AHRQ GRANTS FOR HEALTH SERVICES RESEARCH DISSERTATION 

RELEASE DATE:  December 16, 2003

PA NUMBER:   PAR-04-039 (This PAR has been reissued, see PAR-06-118)
                        (see addendum NOT-HS-04-004)
 
EXPIRATION DATE:  January 13, 2006

Department of Health and Human Services (DHHS)   

PARTICIPATING ORGANIZATION:
Agency for Healthcare Research and Quality (AHRQ) 
 (http://www.ahrq.gov)

Note:  The policies, guidelines, terms, and conditions stated in this 
Announcement may differ from those used by the NIH.

CFDA NUMBER: 93.226 (AHRQ)  

APPLICATION RECEIPT DATES:  (Effective 2005) February 17, June 15, October 15

THIS PA CONTAINS THE FOLLOWING INFORMATION: 

o   Purpose of the PA
o   Research Objectives
o   Mechanism(s) of Support
o   Eligible Institutions
o   Individuals Eligible to Become Principal Investigators
o   Special Requirements
o   Where to Send Inquiries
o   Submitting an Application
o   Supplementary Instructions
o   Peer Review Process
o   Review Criteria
o   Award Criteria
o   Required Federal Citations 
o   References

PURPOSE OF THIS PA 

The Agency for Healthcare Research and Quality (AHRQ) announces its continued 
interest in supporting the health services dissertation research small grant 
program. This program supports research undertaken as part of an academic 
program to qualify for a doctorate. The AHRQ dissertation award R36 supports 
dissertation research costs of students in accredited research doctoral 
programs in the United States (including Puerto Rico, and other U.S. 
Territories or possessions). The dissertation will focus on areas relevant to 
health services research, with emphasis placed on methodological and research 
topics that address the mission of AHRQ. The total direct costs for 
applications submitted under this PA must not exceed $30,000 for the entire 
project period, which is expected to range from a minimum of 9 months to a 
maximum of 17 months.  AHRQ will return without review any application that 
exceeds this amount.

RESEARCH OBJECTIVES

The mission of AHRQ is to improve the quality, safety, efficiency, and 
effectiveness of health care for all Americans.  The research sponsored and 
conducted by the Agency provides better information that enables better 
decisions about health care.  Research that promotes the improvement of health 
care quality will be the Agency’s highest priority during the next few years. 
Accordingly, the Agency has identified the following strategic goals and 
research priorities, each of which will contribute to improving the quality of 
health care for all Americans.  Research applications must address one of 
these areas:

1.   Support improvements in health outcomes.

2.   Strengthen health care quality measurement and improvement.

3.   Identify strategies to improve access, foster appropriate use, and reduce 
unnecessary expenditures related to healthcare. 

4.   Medical Errors/Patient Safety:  One of the important elements in the AHRQ 
mission is to support the development of multidisciplinary research teams in 
building the knowledge base on the scope and impact of medical errors, 
particularly for diverse care settings and populations, identify the root 
causes of threats to patient safety and effective system approaches to prevent 
the occurrence of errors, study the effectiveness of various interventions to 
capture information on medical errors; and disseminate and evaluate the 
outcomes of promising interventions in a variety of health care settings and 
across a variety of health care professionals.

5.  Translating Research Into Practice and Policy (TRIPP): Applicants are 
encouraged to conduct innovative and rigorous research and evaluation projects 
related to the translation of research findings into measurable improvements 
in quality, patient safety, healthcare outcomes and cost, use, and access.  
Particular interest lies in research that can bridge the chasm between 
promising prototypes and generalizable knowledge that can be applied in 
multiple settings and lead to systematic improvement on a large scale.  Some 
of these topics are described in 
“Translating Research into Practice - Joint Program Announcement”,  
http://grants.nih.gov/grants/guide/pa-files/PA-02-066.html.

6.   Bioterrorism: Applicants are encouraged to submit applications that 
investigate and evaluate promising practices and strategies being developed 
and implemented at the State, local, and health system level to promote health 
system readiness in response to bioterrorism.  Also of interest is the 
application of available methods and tools that can be of assistance in 
developing health system readiness capacity and enhancing readiness in rural 
as well as urban areas.   
http://grants.nih.gov/grants/guide/pa-files/PAR-03-130.html

7.   Prevention: Applicants are encouraged to submit applications that relate 
to the Public Health Service’s health promotion and disease prevention 
objectives as outlined in “Healthy People 2010". 
(http://www.health.gov/healthypeople).  Of particular interest would be those 
research projects investigating the appropriate use of clinical preventive 
services, such as screening tests, immunizations, and counseling, which are 
based on the recommendations or the priority areas of the U.S. Preventive 
Services Task Force (USPSTF).

