Full Text ES-95-002 ENVIRONMENTAL JUSTICE: PARTNERSHIPS FOR COMMUNICATION NIH GUIDE, Volume 23, Number 35, October 7, 1994 RFA: ES-95-002 P.T. 34 Keywords: 0725030 Health Services Delivery National Institute of Environmental Health Sciences Letter of Intent Receipt Date: November 17, 1994 Application Receipt Date: January 13, 1995 PURPOSE The purpose of this program is to strengthen the NIEHS effort that supports research aimed at achieving environmental justice for socioeconomically disadvantaged and medically underserved populations in the United States. One goal of the Institute is to stimulate investigative efforts that attempt to address questions related to the influence of economic and social factors on the health status of individuals exposed to environmental toxicants. This component of the NIEHS research program in environmental justice is designed to stimulate community outreach, training, and education efforts which will become the catalyst for reducing exposure to environmental pollutants in underserved populations. The main objective of this RFA is to establish methods for linking members of a community, who are directly affected by adverse environmental conditions, with researchers and health care providers. This will ensure that: o the community is aware of basic environmental health concepts, issues, and resources; o the community has a role in identifying and defining problems and risks related to environmental exposures; o the community is included in the dialogue shaping potential future research approaches to the problem; and o the community actively participates with researchers and health care providers in developing responses and setting priorities for intervention strategies. The aim of this program is to facilitate the process of developing the trust needed for establishment of effective partnerships among individuals who are adversely impacted by an environmental hazard in a socioeconomically disadvantaged community, researchers in environmental health, and health care providers. HEALTHY PEOPLE 2000 The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS-led national activity for setting priority areas. This RFA, Environmental Justice: Partnerships for Communication, is related to the priority area of environmental health. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001- 00474-0) or "Healthy People 2000" (Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington DC 20402-9325 (telephone 202-783-3238). ELIGIBILITY REQUIREMENTS Applications may be submitted by domestic for-profit and non-profit organizations, both public and private including predominantly minority institutions, individually or as joint efforts of minority institutions and majority institutions. Usually, only one award under this RFA will be funded at an institution. While a single institution must be the applicant, a multi-institutional arrangement (consortium) is possible. Such consortia, entailing active participation by more than one organization, are encouraged if there is clear evidence of close interaction and responsible partnership among the participants. It is important to note that, because of the wide range of environmental health problems to be addressed and the diversity of affected communities, applications must include at least one of each of the following: o A research scientist in environmental health sciences (such as those at NIEHS Environmental Health Sciences Centers). o A primary health care provider directly involved in a community affected by an environmental pollutant. This individual must have a record of providing health care to the participating community. He/she could, but need not necessarily, be affiliated with a county or state public health department. o A member of a community organization in an area having an underserved population that is adversely affected by an environmental pollutant. This individual must be someone who lives in or works directly and regularly with the participating community. At least one member of each of these three required personnel groups must have an active and meaningful role in both development of the application and conduct of the proposed project. These personnel should be listed on page 2 of the PHS 398 application, and a biographical sketch should be provided for each. Applications lacking the required personnel will not be considered. The role of each member of these three personnel groups in developing the application and carrying out the project must be clearly identified and fully described. There should be an equitable distribution of responsibilities as well as of requested financial resources among the three personnel groups. The NIEHS has a significant commitment to the support of programs designed to increase the number of underrepresented minority and female scientists participating in biomedical and behavioral research. Therefore, applications from minority individuals and women are encouraged. MECHANISM OF SUPPORT This RFA will use the National Institutes of Health (NIH) Education Grant (R25). Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. The total project period for applications submitted in response to the present RFA may not exceed four years, and projects are not renewable. This RFA is a one time solicitation. FUNDS AVAILABLE The estimated total funds available for the first year of support for the entire program are anticipated to be $500,000. The maximum award will be $150,000 in direct costs per year. Indirect costs will be paid at the approved indirect cost rate for the applicant organization less appropriate exclusions. It is anticipated that one to three grants will be awarded depending upon the availability of funds for this purpose and the quality of the applications received. Awards are not renewable and supplements are not allowed. RESEARCH OBJECTIVES Background Americans want to live long and healthy lives, and the majority of them achieve that goal. In general, however, people who are economically disadvantaged and/or who live or work in areas and occupations where conditions impart greater exposure to hazardous substances are less likely to do so. At every stage of life, these persons suffer disproportionate levels of morbidity and mortality. Evidence suggests that certain groups, especially minorities and low-income communities, bear an uneven share of hazardous environmental exposures. Socioeconomically disadvantaged people suffer the lowest life expectancy and highest adverse health consequences of inadequate access to high-quality health care. Additionally, they most often experience the highest degree of exposure to environmental agents