INFORMAL CAREGIVING RESEARCH FOR CHRONIC CONDITIONS

Release Date:  November 7, 2001

RFA:  RFA-NR-02-001

National Institute of Nursing Research
 (http://www.ninr.nih.gov)
National Institute on Aging
 (http://www.nia.nih.gov)

Letter of Intent Receipt Date:  January 31, 2002
Application Receipt Date:       February 26, 2002

THIS RFA USES "MODULAR GRANT" AND "JUST-IN-TIME" CONCEPTS.  MODULAR 
INSTRUCTIONS MUST BE USED FOR RESEARCH GRANT APPLICATIONS REQUESTING LESS THAN 
$250,000 PER YEAR IN ALL YEARS. MODULAR BUDGET INSTRUCTIONS ARE PROVIDED IN 
SECTION C OF THE PHS 398 (REVISION 5/2001) AVAILABLE AT 
http://grants.nih.gov/grants/funding/phs398/phs398.html.  

PURPOSE

The National Institute of Nursing Research and the National Institute on 
Aging invite applications for research grants to advance the science in 
informal caregiving in the home for care recipients with chronic illness, 
disability, or functional impairment requiring partial or full dependency on 
others. This RFA targets studies of informal caregiving interventions to 
improve caregiver health and quality of life, caregiving processes, and 
caregiving effectiveness and health outcomes. A key aspect of this RFA is to 
encourage research to advance science-based knowledge of informal caregiving, 
with attention to the caregiver. Clinical research areas appropriate to this 
RFA include interventions: to improve the quality of informal caregiving at 
all levels and throughout the caregiving trajectory; to prevent or manage 
caregiver physical and mental health problems related to caregiving; to 
reduce the burden of caregiving; and on the effectiveness of advances in 
caregiving processes, including new technologies. 

HEALTHY PEOPLE 2010

The Public Health Service (PHS) is committed to achieving the health 
promotion and disease prevention objectives of "Healthy People 2010," a PHS-
led national activity for setting priority areas.  This Request for 
Applications (RFA), Informal Caregiving in Non-Institutional Settings, is 
related to one or more of the priority areas.  Potential applicants may 
obtain a copy of "Healthy People 2010" at 
http://www.health.gov/healthypeople/.

ELIGIBILITY REQUIREMENTS

Applications may be submitted by domestic and foreign, for-profit and non-
profit organizations, public and private, such as universities, colleges, 
hospitals, laboratories, units of State and local governments, and eligible 
agencies of the Federal government. Racial/ethnic minority individuals, 
women, and persons with disabilities are encouraged to apply as Principal 
Investigators.

MECHANISM OF SUPPORT

This RFA will use the National Institutes of Health (NIH) Research Project 
Grant (R01) award mechanism.  Responsibility for the planning, direction, and 
execution of the proposed project will be solely that of the applicant.  The 
total project period for an application submitted in response to this RFA may 
not exceed five (5) years.  This RFA is a one-time solicitation.  Future 
unsolicited competing continuation applications will compete with all 
investigator-initiated applications and be reviewed according to the 
customary peer review procedures.  The anticipated award date is September 
30, 2002.

Specific application instructions have been modified to reflect "MODULAR 
GRANT" and "JUST-IN-TIME" streamlining efforts that have been adopted by the 
NIH. Complete and detailed instructions and information on Modular Grant 
applications have been incorporated into the PHS 398 (rev. 5/2001). Additional 
information on Modular Grants can be found at 
http://grants.nih.gov/grants/funding/modular/modular.htm

FUNDS AVAILABLE

The NINR and NIA intend to commit approximately $2.3 million in FY 2002 to 
fund 5 to 6 new and/or competitive continuation grants in response to this 
RFA. An applicant may request a project period of up to 5 years and a budget 
for direct costs of up to $340,000 per year. Because the nature and scope of 
the research proposed may vary, it is anticipated that the size of each award 
will also vary. Although the financial plans of the NINR and NIA provide 
support for this program, awards pursuant to this RFA are contingent upon the 
availability of funds and the receipt of a sufficient number of meritorious 
applications.

