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April 22, 2013 12:00 pm Eastern
Time Coordinator: Welcome
and thank you for standing by.
At this time all participants
are in a listen only mode.
At the end of today's
presentation,
we will conduct a question
and answer session.
To ask a question,
please press star 1.
Today's conference is
being recorded.
If you have any objections,
you may disconnect at this time.
Now I would
like to turn the meeting
over to Miss Peyton Purcell.
Ma'am you may begin.
Peyton Purcell: Great thank you
and welcome everyone.
We're excited to be able
to deliver this webinar
on the dissemination
and implementation, research
and (Hout) program announcement
from NIH.
I'm going to walk us
through quickly a couple
logistics for the call today.
And then we'll turn it
over to Dr. David Chambers
and Joshua -
Dr. Joshua Rosenthal
from Fogarty.
So as the operator mentioned,
questions are encouraged
and there's two ways
to submit your questions.
You can either press star 1
as he indicated
to ask your question live
on the phone during the
Q&A session.
Or you can also type your
question in the Q&A tab
at the top of your screen
and hit ask
to submit your question
that way.
And we'll be going
through some brief slides
and then hopefully opening it
up for some good discussion
and Q&A for the remainder
of the call.
And with that I'll turn it
over to Dr. Chambers.
David Chambers: Thanks Peyton.
So I'm David Chambers,
I'm Associate Director
of Dissemination
and Implementation Research
at the National Institute
of Mental Health,
and I've been one of the people
who has been coordinating
across the National Institutes
of Health some of our activities
around Dissemination
and Implementation Research.
We first of all want
to thank you for taking the time
to join us from all
over the world.
We're grateful for those of you
who got up quite early,
we're grateful of -
for those of you
who stayed late.
And we're hopeful that you see
that this opportunity
to really try
and advance the knowledge base
of how we get effective
interventions to reach people
who can benefit
as one that's exciting.
We are on this call because we
at NIH are very interested
in seeing how we can advance
global Dissemination
and Implementation Research
and so thank you for joining us.
And we will be making a
relatively brief run
through of these slides,
but we do want to have
as much time as possible
for questions.
So as Peyton said there's a
couple of different ways
to answer those.
But we really see
that this time is as much
for you as possible.
It's also the starting
of a dialogue,
so you can always feel free
to reach out to us afterwards
if you're not able
to get your question answered.
So I wanted to start
out basically just
by orienting you a little bit,
for those of you who don't know
as much about the National
Institutes of Health,
a bit about the structure.
So the mission
of the National Institutes
of Health, which is part
of the Department of Health
and Human Services
in the United States,
is to transform discovery
into health.
We are a research agency
that sees its mission
as making sure that we develop
as much of a knowledge base
to ultimately inform the health
of populations.
And while we certainly are
interested in the U.S.
population,
we see our broader mission
as trying to understand better
about improvements
in human health.
The National Institutes
of Health are comprised
of 27 different institutes
and centers, which we refer
to in shorthand as ICs.
The ICs are organized
in some way by disease area,
so there's the National Cancer
Institute, NIDDK is
around digestive diseases,
kidney as well.
The National Institute
of Mental Health focusing more
on mental illness.
We have other institutes
that are focusing more
on biological systems,
the Eye Institute or Dental
and Craniofacial Research.
We have others that focus
on subpopulations and others
that are really aimed at trying
to improve resources
for the broad conduct
of research.
It ends up being a lot
of different abbreviations
and we're certainly happy
to point them
out as we go along.
All of the institutes
and centers will either have
intramural programs,
where we have research that's
conducted within labs
on the National Institutes
of Health campus.
Or extramural programs,
where much of the money goes
to funding research all
over the country and all
over the world.
What we're talking
about here is the
extramural research.
So this isn't
about NIH staff conducting the
research, but it's
about supporting research
around the globe.
They're primarily funded
through research project grants.
You'll see mechanisms (RO-1s,
RO-3s, and R-21s),
which are grants or contracts.