and frequently have the least information available as to the health consequences of exposure to these agents. Environmental justice refers to the need to remedy the perceived unequal burden borne by socioeconomically disadvantaged persons in terms of residential exposure to greater than acceptable levels of environmental pollution, occupational exposure to hazardous substances, and fewer civic benefits such as sewage and water treatment. Geographic location plays an important role in environmental exposure of socioeconomically disadvantaged persons. Inner city poor often live in homes with high lead levels. They may also be exposed to higher levels of air pollution. Toxic wastes sites are more frequent in rural, low socioeconomic counties in the US. Nuclear facilities and chemical plants are often located in rural areas. Exposure to pesticides is another example where rural, socioeconomically disadvantaged populations are at a greater than average risk. Disadvantaged neighborhoods may rely on well water which may be polluted with toxic chemicals. In addition, medical care is often inadequate or unavailable to a significant proportion of the socioeconomically disadvantaged and minority people in America today. Lead poisoning and the cognitive and developmental damage associated with exposure to lead occur disproportionately among minorities. High blood pressure and prostate cancer are very common among African-Americans. Low birth weight babies and other problems during pregnancy are common among groups of women who do not have access to good prenatal care. Some of these conditions or other diseases may have an environmental component in their etiology. The lack of resources for early identification of the effects of toxic agents may lead to an increased disease burden in people who are economically least able to cope with it. Recent Progress and Opportunities Some work has been done to investigate the effects of pesticides in agricultural workers, of polychlorinated biphenyls in children in rural areas, and of lead exposure in socioeconomically disadvantaged urban children. The effect of low versus high air pollutant exposure on pulmonary function has been extensively studied. Evidence from the NHANES study has shown that, for comparable levels of exposure, different racial groups have different levels of blood lead. Some evidence is also available that suggests the toxic effects of some agents such as lead can be mitigated by good nutrition. Many of these studies have engaged underserved populations, but none have focused on such problems from the perspective of identifying issues of highest impact on and priority to these populations. Thus, progress has been minimal in most areas due to the lack of well-developed studies targeting socioeconomically disadvantaged populations. More effort must be put into defining disadvantaged populations having high levels of exposure to various types of environmental hazards in residential or occupational settings. Comprehensive outcomes to these exposures must be defined and measured. Prevention and treatment strategies for these effects must also be generated. Prominent among the goals of the NIEHS is support of research aimed at achieving environmental justice for all populations. It is equally important to bring minority populations into the mainstream of biomedical research as scientists, health care providers, and allied health service professionals. Both of these goals have a clear benefit to the health of the nation and provide a means of addressing a potential labor shortage in the twenty-first century. As one aspect of this effort, the Institute is requesting submission of applications that focus on establishing new avenues of communication among those living or working in a community impacted by an environmentally related health problem and the researchers and health care providers attempting to recognize and ameliorate such problems. Objectives and Scope One component of the mission of NIEHS is to promote research aimed at achieving environmental justice by identifying and addressing disproportionately high and adverse effects of environmental agents on human health in low income and minority populations. The main objective of this program is to establish methods for linking members of a community, who are directly affected by adverse environmental conditions, with researchers and health care providers. Development of community-based strategies to address environmental health problems requires approaches that are not typically familiar to the research and medical communities. Customary approaches to risk assessment and management often neglect the knowledge and experience of at-risk populations and the sociocultural context of environmental hazards. The distinctive needs of individual communities and their inhabitants are only rarely considered in identifying environmental health problems and devising appropriate disease and pollution prevention tactics. Underserved populations are often diverse, fragmented, and isolated, making it difficult to obtain their input and to integrate their concerns in decision- making processes. Assays of the health effects of environmental pollution, as well as regulations based on such assays, are often performed with little or no input from the affected community. The purpose of this program is to institute mechanisms to bridge this communication gap. Applicants are therefore expected to create equitable partnerships among researchers in environmental health, health care providers, and representatives of low-income or minority communities affected by environmental health problems. Types of activities which may be proposed include, but are not limited to: o Develop efficacious methods for risk communication in minority and low-income communities unfavorably impacted by environmental hazards. o Develop community-based, culturally sensitive educational programs to mitigate adverse health effects from environmental toxicants in minority and low-income communities. o Carry out community-based training to increase environmental health literacy, i.e., increase awareness of the public, in such neighborhoods. o Train and educate neighborhood health care professionals in the diagnosis and treatment of disorders having an etiology related to exposure to hazardous substances, i.e., increase awareness of health care providers. These providers should have a direct role in assisting a community affected by exposure to an environmental hazard. NIEHS wishes to encourage a broad, comprehensive approach to this problem. Applicants are encouraged to consider proposing some combination of the