CENTERS FOR MIND/BODY INTERACTIONS AND HEALTH

Release Date:  January 22, 1999

RFA:  OD-99-005

P.T.

Office of Behavioral and Social Sciences Research
National Cancer Institute
National Heart, Lung, and Blood Institute
National Institute on Aging
National Institute on Alcohol Abuse and Alcoholism
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institute of Child Health and Human Development
National Institute of Dental and Craniofacial Research
National Institute on Drug Abuse
National Institute of General Medical Sciences
National Institute of Mental Health
National Institute of Neurological Disorders and Stroke
National Institute of Nursing Research

Letter of Intent Receipt Date:  March 1, 1999
Application Receipt Date:  April 23, 1999

PURPOSE

The Office of Behavioral and Social Sciences Research (OBSSR), National Cancer
Institute (NCI), National Heart, Lung, and Blood Institute (NHLBI), National
Institute on Aging (NIA), National Institute on Alcohol Abuse and Alcoholism
(NIAAA), National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS), National Institute of Child Health and Human Development (NICHD),
National Institute on Drug Abuse (NIDA), National Institute of Dental and
Craniofacial Research (NIDCR), National Institute of General Medical Sciences
(NIGMS), National Institute of Mental Health (NIMH), National Institute of
Neurological Disorders and Stroke (NINDS), and the National Institute of Nursing
Research (NINR) invite applications for Specialized Center Grants (P50) grants
in order to encourage behavioral, psychological, social, and biomedical research
on the interrelationships among cognition, emotion, biological processes, and
physical health.  The NIH sponsoring organizations are issuing this Request for
Applications (RFA) to foster interdisciplinary research on the interactions among
the mind and body in health and disease.  Applications in response to this RFA
are encouraged to propose research topics ranging from basic research to those
involving clinical applications.

HEALTHY PEOPLE 2000

Each NIH RFA addresses one or more of 22 Health Promotion and Disease Prevention
priority areas. These areas can be found via the WWW at
http://www.crisny.org/health/us/health7.html

ELIGIBILITY REQUIREMENTS

Applications may be submitted by domestic 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 organizations are not eligible.  However, foreign
organizations may participate if they are components of domestic, U.S.
organizations or via contractual or consortium agreements with domestic, U.S.
organizations.  Racial/ethnic minority individuals, women, and persons with
disabilities are encouraged to apply as principal investigators.  Questions about
eligibility may be addressed to the program contacts listed under INQUIRIES.

To be considered, applicant organizations must have a Principal Investigator (PI)
who is a recognized leader in the proposed field of research with a demonstrated
history of research funding and scientific productivity as well as demonstrated
experience in the administration of complex research projects such as multiple,
simultaneous research project grants (R01s), program project grants (P01), center
grants, or multi-site clinical investigations.  The PI should have demonstrated
ability to oversee and conduct planning activities, provide direction to the
Center, ensure an interdisciplinary research emphasis, and build a career
development program.

MECHANISM OF SUPPORT

This RFA will use the National Institutes of Health (NIH) specialized center
grant (P50) mechanism.  This mechanism supports the full range of research and
development from basic to clinical and intervention studies, as well as health
services, policy, and surveillance research.  These grants differ from
traditional program project grants in that they are more complex and flexible in
terms of the activities that can be supported.  In addition to support for
interdisciplinary research projects, support may be provided for career
development research activities, a limited number of pilot research projects, and
specialized resources and shared facilities aimed at supporting the range of
proposed research.  PIs will be responsible for the planning, direction, and
execution of the proposed program.  Awards will be administered under NIH grants
policy as stated in the most recent NIH Grants Policy Statement.

P50 awards provide support for a broad interdisciplinary research program
consisting of related research endeavors and associated core infrastructure to
ensure their effective and synergistic functioning. The activities included in
the supported research must be thematically integrated, interdisciplinary, and
synergistic. Research supported through this mechanism must reflect in clear ways
interdependence of components of the research program that would not occur simply
from the mere collection of the individual components. Taken as a whole, a center
is expected to enable a level of achievement that exceeds that expected on the
basis of the "sum of its parts." Further, each center is encouraged to address
the range of research, from basic to clinical applications, around the central
theme of the center. Center support should be essential to the achievement of the
work that is proposed. They are expected to attract established and promising
investigators into Mind/Body Research and to provide opportunities for research
experience, career development, and mentoring.

FUNDS AVAILABLE

The estimated funds available for the first year of support for a maximum of five
centers awarded under this RFA are $10,000,000.  Applicants may request up to
$2,000,000 in annual total costs (direct and indirect costs combined). Annual
increases are limited to three percent. The total project period for an
application may not exceed five years. The anticipated award date for all
applications is September 30, 1999.

Funding in response to this RFA is dependent upon the receipt of a sufficient
number of applications of high scientific merit and upon the anticipated
availability of funds for this purpose. Depending on NIH priorities and budget
at the end of the five-year award period, a RFA may be issued to continue the
Centers Program. If the RFA is not reissued, then grantees will have to compete
for support through other research grant mechanisms (e.g., R01, P01).

RESEARCH OBJECTIVES

(1) Background

The Public Health Service has documented that many of the leading causes of
morbidity and mortality in the U.S. are attributable to social, behavioral, and
lifestyle factors (e.g., tobacco use, lack of exercise, poor diet, and alcohol
abuse). Numerous studies have also documented that psychological stress is linked
to a variety of health outcomes, and researchers and public health officials are
becoming increasingly interested in understanding the nature of this
relationship. Research has shown, for example, that psychological stress can
contribute to increased heart disease and decreased immune system functioning.
Other research has demonstrated that cognition (attitudes, beliefs values),
social support, prayer, and meditation can reduce psychological stress and
contribute to positive health outcomes. Consequently, over the past decade the
National Institutes of Health have increased efforts to encourage and support
Health and Behavior Research (e.g., RFA on Innovative Approaches to Disease
Prevention Through Behavior Change, NIH Guide to Grants and Contracts, Volume 26,
Number 36, October 24, 1997).  Mind/Body Research is viewed as one component of
Health and Behavior Research. The purpose of this RFA is to build upon and expand
the scientific foundation in this area in order ultimately to develop and
implement effective interventions to improve health and functioning.