And those are the major
funding mechanisms.
In terms of the -
just to give you a broad sense
of NIH's mission,
we really do cut
across from basic research,
which is prior to getting
into clinical practice,
prior to even thinking
about humans.
So there's animal research,
there's epidemiology,
there preclinical studies,
there's basic health
services research.
Then moving over into ways
in which those basic findings
can translate into clinical
or community applications,
which we talk about as
from basic research
to the bedside.
And then over to try
and really make an impact
on population health
through policy
and practice changes.
As you can see in this diagram,
which is not an NIH one
but helps to at least identify
this broad continuum
of research,
more of the right end
of the picture is Dissemination
and Implementation Research.
We're really talking
about how do we make the most
of what's been discovered
scientifically in -
and translating
that into the improved health
of populations.
So I wanted
to give you a little bit
of a history
of the dissemination
and implementation PARs,
because these are reissued
program announcements.
We started out not necessarily
with a collective
or a shared vision at NIH
about Dissemination
and Implementation Research.
But starting in 2005,
eight of our institutes
and centers got together
around issuing a combined set
of research priorities.
The program announcements
typically have a lifespan
of three to four years.
And so in 2009,
we had a second round
where we were able
to add an additional four
institutes and centers.
Simultaneously we were also
trying to think about other ways
to grow capacity
within the field.
We had five state
of the science conferences
at the NIH level.
And we've also
over the last couple
of years had a training
institute to try
and get more investigator
knowledge prior to submitting
to these announcements.
And so this is a week long
summer training institute that's
been open the last three years.
Just earlier this year we were
able to reissue
for the third time the NIH
Dissemination
and Implementation Program
Announcements,
which we're talking about today.
Now the program announcements
really have represented a shift
from what has been considered
historically more
of NIH's mission, which has been
in the basic science arena.
While NIH has always had a basic
and applied work, it's only been
within recent years
that we've really been focusing
as much, specifically,
on that last building block
of science,
of how we get effective
interventions
to benefit the most people
they can.
What we wanted to do right
from the beginning,
because we recognized
that terms used
in research may vary,
is for these announcements,
we wanted to lay
out working definitions
for what we saw as two
of the key terms
within the announcement,
dissemination
and implementation.
We recognized
that there might be
different challenges.
There might also be different
terms used, and we wanted
to make sure that anyone
who was interested
in these announcements,
was at least understanding
where we -- NIH --
were coming from.
We defined dissemination
as the targeted distribution
of information
and intervention materials
to specific audiences,
where we're trying
to really spread or scale up
and sustain the knowledge
and associated interventions.
We contrasted
that from what we saw
as a much more intensive process
of implementation,
where you're thinking
about strategies that adopt
and integrate interventions
to try and change practice
patterns within different
settings, be that clinical
or community or other settings.
Now we'll note for this audience
that while we use dissemination
and implementation,
we understand
that there are other countries
who have long histories
and long success
of promoting similar areas.
There may be terms
that you're more familiar
with to cover the same space,
knowledge translation,
knowledge transfer,
knowledge exchange,
research utilization, et cetera.
We're very open certainly
to the use of alternate terms.
We just ask
that people clarify what terms
are they using
and what are they meaning?
We for this announcement,
use dissemination
and implementation.
So while we're not going to go
through line
by line the associated program
announcements,
we wanted to just call your
attention to the breadth
of knowledge that we're looking
to gain from it.
So we've laid it out in terms
of some topics, some questions
that may be more related
to dissemination,
some more related
to implementation,
and some that really do
cut across.
For dissemination again
as we were talking about trying
to best understand knowledge
transfer, how knowledge is
created, transmitted, packaged,
share and received.
There's a number
of different studies that we see
as exemplars,
whether it's the factors
that are affecting each stage
of that health research
knowledge translation process,
whether it's experimental
studies to test the
effectiveness
of different dissemination
strategies, particularly those
that might differentially impact
underserved communities
or other subpopulations.