Information and announcements describing AHRQ's general research areas of 
interest are available at http://www.ahrq.gov (see Funding Opportunities).  
For a description of recent research topics of interest to the Agency, 
applicants are encouraged to review the following research solicitations:

o  Impact of Payment And Organization on Cost, Quality And Equity 
http://grants.nih.gov/grants/guide/pa-files/PA-01-125.html.

o  Patient-Centered Care: Customizing Care to Meet Patients' Needs– 
http://grants.nih.gov/grants/guide/pa-files/PA-01-124.html.

Dissertation applicants are further encouraged to address health services 
research issues critical to priority populations, including: individuals 
living in inner city and rural (including frontier) areas; low-income and 
minority groups; women, children, and the elderly; and individuals with 
special health care needs, including those with disabilities and those who 
need chronic or end-of-life health care.  
http://grants.nih.gov/grants/guide/notice-files/NOT-HS-03-010.html 

MECHANISM OF SUPPORT

This PA will use the dissertation research grant (R36) award mechanism. As an 
applicant, you will be solely responsible for planning, directing, and 
executing the proposed project under the supervision, and with the approval, 
of a university approved and appointed doctoral committee.  

No supplemental funds will be awarded. 

AHRQ does not require cost sharing for applications submitted in response to 
this Program Announcement.

AHRQ is not using the Modular Grant Application and Award Process.   
Applications submitted in modular format will be returned without review.

ELIGIBLE INSTITUTIONS  

You may submit an application if your institution has any of the following 
characteristics:

o   Public or private non-profit academic institutions
o   Domestic and foreign institutions
o   Units of State and local governments
o   Faith-based and community initiative 
o   Tribes and Tribal Organizations   

The institution from which the applicant is applying must be the institution 
at which the candidate is pursuing his/her research doctoral studies.   If 
applying from a foreign institution, applicants must demonstrate the relevance 
of the proposed research to the U.S. healthcare delivery system.

For the purpose of this PA, AHRQ will make grants only to non-profit 
organizations.  For-profit organizations may participate in projects as member 
of consortia or as subcontractors.  Organizations describes in section 501(c) 
4 of the Internal Revenue Code that engage in lobbying are not eligible.

INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS

Any individual with the skills, knowledge, and resources necessary to carry 
out the proposed research is invited to work with their institution to develop 
an application for support.  The dissertation candidate will be the designated 
Principal Investigator.  Individuals from underrepresented racial and ethnic 
groups as well as individuals with disabilities are always encouraged to apply 
for AHRQ programs.

SPECIAL REQUIREMENTS

Eligible applicants must: 

o   be matriculated students in an eligible, accredited doctoral program who 
are at the dissertation stage. 

o   be in good-standing at their academic institutions.

o   have completed all non-dissertation requirements (and non-clinical 
internship requirements) for their degrees, with the exception of the defense 
and approval of their dissertation by their committee (evidence of completion 
of this must be sent to and received by the Division of Scientific Review 
staff (noted under Inquiries below) within 60 days of the appropriate 
application submission date noted above.

o   be a U.S. citizen, non-citizen national (e.g., residents of U.S. 
territories), or permanent resident by the time of award.

o   devote a minimum of 40 hours per week to their dissertation and limit 
additional employment compensation activities to 20 or fewer hours per week.  
A statement affirming these time commitment plans must be included with the 
budget justification. 

Note that individuals supported under T32 institutional training programs and 
F31 awards (Ruth L. Kirschstein National Research Service Award predoctoral 
fellowships) are also eligible to apply for a dissertation award.  However, no 
funds from the R36 dissertation award may be used to supplement the stipend 
paid by the F31 or T32 mechanism.

o    Priority Populations

The Healthcare Research and Quality Act of 1999 (See 
http://www.ahrq.gov/hrqa99a.htm) reauthorized the AHRQ and directed the 
Agency, in carrying out its mission, to conduct and support research and 
evaluations, and to support demonstration projects, with respect to the 
delivery of health care in inner-city and rural areas (including frontier 
areas); and health care for priority populations, which include low income 
groups; minority groups; women; children; the elderly; and individuals with 
special health care needs, including individuals with disabilities and 
individuals who need chronic care or end-of-life health care.  To implement 
this directive, AHRQ published a notice in the NIH Guide on February 28, 2003, 
establishing a new Agency policy on the Inclusion of Priority Populations in 
health services research (see 
http://grants.nih.gov/grants/guide/notice-files/NOT-HS-03-010.html). 
Applicants under this PA who seek funding from AHRQ should address the 
requirements of including priority populations as specified in the Notice.   

