DISSEMINATION RESEARCH IN MENTAL HEALTH

Release Date:  March 5, 1999

PA NUMBER:  PA-99-068

P.T.

National Institute of Mental Health

THIS PA USES "MODULAR GRANT" AND "JUST-IN-TIME" CONCEPTS.  THIS PA INCLUDES
DETAILED MODIFICATIONS TO STANDARD APPLICATION INSTRUCTIONS THAT MUST BE USED
WHEN PREPARING AN APPLICATION IN RESPONSE TO THIS PA.

PURPOSE

National Institute of Mental Health (NIMH) invites applications for studies
addressing factors influencing the dissemination of mental health research
knowledge across mental health service settings.  The purpose of this
announcement is to stimulate research on the array of influences, and their
interaction, that beneficially or adversely affect the adoption of valid
mental health research findings into clinical practice, and to promote the
development of a sound knowledge base on the effectiveness of knowledge
dissemination interventions.

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 Program Announcement (PA),
Dissemination Research in Mental Health, is related to the priority area of
Mental Health and Mental Disorders.  Potential applicants may obtain a copy of
"Healthy People 2000" at http://www.crisny.org/health/us/health7.html

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.  Foreign institutions are not eligible for
Small (R03) awards. Racial/ethnic minority individuals, women, and persons
with disabilities are encouraged to apply as Principal Investigators.

MECHANISM OF SUPPORT

This program announcement will use the National Institutes of Health (NIH)
individual research project grant (R01) and small grant (R03) mechanisms. The
small grant (R03) mechanism is limited to $50,000 per year for no more than
two years.  Small Grants (R03) are not renewable.  Applicants considering the
R03 mechanism are strongly encouraged to consult with program staff listed
under INQUIRIES and to obtain the appropriate program announcement for that
grant mechanism.  Further information on the NIMH R03 mechanism is available
at: http://www.nih.gov/grants/guide/pa-files/PAR-97-015.html

Specific application instructions have been modified to reflect the "MODULAR
GRANT APPLICATION AND AWARD" process which has been adopted by the NIH (see
the NIH Guide, December 15, 1998).

For this PA, funds must be requested in $25,000 direct cost modules. A feature
of the modular grant is that no escalation is provided for future years, and
all anticipated expenses for all years of the project must be included within
the number of modules being requested.  Only limited budget information is
required and any budget adjustments made by the Initial Review Group will be
in modules of $25,000.

More detailed information about modular grant applications, including a sample
budget narrative justification pages and a sample biographical sketch, is
available via the Internet at url: 
http://www.nih.gov/grants/funding/modular/modular.htm

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 PA may not exceed five years.

RESEARCH OBJECTIVES

Mental health research has increasingly yielded substantial knowledge on the
diagnosis, treatment, and course of mental illness.  Ensuring the timely
transfer and utilization of this research knowledge, as part of the effort to
improve the quality of mental health care, has long been an issue of concern. 
At best, the dissemination of research knowledge has been uneven in its
implementation and variable in its consequences.  Common approaches to
delivering research knowledge such as publication in professional journals,
continuing education programs, and the establishment of clinical guidelines
have had limited and often unpredictable utility in influencing clinical
practice.

Gaps in implementing valid research-based strategies and interventions have
hindered the effective delivery of mental health services.  It is recognized
that the effective implementation of research findings requires substantially
more than the mere distribution or dissemination of information.  There is a
need for research on strategies for moving evidence-based knowledge into
broader use in clinical care, and for examining the factors which, adversely
or beneficially, influence the adoption of current knowledge into clinical
practice and policy.

This program announcement addresses the dissemination of evidence-based
knowledge from two perspectives.  Primarily, it is designed to promote
research that moves beyond the effectiveness of clinical trials to determine
the impact of dissemination methods on improving clinical practice.  Outcomes
of interest focus on which dissemination methods most effectively promote the
use of data from effectiveness trials in clinical practice.  Additionally,
however, the program announcement also encourages investigations on the
relative effectiveness of alternative dissemination interventions for
promoting programs of mental health education.