RESEARCH OBJECTIVES

Background

The definition of informal caregivers used by this RFA is adapted from 
Biegel, Sales, and Schulz (1), and includes those individuals who provide 
extraordinary, uncompensated care, predominantly in the home setting, 
involving significant amounts of time and energy for months or years, and 
requiring the performance of tasks that may be physically, emotionally, 
socially, or financially demanding. Studies investigating issues related to 
the parenting of healthy children or studies of caregiving in institutions 
are not responsive to this RFA.

The number of informal caregivers in the U.S. tripled from 1988 to 1996, 
according to a National Alliance for Caregiving/American Association of 
Retired Persons (NAC/AARP) study(2) of informal caregivers for care 
recipients aged 50 or older. In 1996, the U.S. had over 22 million households 
with English-speaking informal caregivers. The intensity of caregiving ranged 
from a few hours per week to constant care. The mean age of caregivers was 46 
with 22% under 35 years and 36% 50+ years old. About 73% of informal 
caregivers were female.  The prevalence of informal caregiving was higher 
among Asian and Black households (31.7% and 29.4%) than among Hispanic 
(26.8%) or White households (24%). The median household income of caregivers 
in 1996 was $35,000. About two-thirds of caregivers worked either full-time 
or part-time, about 20% were not employed, and 16% were retired. Almost 70% 
of caregivers cared for more than one person, while 23% cared for two people 
and 8% cared for three or more people.  Estimates of the number of caregivers 
under the age of 21 are not well documented.

The main illness or problems experienced by care recipients in the 1996 study 
were identified, by groupings, as "aging" (15.5%), mobility problems (10.4%), 
dementia (9.7%), and 43.2% with various chronic diseases including heart, 
cancer, stroke, arthritis, diabetes, and pulmonary disease. Problems with 
smaller percentages were noted for mental or emotional illness and 
neurological problems. Wagner (3) compared 1988 and 1996 informal caregiving 
survey data and predicted, on the basis of the comparison results, that 
during the next decade informal caregiving will continue to increase, there 
will be more employed caregivers with an increase in workplace issues, an 
increase in male caregivers, and an increase in long-distance caregiving. It 
is estimated that currently 4.1 million adults aged 21 to 64 need personal 
assistance with one or more personal or instrumental activities of daily 
living. Approximately 6.8 million adults over the age of 65 have daily 
personal assistance needs.(4,5)

The cost of informal caregiving is significant and is primarily that 
associated with caregiving of adults and older adult populations. Informal 
caregiving cost estimates range from $117 to $292 billion a year for adults 
with a disability or chronic disease, with higher costs occurring in 
caregiving for Alzheimer's disease.(6) The health issues arising from 
informal caregiving are significant and warrant attention. To illustrate, the 
NAC/AARP study2 reports that 15% of caregivers admit to having physical or 
emotional health problems directly related to caregiving while other 
caregivers have one or more pre-existing health problems. More women than men 
caregivers report emotional stress and impaired physical health. 

The national informal caregiving surveys cited previously were targeted to 
older care recipients. With increasing numbers of children surviving birth 
defects (including genetic, neurodevelopment, and birth trauma conditions), 
developing chronic diseases, and the continuing numbers of auto and other 
accidents resulting in traumatic injuries to adolescents and young adults, 
informal caregiving needs are, and will continue to be, present across the 
lifespan. The percentage of children ages 5 to 17 with any limitation in 
activity from chronic conditions is 8%, as reported by the CDC National 
Center for Health Statistics in 1997. Furthermore, there are 1.5 million 
children and adolescents who have serous health conditions that impair daily 
functioning. (5,6) Chronic diseases that are severe require extraordinary 
caregiving. One example is the growing number of health outcomes of very low 
birth weight infants. Low birth weight infants have higher rates of mental 
retardation, cerebral palsy, blindness, deafness, and psychomotor problems 
than do normal weight infants.(7) Many of these health problems require a 
lifetime of committed informal caregiving by parents and family members and 
may have a deleterious impact on family dynamics, quality of life, and 
financial status.  
   