o    Publication Transmittal: General AHRQ Requirements

In keeping with the Agency=s efforts to translate the results of AHRQ-funded 
research into practice and policy, grantees and/or contractors are to inform 
the AHRQ Office of Communications and Knowledge Transfer (OCKT) when articles 
from their studies are accepted for publication in the professional 
literature.  Grantees and contractors should also discuss any ideas about 
other dissemination and marketing efforts with OCKT staff.  The goal is to 
ensure that efforts to disseminate research findings are coordinated with 
other Agency activities to maximize awareness and application of the research 
by potential users, including clinicians, patients, health care systems and 
purchasers and policymakers.  This is critical when outreach to the general 
and trade press is involved.  Contact with the media will take place in close 
coordination with OCKT and the press offices of the grantee=s or contractor=s 
institutions.  In cases when products are created (such as annual or final 
reports, Web-based tools, CD-ROMs), grantees and contractors will be asked to 
submit to OCKT a brief plan describing how the product will be publicized.  An 
OCKT staff person will be assigned to each product and will coordinate the 
implementation of the plan, especially issues related to printing and 
electronic dissemination, and outreach to the media.

WHERE TO SEND INQUIRIES

We encourage your inquiries concerning this PA and welcome the opportunity to 
answer questions from potential applicants.  Inquiries may fall into the 
following areas: application process, programmatic, scientific/research, peer 
review, data sources and financial or grants management issues.

o   Direct your questions regarding programmatic issues, including information 
on the inclusion of women, minorities, and children, and other priority 
populations in study to:
 
Greta Drott
Division of Research Education/Dissertation Program
Office of Extramural Research, Education and Priority Populations
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD  20850            
Telephone:  (301) 427-1530
FAX: (301) 427-1562
Email: training@ahrq.gov

o   Direct your questions about peer review issues to:

Scott Andres, Ph.D.
Division of Scientific Review
Office of Extramural Research, Education and Priority Populations
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD  20850            
Telephone:  (301) 427-1546
FAX: (301) 427-1562
Email: sandres@AHRQ.gov

o   Direct your questions about application process to:

Debbie Rothstein, Ph.D.
Office of Extramural Research, Education and Priority Populations
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD  20850
Telephone:  (301) 427-1525
FAX:  (301) 427-1562

o  Direct your questions about financial or grant management matters to:
 
Catherine Dwyer
Center/Office name
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD  20850
Telephone:  (301) 427-1457
FAX: (301) 427-1462
Email:  cdwyer@ahrq.gov

SUBMITTING AN APPLICATION

Applications must be prepared using the PHS 398 research grant application 
instructions and forms (rev. 5/2001). 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 
is available at http://grants.nih.gov/grants/funding/phs398/phs398.html in an 
interactive format.  For further assistance contact GrantsInfo, Telephone 
(301) 435-0714, Email: GrantsInfo@nih.gov.

The title and number of this program announcement must be typed on line 2 of 
the face page of the application form and the YES box must be checked.

To ensure equity among applicants, however, applicants using this form must 
observe page number and font size requirements specified in the Form PHS 398. 

SUPPLEMENTARY INSTRUCTIONS:  In addition to the instructions in the PHS 398 
form, the following special instructions should be followed.  In instances in 
which instructions in the PHS 398 differ from those in this PA, the 
instructions in the PA take precedence.  

o  The graduate student should be identified as the Principal Investigator and 
the applicant organization should be the doctoral granting institution at 
which the student is registered and matriculated. 

o  The section entitled Research Plan, excluding references, may not exceed 15 
pages. 

o  The only acceptable appendix material is a copy of any survey instrument(s) 
being used in the proposed research application. 

o   A list of literature citations is required, but will not be counted toward 
the 15 page limit requirement for the Research Plan.

o  The application must identify all members of the faculty committee by 
listing the names on Page 2.  As explained in form PHS 398, a brief 
biographical sketch (see Biographical Sketch Format Page) should be provided 
for dissertation committee members, consultants, and other key personnel.  It 
is strongly encouraged that the doctoral dissertation committee includes 
recognized health services researchers with appropriate interdisciplinary or 
multidisciplinary expertise.  

o  A letter from the faculty committee or the university official directly 
responsible for supervising the dissertation research must be submitted with 
the grant application. The letter must certify that: 

1.  The dissertation application must reflect the actual work to be conducted 
by the applicant.  If the applicant has successfully defended his/her 
application, the letter should appropriately indicate that the faculty 
committee has approved the dissertation proposal.  If this certification has 
not yet been obtained, the letter should indicate the proposed date of the 
dissertation defense.  Certification that the defense has been successfully 
completed needs to be received by the Division of Scientific Review, AHRQ, (as 
noted above).  If not received within 8 weeks, the application will be 
returned without review.
 
2.  The candidate demonstrates future career objectives and potential as a 
health services researcher.

3.  An institutional infrastructure exists to support the candidate and 
proposed research application.   

4.  A collaborative process was established between the applicant and advisors 
in the development, review, and editing of the research application.

