientific environment in
which the work will be done contribute to the probability of success?
Do the proposed experiments take advantage of unique features of the
scientific environment or employ useful collaborative arrangements? Is
there evidence of institutional support?
In addition to the above criteria, in accordance with NIH policy,
all applications will also be reviewed with respect to the following:
The adequacy of plans, if research on human subjects
is involved, to include both genders and children as appropriate for
the scientific goals of the research. Plans for the recruitment and
retention of subjects will also be evaluated.
The reasonableness of the proposed budget and
duration in relation to the proposed research.
The adequacy of the proposed protection for humans,
animals or the
[[Page 8467]]
environment, to the extent they may be adversely affected by the
project proposed in the application.
The adequacy of the proposed plan to share data, if
appropriate.
In reviewing the overall Center, the initial scientific review
group will examine evidence of the partners' commitment to the purposes
of the NARCH initiative to develop a cadre of AI/AN scientists and
health professionals engaged in biomedical, clinical, behavioral and
health services research that is competitive for NIH funding; to
increase the capacity of both research-intensive institutions and AI/AN
organizations to work in partnership to reduce distrust by AI/AN
communities and people toward research; and to encourage competitive
research linked to the health priorities of the AI/AN partner and to
reducing health disparities. The evidence will include:
The quality of the partnership of the institutional
and community partners, and the quality of the involvement of the
Community and Scientific Advisory Council, as demonstrated by
documentation of (for instance): the intellectual and tangible
contributions and activities of the partners, and of the Council, in
developing the application and the proposed NARCH; the interactions of
the partners, and of the members of the Council, in meetings (such as
those to develop the application and proposed NARCH); the past
activities and future plans to increase the capacity of the partners
and of the Council; the plans for future contributions and activities
by the partners, and by the Council, in furthering the goals of the
proposed NARCH; and the plans for future development of the partnership
itself;
The experience and commitment of the institutional
and community partners to recruit, retain, and advance AI/AN faculty/
researcher and students, to support faculty/researcher and student
research efforts, and to increase the role of the involved AI/AN
communities in the plans of the proposed NARCH;
The appropriateness of the plan for evaluating the
impact of the proposed NARCH, including the quality of baseline data
and milestones for accomplishments, and a system to track the future
course of program participants; and
The potential of the proposed NARCH to be a regional
and national resource, including: Capacity to provide quality research
training and mentoring for integrated promotion and development of AI/
AN research careers from undergraduate (or if well justified, high
school) through post-doctoral levels; attainment of quality research
linked to health priorities of the AI/AN partner and to reducing health
disparities; plans for research information dissemination and education
activities; and plans for the development of research networks to
support the scientific aims of the proposed NARCH.
3. Anticipated Announcement and Award Dates
Anticipated Announcement Date: March 15, 2004.
Anticipated Award Date: May 1, 2005.
VI. Award Administration Information
1. Award Notices
Grants Management will not award a grant without an approved
application in conformance with regulatory and policy requirements and
which describes the purpose and scope of the project to be funded. When
the application is approved for funding, the Grants Management Office
will prepare a Notice of Grant Award with special terms and conditions
binding upon the award and refer to all general terms applicable to the
award.
2. Administrative and National Policy Requirements
A. Inclusion of Women and Minorities in Research Involving Human
Subjects: It is the policy of the NIH that women and members of
minority groups and their subpopulations must be included in all NIH
supported biomedical, clinical, behavioral and health services research
projects involving human subjects, unless a clear and compelling
rationale and justification is provided that inclusion is inappropriate
with respect to the health of the subjects or the purpose of the
research. This policy results from the NIH Revitalization Act of 1993
(Section 492B of P.L. 103-43). Because the NARCH initiative targets AI/
AN people and communities, a minority population, only the policy of
inclusion of women applies to this RFA. The IHS has fully accepted the
OHRP policy regarding human subjects. The OHRP Web site is http://ohrp.osophs.dhhs.gov/g-topics.htm
.
All investigators proposing research involving human subjects
should read the UPDATED ``NIH Guidelines For Inclusion of Women and
Minorities as Subjects in Clinical Research,'' published in the NIH
Guide for Grants and Contracts on August 2, 2000 (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html
). The
complete Guidelines are available at http://grants1.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.