Informal Caregiving Recipient Populations   

Examples of care recipient populations and caregiving problems are briefly 
discussed. It is not possible, in this context, to specify all possible 
caregiving situations or care recipient groups. The following examples 
illustrate the breadth and depth of informal caregiving problems experienced 
by caregivers. 

Chronic Illnesses. The Centers for Disease Control and Prevention (CDC) 
reports that nearly three quarters of adults age 65 years and older have one 
or more chronic illnesses, and nearly half report two or more. Many chronic 
diseases are debilitating and may have a deleterious affect on self-care 
functions, requiring informal caregiving from family or friends. The moderate 
to severe forms of stroke, for example, often require sudden intense and 
frequent caregiving interventions, with caregiving needs changing over time. 
A review (8) on caregiving for stroke patients found several caregiver well-
being issues including depression, concern for future care, and caregiver 
burden. Burden was related, in various studies, to level of patient 
disability, and psychological distress. Caregiver depression was related to 
the relationship with the patient (spouse), more concern for future care, 
fewer social contacts, more physical symptoms in the caregiver, and stroke 
patient symptoms. Caregiver fatigue and sleep difficulties were found to be 
significantly greater for spousal caregivers of individuals with Alzheimer's 
Disease, Parkinson's disease, or cancer when compared with a control group of 
little or no caregiving requirements.(9) In a longitudinal cohort study (10) 
of almost 400 older spousal caregivers, caregivers who experienced mental or 
emotional strain related to caregiving had mortality risks 63% higher than 
non-caregiving controls. The findings suggest that having caregiver strain is 
an independent risk factor for mortality among older spousal caregivers.

In addition to having more chronic diseases, many people become frail as they 
age.  This affects their ability to manage their activities of daily living 
and to care for their health needs.  Many frail elderly require assistance 
from informal caregivers such as family, neighbors, or friends.

Alzheimer's Disease. At least 5 million Americans provide care for someone 
with Alzheimer's disease (AD).(11) These informal caregivers are twice as 
likely to be providing constant care and 38% have been providing care for 
more than five years. The caregiving required is intense and includes 
assistance with activities of daily living, incontinence, feeding, and 
transfer or use of a wheelchair or walker. The majority (73%) of AD 
caregivers age 65 and over provide the highest levels of care. These 
caregivers are twice as likely to report physical strain and high levels of 
emotional stress as a direct result of caregiving responsibilities. They are 
more likely to report family conflict, to spend less time with other family 
members, and to give up vacations, hobbies, and other personal activities. A 
high level of financial strain is present for AD caregivers as well.

Technology Dependency. Technological caregiving in the home is becoming more 
prevalent. Examples of technology use for care recipients of all ages include 
kidney dialysis, intravenous lines, electronic monitoring, nutritional tube 
feedings, and ventilators. Care recipients who are technology dependent may 
need constant vigilance and monitoring. The need for long-term technology re-
education, support, and caregiving guidance has not been adequately 
addressed. Informal technology caregiving success is related to caregiver and 
care recipient abilities to share responsibilities, to understand tasks, and 
to coordinate efforts with multiple health professionals. (12) The use of 
technology in informal caregiving remains a major problem for caregivers and 
care recipients as technological advances become more common and more 
sophisticated.     

This RFA is based on growing scientific opportunities that reflect the 
increased current and future need for informal caregiving and the lack of 
research across a range of caregiving populations and of interventions to 
enhance the quality of caregiving while reducing caregiver burden.  These 
opportunities were summarized at an NINR-sponsored Research In Informal 
Caregiving:  State of the Science Workgroup Meeting in July 2001 at which a 
group of science experts in informal caregiving, including lay 
representation, reviewed the current state of the science in the field. A 
summary of the workgroup meeting and research questions raised can be found 
under the News and Information link at www.nih.gov/ninr. 

Research Scope

Caregiver and care recipient populations of interest include, but are not 
limited to, understudied populations such as caregiving for ethnic 
minorities, children or adolescents, and highly stressed or overwhelmed 
caregivers. Caregiver and recipient age groups across the lifespan and both 
genders should be considered. All levels of intensity of informal caregiving 
are of interest, ranging from moderate effort to constant and vigilant 
caregiving. Applications focused on caregivers for care recipient populations 
with chronic illness, disability, or functional impairment will be 
considered. Diverse populations are encouraged, including urban, inner city, 
rural, and other understudied groups. Applicants may also consider the 
feasibility of translation to practice and cost effectiveness for 
interventions tested. 

