HIVe Home
HIV VACCINE ELECTRONIC (E) RESOURCE
ID#: PAR-10-039     Posted: 16 Mar 2011
Dissemination and Implementation Research in Health (R03) PAR-10-039
Deadline: 16 Jul 2012
Apply Here
Type of Grant: Research
Topics/Fields of Support: Other
NIH

The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the nation’s medical research agency—making important medical discoveries that improve health and save lives.

Thanks in large part to NIH-funded medical research, Americans today are living longer and healthier. Life expectancy in the United States has jumped from 47 years in 1900 to 77 years today, and disability in people over age 65 has dropped dramatically in the past 3 decades. In recent years, nationwide rates of new diagnoses and deaths from all cancers combined have fallen significantly.

Scientific Leadership

NIH is the largest source of funding for medical research in the world, creating hundreds of thousands of high-quality jobs by funding thousands of scientists in universities and research institutions in every state across America and around the globe.

NIH is made up of 27 Institutes and Centers, each with a specific research agenda, often focusing on particular diseases or body systems. NIH leadership plays an active role in shaping the agency's activities and outlook.

The Office of the Director is the central office at NIH, responsible for setting policy for NIH and for planning, managing, and coordinating the programs and activities of all the NIH components. The NIH Director, with a unique and critical perspective on the entire agency, is responsible for providing leadership to the Institutes and for constantly identifying needs and opportunities, especially for efforts that involve multiple Institutes. The NIH Director is assisted by the NIH Deputy Directors including the Principal Deputy Director, who shares in the overall direction of the agency's activities.

More than 80% of the NIH's budget goes to more than 300,000 research personnel at over 3,000 universities and research institutions. In addition, about 6,000 scientists work in NIH’s own laboratories, most of which are on the NIH main campus in Bethesda, Maryland. The main campus is also home to the NIH Clinical Center, the largest hospital in the world totally dedicated to clinical research.

Successful biomedical research depends on the talent and dedication of the scientific workforce. NIH supports many innovative training programs and funding mechanisms  that foster scientific creativity and exploration. The goal is to strengthen our nation’s research capacity, broaden our research base, and inspire a passion for science in current and future generations of researchers.


Visit web site

DETAILS

Funding Opportunity Description

Research Objectives: Each year, billions of U.S. tax dollars are spent on research and hundreds of billions are spent on service delivery programs.  However, relatively little is spent on, or known about, how best to ensure that the lessons learned from research inform and improve the quality of health and human services and the availability and utilization of evidence-based approaches.  In the context of increased interest and investment in comparative effectiveness research that will help to determine the optimal interventions to be used in clinical and community healthcare practice, it is essential that healthcare settings are equipped with empirically-supported strategies to integrate scientific knowledge and effective interventions into everyday use.  The National Institutes of Health have recognized that closing the gap between research discovery and program delivery is both a complex challenge and an absolute necessity if we are to ensure that all populations benefit from the Nation’s investments in new scientific discoveries.

The National Institute of Mental Health (NIMH), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute on Deafness and Other Communication Disorders (NIDCD), the Office of Behavioral and Social Science Research (OBSSR), the National Institute of Nursing Research (NINR), the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute of Dental and Craniofacial Research (NIDCR),and  the Fogarty International Center (FIC) invite grant applications for research that will identify, develop, and refine effective and efficient  methods, structures, and strategies to disseminate and implement research-tested health behavior change interventions and evidence-based prevention, early detection, diagnostic, treatment, and quality of life improvement  interventions into public health and clinical practice settings. The purpose of this dissemination and implementation research program announcement (FOA) is to support innovative approaches to identifying, understanding, and overcoming barriers to the adaptation, adoption and integration of evidence-based interventions and guidelines that previous research has shown to be efficacious and effective, but where uptake to date has been limited or significantly delayed.