above activities. The following factors must be included in applications submitted in response to this RFA: o A means of establishing effective input from an underserved community affected by an environmental toxicant. For example, applicants may consider creating a community-based advisory board or steering committee to facilitate outreach, planning, and evaluation efforts. This input could be obtained directly from members of a community affected by an environmental toxicant as well as from representatives of such groups as community and neighborhood associations, churches, public housing resident councils, community health centers, local public health service departments, and minority educational institutions. o An objective assessment process designed to identify priority areas in environmental health as perceived by community members, to develop a consensus among community members as to plausible approaches, to build upon existing expertise and knowledge within the community, and to detect any potential constraints in implementing the project. o Development of appropriate education/communication modules. Proposed projects should provide for dissemination of relevant information within the community as well as a means for the community to have a voice that reaches researchers and health care providers. There should be an effective flow of information among all participants. o Feedback and evaluation of the project's effectiveness. A procedure should be established to assess the usefulness of the project's education/communication activities. o Recommendations for future activities, beyond the period of NIEHS funding, to assure continued participation of community members in research and service programs addressing environmental injustices. Each of the above elements is essential to fulfill the education, communication, and outreach aims of this RFA. Applications lacking any of the above components will not be considered. It is important to note that award of a grant under this RFA by the NIEHS does not imply a commitment to future funding of any programs planned with the support of such a grant. Separate applications must be submitted for such programs and such applications will be evaluated on the basis of their own merits. SPECIAL REQUIREMENTS To encourage applicants to share information gained via these grants, a member of each of the three types of required personnel on each project will be asked to attend an annual meeting at NIEHS. Applicants should include such travel in their budget requests. 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 and behavioral 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 new policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43) and supersedes and strengthens the previous policies (Concerning the Inclusion of Women in Study populations, and Concerning the Inclusion of Minorities in Study Populations), which have been in effect since 1990. The new policy contains some provisions that are substantially different from the 1990 policies. All investigators proposing research involving human subjects should read the "NIH Guidelines for Inclusion of Women and Minorities as Subjects in Clinical Research," which have been published in the Federal Register of March 28, 1994 (FR 59 14586-14513) and reprinted in the NIH Guide for Grants and Contracts, Volume 23, Number 11, March 18, 1994. Investigators also may obtain copies of the policy from the program staff listed under INQUIRIES. Program staff may also provide additional relevant information concerning the policy. LETTER OF INTENT Prospective applicants are requested to submit, by November 17, 1994, a letter of intent that includes a descriptive title of the proposed project, the name, address, and telephone number of the Principal Investigator, the identities of other key personnel and participating institutions, and the number and title of the RFA in response to which the application may be submitted. The letter of intent influences neither review nor funding decisions, but it is helpful to NIEHS staff in planning the review process, e.g., in estimating workload and avoiding conflict of interest. Letters of intent are to be directed to: Ethel B. Jackson, D.D.S. Division of Extramural Research and Training National Institute of Environmental Health Sciences P.O. Box 12233, MD 17-09 104 T.W. Alexander Drive Research Triangle Park, NC 27709 APPLICATION PROCEDURES Applicants are to use standard form PHS 398 (rev 9/91), which is available from most institutional offices of sponsored research from the Office of Grants Information, Division of Research Grants, National Institutes of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone (301) 710-0267). The RFA label available in the PHS 398 (rev. 9/91) application form must be affixed to the bottom of the face page of the application. Failure to use this label could result in delayed processing of the application such that it may not reach the review committee in time for review. In order to assure proper identification of the application, item 2a of the application form must be filled in as follows: Check the box indicated as "YES" enter the RFA number as ES-95-002 and the title as "Environmental Justice: Partnerships for Communication." Each application must be presented in the format used for an NIH research grant. Submit a signed, typewritten original of the application, including the Checklist and three signed photocopies, in one package to: Division of Research Grants National Institutes of Health Westwood Building, Room 240 Bethesda, MD 20892** At the time of submission, two additional copies of the application must be sent to: Ethel Jackson, D.D.S. Division of Extramural Research & Training National Institute of Environmental Health Sciences P.O. Box 12233, MD 17-09 104 T.W. Alexander Drive Research Triangle Park, NC 27709 Applications must be received by January 13, 1995. If an application is received after that date, it will be returned to the applicant without review. The Division of Research Grants (DRG) 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 DRG 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. Applicants who are submitting revised applications based on criticisms in summary statements received in response to the previous announcement of this RFA, ES-94-005, are urged to read the appropriate instructions on pages 19-20 of the PHS 398 and to contact program staff listed under INQUIRIES. All human and animal welfare as well as misconduct assurances must be complete for a application to be reviewed. All follow-up assurances and approvals submitted as pending must be