The following research topics are provided as examples that would extend 
current research. The topics are not listed in any priority order and are not 
intended to be inclusive or restrictive. All responsive applications, 
regardless of design or target group, must display awareness of and 
sensitivity to cultural or race/ethnic issues in appropriate components of 
the study.

Caregiver Health and Quality of Life:  
o  Evaluate interventions that help to maintain or improve the caregiver's 
physical and mental health and quality of life across and within different 
geographic regions, racial/ethnic groups, and by recipient health conditions.
o  Test interventions to assist caregivers to cope with or problem solve 
unanticipated demands of caregiving such as time required, loss of social 
interactions with others, other personal lifestyle sacrifices, insufficient 
family assistance, financial impact, and work issues. 
o  Assess methods to intervene for caregivers with dysfunctional family 
dynamics, including aggressive behaviors or abuse.
o Investigate the physical and emotional health consequences for both 
caregiver and care recipient of continuing involvement of an informal family 
caregiver, beyond simple visiting (e.g., the informal caregiver monitors 
prevention of pressure ulcers; grooming) following the institutionalization 
of the individual being cared for.
o Examine how caring for patients with different degrees of disability and 
frailty impact the caregiver.

Caregiver Abilities, Problem Solving, and Care Decisions: 
o  Test interventions that improve the quality of caregiving outcomes for the 
caregiver and care recipient, including caregiver satisfaction, quality of 
life, physical and mental health, cost effectiveness, and other relevant 
factors.
o  Test interventions that improve the caregiving and problem solving 
abilities of caregivers by considering factors such as symptom management, 
caregiving procedures/activities, accessing appropriate health care/social 
services assistance, health care visits, medication management, prevention of 
complications, preventive care, recipient health crises, troublesome 
behaviors, and physical and emotional dependency. Include strategies that 
involve care recipients in care activities and decision making.
o  Examine interventions at different transitions in the trajectory of 
caregiving, for example, when the recipient's condition either improves or 
worsens, or the recipient is institutionalized or dies. 

Formal Health Care and Community Resources for Effective Caregiving: 
o  Test interventions or collaboration strategies between caregivers and 
formal health care systems that improve informal caregiving effectiveness, 
outcomes, and satisfaction for the caregiver and care recipient.
o  Evaluate the impact of health care provider strategies and community 
organizations' (formal and informal) support services on informal caregiver 
health, quality of life, and caregiving trajectory.
o  Investigate the role of telehealth or technology in improving informal 
caregiving and strategies that enable effective caregiving with new or 
advanced technologies.  
o Examine the impact of formal home health care (HHC) on the health and well-
being of the caregiver under differing models of HHC such as companion care, 
formal nursing, household chores, etc. and how this varies by specific 
conditions, such as Alzheimer's Disease.
o Explore the financial impact of informal caregiving of older persons on the 
family and the effect of privately funded long-term care insurance.

References

1.  Biegel, D., Sales, E., and Schulz, R. (1991). Family caregiving in 
chronic illness: Heart disease, cancer, stroke, Alzheimer's disease, and 
chronic mental illness. Newbury Park, CA: Sage Publications.  

2.  National Alliance for Caregiving & American Association of Retired 
Persons (1997). Family caregiving in the U.S.: Findings from a national 
survey. Sponsored by the National Alliance for Caregiving, Bethesda MD, and 
the American Association of Retired Persons, Washington DC. 

3.  Wagner, DL (1997). Comparative analysis of caregiver data for caregivers 
to the elderly 1987 and 1997. National Alliance for Caregiving: Bethesda MD.

4.  Schulz, R, & Quittner, AL (1998).  Caregiving through the life-span: 
Overview and future directions. Health Psychology, 17(2), 107-111.