In order to encompass the broad range of factors that promote the adoption of
research-based change in clinical practice and policy in a variety of
settings, studies to be encouraged range from psychological and social factors
influencing decision-making by practitioners and consumers, to investigations
targeting large-scale service delivery systems and funding sources.  Emphasis
is placed upon the testing of interventions and strategies that will change
practice and policy.

Specifically, this program announcement is designed to: (1) stimulate research
on the factors that beneficially or adversely affect the adoption of evidence-
based mental health treatments into clinical practice and mental health
service systems; (2) identify the factors that influence the delivery of
mental health treatments and that contribute to their adherence by consumers
and providers; (3) test alternative approaches to dissemination of effective
interventions; and (4) promote the development of a sound knowledge base on
the effectiveness and applicability of knowledge dissemination interventions.

Areas of support include, but are not limited to:

o  Analysis of strategies and factors influencing the adoption and utilization
of valid mental health research knowledge, ranging from the psychological and
social factors affecting individual practitioners and groups to investigations
addressing large service delivery systems and funding sources.

o  Experimental studies to test individual and systemic dissemination
strategies

o  Studies of efforts to implement treatments or clinical procedures of
demonstrated efficacy in existing care systems to measure the extent to which
such procedures are utilized, and adhered to, by providers and consumers

o  Development of outcome measures for dissemination approaches

o  Longitudinal and follow-up studies on the factors which contribute to
maintaining research-based improvements in clinical practice.

o  Studies testing the utility of alternative dissemination strategies for
service delivery systems targeting rural, minority, and/or other underserved
populations.

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 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
"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 14508-14513) and in the NIH Guide for Grants and Contracts, Vol. 23,
No. 11, March 18, 1994 available on the web at the following URL address: 
https://grants.nih.gov/grants/guide/notice-files/not94-100.html

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://www.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.

APPLICATION PROCEDURES

Applicants are strongly encouraged to contact the program contacts listed
under INQUIRIES with any questions regarding their proposed project.

Applications are to be submitted on the grant application form PHS 398 (rev.
4/98) and will be accepted at the standard application deadlines as indicated
in the application kit.  Application kits are available at most institutional
offices of sponsored research and from the Division of Extramural Outreach and
Information Resources, National Institutes of Health, 6701 Rockledge Drive,
MSC 7910, Bethesda, MD 20892-7910, telephone (301) 710-0267, Email:
GrantsInfo@nih.gov.  Applications are also available on the World Wide Web at:
http://www.nih.gov/grants/forms.htm.

BUDGET INSTRUCTIONS

o  FACE PAGE:  Items 7a and 7b should be completed, indicating Direct Costs
(in $25,000 increments) and Total Costs [Modular Total Direct plus Facilities
and Administrative (F&A) costs] for the initial budget period.  Items 8a and
8b should be completed indicating the Direct and Total Costs for the entire
proposed period of support.

o  DETAILED BUDGET FOR THE INITIAL BUDGET PERIOD - Do not complete Form Page 4
of the PHS 398.  It is not required and will not be accepted with the
application.

o  BUDGET FOR THE ENTIRE PROPOSED PERIOD OF SUPPORT - Do not complete the
categorical budget table on Form Page 5 of the PHS 398.  It is not required
and will not be accepted with the application.

o  NARRATIVE BUDGET JUSTIFICATION - Use a Modular Grant Budget Narrative page.
(See http://www.nih.gov/grants/funding/modular/modular.htm for sample pages.) 
At the top of the page, enter the total direct costs requested for each year.

o  Under Personnel, list key project personnel, including their names, percent 
of effort, and roles on the project. No individual salary information should
be provided.

For Consortium/Contractual costs, provide an estimate of total costs (direct
plus facilities and administrative) for each year, each rounded to the nearest
$1,000. List the individuals/organizations with whom consortium or contractual
arrangements have been made, the percent effort of key personnel, and the role
on the project.  The total cost for a consortium/contractual arrangement is
included in the overall requested modular direct cost amount.