The revisions
relate to NIH defined Phase III clinical trials and require:
All applications or proposals and/or protocols to
provide a description of plans to conduct analyses, as appropriate, to
address differences by sex/gender and/or racial/ethnic groups,
including subgroups if applicable; and
All investigators to report accrual, and to conduct
and report analyses, as appropriate, by sex/gender and/or racial/ethnic
group differences.
B. Inclusion of Children as Participants in Research Involving
Human Subjects: It is the policy of NIH that children (i.e.,
individuals under the age of 21) must be included in all human
subjects' research, conducted or supported by the NIH, unless there are
scientific or ethical reasons not to include them. This policy applies
to all initial (Type 1) applications submitted.
All investigators proposing research involving human subjects
should read the ``NIH Policy and Guidelines on the Inclusion of
Children as Participants in Research Involving Human Subjects'' that
was published in the NIH Guide for Grants and Contracts, March 6, 1998,
and is available at the following URL address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html.
Investigators may obtain
copies of these policies from the initiative staff listed under
INQUIRIES. Initiative staff may also provide additional relevant
information concerning the policy.
C. URLS in NIH Grant Applications or Appendices: All applications
and proposals for NIH funding must be self-contained within specified
page limitations. Unless otherwise specified in an NIH solicitation,
Internet addresses (URLs) should not be used to provide information
necessary to the review because reviewers are under no obligation to
view the Internet sites. Reviewers are cautioned that their anonymity
may be compromised when they directly access an Internet site.
D. Public Access to Research Data Through the Freedom of
Information Act: The OMB Circular A-110 has been revised to provide
public access to research data through the Freedom of Information Act
(FOIA) under some circumstances. Data that are:
First produced in a project that is supported in
whole or in part with Federal funds; and
Cited publicly and officially by a Federal agency in
support of an action that has the force and effect of law
[[Page 8468]]
(i.e., a regulation) may be accessed through FOIA.
It is important for applicants to understand the basic scope of
this amendment. NIH has provided guidance at: http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm
.
Applicants may wish to place data collected under this PA in a
public archive, which can provide protections for the data and manage
the distribution for an indefinite period of time. If so, the
application should include a description of the archiving plan in the
study design and include information about this in the budget
justification section of the application. In addition, applicants
should think about how to structure informed consent statements and
other human subjects procedures given the potential for wider use of
data collected under this award.
E. Allowable Administrative Cost: Certain administrative costs for
managing a comprehensive program are allowable and may vary, depending
upon the size and complexity of the program's activities. The costs
budgeted for NARCH grants and subcontracts may not duplicate items
already budgeted in other cost centers of the AI/AN, research-
intensive, and subcontracted organizations and institutions, such as
accounts which make up the Facilities and Administration (F&A) cost
pool. The grantee organization receiving the award must be prepared to
provide documentation showing the direct relationship of proposed costs
to the program, and that costs of this type are charged in a uniform
manner to all other grants at all institutions and organizations
participating in the award.
Salary (up to 25 percent effort, although it should
generally be less) for the NARCH Program Director is allowable for that
portion of time or effort specifically employed in directing the
proposed NARCH. (The 25 percent limit does not include salary for being
a research investigator.) Limited salary support for secretarial or
clerical help is allowable only when in direct support of the proposed
NARCH. For guidance, applicants should refer to the OMB Circular
appropriate for them, A-87 (Cost Principles for State, local, and
Indian Tribal Governments), at http://www.whitehouse.gov/omb/circulars or A-122 (Cost Principles for Non-Profit Organizations), http://
http://www.whitehouse.gov/omb/circulars, or should contact the grants
management officer under INQUIRIES.
Costs for evaluation activities are allowable, as
are costs for the Community and Scientific Advisory Council. All
applications must include costs associated with one annual meeting per
year in Rockville, MD, of NARCH directors and their key scientific
personnel.
Student Development Costs. Student (graduate,
undergraduate, and high school if well justified) remuneration through
salary/wages for participation in research experiences may be
requested, provided all the following conditions are met:
The student is performing necessary work
involved in the research.
There is an employer-employee relationship
between the student and the proposed NARCH or its partners. The total
compensation is reasonable for the work performed.