And even broader studies
on how targeted audiences are
defined and how evidence may be
packaged for different
target audiences.
On the implementation front,
again we have a couple
of exemplars, although this is
by no means exhaustive,
where we're looking
at a whole range
of different interventions
across the care continuum.
Prevention, early detention,
diagnostics, treatment,
clinical procedures and thinking
about how well they can
integrate into a whole range
of care systems
and measure the extent
to which they're used
and ultimately sustained
over time.
We have an interest in issues
around fidelity
of implementation efforts,
or how does one know
that you're delivering an
intervention
with substantial quality,
and how can you identify what
those components of quality are.
And then again we're thinking
about this in the longer term
view, so not just looking
at initial implementation,
but what happens over time.
And how can we best enhance the
sustainability
of different improvements
within practice?
On the DNI research topic front,
we do see some overarching
questions - overarching areas
that we could see benefit
from advancing.
So understanding
about the capacity
of different care delivery
settings to conduct
and actually succeed
at implementing effective
interventions
or disseminating
effective knowledge.
We certainly continue
to see a need for development
and even more important the
testing of theoretical models
for dissemination
and implementation processes.
And we're at a point
in the field where there's a lot
of capacity needed in terms
of appropriate outcomes measures
and advances in methodology.
So if this is something
that you're interested in,
really building the research
capacity, there's studies
that fit with that as well.
So just to orient you for anyone
who has looked
at previous versions
of the program announcement.
Similar to the last set
of announcements,
we do have a focus
on both dissemination
and implementation.
We have a focus
on developing generalizable
knowledge, so how does this
knowledge help us all
in thinking about better ways
to disseminate or implement.
We do similarly have -
retain an interest
in transparent reporting
on feasibility issues.
So we want to know how are
people being recruited.
How are the different
interventions being implemented?
The more noise in this kind
of science,
is actually of interest to us.
We really are interested
in mapping the complexity
of trying to change practice
and trying to improve
population health.
We retain an interest
in health disparities
and efforts to remediate them
and in research
in low resource settings.
And retain an interest
in understanding the cost of -
and the needed resources
in order to make successful
implementation take hold.
We do have a couple of things
that we'd like to call your
attention to,
because whether they've been
in previous versions
of the announcement,
we've been trying
to promote them particularly
in this one.
One is an explicit focus
on advancing measures
for dissemination
and implementation.
We've done - we've had efforts
to try and pull together
available measures,
and there are gaps
in what's available.
And so we would love to see
if people have a particular
construct that they're
interested in better measuring,
that that's fair game here
and particularly
when we're thinking
about constructs
in the global environment.
We would like to stress our
increase interest
in sustainability,
as well as the reason why we're
here and increased interest
in applications
that span the globe.
We also wanted to add
within this announcement the
emphasis on what we called
scaffolding of interventions
as well as thinking
about complex patients.
Here we're talking
about not necessarily focusing
on an individual practice
that you're trying to implement,
but how to create better systems
of care that involve a whole
range of evidence
based solutions.
Also not as interested only
in focusing on a single need
of patients, but thinking
about complex patients,
which are often people
who are struggling with
or dealing with multiple health
issues at once.
And how do we improve care
for them?
We like to stress our interest
in innovative designs
that are appropriate
to dissemination
and implementation.
Stressing the opportunity
to make them more relevant
to the different settings
where the research is
taking place.
Make them more rapid
and make us be able
to learn more from the results
of any individual study.
And we do see more
of an interest worldwide really
in understanding the impact
of health policy
and in using not just more
traditional prospective research
methodology, but thinking
about simulation modeling.
Just so you have a sense more
of the sort of word soup,
we do have 15 different
institutes and centers
that are involved
in the announcement.
You can certainly take the time
to either ask us or follow
up on what does each
abbreviation mean.
But it basically represents a
pretty broad areas of health,
areas of population
as we said before,
and areas of interest.