5.  The applicant has completed all requirements for the doctoral degree, 
except the dissertation and the proposal defense (as noted above under item 1.)

o  The applicant should also include a brief cover letter from him/herself, 
which discusses his/her career goals, his/her background and interest in 
health services research, how the proposed dissertation will contribute to 
career goals and the relevance of the proposed dissertation to AHRQ/DHHS 
priorities and interests, as described above. 

o  Section C of the application should be used as an extension of the 
literature review or publications of the faculty dissertation committee as 
they relate to this research.  

o  Applicants should give special attention to the sections of the application 
dealing with human subjects protection and inclusion of priority populations. 
 It is important to discuss this with appropriate committee members and 
officials at the institution prior to submission.  Special attention should be 
paid to the definition of human subjects, as described in the PHS 398 and the 
Priority Populations Inclusion Policy of AHRQ as described above under 
Priority Populations 
http://grants.nih.gov/grants/guide/notice-files/NOT-HS-03-010.html.   
For those projects involving human subjects or individually identifiable 
data, IRB approval is required prior to grant an award.  

Allowable Costs 

Allowable costs include the following: the applicant’s salary; direct project 
expenses such as travel, data purchasing, data processing, and supplies.  Fees 
for maintaining matriculation or other fees imposed on those preparing 
dissertations are allowable costs, provided the fees are required of all 
students of similar standing, regardless of the source of funding. 

Although all of the above costs are allowable, the following guidelines should 
be followed:

o  No salary support will be given for the dissertation committee. 
o  All data costs are to be included in the $30,000 total direct cost limit 
for dissertation applications. 
o  Travel costs are allowable for one professional conference. 
o  Personal computer and statistical consultant service costs at a level not 
to exceed 80 hours are allowable. 
o  Support for a research assistant is generally not permitted. In rare 
circumstances, it may be approved if the justification is acceptable to AHRQ 
staff. 

Applicants applying through institutions receive facilities and administrative 
(F&A) costs in addition to the direct costs of the project.  For calculating 
F&A costs, dissertation research grants are considered training grants.  
Therefore, according to DHHS policy, the institution will receive F&A costs 
based solely on 8 percent of the total allowable direct costs exclusive of 
tuition and related fees, health insurance, and expenditures for equipment. 
Costs should be submitted in a non-modular (detailed) format.

Other Conditions

The following conditions apply to dissertation grants:

o  A Principal Investigator who discontinues or suspends a project during the 
grant period must inform the AHRQ immediately in writing.  AHRQ may suspend or 
terminate the grant as requested by the Principal Investigator or on its own 
initiative.

o  AHRQ will accept one amended resubmitted application. When submitting an 
amended (revised) application the Introduction section must be limited to one 
page.

o  An abstract and Executive Summary of the dissertation constitutes the final 
report of the grant. The Executive Summary must be officially accepted by the 
faculty committee or university official responsible for the candidate's 
dissertation and must be signed by the responsible officials.  Two copies of 
the materials must be submitted to the AHRQ Division of Grants Management, 
listed under the Inquiries section. The final report and all financial status 
reports must be submitted in English.

OTHER INSTRUCTIONS:  Applicants are encouraged to make use of AHRQ’S 
Healthcare Cost and Utilization Program (HCUP) or the Medical Expenditure 
Panel Survey (MEPS).  The HCUP includes databases covering 1988-1997, with 
1998 and 1999 data available in 2001. These all-payer databases were created 
through a Federal- State-industry partnership to build a multi-State 
healthcare data system. The main HCUP databases contain discharge-level 
information for inpatient hospital stays in a uniform format with privacy 
protections. The Nationwide Inpatient Sample (NIS) is a nationwide probability 
sample of about 1000 hospitals. The State Inpatient Databases (SID) contain 
inpatient records for all community hospitals in 22 states. Other HCUP 
databases contain ambulatory surgery data from nine states. These databases 
can be directly linked to county-level data form the Health Resources and 
Services Administration’s Area Resource File and to hospital-level data from 
the Annual Survey of the American Hospital Association.

The MEPS is conducted to provide nationally representative estimates of health 
care use, expenditures, sources of payment, and insurance coverage for the 
U.S. civilian, non-institutionalized population.  MEPS comprises three 
component surveys:  The Household Component (HC), the Medical Provider 
Component (MPC), and the Insurance Component (IC).  The household component is 
the core survey, and it forms the basis for the MPC sample and part of the IC 
sample.  The MEPS IC collects data on health insurance plans obtained through 
employers and unions, including the number and types of private insurance 
plans offered, employer characteristics, premiums, and contributions by 
employers and employees.  More information on the MEPS is available at 
http://www.meps.ahrq.gov.

This does not preclude the use of secondary data sources or primary data 
collection.
  
SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS:

AHRQ is not using the Modular Grant Application and Award Process.  Applicants 
for funding from AHRQ should ignore application instructions concerning the 
Modular Grant Application and Award Process, and prepare applications 
according to instructions provided in form PHS 398.  Applications submitted in 
the Modular format will be returned without review.