It is the practice of the proposed NARCH or its
partners to provide compensation for all students in similar
circumstances, regardless of the source of support for the activity.
Graduate students, but not undergraduate students, are allowed
tuition costs as part of a compensation package. When requesting
support for a graduate student, the NARCH application should provide,
in the budget justification section of the application, the basis for
the compensation level. The IHS staff will review the requested
compensation level and, if it is reasonable and justified, will provide
compensation up to a maximum of $45,000 (http://grants.nih.gov/grants/guide/notice-files/not98-168.html
). Post-doctoral students should be
compensated at a rate commensurate with that of other post-doctoral
employees with similar degrees and experience at the research-intensive
institution.
It is the expectation of the IHS, NIGMS and AHRQ that students who
are enrolled in a accredited graduate program, as part of a proposed
NARCH, will not be excluded from support from other non-Federal or
Federal graduate training sources (such as loans and assistance under
the Veterans' Adjustment Benefit Act or Pell Grants) for which they are
eligible. Graduate and post-doctoral students cannot concurrently hold
another federally-sponsored stipend or fellowship or any other Federal
award that duplicates the NARCH support.
Faculty/Researcher Development Costs. Costs to
support faculty/researcher development activities, such as workshops or
courses, national meetings, or short-term research experiences in the
laboratory of an active NIH-extramurally-funded researcher needed for
acquiring specific skills or methodologies needed for prospective
research, are allowable. Such costs might include tuition, travel and
per diem costs, as well as salary support appropriate to the percent
effort needed for the activity. Also, allowable are costs such as
travel and per diem associated with short-term research experiences in
the laboratory of an active extramurally funded researcher.
Research Project Costs. Direct costs associated with
research and pilot research projects are allowable when adequate
justification is provided. These include faculty/researcher salaries,
reimbursed according to percent effort. Summer salary support can be
paid provided the institution's academic schedule permits such release
and when the institution approves. The maximum summer-salary support
provided by the program cannot exceed the equivalent of three months at
100 percent effort, or time specified by the institution as its policy.
Grant funds may not be used to increase or supplement faculty/
researcher academic year salaries. Salary support for technical
assistance and costs for consultants, if justified, are allowable.
Costs for equipment to be used to carry out the proposed research are
allowable.
Costs for Core Scientific Services. Costs for core
scientific services to support two or more projects are allowable.
Costs for multi-user research equipment are also allowable. A plan for
access to the multi-user equipment, its maintenance, management and use
must be included. To aid in the review, it is suggested that a tabular
summary show the estimated or actual proportional use of this equipment
by each project, and other investigators and students. Justify this
core component by discussing ways in which these centralized services
improve quality, bring about an economy of effort, and/or save overall
costs as compared to their inclusion as part of each research project.
Personnel costs to maintain and service the equipment are an allowable
cost. Support for very large pieces of equipment, however, may be
restricted by the NARCH budget. Plans to maintain the shared core
scientific services and facility beyond the grant period should be
discussed.
Cost for Supplies. Costs for supplies, including
costs for animals, necessary to carry out the proposed research may be
included. Travel costs for the investigator(s) are permitted when
direct benefits to the program are
[[Page 8469]]
expected, and when adequate justification is provided. Alterations and
Renovations costs (up to $40,000) are allowable only when essential for
conduct of the proposed research. Other permitted costs include animal
maintenance (unit care costs and number of care days), donor fees,
publication costs, computer charges, rentals and leases, equipment
maintenance, and service contracts.
Consortium and Contract Arrangements. Consortium
arrangements that may involve personnel costs, supplies, and other
allowable costs, including F&A costs; contractual costs for support
services, such as the laboratory testing of biological materials,
clinical services, data processing, or core administrative services,
are allowable expenses. Consortia and contractual costs with Native
health organizations, tribes and/or research institutions in Canada are
allowable expenses.
Pilot Research Projects. The intent of pilot
research projects is to lead to regular research projects funded as
part of the center grant or as freestanding grants. For pilot research
projects, applications may request support for up to $50,000 (direct
costs) per year. This support is non-renewable.
Subcontracts. The grant recipient may issue
subcontracts to other organizations (such as the research-intensive
institution of the partnership), as long as at least 30 percent of the
grant remains with the AI/AN organization; that is, no more than 70
percent may be subcontracted.