received within 60 days of the application receipt deadline as the application will not be reviewed. The following is the schedule planned for this initiative. It should be noted that this schedule may be changed without notification due to factors that were unanticipated at the time of the announcement. Please contact the program official listed below regarding any changes in the schedule. Letter of Intent Receipt Date: November 17, 1994 Application Receipt Date: January 13, 1995 Initial Scientific Review: March 1995 Advisory Council Review: May 1995 Anticipated Date of Award: July 1, 1995 REVIEW CONSIDERATIONS Review will be carried out by the Scientific Review Branch, Division of Extramural Research and Training. Applications will be screened by staff for completeness and responsiveness to the RFA. Those that are incomplete or nonresponsive will be returned to the applicant without review. Complete and responsive applications will be reviewed by either the Environmental Health Sciences Review Committee or a special review committee impaneled by the Scientific Review Branch. As part of the initial merit review, a process (triage) may be used by the initial review group in which applications will be determined to be competitive or noncompetitive based on their scientific merit relative to other applications received in response to the RFA. Applications judged to be competitive will be discussed and be assigned a priority score. Applications determined to be noncompetitive will be withdrawn from further consideration and the Principal Investigator and the official signing for the applicant organization will be notified. The second level of review will be provided by the National Advisory Environmental Health Sciences Council. The review factors listed below will be used in evaluation of applications for this RFA: o Scientific, technical, and/or medical significance and merit of the proposed project as determined by such factors as its content, originality, and feasibility. o Evidence of access to, interaction with, and input from a minority, low-income, or underserved community, whose members' health is adversely impacted by an environmental toxicant. There should be evidence of effective involvement of such a community in development of the application as well as in conduct of the project. o Capacity of the project to: 1. Identify key environmental hazards that affect the health and quality of life of people who live in or around communities thought to be at risk. 2. Establish a focus for information exchange related to environmental health problems in socioeconomically disadvantaged communities. 3. Enhance awareness of environmental health problems among members of the public and/or health care providers living or working in minority or low-income communities. 4. Have a direct impact on the health or quality of life of individuals in affected communities, e.g., by diminishing exposure to environmental toxicants. o Appropriateness and adequacy of the approach and methodology proposed to accomplish the project's objectives. Effectiveness of the proposed plan in reaching the target audience. For example, many socioeconomically disadvantaged persons tend not to obtain information from the written word. Low- or no-literacy, as well as bilingual, materials may need to be generated. o Qualifications and experience of the principal investigator and staff, particularly but not exclusively in areas relevant to the mission of NIEHS. Personnel should demonstrate knowledge of the needs of their target audience. Applications must include, at a minimum, a researcher in environmental health sciences, a health care provider, and a member of a community organization in an area having an underserved population that is adversely affected by an environmental pollutant. There should be evidence of effective cooperation and interaction among these staff members in development of the application as well as in execution of the project. There should be an equitable distribution of responsibilities among the three types of required personnel. o Strength of institutional commitment as evidenced by provision of appropriate resources, services, technical support, and allocation of space. o Availability of resources necessary to carry out the project. o Appropriateness of the proposed budget and duration in relation to the project's objectives. Consistent with an equitable distribution of responsibilities, there should likewise be an equitable distribution of requested financial support among the three types of required personnel. o Plans for evaluation of factors contributing to the project's effectiveness. Evaluations should include a measure of the impact of the project on community members' knowledge and awareness of issues and resources related to environmental health sciences. AWARD CRITERIA The anticipated date of award is July 1, 1995. The following will be considered in making funding decisions: o Quality of the proposed applications as determined by peer review. o Responsiveness to the goals of this RFA and the mission of the NIEHS. o Availability of funds. Although this program is provided for in the financial plans of the NIEHS, awards pursuant to this RFA are contingent upon the availability of funds for this purpose. Funding beyond the first and subsequent years of the award will be contingent upon satisfactory progress during the preceding year and upon availability of funds. INQUIRIES Inquiries concerngin this RFA ar encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Allen Dearry, Ph.D. Division of Extramural Research and Training National Institute of Environmental Health Sciences P.O. Box 12233, MD 3-02 Research Triangle Park, NC 27709 Telephone: (919) 541-7825 / 4943 FAX: (919) 541-2843 E-mail: DEARRY@NIEHS.NIH.GOV Direct inquiries regarding fiscal matters to: Ms. Carolyn Winters Division of Extramural Research and Training National Institute of Environmental Health Sciences P.O. Box 12233, MD 2-01 Research Triangle Park, NC 27709 Telephone: (919) 541-7623 FAX: (919) 541-2860 E-mail: WINTERS@NIEHS.NIH.GOV AUTHORITY AND REGULATIONS This program is described in the Catalog of Federal Domestic Assistance Number 93.113, 93.114, and 93.115. Awards are made under authorization of the Public Health Service Act, Title IV, Part A (Public Law 100-607) and administered under PHS grants policies and Federal Regulations 42 CFR Part 52 and 45 CFR Part 74. The program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review. The Public Health Service (PHS) strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people. .
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