SENDING AN APPLICATION TO THE NIH and AHRQ:  Submit a signed, typewritten 
original of the application, including the checklist, and three signed 
photocopies in one package to:

Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1040 - MSC 7710
Bethesda, MD  20892-7710
(20817 for express/courier service)
 
At the time of submission, two additional copies of the application, labeled 
AAdvanced Copy (s)@ must also be sent to

Greta Drott
Division of Research Education/Dissertation Program
Office of Extramural Research, Education and Priority Populations
Agency for Healthcare Research and Quality
540 Gaither Road
Rockville, MD  20850            
Telephone:  (301) 427-1530
FAX: (301) 427-1562
Email: training@ahrq.gov

APPLICATION PROCESSING:  Applications must be mailed on or before the receipt 
dates described in the heading of this PA.

The CSR and AHRQ will not accept any application in response to this PA that 
is essentially the same as one currently pending initial review unless the 
applicant withdraws the pending application.  The CSR and AHRQ will not accept 
any application that is essentially the same as one already reviewed.  This 
does not preclude the submission of a substantial revision of an application 
already reviewed, but such application must include an Introduction addressing 
the previous critique.

Although there is no immediate acknowledgment of the receipt of an 
application, applicants are generally notified of the review and funding 
assignment within 8 weeks.

Applicants are encouraged to read all PHS Forms 398 instructions prior to 
preparing an application in response to this PA.  The PHS 398 type size 
requirements (p.6) will be enforced rigorously and non-compliant applications 
will be returned. It is very important to note that limitations on number of 
pages and size of font must be observed; applications violating these 
requirements will be returned without review.

Institutional Review Board (IRB) approval of human subjects is not required 
prior to peer review of an AHRQ application.  The "AHRQ Revised Policy for IRB 
Review of Human Subjects Protocols in Grant Applications" was published in the 
NIH Guide on September 27, 2000.
(http://grants.nih.gov/grants/guide/notice-files/not-hs-00-003.html). 

The PA is also available on AHRQ's Web site, http://www.AHRQ.gov, (see under 
Funding Opportunities). 

Application Preparation (for Using CMS Data)  
 
Purchase of CMS public-use data, if required, should be discussed in the 
application narrative and included in the budget.  Projects will ordinarily 
not use CMS (Medicare or Medicaid) data involving individual identifiers.  
However, for applications that propose to use Medicare or Medicaid data that 
are individually identifiable, applicants should state explicitly in the 
“Research Design and Methods” section of the Research Plan (form 398) the 
specific files, time periods, and cohorts proposed for the research.  In 
consultation with Center for Medicare and Medicaid Services (CMS), previously 
called Health Care Financing Administration (HCFA), AHRQ will use this 
information to develop a cost estimate for obtaining the data.  This estimate 
will be included in the estimated total cost of the grant at the time funding 
decisions are made. 

Applicants should be aware that for individually identifiable Medicare and 
Medicaid data, Principal Investigators and their grantee institutions will be 
required to enter into a Data Use Agreement (DUA) with CMS to protect the 
confidentiality of data in accordance with AHRQ’s confidentiality statue, 42 
USC 299c-3(c), the Privacy rules at 45 CFR Parts 160 and 164, if applicable, 
and standards set out in OMB Circular A-130, Appendix III–Security of Federal 
Automated Information Systems.  The use of the data will be restricted to the 
purposes and time period specified in the DUA.  At the end of this time 
period, the grantee will be required to return the data to CMS or certify that 
the data have been destroyed.  

Unless AHRQ is able to negotiate exceptional arrangements included in the DUA 
is the requirement that the User agrees to submit to CMS, a copy of all 
findings within 30 days of making such findings, for the sole purpose of 
assuring CMS that data confidentiality is maintained.  The user further agrees 
not to submit these findings to any third party (including but not limited to 
any manuscript to be submitted for publication) until receiving CMS’s approval 
to do so.

In developing research plans, applicants should allow time for refining, 
obtaining approval, and processing of their CMS data requests.  Requests may 
take 6 months from the time they are submitted to complete.  Applications 
proposing to contact beneficiaries or their providers require the approval of 
the CMS Director and may require meeting(s) with CMS staff.

CMS data are provided on IBM mainframe tapes using the record and data formats 
commonly employed on these computers.  Applicants should either have the 
capability to process these tapes and formats or plan to make arrangements to 
securely convert them to other media and formats.

Questions regarding CMS data should be directed to the AHRQ program official 
listed under INQUIRIES.

Assessment of AHRQ Grant Programs 

In carrying out its stewardship of research programs, the AHRQ may request 
information essential to an assessment of the effectiveness of Agency research 
programs.  Accordingly, grant recipients are hereby notified that they may be 
contacted after the completion of awards for periodic updates on publications 
resulting from AHRQ grant awards, and other information helpful in evaluating 
the impact of AHRQ-sponsored research.  