F. Unallowable Costs: Unallowable costs for research projects
(including for pilots projects) include costs for student development,
textbooks, journals, memberships, and Internet subscription costs, as
well as other costs prohibited by OMB Circulars A-87 or A-122 as
applicable. Employees of the applicant organization may not serve as
paid consultants but may be paid.
The pilot research project is intended for faculty/researcher
without current research support. Therefore, investigators with
significant current support from other mechanisms such as the R01 and
research funding from other extramural sources are not eligible, and
the costs therefore are not allowable. Release time for preparing
proposals or mini-research projects, not submitted, as pilot projects,
is not allowed.
G. Qualifications of the NARCH Program Director and Key Personnel:
As leader of the research and research training for the proposed NARCH,
the NARCH Program Director is expected to possess certain essential
qualifications such as:
Strong leadership skills, including scientific
leadership experience and a strong academic and scientific background,
as exemplified, ideally, by scientific publications and a record of
peer-reviewed scientific support;
The knowledge of and personal working relationship
with the AI/AN Tribes or communities involved in the NARCH research,
and with the partners of the proposed NARCH;
Strong mentoring and supervision skills, to exercise
responsibility for mentoring activities, organization of communicating
skills programs, special methods workshops, tracking of student career
plans, etc.; and
Knowledge of IHS and NIH policies, including those
concerning human participants in research, human biological material,
animals, hazardous materials, and Tribal review and approval of
research.
The names and qualifications of the NARCH Program Director, the
Student and Faculty/Researcher Development Director and directors of
individual projects within the program (where appropriate), and any
other key personnel, should be listed in the application under the Key
Personnel section. Biographical Sketches of these individuals,
including other grant support, should be included.
3. Reporting
The NARCH Program Office and the Grants Management have
requirements for the progress reports and financial reports based on
the terms and conditions of the grant. Grantees are responsible and
accountable for accurate reporting of the Progress Reports and
Financial Status Reports which are generally due annually. Financial
Status Report (SF 269) are due 90 days after each budget period and the
final SF 269 must be verified from the grantee records on how the value
was derived.
Grantees are allowed a reasonable period to time in which to submit
required financial and performance reports.
Failure to submit required reports within the time allowed may
result in suspension or termination of an active grant, withholding of
additional awards for the project, or other enforcement actions such as
withholding of payments or converting to the reimbursement method of
payment. Continued failure to submit required reports may result in the
imposition of special award provisions, or cause other eligible
projects or activities involving that grantee organization, or the
individual responsible for the delinquency to not be funded.
Failure to obtain prior approval for change in Scope, Principal
Investigator, Grantee Institutions, Successor in Interest, or Recipient
Institute Name, undertaking any activities disapproved or restricted as
a condition of the award, may result in fund restrictions.
VII. Agency Contact(s)
1. Questions on the initiative, regarding IHS NARCH issues and
policies, may be directed to: Alan Trachtenberg, M.D., M.P.H., Research
Program Director, Indian Health Service, 801 Thompson Avenue, TMP,
Suite 450, Rockville, MD 20852-1750, Telephone: (301) 443-0222, Fax:
(301) 443-1522, e-mail: atrachte@hqe.ihs.gov.
2. Questions on grants management and fiscal matters may be
directed to: Sylvia Ryan, Grants Management Branch, Indian Health
Service, Reyes Building, 801 Thompson Avenue, Rockville, MD 20852-1627,
Telephone: (301) 443-5204, Fax: (301) 443-9602, e-mail:
sryan@hqe.ihs.gov.
3. Questions on NIGMS issues and policies, may be directed to:
Clifton A. Poodry, Ph.D., Minority Opportunities in Research Division,
National Institute of General Medical Sciences, 45 Center Drive, Suite
2AS.37, MSC 6200, Bethesda, MD 20892-6200, Telephone: (301) 594-3900,
Fax: (301) 480-2753, e-mail: poodryc@nigms.nih.gov.
4. Questions on the review of Applications may be directed to:
Michael R. Martin, Ph.D., Director, Division of Physiological Systems,
Center for Scientific Review, MSC 7892, Room 6160, 6701 Rockledge
Drive, Bethesda, MD 20892-7892, Telephone: (301) 594-7945, Fax: (301)
480-2065, e-mail: mm72k@nih.gov.