For the purposes of this RFA, Mind/Body Research encompasses behavioral, social,
and biomedical research on the interrelationships among stress, cognition,
emotion, biological processes, and physical health. Research activities supported
under this RFA should go beyond merely documenting the relationship between
stress and illness; it should elucidate the mind/body pathways or processes
linking them.

(2) Areas of Emphasis

Three areas of research are emphasized. In addition, special importance is given
to Mind/Body Research in diverse racial/ethnic and socioeconomic status
populations (e.g., cultural beliefs regarding health; perceived racism and
health; distrust of health care systems and health care utilization). The
formation of multidisciplinary teams to perform the research of this initiative
is viewed as essential.

o  The first area of emphasis is the effects of beliefs, attitudes, and values
on physical health, including research on social, psychological, behavioral,
affective, and biological factors mediating these effects.

o  The second emphasis is on determinants or antecedents of health-related
beliefs, attitudes, or values. That is, given that some beliefs and attitudes
have been shown to affect health, how are these beliefs, attitudes, and values
developed, maintained, or changed?

Specifically, this RFA will support research addressing issues such as: What are
the physiological, behavioral, or social pathways by which beliefs, attitudes,
and values or particular stress-management interventions affect health? What are
the physiological and/or behavioral underpinnings of placebo effects? What
contributes to individual differences in the beliefs, attitudes, and values that
affect health and biological processes? How are health-related beliefs,
attitudes, and values formed, maintained, and changed? What are the factors that
lead to individual differences in how stress is experienced and in the health
consequences of stress? How do social class, family, culture, disability, age,
gender, or ethnicity influence health-related beliefs, attitudes, and values?

o  The third is on how stress influences physical health, including: (a) basic
research investigating how attitudes, beliefs, and values influence perceived
stress, individual differences in the biology of stress, and interactions between
stress and behavioral risk factors for disease; (b) behavioral and biological
mediators of the relationship between stress and health or disease, and (c) the
evaluation of relaxation response-based interventions or other stress management
interventions for physical illness and/or biological functioning.  Relaxation
response-based interventions are those that result in reduced physiological
arousal.  They include such stress management approaches as meditation, autogenic
relaxation, progressive muscle relaxation, breathing exercises, or the focused
repetition of a word, sound, prayer, or phrase.  These interventions may be
examined alone or in conjunction with other stress management techniques such as
cognitive therapy and support groups. Research proposals examining aspects of
successful stress-management interventions, including relaxation response-based
interventions or the interaction of these interventions with other stress
management approaches, are also invited.

Issues such as the following would be appropriate here: Through which
psychological or physiological pathways do relaxation response-based
interventions or other stress management approaches affect health? What are the
effective components in successful stress-management practices? Does the
combination of relaxation response-based approaches with other stress management
techniques improve outcome? Are particular stress-management interventions more
effective for certain individuals, populations, or health outcomes? Can
successful stress-management practices be effectively implemented in natural
settings? What are the possible economic implications of utilizing stress
management interventions?

Twelve NIH Institutes have joined with OBSSR to support this initiative. Examples
of topics of interest to specific Institutes are:

The NATIONAL CANCER INSTITUTE is particularly interested in stimulating research
with cancer patients and survivors that examines interactions among psychological
factors, immune, neuroendocrine, genetic, and other potential biological
mediators, and disease related outcomes.  These outcomes might include disease
free survival, number, type and severity of disease recurrence, incident co-
morbidities diagnosed during treatment and/or follow-up and health related
quality of life.  Special emphasis is placed on research that examines mind/body
mechanisms through the development of novel methods and integrative conceptual
models.  In addition, the impact of psychological and behavioral interventions
on outcomes such as adaptation or adherence to treatment regimens, post-treatment
follow-up recommendations, and screening behaviors relevant to secondary and
tertiary prevention in cancer survivors is of interest.

The NATIONAL HEART, LUNG, AND BLOOD INSTITUTE is interested in the study of
relationships between mental states and any of the diseases or conditions under
its mandate. Included is research on the role of stress in coronary heart disease
and hypertension, the experience of pain due to a disease or condition, causes
or precipitants of asthma, and sleep disorders. Applications should describe an
integrated, interdisciplinary research program that includes the following: a)
basic research to identify the biological mechanisms that underlie associations
between mental states (such as stress) and disease, conducted in animal models
or humans; b) clinical research to investigate the role of stress or related
mental attributes on conditions such as atherosclerosis, asthma, or acute cardiac
events; and, c) testing of clinically beneficial interventions such as stress
management techniques, cognitive behavior therapy, or other approaches to improve
adherence to therapy, effectiveness of medical treatment, or prevention of
disease in the general population or in targeted groups.  Applicants are
encouraged to consider research approaches that develop or apply promising new
technologies, such as ambulatory techniques for real-time assessment of
behavioral and psychological states, event-related functional magnetic resonance
imaging (fMRI), or genetic technologies that may improve understanding of
relationships between mental states and disease. Other research that may be of
interest to this solicitation is described in the Report of the NHLBI Task Force
on Behavioral Research in Cardiovascular, Lung, and Blood Health and Disease,
available at http://www.nhlbi.nih.gov/nhlbi/sciinf/taskforc.htm