AHRQ expects grant recipients to keep the Agency informed of publications as 
well as the known uses and impact of their Agency-sponsored research.  
Applicants are to agree to notify AHRQ immediately when a manuscript based on 
research supported by the grant is accepted for publication, and to provide 
the expected date of publication as soon as it is known, regardless of whether 
or not the grant award is still active. 

To receive an award, applicants must agree to submit an original and 2 copies 
of an abstract, executive summary, and full report of the research results in 
the format prescribed by AHRQ no later than 90 days after the end of the 
project period.  The executive summary should be sent at the same time on a 
computer disk which specifies on the label the format used (Word Perfect, or 
Word, or ASCII format).
 
The past cooperation of applicants with regard to the submissions described in 
this section may be considered in the application review to assess applicants’ 
potential for responsible stewardship of awarded funds

PEER REVIEW PROCESS

Upon receipt, applications will be reviewed for completeness and 
responsiveness to the PA by the Agency Referral Officer, program staff, and 
grant management staff.  Incomplete and/or non-responsive applications or 
applications not following instructions given in this PA will be returned to 
the applicant without further consideration.  Applications that are complete 
and responsive to the PA will be evaluated for scientific and technical merit 
by an appropriate peer review group convened in accordance with standard AHRQ 
peer review procedures.  

As part of the merit review, all applications will:

o   Undergo a process in which only those applications deemed to have the 
highest scientific merit will be discussed and assigned a priority score. 
o   Receive a written critique

REVIEW CRITERIA

In the written comments, reviewers will be asked to balance the technical 
merit of the grant application with strong emphasis placed on their assessment 
of the applicant's potential as a future health services research, as 
reflected in accompanying letters, the relevance of the written proposal, the 
caliber of the infrastructure to provide necessary guidance and support to the 
student, the dissertation chair or faculty advisor evaluation of the student, 
faculty biosketches, background of committee, and accompanying letters of 
support.  Specific review criteria will include: 

o   Significance/Impact
o   Approach
o   Innovation
o   Investigator/Mentoring
o   Environment 
o   Inclusion of Priority Populations
o   Budget

The scientific review group will address and consider each of these criteria 
in assigning an application=s overall score, weighting them as appropriate for 
each application.
 
(1)   SIGNIFICANCE/IMPACT:  Does your study address an important problem from 
a scientific and/or translational (i.e., is the work proposed or subsequent 
efforts stemming from it likely to be relevant to the delivery of clinical 
care, operations of health care delivery systems, or local, regional or 
national policy) perspective? If the aims of the application are achieved, how 
do they advance scientific knowledge or how usable are they to decision makers 
or consumers?  What will be the effect of these studies on the concepts or 
methods that drive this field?

(2)   APPROACH:  Are the conceptual framework, design, methods, and analyses 
adequately developed, well integrated, and appropriate to the aims of the 
project?  Do you acknowledge potential problem areas and consider alternative 
tactics?

(3)   INNOVATION:  Does your project employ novel concepts, approaches or 
methods? Are the aims original and innovative?  Does your project challenge 
existing paradigms or develop new methodologies or technologies?

(4)   INVESTIGATOR/MENTORING: Is the student-investigator appropriately 
trained and well suited to carry out this work?  Is the work proposed 
appropriate to the mentor’s experience level of the student-investigator?  Are 
the mentors appropriately qualified to provide guidance as needed?  Have the 
mentors indicated that they will provide sufficient time and attention to the 
student?  Is evidence of strong mentoring seen in the quality of the 
dissertation application?  Does the student-investigator hold promise to be a 
contributor to the field of health services researcher, as determined by 
his/her career plans, mentor(s) written assessments, the topic of his 
dissertation?  Is evidence of strong mentoring seen in the quality of the 
dissertation application?  

(5)   ENVIRONMENT:  Does the scientific environment in which the student’s 
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 the form of adequate office, computer, methodological, and 
statistical support? 

(6)  INCLUSION OF PRIORITY POPULATIONS:  Does the applicant adequately address 
the priority population policy of AHRQ, found in 
http://grants.nih.gov/grants/guide/notice-files/NOT-HS-03-010.html.  For a 
list of frequently asked questions and answers with regard to the 
implementation of this policy, please see http://www.ahrq.gov/fund/ppopfaq.htm

(7)   BUDGET:   the reasonableness of the proposed project budget and the 
requested period of support in relation to the proposed research;

ADDITIONAL REVIEW CRITERIA:  In addition to the above criteria, the following 
items will be considered in the determination of scientific merit and the 
priority score:

o   PROTECTIONS:  The adequacy of the proposed protection for humans or the 
environment, to the extent they may be adversely affected by the project 
proposed in the application.

o   INCLUSION:  The adequacy of plans to address the need of both genders, all 
racial and ethnic groups (and subgroups), and children as appropriate for the 
aims of the project.  Adequacy of attention to other populations of special 
priority to AHRQ (see discussion on Priority Populations in the section on 
Special Requirements, above, and Inclusion Criteria included in the section on 
Agency Policies and Requirements, below).

