MENTAL HEALTH AND HIV/STD PREVENTION IN RURAL SETTINGS NIH Guide, Volume 26, Number 38, November 21, 1997 RFA: MH-98-004 P.T. National Institute of Mental Health Letter of Intent Receipt Date: December 22, 1997 Application Receipt Date: January 21, 1998 PURPOSE The National Institute of Mental Health (NIMH) is requesting research applications to increase the knowledge base on the HIV and STD risk factors of persons living in rural areas and test viable HIV/STD prevention programs in rural/tribal settings. The term "rural" refers to non-urban settings with populations of approximately 50,000 or less. This Request for Applications (RFA) solicits applications to conduct pre-intervention, preventive intervention, or health services research appropriate for rural areas. 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, Mental Health and HIV/STD Prevention in Rural Settings, is related to the priority areas of mental health and mental disorders and HIV infection. Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0 or Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (telephone 202-512-1800). 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 First Independent Research Support and Transition (FIRST)(R29) awards or Small Grant (R03) awards. 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), the FIRST (R29) award, and the Small Grant (R03) award. 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 years. The anticipated award date is July, 1998. Because the nature and scope of the research proposed in response to this RFA may vary, it is anticipated that the size of an award will vary also. 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. Because the small grants and FIRST awards have special eligibility requirements, application formats, and review criteria, applicants are strongly encouraged to consult with program staff (listed under Inquiries) and to obtain the appropriate additional announcements for those grant mechanisms. FUNDS AVAILABLE In fiscal year 1998, a minimum of $750,000 has been set aside for this RFA for a minimum of two to three awards. Support may be requested for a period of up to five years, except for the R03 mechanism which is limited to 2 years. Noncompeting continuation awards will be made subject to availability of funds and progress achieved. RESEARCH OBJECTIVES Background The urgency of the AIDS crisis demands that priority be given to research addressing preventive interventions that reduce the incidence of HIV/STD infection and minimize its negative consequences. The rapidly rising epidemic in rural America, that is, in cities of approximately 50,000 or fewer people has largely been ignored. However, between 1991 and 1995, in the rural South for example, HIV infection in African American women increased by 170 fold and in White women by 23 fold. Migrant and itinerant farm workers are other groups in which seroprevalence is disproportionately increasing. Yet little HIV-related information is available about the men and women who live in rural America and account for 25 percent of the population, and approximately 33 percent of persons who live in poverty. This increased risk for HIV is against a background of increasing stress for persons living in rural America resulting from fewer economic options due to farm foreclosures and failing businesses. Areas of Interest Proposed research should be field-based and practical, and should provide the potential to directly impact HIV/STD prevention programs in rural settings. The following sections suggest areas of research to meet the health promotion and disease prevention objectives outlined above. Researchers need not limit themselves to these topics. A. Pre-Intervention Studies of HIV/STD in Rural Populations In order to design and test effective prevention programs, it is necessary to understand the diverse nature of HIV/STD transmission within at-risk groups in rural settings: o Prevalence of HIV risk behaviors within at-risk populations living in rural settings, including African- Americans Latinos, rural reservation-based Native Americans, migrant workers, women, and teenagers; o Description of rural social network configurations and identification of points and sites for intervention, which may include church congregations, school groups, the Cooperative Extension Service, tribal, and civic groups; o Documentation of migration patterns of seropositive and at-risk rural and transient populations and their effects on the spread of HIV; o Study of knowledge, attitudes and behaviors (KABs) associated with the risk of contracting and spreading HIV and STDs; o Evaluation of perceptions of risk of HIV/STDs and its association with high risk behaviors; o Investigation into the barriers/opportunities for discussing issues related to sexual activity; o Analysis of the impediments to the utilization of HIV/STD testing and counseling; o Examination of the role of self-disclosure and confidentiality in high risk behaviors and health seeking behaviors; o Exploration of the negative mental health consequences of HIV infection in the context of the stress of rural or tribal living; o Study of the impact of lack of support networks in the spread of HIV/STD infection; o Identification of strategies to implement an HIV/STD prevention program given the social, cultural, and economic diversity of rural populations. B. Intervention Studies In designing or adapting HIV/STD interventions aimed at decreasing the spread of HIV/STD infection and minimizing mental and physical health outcomes of HIV/STD infection, investigations are needed to: o Test the effectiveness of outcome-based rural HIV/STD preventive intervention programs in the context of specific or diverse rural community characteristics; o Test strategies to enlist the support of community leaders in AIDS prevention and overcoming stigma; o Develop and test innovative community-wide interventions suitable for rural settings, and in the case of Indian Reservations sensitive to traditional Native American concepts of healing; o Develop and test effective media campaigns and ads. C. Mental and Physical Health Services Delivery In underserved rural areas, health and mental health patients face immense challenges in securing critical services in a confidential manner. Indeed, in some settings even services as basic as clean running water, mail service, and ambulance and fire department services are lacking. In order to address HIV/STD- related service delivery in rural settings, research efforts are needed to study the: o Availability and