5.  Quittner, AL, Opipari, LC, Regoli, MJ, Jacobsen, J, & Eigen, H (1992).  
The impact of caregiving and role strain on family life: Comparisons between 
mothers of children with CF and matched controls. Rehabilitation Psychology, 
37, 289-304.

6.  Arno, PS, Levine C, Memmott, MM (1999). The economic value of informal 
caregiving. Health Affairs, 18(2):182-188.

7   Hack, M, Klein, NK, & Taylor, HG (1995). Long-term developmental outcomes 
of low birth weight infants. In RE Behrman (Ed.), The Future of Children, 
5(1):176-196. Published by the Center for the Future of Children, The David 
and Lucile Packard Foundation.

8.  Han, B, & Haley, WE (1999). Family caregiving for patients with stroke: 
review and analysis. Stroke, July, 1478-1485.

9.  Teel CS, & Press AN (1999). Fatigue among elders in caregiving & non-
caregiving roles. West J Nurs Res, Aug;21(4):498-514.    

10  Schulz R. & Beach (1999). Caregiving as a risk factor for mortality: The 
caregiver health effects study. JAMA, 282:2215-2219.  

11 Alzheimer's Association & the National Alliance for Caregiving (1999). Who 
cares? Families caring for persons with Alzheimer's disease. A report of the 
Alzheimer's Association, Washington DC, and the National Alliance for 
Caregiving, Bethesda MD.

12 Smith, C. (1996). Quality of life and caregiving in technological home 
care. In J Fitzpatrick & J Norbeck (Eds.), Annual review of nursing research 
(Vol. 14, pp. 95-118). New York: Springer Publishing.

Upon initiation of the program, one meeting will be organized to encourage 
the exchange of information among principal investigators who participate in 
this program. Travel funds for the PI, and possibly one other person, for a 
two-day meeting in the fourth year, to be held in Bethesda, Maryland, must be 
included in the application. Applicants must include a statement indicating 
their willingness to participate in this meeting.

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 sub-populations must be included in all NIH-supported biomedical and 
behavioral research projects involving human subjects, unless a clear and 
compelling rationale and justification are provided indicating that inclusion 
is inappropriate with respect to the health of the subjects or the purpose of 
the research.  This policy results from the NIH Revitalization Act of 1993 
(Section 492B of Public Law 103-43). 

All investigators proposing research involving human subjects should read the 
AMENDED "NIH Policy and Guidelines on the Inclusion of Women and Minorities 
as Subjects in Clinical Research - Amended, October, 2001," 
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm  
announced in the NIH Guide for Grants and Contracts on October 9, 2001: 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html.  The 
amended policy incorporates: the use of an NIH definition of clinical 
research; updated racial and ethnic categories; clarification of language 
governing NIH-defined Phase III clinical trials consistent with the new PHS 
Form 398; and updated roles and responsibilities of NIH staff and the 
extramural community with this policy.  The amended policy provides 
additional guidance on the analyses and reporting of analyses of sex/gender, 
racial/ethnic and relevant subpopulation differences in intervention effects 
for NIH-defined Phase III clinical trials. 

INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS

It is the policy of NIH that children (i.e., individuals under the age of 21) 
must be included in all human subjects research, conducted or supported by 
the NIH, unless there are scientific and ethical reasons not to include them.  
This policy applies to all initial (Type 1) applications submitted for 
receipt dates after October 1, 1998.

All investigators proposing research involving human subjects should read the 
"NIH Policy and Guidelines" on the Inclusion of Children as Participants in 
Research Involving Human Subjects that was published in the NIH Guide for 
Grants and Contracts, March 6, 1998, and is available at the following URL 
address: http://grants.nih.gov/grants/guide/notice-files/not98-024.html

Investigators also may obtain copies of these policies from the program staff 
listed under INQUIRIES.  Program staff may also provide additional relevant 
information concerning the policy.

REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS

NIH policy requires education on the protection of human subject participants 
for all investigators submitting NIH proposals for research involving human 
subjects.  This policy announcement is found in the NIH Guide for Grants and 
Contracts Announcement dated June 5, 2000, at the following website: 
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.