The NATIONAL INSTITUTE ON AGING solicits research on how aging-related processes
influence Mind/Body interactions. NIA is interested in integrative studies that
consider the impact of beliefs and experiences across multiple systems and
pathways (e.g., influences on cardiovascular, neuroendocrine, or immunological
systems) of relevance to the health of older people. In addition to single
disease or organ approaches, NIA focuses on mind/body interactions that influence
overall psychosocial and physiological functioning in later life as well as the
onset and course of an array of age-related illnesses and conditions including
arthritis, cancer, cardiovascular and cerebral functioning, dementia, diabetes,
hypertension, stroke, etc. Examples of particular topics of interest include: how
individual factors, the social context (e.g., sociodemographic factors, social
institutions, social density, crime rates, responsiveness to changing physical
challenges) influence and maintain health-related attitudes and behaviors in old
age; the psychosocial and physiological pathways (e.g., molecular, cellular, and
integrative neural systems) linking beliefs and value systems with health and
functional outcomes for older people as they age; and the design, testing and
comparison of stress-management interventions for improving the health and
functioning of older people.  Special emphasis is placed on the most socially
(e.g, low SES or minority status) and/or clinically vulnerable older population
where the links among stress, biological processes, and health may be especially
potent, and where beliefs can play a major role in the definition of and reaction
to stressors. A cohort and life-course perspective is important in understanding
factors that influence the development and modification of specific health
beliefs and attitudes (e.g., impact of stressful life transitions such as
widowhood, retirement, or geographic relocation). Also important is an
understanding of how old age affects the design and evaluation of proposed
interventions.

The NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM encourages applications
addressing spirituality as a mediator for Twelve Step Facilitation and
effectiveness in treatment for alcohol-related problems; effects of attitudes,
beliefs, and expectancies on responses to acute administration of alcohol,
initiation of alcohol- seeking behavior, development of addictive behavior,
inability to stop drinking, treatment efficacy and effectiveness; ability of
relaxation training and increased self-efficacy to enhance effectiveness of
cognitive behavioral therapy for alcohol-related problems; and behavioral and
social techniques for increasing compliance with alcohol treatment and prevention
efforts.

The NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES is
particularly interested in the use of cognitive behavior therapy for pain
management in rheumatic diseases such as fibromyalgia and in low back pain, the
adaptation of self-efficacy programs in management of chronic diseases such as
arthritis and osteoarthritis to minority populations, and the association between
potentially modifiable psychosocial factors and disease activity and health
status in immunological disorders such as lupus.

The NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT is particularly
interested in interdisciplinary research projects examining the role of health-
related beliefs or attitudes on achieving and maintaining health and well-being
of children and youth with physical, learning or developmental disabilities.
These studies could include, but are not limited to, studies on the antecedents
and consequences of health-related beliefs or attitudes, studies on gender and
stress response in persons with disabilities, or interventions that promote
specific outcomes in particular populations of children.

The NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH is particularly
interested in supporting research that exploits the accessibility of the oral
cavity in studying mechanisms underlying mind/body interrelationships. For
example, the use of saliva or other oral tissues as diagnostic for stress and
stress-related physiological states would be of interest. In addition, disease
processes occurring in the oral cavity are related to and/or influenced by
disease in other, more remote, parts of the body (e.g., cardiovascular,
respiratory diseases, diabetes). Mental states (e.g., depression, stress) may
influence both oral cavity and other diseases as well as be the intervening
condition connecting them. The utilization of common dental interventions (e.g.,
tooth extractions, gum surgery) or common infectious or chronic oral/craniofacial
diseases and conditions (periodontal diseases, TMJ/masticatory muscle disorders,
salivary disorders) could potentially provide powerful and practical models for
testing the mechanisms underlying mind/body associations and evaluating the
biological outcomes of stress-management interventions. Of particular relevance
is research on the relationships between beliefs, attitudes, and/or values and
(a) the speed of oral mucosal wound healing following oral surgeries (third molar
extraction, periodontal surgery), (b) oral mucosal barriers to infection (i.e.,
immunological defense), (c) responses to pain in the oral and craniofacial
structures, and (d) inadequate or excessive utilization of health care services.
Also of interest is research on the biological mechanisms underlying associations
between beliefs/attitudes and oral mucosal wound healing, on the mechanisms
through which attitudes and behaviors influence risks for developing persisting
or chronic craniofacial pain or pain-related disability, and on the effectiveness
of stress-management interventions in improving outcomes for persisting
craniofacial pain conditions or inherited or chronic disorders (e.g., inherited
craniofacial deformities, Sjogren's Syndrome).

The NATIONAL INSTITUTE ON DRUG ABUSE notes that some case studies suggest that
hypnosis, relaxation and guided imagery may be effective in treating drug
addiction or, in the case of pain patients, may allow for dose reductions of
opiates for analgesia.  Further controlled research is invited in this area. Also
of interest is the use of placebos studied as a possible adjunct to more
traditional therapy, both pharmacological and behavioral. In addition, research
that seeks to understanding the underlying neuropsychological mechanisms of
placebo in treating drug abuse and relapse is of particular interest. In
addition, applications that examine stress as independent and dependent
variables, and as a modulating variable in the study of addiction, are sought. 
For example, proposals that seek to show how stress can lead to drug use and
relapse to drug use; the conditions under which drugs are abused to alleviate
stress; and whether potential drug abusers are more sensitive to stress are
invited. Behavioral, neurobiological/neuroendocrine, and genetic studies will be
important in this area, including animal models research. In addition, studies
of stress reduction as treatment for drug addiction are sought. Also of interest
are studies of how beliefs, attitudes, and expectations about the effects of
drugs can induce vulnerability or resilience to using drugs, and how such beliefs
can alter the course of addiction treatment. Drug beliefs examined may be either
positive (e.g., euphoria, social effects, withdrawal relief, pain control, weight
control, antianxiety, attaining spiritual states) or negative (e.g., overdose bad
effects, nausea, loss of control, paranoia, aggression), or both. Approaches can
include, for example, laboratory studies, linguistic and metaphor analysis, life
span studies (e.,g., how these beliefs change with life roles and age), how such
beliefs and attitudes change with initiation into drug use and dependence, or
during abstinence.  Cultural, gender and ethnic differences, as well as the
interactive effects of co-morbid states such as AIDS dementia and other mental
disorders also are important to examine in this context. Studies of self-esteem,
self-worth and self-efficacy, including research into attributions of
responsibility for drug addiction and dependence, or attributions about treatment
outcomes are relevant.