Provide an additional narrative budget justification for any variation in the
number of modules requested.

o  BIOGRAPHICAL SKETCH - The Biographical Sketch provides information used by
reviewers in the assessment of each individual's qualifications for a specific
role in the proposed project, as well as to evaluate the overall
qualifications of the research team.  A biographical sketch is required for
all key personnel, following the instructions below.  No more than three pages
may be used for each person.  A sample biographical sketch may be viewed at:
http://www.nih.gov/grants/funding/modular/modular.htm

- Complete the educational block at the top of the form page;
- List current position(s) and then previous positions;
- List selected peer-reviewed publications, with full citations;
- Provide information, including overall goals and responsibilities, on
research projects ongoing or completed during the last three years.

o  OTHER SUPPORT - Form Page 7.  This form must be completed for applications
in response to this PA to allow awards to be negotiated and made on or before
September 30, 1999.

o  CHECKLIST - This page should be completed and submitted with the
application.  If the F&A rate agreement has been established, indicate the
type of agreement and the date. It is important to identify all exclusions
that were used in the calculation of the F&A costs for the initial budget
period and all future budget years.

The applicant should provide the name and phone number of the individual to
contact concerning fiscal and administrative issues if additional information
is necessary following the initial review.

Applications not conforming to these guidelines will be considered
unresponsive to this PA and will be returned without further review.

Applicants planning to submit an investigator-initiated new (type 1),
competing continuation (type 2), competing supplement, or any amended/revised
version of the preceding grant application types requesting $500,000 or more
in direct costs for any year are advised that he or she must contact Institute
program staff before submitting the application, i.e., as plans for the study
are being developed.  Furthermore, the applicant must identify, in a cover
letter sent with the application, both the staff member and the Institute
which have agreed to accept assignment of the application.

This policy requires an applicant to obtain agreement for acceptance of both
any such application and any subsequent amendment.  Refer to the NIH Guide for
Grants and Contracts, March 20, 1998, located at:
http://www.nih.gov/grants/guide/notice-files/not98-030.html


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

Submit a signed, typewritten original of the application, including the
Checklist, and five 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 (express/courier service)

REVIEW CONSIDERATIONS

Applications will be assigned on the basis of established PHS referral
guidelines.  Applications that are complete will be evaluated for scientific
and technical merit by an appropriate peer review group convened in accordance
with the standard NIH peer review procedures.  As part of the initial merit
review, all applications will receive a written critique and may undergo a
process in which only those applications deemed to have the highest scientific
merit, generally the top half of applications under review, will be discussed,
assigned a priority score, and receive a second level review by the
appropriate national advisory council or board, when applicable.

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?

The initial review group will also examine: the appropriateness of proposed
project budget and duration; the adequacy of plans to include both genders,
minorities and their subgroups, and children as appropriate for the scientific
goals of the research and plans for the recruitment and retention of subjects;
the provisions for the protection of human and animal subjects; and the safety
of the research environment.

AWARD CRITERIA

Applications will compete for available funds with all other approved
applications assigned to NIMH.  The following will be considered in making
funding decisions:  Quality of the proposed project as determined by peer
review, availability of funds, and program priority.

INQUIRIES

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

Direct inquiries regarding programmatic issues to:

Harold Goldstein, Ph.D.
Division of Services and Intervention Research
National Institute of Mental Health
6001 Executive Boulevard, Room 7146 MSC 9631
Bethesda, MD  20892-9631
Telephone:  (301) 443-3747
FAX:  (301) 443-4045
Email:  goharold@nih.gov

Direct inquiries regarding fiscal matters to:

Diana S. Trunnell
Grants Management Branch
National Institute of Mental Health
6001 Executive Boulevard, Room 6115 MSC 9605
Bethesda, MD  20892-9605
Telephone: (301) 443-2805
FAX:  (301) 443-6885
Email:  Diana_Trunnell@nih.gov

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance No.
93.242.  Awards are made under authorization of the Public Health Service Act,
Title IV, Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC
241 and 285) and administered under PHS grants policies and Federal
Regulations 42 CFR 52 and 45 CFR Part 74.  This program is not subject to the
intergovernmental review requirements of Executive Order 12372 or Health
Systems Agency review.  Awards will be administered under PHS grants policy as
stated in the NIH Grants Policy Statement (October 1, 1998).

PHS strongly encourages all grant and contract recipients to provide a smoke-
free workplace and promote the nonuse 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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