Most researchers who propose to develop and test disease control interventions either explicitly or implicitly intend to promote efficacious interventions to the broader population from which the efficacy study sample was drawn or the public health or clinical practice settings in which the intervention was originally tested. Thus, for many years, health researchers may have assumed that an intervention deemed efficacious within clinical or community-based trials would be easily transmitted to the field; evidence suggests that this has not been the case. Even when interventions have been tested within real-world effectiveness studies, knowledge to support the broader dissemination and implementation of those interventions (e.g., cost and financing of the intervention, provider training, availability of resources, monitoring the quality of intervention delivery) has remained outside the scope of these large-scale clinical trials.  Currently, few empirically-supported models exist to guide dissemination and implementation of evidence-based interventions both in the U.S. and abroad.

Recent literature has underscored the importance of understanding the many factors that affect whether the public health or clinical practice communities will use a given intervention.  Invited research on dissemination will address how information about health promotion, treatment, preventive and services interventions is packaged, transmitted, and interpreted among a variety of important stakeholder groups.  Research on implementation will improve the knowledge base to guide efforts to fit health interventions within real-world public health, clinical and community service systems.

The goals of this FOA are to encourage trans-disciplinary teams of scientists and practice stakeholders to work together to develop and/or test conceptual models of dissemination and implementation that may be applicable across diverse community and practice settings, and design studies that will accurately assess the outcomes of dissemination and implementation efforts.

This FOA addresses priorities laid out in a number of reports including: The Road Ahead:  A Report by the National Advisory Mental Health Council's Services Research and Clinical Epidemiology Workgroup (http://www.nimh.nih.gov/council/TheRoadAhead.pdf); The NIMH Strategic Plan (http://www.nimh.nih.gov/about/strategic-planning-reports/index.shtml); Designing for Dissemination Conference Summary Report (http://cancercontrol.cancer.gov/d4d/info.html#conferences); Diffusion and Dissemination of Evidence-based Cancer Control Interventions (http://www.ahcpr.gov/clinic/epcsums/canconsum.htm); National Institute on Drug Abuse Blue Ribbon Task Force Report on Services Research (http://www.drugabuse.gov/about/organization/nacda/HSRReport.pdf).

For additional resources on dissemination research please visit http://cancercontrol.cancer.gov/d4d.

For additional information on dissemination and implementation research in blood diseases, http://www.nhlbi.nih.gov/resources/docs/index.htm#blood, and for the reports on sickle cell disease, http://www.nhlbi.nih.gov/meetings/scdmtg/execsum.htm and http://www.nhlbi.nih.gov/meetings/workshops/conscd.htm, may be useful.

For information on international implementation research needs:

Madon T, Hofman KJ, Kupfer L, Glass RI. Implementation science.

Science. 2007 Dec 14;318(5857):1728

(http://www.fic.nih.gov/news/publications/global_health_matters/Science14Dec07.pdf)

Fogarty International Center's Strategic Plan 2008-2012: - Pathways to Global Health Research. (http://www.fic.nih.gov/about/plan/strategicplan_08-12.htm)

In addition, NIH welcomes applications from grantees with Clinical Translational Science Awards (CTSA) and other research and practice networks looking to conduct dissemination and research implementation studies. 

RESEARCH OBJECTIVES

Dissemination and implementation research intends to bridge the gap between public health, clinical research, and everyday practice by building a knowledge base about how health information, interventions, and new clinical practices are transmitted and translated for public health and health care service use in specific settings.  Unfortunately, there continues to be great variation in how these terms are used.  Dissemination and implementation have both been used to represent the complete process of bringing "evidence" into practice, originally defined as "diffusion."  While using the terms dissemination and implementation to cover such a wide area can be very helpful in facilitating discussion, it does not allow for the division of this very complex diffusion process into smaller, more easily addressed research questions that can develop a robust knowledge base.  We are inviting applications that will continue to break down the complexity of bridging research and practice.

For the purpose of this FOA, we make a distinction between "dissemination" and "implementation."

  • Dissemination is the targeted distribution of information and intervention materials to a specific public health or clinical practice audience.  The intent is to spread knowledge and the associated evidence-based interventions.
  • Implementation is the use of strategies to adopt and integrate evidence-based health interventions and change practice patterns within specific settings.