The NATIONAL INSTITUTE OF GENERAL MEDICAL SCIENCES is interested in research
proposals that address mind/body interactions related to the host's response to
and recovery from injury or critical illness, including blunt or penetrating
trauma, burn injury, shock, sepsis, surgical procedures, and multiple organ
failure. Specific areas of interest include injury or critical illness-induced
alterations in localized microcirculation, the inflammatory and immune responses,
metabolism and nutritional requirements, and the complex dynamic interactions
between tissues or organ systems.  NIGMS is also interested in the processes of
tissue repair and wound healing following injury. Proposals should focus upon
mechanisms at the molecular, cellular, organ, or integrated systemic
physiological levels through which mind/body interactions exert any effects.

The NATIONAL INSTITUTE OF MENTAL HEALTH is primarily interested in research that
examines fundamental social, psychological, and neurobiological mechanisms
involved in health-related beliefs and behaviors, interventions, and
physiological states or processes related to health and disease. Priority is
placed on understanding processes that promote health or "wellness" and on
investigating mechanisms that are fundamental to a range of disorders, although
particular studies may examine these mechanisms in relation to specific disorders
or risk factors. Illustrative topics include: Effects of personality variation
(e.g., self-efficacy, self-monitoring ability, optimism, neuroticism) on
perceptions of risk, symptom reporting, health-related behavior, help-seeking,
and adherence to treatment; effects of social relationships and
cultural/religious beliefs on health-related attitudes and behaviors; social-
psychophysiological mechanisms underlying the effects on health of emotional
expression and/or emotion regulation; social, psychological, and neurobiological
factors underlying stress responsivity, relaxation, and placebo effects; the
social-psychophysiological pathways accounting for effects of socioeconomic
status and of social support on health; mechanisms accounting for the influence
of mental disorder (e.g., depression) on the incidence or progression of physical
disease; and the central, neuroendocrine, autonomic and somatic changes resulting
from preventive or therapeutic interventions such as stress-management,
meditation, cognitive therapy, and support groups, including the relations of
these changes to health outcomes in physical and/or mental disorders.
Experimental approaches should encompass the range of cutting-edge methods in
social and behavioral science as well as neuroscience (e.g., neuroimaging).

The NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE seeks research on the
interrelationships between psychological state, e.g., motivation, attitude, mood
and emotion on neurological disorders, with particular emphasis on the following
four topics. (1) Pain: Even though their basic physiology may be similar, people
react in very different ways to pain, perhaps due to stress, psychological state,
gender, and cultural background. Thus, the pain experience needs to be examined
with the goal of developing biobehavioral interventions (Mind/Body/Brain) to
manage or prevent pain. Research is especially needed that will integrate
psychological, neurochemical, and molecular approaches to the treatment of pain
and that will explore basic neurobiological mechanisms of the conscious
perception of pain and the affective responses to pain. (2)
Psychoneuroimmunology: Research is encouraged on psycho-neuro-immune
interactions, in order to characterize effects of psychological states such as
stress and coping, sleep, intellectual activity, and meditation on neural and
immune functions. (3) Motivation and Attitude in Movement Disorders: The extent
of disability in some movement disorder patients is influenced by their
motivational state. Research is encouraged on the parameters of such functional
effects and on the mechanisms underlying them. (4) Emotion and Mood in
Neurological Disorders: Research is needed on emotional changes that follow acute
neurological insults such as stroke or trauma as well as those that accompany
chronic neurodegenerative conditions and permanent or semi-permanent neural
disability such as spinal cord paralysis and on the brain mechanisms underlying
the interaction of mood and treatment efficacy.

(3) Types of Research

Applications must address two or more Areas of Emphasis discussed under PURPOSE
and BACKGROUND. Similarly, applications should be responsive to one or more of
the topics suggested by the Institutes as described in the BACKGROUND section. 
Applications relevant to the interests of more than one Institute are encouraged,
but not required. That is, while applications may be solely relevant to the
interests of a single IC, cross-cutting applications are also acceptable and
encouraged.

The principal aim in this research initiative is to expand the science base in
the Mind/Body field. As such, the initiative hopes to stimulate and support basic
research in order to more fully understand Mind/Body relationships. In addition,
assessments of the effectiveness of Mind/Body interventions, including processes
underlying effectiveness, are encouraged. While this research initiative is not
principally concerned with the dissemination and implementation of Mind/Body
research findings, it encourages translational research that explores the best
methods and cost/benefits for disseminating successful practices to individuals
and health care practitioners. The state of knowledge in a given research area
will determine whether implementation and dissemination components are
appropriate.