URLS IN NIH GRANT APPLICATIONS OR APPENDICES

All applications and proposals for NIH funding must be self-contained within 
specified page limitations.  Unless otherwise specified in an NIH 
solicitation, internet addresses (URLs) should not be used to provide 
information necessary to the review because reviewers are under no obligation 
to view the Internet sites.  Reviewers are cautioned that their anonymity may 
be compromised when they directly access an Internet site.

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.  It is important for applicants to understand the basic scope 
of this amendment.  NIH has provided guidance at:
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm

Applicants may wish to place data collected under this RFA in a public 
archive, which can provide protections for the data and manage the 
distribution for an indefinite period of time.  If so, the application should 
include a description of the archiving plan in the study design and include 
information about this in the budget justification section of the 
application. In addition, applicants should think about how to structure 
informed consent statements and other human subjects procedures given the 
potential for wider use of data collected under this award.

LETTER OF INTENT

Prospective applicants are asked to submit a letter of intent that includes a 
descriptive title of the proposed research, 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.  Although a letter of 
intent is not required, is not binding, and does not enter into the review of 
a subsequent application, the information that it contains allows IC staff to 
estimate the potential review workload and plan the review.

The letter of intent is to be sent Dr. Nell Armstrong at the address below by 
the letter of intent receipt date listed.

APPLICATION PROCEDURES

The PHS 398 research grant application instructions and forms (rev. 5/2001) 
at http://grants.nih.gov/grants/funding/phs398/phs398.html must be used in 
applying for these grants. This version of the PHS 398 is available in an 
interactive, searchable format. For further assistance contact GrantsInfo, 
Telephone 301/435-0714, Email: GrantsInfo@nih.gov.

SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS

The modular grant concept establishes specific modules in which direct costs 
may be requested as well as a maximum level for requested budgets. Only 
limited budgetary information is required under this approach.  The 
just-in-time concept allows applicants to submit certain information only 
when there is a possibility for an award. It is anticipated that these 
changes will reduce the administrative burden for the applicants, reviewers 
and NIH staff.  The research grant application form PHS 398 (rev. 5/2001) at 
http://grants.nih.gov/grants/funding/phs398/phs398.html is to be used in 
applying for these grants, with modular budget instructions provided in 
Section C of the application instructions.

The RFA label available in the PHS 398 (rev. 5/2001) application form must be 
affixed to the bottom of the face page of the application.  Type the RFA 
number on the label.  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 addition, the RFA title and number must be typed on 
line 2 of the face page of the application form and the YES box must be 
marked. The RFA label is also available at: 
http://grants.nih.gov/grants/funding/phs398/label-bk.pdf.

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
BETHESDA, MD  20817 (for express/courier service)

At the time of submission, two additional copies of the application must be 
sent to:

John Richters, PhD
Office of Review
National Institute of Nursing Research
Building 45, Room Number 3AN12, MSC 6300
Bethesda, MD  20892-6300

Applications must be received by the application receipt date listed in the 
heading of this RFA.  If an application is received after that date, it will 
be returned to the applicant without review.

The Center for Scientific Review (CSR) will not accept any application in 
response to this RFA that is essentially the same as one currently pending 
initial review, unless the applicant withdraws the pending application.  The 
CSR will not accept any application that is essentially the same as one 
already reviewed. This does not preclude the submission of substantial 
revisions of applications already reviewed, but such applications must 
include an Introduction addressing the previous critique.

REVIEW CONSIDERATIONS

Upon receipt, applications will be reviewed for completeness by the CSR and 
responsiveness by the NINR and NIA.  Incomplete and/or non-responsive 
applications will be returned to the applicant without further consideration.

Applications that are complete and responsive to the RFA will be evaluated 
for scientific and technical merit by an appropriate peer review group 
convened by the NINR in accordance with the review criteria stated below.  As 
part of the initial merit review, all applications will receive a written 
critique and undergo a process in which only those applications deemed to 
have the highest scientific merit, generally the top half of the applications 
under review, will be discussed, assigned a priority score, and receive a 
second level review by the National Advisory Council for Nursing Research and 
the National Advisory Council on Aging.