This distinction needs to be made because interventions developed in the context of efficacy and effectiveness trials are rarely transferable without adaptations to specific settings.  Therefore, research is needed to examine the process of transferring interventions into various local and international settings, settings that may be similar to but also somewhat different from the ones in which the intervention was developed and tested.

Dissemination Research

We are currently missing critical information about how, when, by whom, and under what circumstances research evidence spreads throughout the agencies, organizations, and front line workers providing public health and clinical services.  As a necessary prerequisite for unpacking how information can lead to intervention or service changes, we need to understand how and why information on mental health, drug abuse, and other disease treatments may or may not reach many different stakeholders.  We need to understand what underlies the creation, transmission, and reception of information on evidence-based psychopharmacological, behavioral, and psychosocial interventions.  Successful dissemination of health information (including information about underutilized interventions) may occur quite differently depending on whether the audience consists of consumers, caregivers, practitioners, policymakers, employers, administrators, or other stakeholder groups.  Moving the field forward will require studies identifying mechanisms and approaches to package and convey the evidence-based information necessary to improve public health and clinical care services.

Implementation Research

Implementation Research is the scientific study of methods to promote the integration of research findings and evidence-based interventions into healthcare policy and practice.  It seeks to understand the behavior of healthcare professionals and support staff, healthcare organizations, healthcare consumers and family members, and policymakers in context as key variables in the sustainable adoption, implementation and uptake of evidence-based interventions.  Implementation research studies should distance from prior assumptions that empirically-supported interventions can be transferred into any service setting without attention to local context and that a unidirectional flow of information (e.g., publishing a guideline) is sufficient to achieve practice change.  Relevant studies should develop a knowledge base about "how" interventions are transported to real-world practice settings, which will likely require more than the dissemination of information about the interventions.  This research announcement encourages theory-driven studies to test conceptual frameworks of the implementation process that move away from an exclusively "top-down" approach to a greater emphasis on the resources of local care settings and the needs of multiple stakeholders.

Dissemination and Implementation research needs to involve both interdisciplinary cooperation and trans-disciplinary collaboration, utilizing theories, empirical findings, and methods from a variety of fields not traditionally associated with health research.  Relevant fields include but are not limited to:  information science, communications, clinical decision-making, organizational and management theory, finance, individual and systems-level behavioral change, public health, business administration, statistics, anthropology, learning theory, and marketing. Meaningful research will include collaboration with stakeholders from multiple public health and/or clinical practice settings as well as consumers of services and their families/social networks.

Research Issues:  Listed below are examples of topics supported by this program announcement for dissemination and implementation research.  The list is illustrative, not exhaustive.  It is expected that investigators responding to this FOA will identify other important research areas.

  • Analysis of factors influencing the creation, packaging, transmission and reception of valid health research knowledge, ranging from psychological and socio-cultural factors affecting individual practitioners, consumers, primary caregivers and other stakeholder groups to investigations addressing large service delivery systems and funding sources.
  • Experimental studies to test the effectiveness of individual and systemic dissemination strategies, focusing on outcomes related to the direct outcomes of the strategies (e.g., acquisition of new knowledge, maintenance of knowledge, attitudes about the dissemination strategies, use of knowledge in practice decision-making).
  • Studies of systemic interventions to impact organizational structure, climate, culture, and processes to enable dissemination and implementation of clinical information and effective clinical interventions.
  • Studies of efforts to implement health promotion, prevention, early detection, and diagnostic interventions, as well as effective treatments, clinical procedures or guidelines into existing care systems across the lifespan to measure the extent to which such procedures are utilized, and adhered to, by providers and consumers.
  • Studies of the capacity of specific care delivery settings (primary care, schools, worksites, community health settings, etc.) to incorporate dissemination or implementation efforts within current organizational forms.
  • Studies that focus on the development and testing of theoretical models for dissemination and implementation processes.
  • Studies on the fidelity of implementation efforts, including the identification of components of implementation that will enable fidelity to be assessed meaningfully.
  • Development of outcome measures and suitable methodologies for dissemination and implementation approaches that accurately assess the success of an approach to move evidence into practice (i.e., not just clinical outcomes).
  • Longitudinal and follow-up studies on the factors that contribute to the sustainability of research-based improvements in public health and clinical practice.
  • Studies testing the effectiveness of dissemination or implementation strategies to reduce health disparities and improve quality of care among rural, minority, and/or other underserved populations.
  • Studies of the dissemination of palliative care and end of life research into practice that enhances quality of life for patients and families
  • Studies of the dissemination of different strategies to promote effective patient and caregiver communication.
  • Studies of how implementation is affected by “packaging” effective interventions for target audiences.
  • Studies examining incentives and dynamics that affect:  a) adopting new knowledge and/or practices, b) adapting existing knowledge and/or practices to optimize the benefit of new, evidence-based approaches, and c) discouraging resistance to change and adherence to less effective practices.
  • Studies of how approaches to shared decision-making may be implemented among practitioners.
  • Studies of how successful screening promotion approaches are implemented in healthcare and community practice.
  • Studies in low- and middle-income countries that examine facilitators or barriers that influence the implementation of evidence-based interventions that address major global health issues.
  • Implementation studies in low- and middle-income countries of evidence-based interventions that address global health issues that disproportionately affect the developing world (e.g., infectious diseases, chronic diseases, weaknesses in health systems). 