Mind/Body Research is inherently interdisciplinary, and Mind/Body Centers should
serve to facilitate and stimulate interdisciplinary projects. In that spirit, a
variety of quantitative, qualitative, experimental, interview, and observational
research methods are appropriate. Research projects or resources involving animal
models or drugs may be included if they assist in explicating the relationship
between cognition and health and if they do not dominate the research projects.
For example, animal models or drugs may be appropriate for investigating a
mediating step between mental factors and health.  A related issue concerns
research on the bidirectional relationships between "mind" and "body." These
relationships most likely involve complex feedback loops among mental states and
processes (e.g., cognition, affect), and physiological processes, which need to
be taken into account.  While research on the influence of biological processes
on cognition and affect are appropriate subjects for this RFA, they should not
be the sole or the predominant subject matter. The overall, dominant thrust of
the center and its research should be on the influence of cognition (e.g.,
attitudes, beliefs, values) and affect on health and functioning.

SPECIAL REQUIREMENTS

(a) GENERAL

The Specialized Center Grant for this RFA minimally consists of (1) an
Administrative and Planning Core, which will provide coordination, research
planning, logistical, and technical support and (2) a Research Component
providing for the implementation of R01-like research projects. Optionally, the
Center Grant may include (3) one or more Resource Cores (e.g., clinical
populations, epidemiologic or survey research samples; statistical and
methodological assistance, animal colonies) and/or (4) a Pilot Research Component
providing for the implementation of pilot, feasibility, or preliminary research
projects.

A Mind/Body Center should be an identifiable organizational unit formed by a
single institution or a consortium of cooperating institutions. Such a center
will involve the interaction of broad and diverse organizations or units.
Therefore, lines of authority by the appropriate institutional officials must be
clearly specified.

Interactions among the Mind/Body Research Centers are an important part of this
initiative.  This may be in the form of research collaborations, exchange of
scientists on a visiting basis, exchange of resources and materials, and other
innovative mechanisms.  A requirement for all Mind/Body Research Center Principal
Investigators and selected project investigators is participation in one meeting
per year in the Washington, DC metropolitan area or other mutually convenient
location. Funds should be included in the proposed budgets to support attendance
at this annual meeting. The purpose of the meeting is to share scientific
information, assess scientific progress, solve problems, identify new research
opportunities, and establish priorities that will accelerate the translation of
basic research findings to applied settings in patients and populations.

(b) CAREER DEVELOPMENT (REQUIRED)

The Mind/Body Centers should demonstrate a strong commitment to career
development, with a plan included as part of the application. This may include
new investigators or established investigators who wish to change research
directions. Recruitment must include qualified women and minorities. To this end,
each applicant should propose a clear policy and plan for recruitment of career
development candidates. The application should state the number of career
development positions proposed, the criteria for eligibility and for selection
of candidates, and describe the selection process.  The candidates may be
advanced graduate students, post-doctoral researchers, or junior faculty. Also,
the application should indicate potential mentors who are already in place at the
proposed Center, briefly describe their research programs, and describe
complementary activities that contribute to the interdisciplinary environment for
career development (e.g., existing training grants, other career development
mechanisms and relevant programs). Mentoring to enhance junior researchers' or
other researchers' skills should be conducted in the context of the research, but
funds may not be used for training stipends or training not required to conduct
the research. Researchers receiving mentoring may be paid a salary so long as it
is received in conjunction with conducting the research.

(c) CORES

(1) ADMINISTRATIVE AND PLANNING CORE (REQUIRED)
This core manages the overall activities of the center and should include a
specified director and a discrete administrative structure. Each applicant
institution should name a CENTER DIRECTOR who will be the key figure in the
scientific administration and management of the Center Grant. The Director should
be an experienced researcher with demonstrated leadership appropriate to the
coordination of the center.  A minimum of 25% (minimum 10% administrative and
minimum 15% research) effort on activities directly supported by the center's
funding is required of the Director. The Director is encouraged, but not
required, to serve as a Project Director of one of the required Research Projects
(see below).

The center's Administrative and Planning Core should accomplish the following:

o Coordinate and integrate the center's activities.

o Plan and review the utilization of funds, including funds for research studies.

o Advise the Center Director on the activities of the center.

While the final administrative structure of the center will be left up to the
discretion of the applicant institution, experience demonstrates that effective
development of center programs requires interaction among the Director, the
principal investigators of the associated research studies, appropriate
institutional administrative personnel, and the staff of the NIH. Like other
interdisciplinary grant programs, the success of the center depends on the
involvement of scientific and professional personnel representing a variety of
disciplines who must be willing to collaborate and cooperate with each other in
order to facilitate the development of new knowledge. Moreover, it is important
that a person with institutional management expertise and experience be involved
directly with the fiscal aspects of the application and grant.

An ADVISORY COMMITTEE should be established to assist the Director in making
scientific and administrative decisions related to the center. With the Director,
the Advisory Committee will be responsible for the allocation of center funds as
well as the identification and selection of personnel. It will have the
responsibility of evaluating and selecting the research studies proposed in the
initial application and to be modified or developed during the subsequent years.
It should also review and appraise the progress of active research projects
comprising the Research Component. It may perform other duties deemed appropriate
by the applicant institution such as decisions concerning the career development
program, the (optional) resource core(s), and the (optional) pilot research
program. The committee should be composed of scientists and administrators with
expertise and experience relevant to the center's scientific program. Members may
be employees of the grantee institution or other institutions. However, at least
one member must be from outside the center (i.e., either at the applicant
institution or another institution, but not receiving support from the center).

(2) RESOURCE CORE (OPTIONAL)
The Center may establish one or more Resource Cores to provide and administer
shared resources, such as data sets or populations, community or clinical
research facilities, or provide research design, data collection, data analysis,
or statistical services (e.g., statistics or survey cores).