ADDITIONAL CONSIDERATIONS

DATA SHARING:

Data Confidentiality
 
Pursuant to section 924(c) of the Public Health Service Act (42 USC 299c- 
3(c)), information obtained in the course of any AHRQ supported-study that 
identifies an individual or entity must be treated as confidential in 
accordance with any explicit or implicit promises made regarding the possible 
uses and disclosures of such data. There are now civil monetary penalties for 
violation of this confidentiality statute [42 U.S.C.299c-3(d)).  In the Human 
Subjects section of the application, applicants must describe procedures for 
ensuring the confidentiality of the identifying information to be collected. 
The description of the procedures should include a discussion of who will be 
permitted access to the information, both raw data and machine readable files, 
and how personal identifiers and other identifying or identifiable data will 
be restricted and safeguarded. Identifiable patient health information 
collected by grantees under this PA will also be managed in accordance with 42 
CFR Parts 160 and 164, federal regulations pertaining to the privacy of 
protected health information. These privacy regulations, developed by the 
Department of Health and Human Services pursuant to the Health Insurance 
Portability and Accountability Act of 1996 (HIPAA) became mandatory for 
covered entities on April 14, 2003.  These regulations serve to limit the 
disclosure of personally identifiable patient information by covered entities 
and define when and how such information can be disclosed e.g., to 
researchers. Thus, for example, health care plans, will require either patient 
authorization of disclosures of identifiable information to be made to 
researchers or waivers of such authorizations obtained from an IRB or Privacy 
Board (defined in the regulations) satisfied that any identifiable health 
information will be appropriately safeguarded by the investigators. The HHS 
Office of Civil Rights is the enforcement body for this regulation. Additional 
information about the regulations, their implementation, and alternative 
methods of permissible disclosures to researchers (limited data sets with data 
use agreements, de-identified data sets, data about deceased persons, and data 
use to develop protocols) can be obtained from: 
http://www.aspe.hhs.gov/admnsimp/ or http://www.hhs.gov/ocr/hipaa/

The awardee should ensure that computer systems containing confidential data 
have a level and scope of security that equals or exceeds those established by 
the Office of Management and Budget (OMB) in OMB Circular No. A-130, Appendix 
III - Security of Federal Automated Information Systems. The National 
Institute of Standards and Technology (NIST) has published several 
implementation guides for this circular. They are: An Introduction to Computer 
Security: The NIST Handbook; Generally Accepted Principals and Practices for 
Securing Information Technology Systems; and Guide for Developing Security 
Plans for Information Technology Systems. The circular and guides are 
available on the web at http://csrc.nist.gov/publications/nistpubs/800-12/.  
The applicability and intended means of applying these confidentiality and 
security standards to subcontractors and vendors, if any, should be addressed 
in the application. 

Rights in Data 

AHRQ grantees may copyright, unless otherwise provided in grant awards, or 
seek patents, as appropriate, for final and interim products and materials 
including, but not limited to, methodological tools, measures, software with 
documentation, literature searches, and analyses, which are developed in whole 
or in part with AHRQ funds. Such copyrights and patents are subject to a 
worldwide irrevocable Federal government license to use and permit others to 
use these products and materials for government purposes. In accordance with 
its legislative dissemination mandate, AHRQ purposes may include, subject to 
statutory confidentiality protections, making project materials, databases, 
results, and algorithms available for verification or replication by other 
researchers; and subject to AHRQ budget constraints, final products may be 
made available to the health care community and the public by AHRQ or its 
agents, if such distribution would significantly increase access to a product 
and thereby produce substantial or valuable public health benefits. 
Ordinarily, to accomplish distribution, AHRQ publicizes research findings but 
relies on grantees to publish research results in peer-reviewed journals and 
to market grant-supported products. AHRQ's Office of Health Care Information 
wishes to be consulted in advance of publication in order to coordinate these 
issuances with other AHRQ dissemination activities. Important legal rights and 
requirements applicable to AHRQ grantees are set out or referenced in the 
AHRQ's grants regulation at 42 CFR Part 67, Subpart A (Available in libraries 
and from the GPO's website http://www.gpoaccess.gov/cfr/index.html). 

RECEIPT AND REVIEW SCHEDULE

Application Receipt Dates:  (Effective 2005) February 17, June 15, and 
October 15 annually 
(Applications considered for review must be post marked by the receipt date. 
If the  receipt date falls on a weekend or Holiday, the receipt date will be 
the next business day.)

Peer Review Date:   May, September and January annually. 