There are the (RO-1s),
which are the larger -
the largest research
project grants.
There are small grants
that are the (RO-3s),
which are up to $50,000
in direct costs per year.
And then there's somewhere
in between.
The (R-21s),
hich are exploratory
and developmental
and basically aimed
at where you may have some early
work that you're trying to do
in a sort of more pilot way,
building toward a larger study.
You'll notice that the (RO-3)
and the (R-21) do have a sign
on from the Fogarty
International Center,
which has done a wonderful job
over the years in promoting
and improving global
health research.
Just to underscore a couple more
things within the program
announcement,
we do see an expansion in terms
of the health topics
that are covered
under this announcement
versus previous ones.
An expansion in our thinking
about what context would serve
as good locations
for implementation efforts.
And also more focused
on sustainability
and the evolution of practices
over time, rather than assuming
that a practice is tested
and then frozen.
On the method side,
we're certainly interested
in taking advantage
of methodology
around comparative effectiveness
research, comparing different
alternatives toward improving a
particular outcome.
As we said before,
we're interested
in simulation modeling
and actually the development
of new and better methods.
We're also interested
in thinking
about how each individual study
can build lessons.
And that those lessons can
really come together
across different studies.
So where you're interested
in a particular question,
we'd like you to think
about how is this advancing the
field on the basis
of what has been known before.
And we also retain our interest,
whether it's
within our training institute
that we run each year,
which is open to people from all
over the world.
Or it's through some
of the grants,
where sometimes a particular
study may be a nice opportunity
to train new investigators.
We wanted to just lay
out a couple of considerations
that we think about in terms
of foreign applications,
just to let you know.
And this is something
that I think Josh may be able
to clarify anything
that I'm missing
from his vantage point
at Fogarty.
But just some
general considerations.
We can -- the National
Institutes of Health --
can make grant awards directly
to foreign institutions.
So there isn't a problem as long
as it specifically lays it
out within the announcement
of having direct award go
to the institutions
that you may be working in.
It is important
to check the eligibility
criteria on the funding
opportunity announcement.
For this particular set of PAs,
international applicant program
announcements,
international applicants
are eligible.
We also do think that -
and hope that you see the
special opportunities
that international
or foreign applications can
provide for furthering research.
Whether it's begin able
to capitalize on unusual talent
that might not be in existence
or in abundance within some
of the domestic institutions.
Or really from capitalizing
on the chance to learn
from unique resources,
unique populations,
or unique conditions
that can help
to advance our knowledge
about health in general.
It's also the case
that a foreign applications may
be seen as augmenting what's
currently going
on within U.S. located research.
Within - at NIH there are
some limitations.
There are some programs -
there are some grant programs --
for example small business
related research programs --
that are limited
to U.S. citizens.
So if you're interested more
broadly in applying to NIH,
it's just important
that you're understanding what
some of the opportunities are,
but also some
of the limitations.
We don't want you
to go too far along a given
path, only to find
out that it's not as eligible
for your
particular circumstances.
Note that we do recognize the
potential and the importance
for foreign applications
benefiting the health
of the American population
as well as your
local population.
So usually working
with program staff
to identify how might this not
only be relevant
to your local circumstances,
but be more broadly relevant
to populations
within the U.S. There's been a
long history
of successfully explaining this
and so our program staff
across the different institutes
should be well versed
in helping you
if you have any questions
about that.
We also do see the opportunity
that many take advantage of,
of partnering
with a United States based
principal investigator
on the application.
It can be recommended,
it's certainly not required.
But given that we're at a state
where all NIH applications can
now use a multiple PI
designation,
meaning that you can share
leadership among different
investigators,
we see it that it can be an
advantage, particularly
if you haven't had experience
with NIH funding before.
So when you can partner
with researchers
who have previous funding
experience working with NIH,
that can be an asset.