(d) RESEARCH COMPONENTS

The Research Components consist of research studies funded through the Mind/Body
Center. While an application need not address all three Areas of Emphasis
described in the BACKGROUND section, it should include studies relevant to two
of them. Similarly, the application need not address all the topical areas
identified by the participating ICs.  At least one of these topics should be
addressed, however. Applicants are encouraged, but not required, to develop
research programs cutting across traditional IC-specific mandates (e.g., cancer
and heart disease) and including diverse racial/ethnic populations.

(1) RESEARCH PROJECTS (REQUIRED)
Applications must propose at least three (3) research projects to be supported
during each of the requested years for grant support. Research projects may be
phased in and out over the life of the Center grant. The research projects should
be of scope similar to the traditional NIH research grant (R01). Ideally, these
should include research, from basic to applied, oriented toward critically needed
areas, and should stimulate and sustain novel collaborations and test novel
ideas. The projects should evidence an interdisciplinary focus.  Thus, an
explanation of how the projects fit together across disciplines to promote
synergy and syntheses should be included.

(2) PILOT RESEARCH PROJECTS (OPTIONAL)
Applicants may propose support for Pilot Research Projects that will facilitate
the development of preliminary data sufficient to provide the basis for
applications for independent research through conventional granting mechanisms
(e.g., R01, P01) or improve the prospects for the Research Projects described
above. Pilot Projects should take maximum advantage of the new research
opportunities created through the Center.  The application should provide a
description of the initial pilot research grants selected for implementation
during the first year of funding. The Center Grant application should also
include an institutional review process, which might involve the Advisory
Committee, for selecting pilot projects during the subsequent years of the grant.
Pilot Research studies are typically limited to a period of one to two years. No
more than $100,000 (direct costs) per year may be devoted to Pilot Research
Projects. (This is not a per project maximum, but rather an aggregated maximum
of all Pilot Research Projects.)

(e) CONSORTIUM ARRANGEMENTS (OPTIONAL)

See SUPPLEMENTAL INSTRUCTIONS FOR COMPLETING PHS FOR 398. These instructions can
be obtained at http://www1.od.nih.gov/obssr/mbpage.htm or from the program staff
listed under INQUIRIES.

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 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, 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.

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 to exclude them.(See NIH
Guide to Grants and Contracts, March 6, 1998 or
http://www.nih.gov/grants/guide/notice-files/not98-024.html.)

LETTER OF INTENT

Prospective applicants are asked to submit, by March 1, 1999, 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 (including research project collaborators and consultants) and
participating institutions, and the number and title of this RFA. Although a
letter of intent is not binding and does not enter into the review of a
subsequent application, the information that it contains allows NIH staff to
estimate the potential review workload and avoid conflict of interest in the
review.

The letter of intent is to be sent to:

Ronald P. Abeles, Ph.D.
Office of Behavioral and Social Sciences Research
National Institutes of Health
7201 Wisconsin Avenue, Room 2C234, MSC 9205
Bethesda, MD  20892-9205
Telephone:  (301) 594-5943
FAX:  (301) 402-0051
Email:  Ronald_Abeles@nih.gov

APPLICATION PROCEDURES

The research grant application form PHS 398 (rev. 4/98) is to be used in applying
for these grants.  Applications 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) 435-0714, Email:
GrantsInfo@nih.gov.  Applications are also available on the World Wide Web at
http://www.nih.gov/grants/forms.htm.

In addition, applicants should obtain and follow guidelines specified in
SUPPLEMENTAL INSTRUCTIONS FOR COMPLETING PHS FORM 398.  These instructions can
be obtained from http://www1.od.nih.gov/obssr/mbpage.htm or from the program
staff listed under INQUIRIES.

The RFA label available in the PHS 398 (rev. 4/98) 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, must be typed on Line 2 of the face page of the application form and the
YES box must be marked.

Submit a signed, original of the application, including the Checklist, and four
signed photocopies of the application 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, send one additional copies of the application to:

Ronald P. Abeles, Ph.D.
Office of Behavioral and Social Sciences Research
National Institutes of Health
7201 Wisconsin Avenue, Room 2C234, MSC 9205
Bethesda, MD 20892-9205

It is important to send these copies at the same time that the original and four
copies are sent to the Center for Scientific Review (CSR).

Applications must be received by April 23, 1999. If an application is received
after that date, it will be returned to the applicant without review. The 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 CSR and
responsiveness by the participating NIH entities. Incomplete and nonresponsive
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 CSR in accordance with the review criteria stated below. 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.

Review Criteria

In addition to the criteria list below, the initial review group will 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. Review criteria
for the components of the center are:

A. Center as a Whole

o Quality of integration of center components to an over-arching theme that
integrates and focuses the center, as well as the presence of an essential
relationship of each component to the theme. Interdependency and linkages of
components to each other need to be demonstrated for at least a significant
nucleus of components.

o Evidence of synergy as components are configured in the applications. To aid
in these determinations, reviewers may look at the quality of provisions for the
sharing of resources, procedures for formal and informal planning, and plans for
developmental or pilot work in order to determine if the application reflects a
depth and breadth of expertise and experience not normally present in an
individual research project grant.

o The involvement of different scientific disciplines or subdisciplines in the
center's activities and the demonstration of substantial interaction among
scientists from different disciplines or subdisciplines and different
perspectives.