Earliest Anticipated Start Date:  4 months after application receipt date.

AWARD CRITERIA

Award criteria that will be used to make award decisions include:

o   Scientific merit  of the proposed project as determined by peer review
o   Availability of funds
o   Agency portfolio balance
o   Relevance to program priorities, including those related to inclusion of 
priority populations.
o   The extent to which the application addresses an area that  is “unique” to 
AHRQ.

REQUIRED FEDERAL CITATIONS

INCLUSION OF WOMEN, MINORITIES, AND CHILDREN IN RESEARCH STUDY POPULATIONS:   
It is the policy of AHRQ that women and members of minority groups be included 
in all AHRQ-supported research projects involving human subjects, unless a 
clear and compelling rationale and justification are provided that inclusion 
is inappropriate with respect to the health of the subjects or the purpose of 
the research.  

All investigators proposing research involving human subjects should read the 
UPDATED "NIH Guidelines on the 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).  
A complete copy of the updated Guidelines is available at 
http://grants.nih.gov/grants/funding/women_min/guidelines_update.htm.  
To the extent possible, AHRQ requires adherence to these NIH Guidelines.

Investigators may obtain copies from the above sources or from the AHRQ 
Publications Clearinghouse, listed under INQUIRIES, or from the NIH Guide Web 
site http://grants.nih.gov/grants/guide/index.html.  AHRQ Program staff may 
also provide additional information concerning these policies (see INQUIRIES).

AHRQ also encourages investigators to consider including children in study 
populations, as appropriate.

PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT:   The 
Office of Management and Budget (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 (1) first produced in a project 
that is supported in whole or in part with Federal funds and (2) cited 
publicly and officially by a Federal agency in support of an action that has 
the force and effect of law (i.e., a regulation) may be accessed through FOIA. 
If no Federal act is taken, having the force and effect of law, in reliance 
upon an AHRQ-supported research project, the underlying data is not subject to 
this disclosure requirement.  Furthermore, even if a Federal regulation action 
is taken in reliance on AHRQ-supported data under FOIA, 5 USC 552(b), 
disclosure of statutorily protected confidential identifiable data from such 
study is exempted from disclosure under "the (b)(3) exemption." It is 
important for applicants to understand the scope of this requirement and its 
limited potential impact on data collected with AHRQ support.  Proprietary 
data might also be exempted from FOIA disclosure requirements under "the 
(b)(4) exemption", for example, if it constituted trade secrets or commercial 
information collected. NIH has provided general related guidance at 
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm which does 
not include discussion of the exception applicable to confidential 
identifiable data collected under AHRQ’s authorities. 

Should applicants wish to place data collected under this RFA in a public 
archive, which can provide protections for the data (e.g., as required by the 
confidentiality statute applicable to AHRQ supported projects, 42 U.S.C. 299c-
3(c)) and manage the distribution of non-identifiable data for an indefinite 
period of time, they may. The application should include a description of any 
archiving plan in the study design and include information about this in the 
budget justification section of the application. In addition, applicants 
should consider how to structure informed consent statements or other human 
subject protection procedures to permit or restrict disclosures of 
identifiable data, as warranted.

STANDARDS FOR PRIVACY OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION:   The 
Department of Health and Human Services (DHHS) issued the last modification 
the "Standards for Privacy of Individually Identifiable Health Information", 
was mandated by the "Privacy Rule," on August 14, 2002.  This regulation was 
mandated by the Health Insurance Portability and Accountability Act (HIPAA) of 
1996 which governs the protection of individually identifiable health 
information.  It is administered and enforced by the DHHS Office for Civil 
Rights (OCR). Mandatory compliance with the Privacy Rule (for those classified 
under the Rule as "covered entities") must do so by April 14, 2003 (with the 
exception of small health plans which have an extra year to comply).  

Decisions about applicability and implementation of the Privacy Rule reside 
with covered entities. The OCR website (http://www.hhs.gov/ocr/) provides 
information on the Privacy Rule, including a complete Regulation Text and a 
set of decision tools that may be used to determine whether a researcher is a 
staff of a covered entity.  Project Officers will assist grantees in resolving 
questions about the applicability of HIPAA requirements.

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 health improvement 
priorities for the United States.  AHRQ encourages applicants to submit grant 
applications with relevance to the specific objectives of this initiative.  
Potential applicants may obtain a copy of "Healthy People 2010" at 
http://www.health.gov/healthypeople.   

AUTHORITY AND REGULATIONS:   This program is described in the Catalog of 
Federal Domestic Assistance, Number 93.226.  Awards are made under Title IX of 
the Public Health Service Act (42 USC 299-299c-7) as amended by P.L. 106-129 
(1999).  Awards are administered under the PHS Grants Policy Statement and 
Federal Regulations 42 CFR 67, Subpart A, and 45 CFR Parts 74 or 92.  This 
program is 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.


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