See Section VIII, Other Information - Required Federal Citations, for policies related to this announcement.

See grant posting webpage on NIH website for application details.

ELIGIBILITY

Eligibility Information

1. Eligible Applicants

1.A. Eligible Institutions
The following organizations/institutions are eligible to apply:

  • Public/State Controlled Institutions of Higher Education
  • Private Institutions of Higher Education
  • Hispanic-serving Institutions
  • Historically Black Colleges and Universities (HBCUs)
  • Tribally Controlled Colleges and Universities (TCCUs)
  • Alaska Native and Native Hawaiian Serving Institutions
  • Nonprofits with 501(c)(3) IRS Status (Other than Institutions of Higher Education)
  • Nonprofits without 501(c)(3) IRS Status (Other than Institutions of Higher Education)
  • Small Businesses
  • For-Profit Organizations (Other than Small Businesses)
  • State Governments
  • Indian/Native American Tribal Governments (Federally Recognized)
  • Indian/Native American Tribally Designated Organizations
  • County Governments
  • City or Township Governments
  • Special District Governments
  • Independent School Districts
  • Public Housing Authorities/Indian Housing Authorities
  • U.S. Territory or Possession
  • Indian/Native American Tribal Governments (Other than Federally Recognized)
  • Regional Organizations
  • Non-domestic (non-U.S.) Entities (Foreign Organizations)
  • Eligible Agencies of the Federal Government
  • Faith-based or Community-based Organizations.

1.B. Eligible Individuals

Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the PD/PI is invited to work with his/her organization to develop an application for support. Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH support.

More than one PD/PI (i.e., multiple PDs/PIs), may be designated on the application for projects that require a “team science” approach and therefore clearly do not fit the single-PD/PI model. Additional information on the implementation plans and policies and procedures to formally allow more than one PD/PI on individual research projects is available at http://grants.nih.gov/grants/multi_pi. All PDs/PIs must be registered in the NIH electronic Research Administration (eRA) Commons prior to the submission of the application (see http://era.nih.gov/ElectronicReceipt/preparing.htm for instructions).

The decision of whether to apply for a grant with a single PD/PI or multiple PDs/PIs is the responsibility of the investigators and applicant organizations and should be determined by the scientific goals of the project. Applications for grants with multiple PDs/PIs will require additional information, as outlined in the instructions below.  When considering the multiple PD/PI option, please be aware that the structure and governance of the PD/PI leadership team as well as the knowledge, skills and experience of the individual PDs/PIs will be factored into the assessment of the overall scientific merit of the application.  Multiple PDs/PIs on a project share the authority and responsibility for leading and directing the project, intellectually and logistically. Each PD/PI is responsible and accountable to the grantee organization, or, as appropriate, to a collaborating organization, for the proper conduct of the project or program, including the submission of required reports. For further information on multiple PDs/PIs, please see http://grants.nih.gov/grants/multi_pi.