5. Questions on Health Services Research and AHRQ policies may be
directed to: Wendy Perry, Office of the Director, Agency for Healthcare
Research and Quality, Room 3012, 540 Gaither Road, Rockville, MD 20850,
Telephone: (301) 427-1216, Fax: (301) 427-1210, e-mail:
wperry@ahrq.gov.
VIII. Other Information
1. Healthy People 2010
The Public Health Service (PHS) is committed to achieving the
health promotion and disease prevention objectives of ``Healthy People
2010'', a PHS led national activity for setting priority areas. This
Request for Application (RFA) announcement is related to one or more of
the priority areas. Potential applicants may obtain a
[[Page 8470]]
copy of ``Healthy People 2010'' at http://www.health.gov/healthypeople/
.
2. Technical Assistance Workshop
The IHS and NIH intend to conduct technical assistance and
information sharing workshops about this grant initiative in March, and
May, 2004 in at least two regional centers. Potential grantees wanting
to attend one of these workshops will have to provide names and the
eligible organization to Ms. Sylvia Ryan, at telephone number (301)
443-5204 or Fax (301) 443-9602, or by e-mail to sryan@hqe.ihs.gov as
soon as possible and no later than March 15, 2004. This notification
will help the IHS and the NIH to determine the best times and locations
for potential grantees' training and to have adequate workshop
supplies. The details of the workshops and locations will be posted (as
they are finalized) on the IHS Research Program Web site at http://www.ihs.gov/medicalprograms/research
.
3. Context
The AI/AN Tribal nations and communities have long experienced
poorer health status than other Americans. Although major gains of
reducing health disparities were made in the last half of the twentieth
century, most gains stopped by the mid 1980s (Trends in Indian Health
1998-99) and a few diseases, e.g., diabetes, worsened. ``All Indian''
rates contain marked variation among the ``IHS Areas'' or regions
(Regional Differences in Indian Health 1998-99); variation by Tribe
exists within Areas as well. The Trends and Regional Differences
reference can be found at the IHS website at http://www.ihs.gov/publicInfo/publications/index.asp.
Although the ``All Indian''
mortality rates for all cancers are about 20 percent lower than the
U.S. rates for all races, there is variation among IHS Areas for
specific cancers; moreover, the favorable AI/AN mortality rates for
some cancers may be due to markedly lower incidence rates partly offset
by higher case-fatality rates. Unfamiliarity with modern health care
may adversely influence health status among the elderly, the low-income
elderly, and Tribes, and also may reduce the acceptability of health
research among them. The daunting tasks confronting Tribes,
researchers, and health care and public health programs in the
beginning of the twenty-first century are to resume the reduction of
health disparities that had occurred up to the 1980s, to reverse the
worsening in a few diseases, to maintain and strengthen the favorable
status, and to reduce the disparities among and within Areas and
Tribes.
Factors known to contribute to health status and disparities are
complex, and include underlying biology, physiology, and genetics, as
well as ethnicity, culture, socioeconomic status, gender/sex, age,
geographical access to care, and levels of insurance. Additional
factors known to contribute to health status and disparities include:
family, home, and work environments; general or culturally specific
health practices; social support systems; lack of access to culturally-
appropriate health care; and attitudes toward health. Yet none of these
alone or in combination accounts for all documented differences.
Health disparities of AI/ANs may also reflect a lack of research
relevant to improve their health status. Many AI/ANs distrust research
for historical reasons. One approach that combats this distrust is to
ensure that Tribes are senior partners in training and research that
involves them, as for example in community-based participatory
research. This approach is especially helpful to design both training
relevant to researchers from Tribal communities, and research relevant
to the health needs of the communities.
The mission of NIH is to acquire new knowledge that will lead to
better health by understanding the processes underlying health and
disease that in turn will help prevent, detect, diagnose, and treat
disease and disability. The NARCH initiative works toward the NIH
mission by supporting research that discovers the interrelationships
among the many factors that contribute to health and disease, and by
helping train and promote researchers concerned with AI/AN health.