B. Administrative and Planning Core

o Organizational and administrative structure and support conducive to research,
synergy, and joint planning. Plans for development and maintenance of an
environment that promotes the conduct of the highest quality of research,
innovation, and leadership.  Demonstrations of past productivity may be used as
evidence of likely future productivity.

o Advisory structures that provide appropriate and objective advice and
evaluation, as needed. An internal process that allows for priority setting and
decision making to sustain the center. Appropriate specification of criteria and
processes for determining and sustaining individual participation in the center
based on productivity, research direction, and overall contribution. Structure
for long range planning and evaluation of center activities.

o Adequacy of provisions for sharing of data base development and analytic
capacities.  Quality and extent of data analytic capacities, data base
facilities, and data resources.

o Appropriateness and adequacy of facilities for administrative, research, and
shared resources, including a clearly identifiable physical location for the
center that assures necessary functions can occur. Programmatic structure that
effectively promotes productive scientific interactions and takes maximum
advantage of the applicant institution's Mind/Body Research capacity.

o Facilities that indicate the center is or would soon be a national scientific
research resource. Clear and convincing evidence of the applicant institution's
substantial commitment to the center and appreciation of its goals.

o Evidence that core components contribute toward cost-effectiveness and quality
control in resource utilization. Arrangements for internal quality control of
research, publications, and grant applications.

C. Research Cores

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 this field?
For Pilot Research Projects, what is the likelihood that the research will
contribute to the development of interdisciplinary programs or more mature
research endeavors?

o 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?

o 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?

o INVESTIGATORS: Is each 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)?

o ENVIRONMENT: Does the scientific environment in which the work will be done
contribute to the probability of success of the project? Do the proposed studies
take advantage of unique features of the scientific environment or employ useful
collaborative arrangements?

D. Qualifications of Key Staff

CENTER DIRECTOR
o Ability to lead a scientific and career development program, as noted by
scientific achievements, productivity, stature in a relevant field, and planned
activities.

o Ability to lead administrative and operational aspects of the center, as noted
by administrative skills, achievements, and planned activities.

o Ability to develop a role for the center as a national resource.

o Adequacy of commitment of time and effort for the research and administration
of the center. (A minimum of 25% effort on activities directly supported by the
center's funding is required.)

COLLABORATING INVESTIGATORS
o Quality of cadre of investigators and their productivity, as noted by their
scientific achievements, honors, and recognition.

o Quality of interactions among investigators and investigative teams.

o Breadth of expertise represented among investigators.

o Quality of investigators at collaborating sites and the nature of
collaborations.

AWARD CRITERIA

Applications will compete for available funds with all other approved
applications submitted in response to this RFA. The following will be considered
in making funding decisions:

o The quality of the proposed project as determined by peer review
o Availability of funds
o The research priorities of the participating NIH Institutes/Centers.

INQUIRIES

Inquiries concerning this RFA are encouraged. The opportunity to clarify any
issues or questions from potential applicants is welcome. Applicants may also
subscribe to the OBSSR's automated e-mail service in order to obtain subsequent
information about this RFA and the Mind/Body Centers Program. To subscribe,
please send a message addressed to listserv@list.nih.gov. The message should read
SUBscribe Mind-Body-L [your full name]. The message is case sensitive; so
capitalize as indicated! Do not include the brackets. For example, for Robin
Smith to subscribe, the message would read "SUBscribe Mind-Body-L Robin Smith"
(omit the quotation marks). The subject line should be blank. Subscribers will
receive a confirmation of their subscription along with instructions on how to
use the LISTSERV and how to unsubscribe.

Direct general inquiries to:

Dr. Ronald P. Abeles
Office of Behavioral and Social Sciences Research
National Institutes of Health
7201 Wisconsin Avenue, Room 2C234, MSC 9205
Bethesda, MD  20892-9205
Telephone:  (301) 594-5943
FAX:  (301) 402-0051
Email: Ronald_Abeles@nih.gov

Direct inquiries regarding specific programmatic issues to the staff of the
appropriate Institute/Center:

National Cancer Institute
Dr. Noreen M. Aziz
Division of Cancer Control and Population Sciences
6130 Executive Plaza North, Room 211/E
Rockville, MD 20852
Telephone:  (301) 496-0598
Email:  na45f@nih.gov

National Heart, Lung, and Blood Institute
Dr. Peter G. Kaufmann
Division of Epidemiology and Clinical Applications
6701 Rockledge Drive MSC-7936
Bethesda, MD 20892-7936
Telephone:  (301) 435-0408
FAX:  (301) 480-1773
Email:  Peter_Kaufmann@nih.gov

National Institute on Aging
Dr. Marcia G. Ory
Behavioral and Social Research
7201 Wisconsin Avenue, Room 533, MSC 9205
Bethesda, MD  20892-9205
Telephone:  (301) 402-4156
FAX:  (301) 402-0051
Email:  Marcia_Ory@nih.gov

National Institute on Alcohol Abuse and Alcoholism
Dr. John Allen
Division of Clinical and Prevention Research
6000 Executive Boulevard, Suite 505
Bethesda, MD 20892-7003
Telephone: 301-443-0633
Fax: 301-443-8774
Email: ja55o@nih.gov

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Dr. Julia B. Freeman
Centers Program
45 Center Drive, Room 5AS-19F, MSC 6500
Bethesda, MD 20892-6500
Telephone:  (301) 594-5052
FAX:  (301) 480-4543
Email:  freemanb@exchange.nih.gov

National Institute of Child Health and Human Development
Dr. Louis A. Quatrano
National Center for Medical Rehabilitation Research
6100 Executive Boulevard, Room 2A03
Rockville, MD  20852
Telephone:  (301) 402-2242
Email: lq2n@nih.gov

National Institute of Dental and Craniofacial Research
Dr. Norman S. Braveman
Division of Extramural Research
Natcher Building, Room 4AN24B
Bethesda MD 20892-6402
Telephone:  (301) 594-2089
FAX:  (301) 480-8318
Email: BravemanN@email.nidcr.nih.gov

National Institute on Drug Abuse
Dr. Jaylan S. Turkkan
Behavioral Sciences Research Branch
5600 Fishers Lane, Room 10A-20
Rockville, MD  20857
Telephone:  (301) 443-1263
FAX:  (301) 594-6043
Email:  jaylan@nih.gov