2. Cost Sharing or Matching

This program does not require cost sharing as defined in the current NIH Grants Policy Statement.

3. Other-Special Eligibility Criteria

Number of Applications. Applicants may submit more than one application, provided that each application is scientifically distinct. 

Resubmissions. Applicants may submit a resubmission application, but such application must include an Introduction addressing the previous peer review critique (Summary Statement). Beginning with applications intended for the January 25, 2009 official submission due date, all original new applications (i.e., never submitted) and competing renewal applications are permitted only a single amendment (A1).  See new NIH policy on resubmission (amended) applications (NOT-OD-09-003, NOT-OD-09-016). Original new and competing renewal applications that were submitted prior to January 25, 2009 are permitted two amendments (A1 and A2).  For these “grandfathered” applications, NIH expects that any A2 will be submitted no later than January 7, 2011, and NIH will not accept A2 applications after that date.

Renewals. The R03 is not renewable.

Small grant support may not be used for thesis or dissertation research.

CONTACT INFORMATION

Agency Contacts - We encourage your inquiries concerning this funding opportunity and welcome the opportunity to answer questions from potential applicants. Inquiries may fall into three areas: scientific/research (program), peer review, and financial or grants management issues:

1. Scientific/Research Contact(s):

David A. Chambers, D.Phil.
Division of Services and Intervention Research
National Institute of Mental Health
6001 Executive Boulevard, Room 7133, MSC 9631
Bethesda, MD  20892-9631
Telephone: (301) 443-3747, FAX: (301) 443-4045
Email: dchamber@mail.nih.gov

Chris Gordon, Ph.D.
Division of AIDS and Health and Behavior Research
National Institute of Mental Health
6001 Executive boulevard, Room 6199, MSC 9619
Bethesda, MD  20892-9619
Telephone:  (301) 443-1613, FAX:  (301) 443-9719
Email:  cgordon1@mail.nih.gov

Cynthia Vinson, M.A.
Division of Cancer Control and Population Sciences
National Cancer Institute
6130 Executive Boulevard, Room 6146, MSC 7338
Bethesda, MD 20892-7338
Telephone: (301) 594-5906, FAX: (301) 443-4505
Email: cvinson@mail.nih.gov

Cherry Lowman, Ph.D.
Division of Treatment and Recovery Research
National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane, Room 2051, MSC 9304
Bethesda, MD 20892-9304
Telephone: (301) 443-0637, FAX: (301) 443-8774
Email: clowman@mail.nih.gov

Melanie Bacon, R.N.
Division of Acquired Immunodeficiency Syndrome
National Institute of Allergy and Infectious Diseases
6700B Rockledge Drive, Room 4102, MSC 7626
Bethesda, MD 20892-7626
Telephone:  (301) 451-2747, FAX:  (301) 402-1505 
Email: mbacon@mail.nih.gov

Thomas F. Hilton, Ph.D.
Division of Epidemiology, Services, and Prevention Research
National Institute on Drug Abuse
6001 Executive Boulevard, Room 5197, MSC 9589
Bethesda, MD  20892-9589
Rockville, MD 20852 (for express/courier service)
Telephone: (301) 435-0808, FAX:  (301) 443-6815
Email: tom.hilton@nih.gov

Amy Donahue, Ph.D.
Division of Scientific Programs
National Institute on Deafness and Other Communication Disorders
6120 Executive Boulevard, Room 400C, MSC 7180
Bethesda, MD 20892-7180
Telephone: (301) 402-3458, FAX:  (301) 402-6251
Email: donahuea@nidcd.nih.gov

Ruth Nowjack-Raymer, MPH, PhD
Center for Clinical Research
National Institute of Dental and Craniofacial Research
6701 Democracy Boulevard, Room 640, MSC 4878
Bethesda, MD 20892-4878
Telephone: (301) 594-5394, FAX: (301) 480-8322
Email: Ruth.Nowjack-Raymer@nih.gov