The Agency for Healthcare Research and Quality (AHRQ), formerly the
Agency for Health Care Policy and Research (AHCPR), a component of the
U.S. Department of Health and Human Services, is the Federal
Government's focal point for research to improve the quality, safety,
efficiency, and effectiveness of health care for all Americans. AHRQ
accomplishes this mission through the establishment of a broad base of
scientific research to: (1) Improve clinical practice, (2) improve the
health care system's ability to provide access to and deliver high
quality, high-value health care, and (3) provide policymakers with the
ability to assess the impact of system changes on outcomes, quality,
access to, cost, and use of health care services. An important element
in AHRQ's portfolio is research (including demonstrations) that
identifies successful strategies for translating evidence into
sustainable improvements in clinical practice and outcomes.
4. IHS Research Program Objectives
Due to the complexity of factors contributing to the health and
disease of AI/ANs, and to their health disparities compared with other
Americans, the collaborative efforts of the agencies of the Department
of Health and Human Services, and the collaboration of researchers and
AI/AN communities, are needed to achieve significant improvements in
the health status of AI/AN people. To accomplish this goal, in addition
to objectives set by the Tribe, Tribal Organization or Indian Health
Board, the NARCH will pursue the following program objectives:
A. To develop a cadre of AI/AN scientists and Health Professionals-
-Offering opportunities to develop more AI/AN scientists and health
professionals engaged in research, and to conduct biomedical, clinical,
behavioral and health services research that is responsive to the needs
of the AI/AN community and the goals of this initiative; Faculty/
researchers and students at each proposed NARCH will develop
investigator-initiated, scientifically meritorious research projects,
including pilot research projects, and will be supported through
science education projects designed to increase the numbers of, and to
improve the research skills of, investigators involved with AI/ANs.
B. To enhance Partnerships--Recent community-based participatory
research suggests that AI/AN communities can work collaboratively in
partnership with health researchers to further the research needs of
AI/ANs. Fully utilizing all cultural and scientific knowledge,
strengths, and competencies, such partnerships can lead to better
understanding of the biological, genetic, behavioral, psychological,
cultural, social, and economic factors either promoting or hindering
improved health status of AI/ANs, and generate the development and
evaluation of interventions to improve their health status.
C. To Reduce Health Disparities--In the amended Indian Health Care
Improvement Act, Public Law (Pub. L.) 94-437, IHS was legislatively
mandated to improve the delivery of effective health care to AI/ANs. In
the NIH Revitalization Act of 1993, NIH was encouraged to increase the
number of under-represented minorities participating in biomedical,
clinical, behavioral and health services research, including studies on
drug abuse and alcoholism, and the examination of the role of
resiliency in the prevention and treatment of those conditions. Also,
the ``Initiative to Eliminate Racial and
[[Page 8471]]
Ethnic Disparities in Health'' by HHS (http://raceandhealth.hhs.gov/)
encouraged NIH to help reduce health disparities. In its 1999
reauthorizing legislation, AHRQ was directed to conduct and support
research to identify and reduce health care disparities (Pub. L. 106-
525). NIH published the ``Strategic Research Plan and Budget to Reduce
and Ultimately Eliminate Health Disparities, Fiscal Years 2002-2006''
at (http://www.ncmhd.nih.gov). Finally, the ``NIGMS Strategic Plan for Reducing Health Disparities'' (http://www.nigms.nih.gov/news/reports/
s/
reduction through its focused programs on research infrastructure to
increase the number and capabilities of under-represented minority
health researchers. In response to these priorities, the IHS, NIGMS and
AHRQ have established a collaboration to support Native American
Research Centers for Health. Reducing health disparities among AI/AN
communities and individuals may be fostered by greater understanding of
how to enhance their strengths and resiliencies. While AI/AN
communities have relied on health research and medical science to
reduce health disparities, they also have relied on their own
psychological, organizational, and cultural assets and strengths to
survive major harms and disruptions over the centuries, and to rebound
from insults to health. For research about resiliencies, see http://www.nida.nih.gov/ResilandRiskWG/ResilandRiskWG.html
.
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Freeman, W.L. The role of community in research with stored tissue
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Dated: February 17, 2004.
Michel E. Lincoln,
Deputy Director, Indian Health Service.
[FR Doc. 04-3867 Filed 2-23-04; 8:45 am]
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