Strategies to Increase Delivery of Guideline-Based Care to Populations with Health Disparities (R01)

Overview

This document is intended to answer many of the questions that potential applicants for the PAR “Strategies to Increase Delivery of Guideline-Based Care to Populations with Health Disparities (R01)” (PAR-15-279) may have regarding requirements of the application package, definitions of guideline-based care and intended population of interest, and administrative requirements.  Information in this document is a clarification of guidance provided in the PAR.

The purpose of this Funding Opportunity Announcement (FOA) is to encourage the development of innovative, multi-level studies to test systems, infrastructures, and strategies that will accelerate the adoption of guideline-based recommendations into clinical care relevant to HLBS disorders.  Proposed strategies that focus on providers who care for clinical populations with excess burden of HLBS diseases and disorders, in concert with the health care delivery systems in which they practice and the patients themselves, are the focus of this initiative.

Q: What are the review criteria for this PAR?
A: The specific review criteria are described in the Funding Announcement under Section V. Application Review Information.  Applications will be reviewed in a Special Emphasis Panel.

Q: Are multiple PI applications permitted?
A: Yes.  The justification for multi-PI applications is that the co-PIs bring expertise in the areas necessary to undertake the proposed research.

Q: What is meant by multi-level interventions?
A: A multi-level intervention is one that addresses the issue at multiple parts of the environment, which may include places where participants/providers live, work, socialize, attend school, or receive health care. The optimal number of levels is determined by the needs of the relevant participants. 

Q: Will respondents be required to have experts in implementation research as part of their team? What other team members are required?
A: Applications should include expertise in all relevant dimensions of the proposed research, including but not limited to implementation science, clinicians, and stakeholders.

Q: Since this Funding Announcement has multiple receipt dates, are resubmissions allowed?
A: Yes, an unfunded application that has been modified following initial review may be resubmitted for new consideration under this FOA.

Q: Is it required that projects work directly with healthcare delivery organizations?
A: Applicants should outline details and plans for the multi-disciplinary team of scientists and practice stakeholders to work together across diverse community and clinical practice settings and populations of patients. The process for engagement and involvement of stakeholders should be delineated. Applications must include a letter of support from relevant healthcare providers or other healthcare organizations related to the proposed project, indicating their commitment to participate.

Q: Who is the population of interest being served in these applications?
A: The implementation strategies being proposed must target providers and health care delivery systems that serve vulnerable patient populations.  These populations include adults and/or children who are medically underserved, racial/ethnic minorities, low income, and/or rural dwelling patients in either primary care or specialty care. 

Q: Are clinical outcomes required?
A: Appropriate outcomes include process-focused measures such as provider acceptability, uptake and adoption of guidelines, cost analysis, and provider assessments of suitability and feasibility of the guideline for settings in which there are significant health disparities.  Outcomes that indicate that factors at the provider, healthcare system, and patient levels that determine successful implementation of specific guideline-based practices are desirable.  Clinical outcomes are also desirable but not required.

Q: Would a study examining low-dose CT for lung cancer screening be appropriate for this PAR?
A: No.  We recommend that you contact a program officer at the National Cancer Institute to determine whether a study of this type is appropriate for that institute.

Q: Is it required that studies use randomized controlled trials?
A: Not necessarily.  The PAR recommends that investigators propose the most rigorous study design possible for the specific questions being addressed, which may or may not be a randomized controlled trial (RCT). 

Q: Are application revisions allowed under this PAR?
A: Yes.  Revisions, resubmissions and renewals are allowable.

Q: What is meant by a stakeholder?
A: This could depend on the study, but stakeholders might include providers, patients, patient families, and healthcare organizations, among others.

Q: Is the purpose of the PAR for study of implementation of evidence-based guidelines, if effective, to be replicated nationwide?
A: The purpose of the PAR is to identify strategies that, if implemented, will lead to improvements in the delivery of guideline-based care.

Q: Where can I find more information on the scientific review criteria (significance, investigator, innovation, approach, environment)?
A: Please refer to Section V (Application Review Information) in the funding opportunity announcement (http://grants.nih.gov/grants/guide/pa-files/PAR-15-279.html).  Review criteria are specified in that section.

Q: Will a recording of the webinar be available?
A: No, please direct questions about this FOA to the Scientific Contact listed in the Funding Announcement. 

Q: Are there other resources available regarding the grant review process?
A: Yes, applicant resources, including an overview of the grant review process, are available at http://public.csr.nih.gov/ApplicantResources/Pages/default.aspx.

Last Updated: September 19, 2016