Karen Huss, PhD, RN, APRN-BC, FAAN, FAAAAI
Division of Extramural Activities
National Institute of Nursing Research
6701 Democracy Boulevard, Room 710, MSC 4870
Bethesda, MD 20892-4870
Telephone:  (301) 594-5970, FAX:  (301) 451-5649
Email: hussk@mail.nih.gov

Helen Meissner, Ph.D.
Office of Behavioral and Social Sciences Research
National Institutes of Health
31 Center Drive, Room B1C19, MSC 2027
Bethesda, MD 20892-2027
Telephone: (301) 594-2105, FAX: (301) 480-6637
Email: meissneh@mail.nih.gov

Xingzhu Liu, M.D., Ph.D.
Division of International Training and Research
Fogarty International Center
31 Center Drive, Room B2C39, MSC 2220
Bethesda, MD 20892-2220
Telephone: (301) 496-1653, Fax: (301) 402-0779
Email: liuxing@mail.nih.gov

2. Peer Review Contact(s):

Katherine Bent, Ph.D.
Chief, Healthcare Delivery and Methodologies (HDM)
Center for Scientific Review
6701 Rockledge Drive, Room 3160, MSC 7770
Bethesda, MD 20892-7770 (20817 for overnight mail)
Telephone: (301) 435-0695, FAX: (301) 480-1056
Email: bentkn@csr.nih.gov

3. Financial/Grants Management Contact(s):

Joy R. Knipple
Division of Extramural Activities
National Institute of Mental Health
6001 Executive Boulevard, Room 6131, MSC 9605
Bethesda, MD  20892-9605
Rockville, MD 20852 (for express/courier service)
Telephone:  (301) 443-8811, FAX:  (301) 443-6885
Email: jk173r@nih.gov

Crystal Wolfrey
Division of Extramural Activities
National Cancer Institute
6120 Executive Boulevard, Room 243, MSC 7150
Bethesda, MD, 20892-7150
Telephone: (301) 496-8634, FAX: (301) 496-8601
Email: wolfreyc@mail.nih.gov

Judy S. Fox
Grants Management Branch
National Institute on Alcohol Abuse and Alcoholism
5635 Fishers Lane, Room 3021, MSC 9304
Bethesda, MD 20892-9304
Telephone: (301) 443-4704, FAX: (301) 443-3891
Email: jfox@mail.nih.gov

Jane Paull
Grants Management Program
National Institute of Allergy and Infectious Diseases
6700B Rockledge Drive, Room 2119, MSC 7614
Bethesda, MD 20892-7614
Telephone:  (301) 594-1544, FAX:  (301) 493-0597
Email: paullj@mail.nih.gov

Pamela Fleming
Grants Management Branch
National Institute on Drug Abuse
6001 Executive Boulevard, Suite 270, MSC 8403
Bethesda, MD 20892-8403
Telephone: (301) 435-1369, FAX: (301) 594-6849
Email: pfleming@nida.nih.gov

Christopher Myers
Grants Management Branch
National Institute on Deafness and Other Communication Disorders
6120 Executive Boulevard, Room 400B, MSC 7180
Bethesda, MD 20892-7180
Telephone: (301) 435-0713, FAX: (301) 402-1758
Email: Myersc@mail.nih.gov

Mary E. Greenwood
Division of Extramural Activities
National Institute of Dental and Craniofacial Research
6701 Democracy boulevard, Room 658, MSC 4878
Bethesda, MD 20892-4787
Telephone:  (301) 594-4808, FAX: (301) 480-3562
Email: md74u@nih.gov

Lawrence Haller
Office of Grants and Contracts Management
National Institute of Nursing Research
6701 Democracy Boulevard, Room 710, MSC 4870
Bethesda, MD 20892-4870 (Courier use 20817)
Telephone: (301) 402-1878, FAX: (301) 451-5652
Email: hallerl@nih.mail.gov

Bruce Butrum
Fogarty International Center
31 Center Drive, Room B2C29, MSC 2220
Bethesda, MD 20892-2220
Telephone: (301) 496-1670, FAX: (301) 594-1211
Email: butrumb@mail.nih.gov