Because they may be better able
to answer questions and really
to solve some of the problems
that you might have a difficult
time anticipating, just in terms
of the conduct of the research.
Some applicants will choose
to have the domestic
or the U.S. based institution
as the primary and think
about foreign partnership
through subcontract.
Others may do the reverse,
where you may have the primary
grant would go
to the foreign institution
and there might be subcontracts
for U.S. based institutions.
We do want to mention
that all projects
that have non-U.S. research
activities do need
to have an additional clearance
process, which basically goes
through you know more
or less the U.S. Department
of State, but also
in many countries there may be
local procedures
within your countries
through the local government
in order to ensure
that you have the clearance
to be able to conduct
the research.
So again really important
that you not only reach
out to local resources
that you may have in terms
of understanding research
within your country,
but also to program staff
over here who can help
with navigating
through the U.S. System.
So just a couple of things
to remember.
It's not an instant process,
and in fact it may take a number
of months to even walk
through the process of preparing
for applying.
So it's important
to start early.
There are windows for which -
through which you can submit
your application
that usually are
up to a month before the due
date of the application.
But just in terms of making sure
that you have all of the steps
in place in order to apply,
it's very important
to start early and to reach
out early to your
program officers.
Because most of our applications
at this point are submitted
electronically,
there are several different
processes that you need to go
through to ensure
that your institution is able
to do that.
And so there's a registration
process, both for you
and your institution that needs
to take place prior
to submission.
And it may take a number
of weeks to make that happen,
so again start early.
If you're thinking
about an applications
of a particular size,
for example one
that exceeds $500,000 in terms
of the direct costs
of the application,
you do need prior approval
from NIH.
And specifically
from the institute at NIH
that you're targeting
your research.
So it's important to ensure
that you're connecting again
with your program staff as early
as possible.
Just a quick point not to skimp
on methods.
Sometimes it may be hard
to figure out how do I fit all
of the information
within a given application.
It's important that make sure
that it's clear
to reviewers exactly how you're
trying to conduct research,
where you can use shorthand
to talk about how this follows
established procedures
for conducting different
analyses, that's great.
But don't assume
that the reviewers will know
what you're going to do.
It really is important
that you lay it out as much
as possible,
as part of the approach
of the application,
what methods you're using.
You do want
to demonstrate your partnership
where - particularly
in this announcement
where it's important
to understand how are
researchers working together
with local stakeholders.
As well as your understanding
of the context
in which implementation efforts
are going to be set.
We have it red,
we can't underscore it too much,
because - that we do see it
important to talk
with your program officers.
There's a set
of institute contacts,
not all are available
on the call today,
but all are available
to answer questions following.
So if you look
on the program announcement,
you can see
for each participating
institute, that there's a
specific person
who has made themselves
available to answer
any questions.
If you do have any difficulty
contacting a particular
institute, or you're not as sure
on the international front,
you can always contact me.
You can always contact my
collaborator
at the National Cancer Institute
(Russ Glasgow).
You can also I would assume,
particularly
around international issues,
contact Josh Rosenthal,
who is a contact on the (RO-3)
and the (R-21).
We're here to help.
So the more
that we can answer your
questions, the better.
There are just to close off -
there are a number
of resources available
if you want
additional orientation.
And as I said,
you can always contact us.
But there are a few more general
resources available
around NIH grants.
There are specific web sites
that help to orient you
to what's been done in terms
of implementation.
So the National Cancer Institute
maintains an implementation
science web site,
where they list here the studies
that have already been funded
and their topics.
It lists key references
and publications
that might help you orient.
And it does link
to these announcements
that we're talking about.
There also are other resources
available to help navigate you
through the whole electronic
submission process,
which has been
around for a number of years.
It's far smoother than it was
when it first started.
But the resources have been
refined over time
to really help you.
So before we open it
up for questions,
just wanted to turn it
over to Josh
for any either clarifications
or additional points that you'd
like to make.
Joshua Rosenthal: Thanks David.