access to a range of services, service providers, and related local resources, and the effect of insufficient or lack of insurance coverage in precipitating inadequate health or mental health care; o Problems associated with large geographic distances between the patient's home and provider/service agencies, and effective ways to address such problems; o Experience of rural health and mental health care providers and tribal practitioners with HIV/AIDS patients; o Applicability of effective HIV/STD preventive intervention techniques developed in urban settings to rural settings. D. Methodological issues Methodological development may be necessary to collect meaningful data on populations living in rural settings and to analyze data collected from multiple sources. o Recruitment and retention strategies in rural populations that may be geographically scattered, particularly in sparsely populated states and on tribal reservations, and are sensitive to issues of confidentiality; o Measurement and evaluation strategies tailored to risk assessment and interventions in rural settings, e.g., methods for analyzing small samples, and appraisal of interviewer/client rapport; o Issues in generalizing findings from one rural setting to another or to International Third World settings given population diversities; o Development and testing of theories and models appropriate to HIV/STD prevention research with rural at-risk 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 new 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, 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 asked to submit, by December 22, 1997, 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 NIMH staff to estimate the potential review workload and avoid conflict of interest in the review. The letter of intent is to be sent to: Willo Pequegnat, Ph.D. Office on AIDS National Institute of Mental Health 5600 Fishers Lane, Room 18-101 Rockville, MD 20857 Telephone: (301) 443-6100 FAX: (301) 443-9719 Email: WPEQUEGN@NIH.GOV APPLICATION PROCEDURES The research grant application form PHS 398 (rev. 5/95) is to be used in applying for these grants. These forms are available at most institutional offices of sponsored research or from the Office of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910; telephone (301) 710-0267; fax (301) 480-0525; Email: ASKNIH@OD.NIH.GOV. The RFA label available in the PHS 398 (rev. 5/95) 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 addition, the RFA title and number,(Mental Health and HIV/STD Prevention in Rural Settings) (MH-98-004), must be typed in section 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 three signed, photocopies, in one package to: CENTER FOR SCIENTIFIC REVIEW (formerly Division of Research Grants) NATIONAL INSTITUTES OF HEALTH 6701 ROCKLEDGE DRIVE, ROOM 1040 - MSC 7710 BETHESDA, MD 20892-7710 BETHESDA, MD 20817 (for courier/overnight mail service) At the time of submission, two additional copies of the application must be sent to: Willo Pequegnat, Ph.D. Office on AIDS National Institute of Mental Health 5600 Fishers Lane, Room 18-101 Rockville, MD 20857 Applications must be received by January 21, 1998. If an application is received after that date, it will be returned to the applicant without review and can later be submitted under the regular AIDS receipt dates. 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 NIH Center for Scientific Review (CSR)and for responsiveness by NIMH staff. Incomplete and/or non- responsive applications will be returned to the applicant without further consideration. Applications that are complete and responsive to the Request for Applications will be evaluated for scientific and technical merit by an appropriate peer review group convened 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 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 their 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. o 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 the study of AIDS/STD prevention in rural settings? o Approach: Are the conceptual framework, design, methods, and analyses adequately developed, well-integrated, and appropriate to the target populations and aims of the project? Does the applicant acknowledge potential problem areas and consider alternative tactics? Does the conceptual and theoretical framework for the research include cultural relevance to the target population and evidence of familiarity with research literature? o Innovation: Does the project employ novel concepts, approaches or methods? Are the aims original and innovative? Does the project challenge existing paradigms or develop new methodologies or technologies? o 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)? Do the qualifications and experience of the principal investigator and staff reflect expertise in rural communities, prevention research, statistics, cultural competence, AIDS, STDs, and other areas specific to the questions under investigation? Does the investigator have access to target population(s) and a history of working with similar populations? o 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 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. AWARD CRITERIA The following criteria will be used in making funding decision: o scientific merit as determined during the peer review process and availability of funds: o balance among target populations with priority given to understudied populations; o balance among theoretical and multicultural approaches; and o balance among geographic areas. INQUIRIES Inquiries concerning this RFA are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome. Direct inquiries regarding programmatic issues to: Willo Pequegnat, Ph.D. Office on AIDS National Institute of Mental Health Parklawn Building, Room 18-101 Rockville, MD 20857 Telephone: (301) 443-6100 FAX: (301) 443-9719 Email: WPEQUEGN@NIH.GOV Direct inquiries regarding fiscal matters to: Diana S. Trunnell Grants Management Branch National Institute of Mental Health Parklawn Building, Room 7C-08 Rockville, MD 20857 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 Public Health Service Grants Policy Statement (April 1, 1994). 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.
Return to NIH Guide Main Index
Office of Extramural Research (OER) |
National Institutes of Health (NIH) 9000 Rockville Pike Bethesda, Maryland 20892 |
Department of Health and Human Services (HHS) |
||||||||
Note: For help accessing PDF, RTF, MS Word, Excel, PowerPoint, Audio or Video files, see Help Downloading Files. |