Review Criteria

The goals of NIH-supported research are to advance our understanding of 
biological systems, improve the control of disease, and enhance health.  In 
the written comments reviewers will be asked to discuss the following aspects 
of the application in order to judge the likelihood that the proposed 
research will have a substantial impact on the pursuit of these goals.  Each 
of these criteria will be addressed and considered in assigning the overall 
score, weighting them as appropriate for each application.  Note that the 
application does not need to be strong in all categories to be judged likely 
to have major scientific impact and thus deserve a high priority score.  For 
example, an investigator may propose to carry out important work that by its 
nature is not innovative but is essential to move a field forward.

(1) Significance:  Does this study address an important problem? If the aims 
of the application are achieved, how will scientific knowledge be advanced?  
What will be the effect of these studies on the concepts or methods that 
drive this field?

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

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

(4) Investigator:  Is the investigator appropriately trained and well suited 
to carry out this work?  Is the work proposed appropriate to the experience 
level of the principal investigator and other researchers (if any)?

(5) Environment:  Does the scientific environment in which the work will be 
done contribute to the probability of success?  Do the proposed experiments 
take advantage of unique features of the scientific environment or employ 
useful collaborative arrangements?  Is there evidence of institutional 
support?

In addition to the above criteria, in accordance with NIH policy, all 
applications will also be reviewed with respect to the following:

o  The adequacy of plans to include both genders, minorities and their 
subgroups, and children as appropriate for the scientific goals of the 
research.  Plans for the recruitment and retention of subjects will also be 
evaluated.

o  The reasonableness of the proposed budget and duration in relation to the 
proposed research.

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

(o  The adequacy of the proposed plan to share data, if appropriate.)

Schedule

Letter of Intent Receipt Date:    January 31, 2002
Application Receipt Date:         February 26, 2002
Peer Review Date:                 May/June 2002
Council Review:                   September 2002
Earliest Anticipated Start Date:  September 30, 2002

AWARD CRITERIA

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

o  scientific merit (as determined by peer review)
o  availability of funds
o  programmatic priorities.

INQUIRIES

Inquiries concerning this RFA are encouraged.  The opportunity to clarify any 
issues or answer questions from potential applicants is welcome.

Direct inquiries regarding programmatic issues to:

Nell Armstrong, PhD, RN
Office of Extramural Programs
National Institute of Nursing Research
Building 45, Room Number 3AN12, MSC 6300
Bethesda, MD  20892-6300
Telephone:  (301) 594-5973
FAX:  (301) 480-8260
Email:  nell_armstrong@nih.gov

The National Institute on Aging interests in caregiving involve older 
persons.  Direct inquiries regarding programmatic issues to:

Sidney M. Stahl, PhD
Chief, Behavioral Medicine
National Institute on Aging
7201 Wisconsin Ave., #533
Bethesda, MD  20892-9205
Telephone:  (301) 402-4156
FAX:  (301) 402-0051
Email:  Sidney_Stahl@nih.gov

Direct inquiries regarding review issues to:

John Richters, PhD
Office of Review
National Institute of Nursing Research
Building 45, Room Number 3AN12, MSC 6300
Bethesda, MD  20892-6300
Telephone:  (301) 594-5971
FAX:  (301) 480-8260
Email:  john_richters@nih.gov

Direct inquiries regarding fiscal matters to:

Cindy McDermott
Office of Grants and Contracts Management
National Institute of Nursing Research
Building 45, Room Number 3AN12, MSC 6300
Bethesda, MD  20892-6300
Telephone:  (301) 594-6869
FAX:  (301) 480-8260
Email:  cindy_mcdermott@nih.gov

Grace Poe
Grants and Contracts Management Office
National Institute on Aging
7201 Wisconsin Ave., #212
Bethesda, MD  20892-9205
Phone:  (301) 496-1472
FAX:  (301) 402-3672
Email:  Poeg@mail.nih.gov
 
AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance No. 
93.361 (NINR) and 93.866 (NIA).  Awards are made under authorization of 
Sections 301 and 405 of the Public Health Service Act as amended (42 USC 241 
and 284) and administered under NIH grants policies and Federal Regulations 
42 CFR 52 and 45 CFR Parts 74 and 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 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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