My name is Josh Rosenthal.
I'm the Division Director
of Extramural Research
and Training Division here
at Fogarty.
And we're very excited
to continue to participate
in this valuable initiative.
It's been an area
of keen interest here
at Fogarty.
For those of who aren't familiar
with the Fogarty International
Center, our focus
on global health and research
and training
with the particular focus in low
and middle income countries.
And the implementation science
is something
that we have paid particular
attention to in the last couple
of years, especially
around the *** scale up
and delivery of both treatment
and prevention kinds
of services.
We're also increasingly
interested in the relevance
of dissemination
and implementation science
in low resource settings
in the developing world
and how those may inform
practices here in the States.
So those are just some general
things about Fogarty.
Let me emphasize a couple
of points that David made
regarding more generally
applicants for -
either from directed -
from international applications
institutions or for work
in the national setting.
While there are a number
of successful direct
applications
from the developing world
or from other parts
of the world,
most often people are successful
when they are applying
with U.S. investigators
that have a history
and a knowledge
of the NIH funding process.
It's both the mechanics
and the culture,
the grantsmanship involved
in getting a grant
through successfully here take a
fair amount of experience.
So if you haven't -
if you're from another country
and planning to apply
and you have not thought
about involving a U.S.
investigator,
you might give it more thought
and either apply
with them directly coordinated
with your or vice versa.
When you do that,
be clear about the roles
of both the local
and the U.S. investigators,
what each of the partners are
going to do
in the research endeavor.
And make that clear
in your application
so the peer review committee can
- and the program officers can
evaluate that clearly.
The other thing
that I think can't be stressed
enough and that will come
naturally from the orientation
of this effort
through stakeholder involvement
and the like.
But seek and document your local
institutional support
at the universities,
ministries of health, (NGOs),
other organizations
that you plan
to collaborate with.
And then make sure that's clear
in your application as well.
That will not only help its
probability of getting funded,
but will also help you
downstream to get the research
off the ground
in a timely manner
and help you address any
unforeseen challenges.
Unforeseen challenges are common
in the developing world,
with political changes,
budgetary changes,
currency fluctuations,
changes of staffing.
So expect the unexpected
and make sure
that your community is
behind you.
The other thing I want
to emphasize is something
that David said, apply early.
If you're applying
from a foreign institution,
especially one that has not
in the last year
or two had an NIH grant, the -
while the electronic submission
process has been
around for a few years
and is working more smoothly
now, there are new
barriers (unintelligible).
There are new wrinkles
in the system just
about every year.
And we've had a number
of very good applications not
make it to the peer review
simply because they did not
check in with all the
appropriate registrations
and stay in touch
as their application was making
its way through grants.gov
and (unintelligible), et cetera.
So I would recommend you start
two weeks early if you can.
And I would start
with the registrations even
before that,
but even start submitting the
application a couple weeks early
and then stay on top of it,
follow it through the various
registrations and processes.
And at the web sites
that are indicated
in that email,
especially the electronic
submissions,
there's a webinar there
and there are other links
for help desks and other.
But it's more complicated
than it ought to be.
It's getting better,
but it's still a bit of a trick.
And I think the last thing is a
general point and something
that embodies the spirit
of the Fogarty Center
and that is your research is
intended to generate general
knowledge with both local
implications
for the improvement of health.
And ideally
for a more global setting.
But make sure
that you leave knowledge
and expertise behind.
That you can train some
of the people involved
so that beyond these fine
publications
and potential interventions
that are developed,
there are people there
that embody the skills
that you have developed
and employed throughout the
application process.
I'll stop there David.
David Chambers:
Thanks very much Josh.
Peyton Purcell: Great thank you.
So now we want to open it
up for questions.
And again just
to remind everyone,
there's two ways
to submit your questions,
and I know we already have a few
in the queue.
You can press star 1
to ask your question live
on the phone.
Or you can type you question
in the Q&A tab and just be sure
to hit ask, not the little hand.