National Institute of General Medical Sciences
Dr. Scott D. Somers
Division of Pharmacology, Physiology, and Biological Chemistry
45 Center Drive, Room 2As.49J, MSC 6200
Bethesda, MD 20892-6200
Telephone:  (301) 594-5560
FAX:  (301) 480-2808
Email:  somerss@nigms.nih.gov

National Institute of Mental Health
Dr. Stephen L. Foote
Acting Director, DBCNR
5600 Fishers Lane, Room 11-103
Rockville, MD 20857
Telephone: 301-443-3563
Fax: 301-443-1731 (fax)
Email: sfoote@mail.nih.gov

National Institute of Neurological Disorders and Stroke
Dr. Cheryl Kitt
Division of Convulsive, Infectious, and Immune Disorders
7550 Wisconsin Avenue, Room 504
Bethesda, MD  20892
Telephone:  (301) 496-1431
FAX:  (301) 402-0302
Email:  ck82j@nih.gov

National Institute of Nursing Research
Dr. Carole Hudgings
Program Director
Building 45, Room 3AN12 MSC 6300
Bethesda, MD 20892-6300
Telephone: 301-594-5976
Fax: 301-480-8260
Email: carole_hudgings@nih.gov

Direct inquiries regarding fiscal matters to the staff of the appropriate
Institute/Center:

National Cancer Institute
Mr. William Wells
Grants Management Branch
Executive Plaza South, Room 243
Bethesda, MD 20891-7150
Telephone: 301-496-7800 ext. 250
Fax: 301-496-8601
E-mail: wellsw@gab.nci.nih.gov

National Heart, Lung, and Blood Institute
Ms. Marie A. Willettt
Grants Operations Branch
Division of Extramural Affairs
National Heart, Lung, and Blood Institute
6701 Rockledge Drive MSC 7926
Bethesda, MD 20892
Telephone: 301-435-0144
Fax: 301-480-3310
E-mail: WillettM@gwgate.nhlbi.nih.gov

National Institute on Aging
Mr. David Reiter
Grants and Contracts Management Office
7201 Wisconsin Avenue, Suite 2N212, MSC 9205
Bethesda, MD 20892-9205
Telephone: (301) 496-1472
Fax: (301) 402-3672
E-mail: David_Reiter@nih.gov

National Institute on Alcohol Abuse and Alcoholism
Ms. Linda Hilley
Grants Management Officer
6000 Executive Blvd., Suite 504
Bethesda, MD 20892-7003
Telephone: 301-443-4704
Fax: (301) 443-3891
E-mail: lh67b@nih.gov

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Ms. Sally A. Nichols
Chief, Grants Management Branch
Natcher Building, Room 5AS-49F
45 Center Drive, MSC 6500
Bethesda, MD 20892-6500
Telephone: 301-594-3535
E-mail: nicholss@exchange.nih.gov

National Institute of Child Health and Human Development
Ms. Mary Ellen Colvin
Grants Management Branch
National Institute of Child Health and Human Development
Building 61E, Room 8A17G
6100 Executive Boulevard
Rockville, MD 20852
Telephone: 301-496-1304
E-mail: mc113b@nih.gov

National Institute of Dental and Craniofacial Research
Mr. Martin R. Rubinstein
Chief, Grants Management Section
Division of Extramural Research
Natcher Bldg, Room 4AS55
Bethesda, MD 20892-6402
Telephone: 301-594 4800
Fax: 301-402-1517
E-mail: RubinsteinM@de45.nidcr.nih.gov

National Institute on Drug Abuse
Mr. Gary Fleming
Grants Management Branch
National Institute on Drug Abuse
5600 Fishers Lane, Room 8A-54
Rockville, MD 20857
Telephone: 301-443-6710
E-mail: gf6s@nih.gov

National Institute of General Medical Sciences
Ms. Toni Holland
Grants Management Officer
45 Center Drive, Room 2An.50B, MSC 6200
Bethesda, MD 20892-6200
Telephone: 301-594-5132
Fax: 301-480-3423
E-mail: hollandt@nigms.nih.gov

National Institute of Mental Health
Ms. Diana S. Trunnel
Grants Management Branch
5600 Fishers Lane, Room 7C-08
Rockville, MD 20857
Telephone: 301-443-2805
Fax: 301-443-6885
E-mail: diana_trunnell@nih.gov

National Institute of Neurological Disorders and Stroke
Ms. Karen Shields
Grants Management Specialist
Federal Building 1004
7550 Wisconsin Avenue
Bethesda, Maryland 20892
Telephone: 301-496-9231
Fax: 301-402-0219
E-mail: ks26n@nih.gov

National Institute of Nursing Research
Mr. Jeff Carow
Grants Management Officer
Building 45, Room 3AN12 MSC 6300
Bethesda, MD 20892-6300
Telephone: 301-594-6869
Fax: 301-480-8260
E-mail: jeff_carow@nih.gov

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance
Nos.93.395 and 93.393 (NCI), 93.937 (NHLBI), 93.866 (NIA), 93.891 (NIAAA), 93.846
(NIAMS), 93.929 (NICHD), 93.121 (NIDCR), 93.279 (NIDA), 93.859 (NIGMS), 93.242
(NIMH), 93.853 (NINDS), and 93.361 (NINR). 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.

The PHS strongly encourages all grant and contract recipients to provide a smoke-
free workplace and promote the non-use of all tobacco products. In addition,
Public Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain
facilities (or in some cases, any portion of a facility) in which regular or
routine education, library, day care, health care or early childhood development
services are provided to children. This is consistent with the PHS mission to
protect and advance the physical and mental health of the American people.


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