And just as a reminder,
if you have additional
questions, you can email us
after at N-C-I-D-C-C-P-S-I-S
team at mail dot NIH dot gov.
I know that's a long one.
And you can also request a copy
of the slides from us then.
And with that we'll go ahead
and get right to some
of the questions that came
in during the presentation.
From (Cheryl),
she asks can an investigator be
on more than one research grant?
So for example a dissemination
grant and on an
intervention grant.
David? David Chambers:
Yes so the answer
to that is absolutely.
In fact many
of our investigators do have
over time multiple grants
that they're on.
The major thing is
that with each grant you're
specifying a particular
of effort on it.
And at this point it's done
in terms of months of the year
of full time work on a grant.
So obviously there are questions
raised if it looks
like your total effort is
exceeding 12 months of the year.
But short of that absolutely you
can think about multiple grants.
It's often a good experience
to think about the learning
across a set
of different grants.
Peyton Purcell: Great.
A second question
from (Raphael) is the examples
that are listed
on the NCI web site
for the 34 grants
that have funded through NCI,
none of them are international -
or non-U.S. institutions
and so I guess the question is,
is this process likely
to be different in this call
and what are the real chances
of applications coming
from outside
of the U.S. being funded?
And just to clarify,
the NCI web site
that we've listed there does not
list all of the grants
that have been funded.
So... (Cindy Vincent):
Actually on the NCI web site,
there is a link to the Office
of Behavioral
and Social Sciences Research web
site, which does have all
of the NIH funded grants on it.
David Chambers:
Yes but it a broader -
I think it's a very good
question, because I think one
of the things that we have seen
in recent years is not
that we're seeing zero
applications coming
from outside the U.S.,
but we're not seeing as many
as might be advantageous.
So the reason why we're having
this webinar is to promote
that this opportunity is open
to folks around the world.
And if over time we can see more
opportunities to take advantage
of non-U.S. studies,
then that would be terrific.
So it is a relatively smaller
amount, even as you -
as (Cindy Vincent) had said,
if you go to the OBSSR web site,
which lists broader.
But again the reason why we're
here today, is to suggest
that maybe not everyone has
heard about this opportunity
and thus, we might see more
over time.
Peyton Purcell:
Great good clarification.
From (John) the question is,
prior approval is required
for $500,000 per year
or $500,000 overall?
David Chambers:
Right it's a good question.
The answer is per year.
So if the direct costs
of your application across all
of the years sums to $500,000
that does not require
prior approval.
However if in any one year
you're wanting to use more
than $500,000 of research funds
in direct costs,
then you do need
to get prior approval.
Just note that the procedures
may differ across the individual
institutes to which the
application would be assigned
so again it's helpful to talk
to your program staff.
It's also usually the
requirement that it's
at least six weeks before the
submission date.
So if you're thinking
about a larger study,
you really do want
to contact folks as soon
as possible.
And just to make a more general
comment about submission,
these announcements do go along
with the regular submission
deadlines for NIH,
which means
that new grants can come
in in February, in June,
and in October.
So it's not that you have to try
and you know -
it's going to be a one shot
and if you miss that,
you're not going to be able
to get through.
It would roll
over to the next opportunity.
But think about your timeline
in terms of when you think
you'll be submitting in one
of those three months,
and then allow enough time
in advance to get
everything done.
Peyton Purcell:
Great we have a couple more
questions online, but I did want
to check in with our operator
and see if there's any questions
on the phone.
Coordinator:
I'm showing no questions
on the phone line.
I would like to remind
participants if you would
like to ask a question, please -
on the phone line,
please press star 1.
Peyton Purcell: Right thank you.
So then we'll return
to the questions on the web.
And one from (Borsica)
about whether
or not there are any
recommendations
for a multi-country grant
proposal, that would involve
multiple European countries.
That this might raise some
additional issues in terms
of logistics.
And is there any examples
of such a proposal that's
been funded?
David Chambers:
Thank you (Borsica).
It's a good question
if I understand it correctly,
it's just trying to think
about are there sort
of successful previous studies
that one could draw on.
I think the most important thing
as always is depending
on the area of research,
there may be some different
suggestions
and different successes
across different institutes.
So I think the first thing
that you would want
to do certainly is
to contact the program officer
who would be more specifically
within that area.
Within the announcements
to my knowledge we haven't seen
a specific grant application
that cut across different
countries, particularly those
in Europe.
But certainly there's experience
at different institutes
with clinical trials
or other research that's
involved consortium among
multiple countries.
So I think the shortest answer
is, depending on the area,
you might be able to benefit
from a number
of different experiences.
But it's going to be important
to make sure that you're
in touch with the particular
program contact.
Peyton Purcell: Great.
From (Jessica) there's a
question about the three cycle
due dates that you mentioned.
And just to clarify,
does that mean
that for each grant there are
three opportunities
to submit an application so.
David Chambers:
So there are two - that's a -
thank you very much
for the question.
There's actually two different
pieces to this.
So one of which is the available
deadlines for anybody
to submit an application.
That's what I was talking
about in terms
of the three due dates.
So that means if you're thinking
about an application
that you want to submit to NIH,
there are standard three
different months of the year
in which you can make
that submission.
And that would be February,
or you could submit
that same application in June,
or you could submit
that same application
in October,
and that's for a new one.
There are actually two
opportunities over the years
to submit any individual
study idea.
So if you submit an application
in one of those deadlines
and it doesn't matter which one,
it will get a review
and then you'll get the
comments back.
The comments may either suggest
that the application
or the study is ready to go
and it would move
on toward ultimately,
optimistically there being
an award.
So you could just start working
on the actual study.
If it happens
that for whatever reason there
are weaknesses
that the reviewers pointed out
or it doesn't
yet have the strength
to make thorough what can be
tight funding lines,
you can resubmit any application
a second time.
It used to be the case
that NIH applications could come
in a total of three times.
But a couple of years ago,
there was a decision
to reduce it to two.
So you can submit any study idea
once under the
original submission.
And then if it doesn't get
through on that first time
around, you can submit it one
other time.
After that,
there's actually a lot
of efforts trying to ensure
that any one study only has
those two
submission opportunities.
And so what it means is
at the end of those two,
you really do need to think
about a new study.
It may be related,
but it has to be substantially
different in order to qualify
as a new application.
Joshua Rosenthal:
David can I just
add (unintelligible)...
David Chambers: Yes Josh.
Joshua Rosenthal:
Just to clarify,
when David refers
to resubmitting
that application the assumption
is that the application has been
revised and amended
to incorporate any comments
from the peer review
that you received
in the last round.
And so a resubmission should
really pay careful attention
to what the comments were
in the last round.
And amend the
application accordingly.
In fact the peer review staff
will look at that.
They'll look
at the previous critique
and see whether
or not the application has
in fact addressed the
previous concerns.
So it's referred
to as an amended application,
and you get one shot
to amend it is what David
was saying.
Peyton Purcell: Okay thank you
for the clarification
there Josh.
Another question that came in,
this one from (Barb) on whether
or not program officers are open
to reviewing an abstract
or concept for relevance
to the funding competition.
And a second part
to that is whether program
offices are -
officers are situated
within each institute only
or whether or not there's some
general program officers
for DNI more generally?
David Chambers:
Right okay thanks (Barb)
for that.
So absolutely program officers
are open and in fact would
prefer to have the chance
to talk and discuss an abstract
or a concept
for relevance prior.
We certainly want to provide
as much assistance as we can
to help you.
And often it means
that you have additional chances
before the review
to get feedback from folks
who have a lot of experience
in guiding different applicants.
So we would love to see,
usually it's great
when you're contacting a program
officer to be able to have -
even if it's a one page abstract
or just the set of specific aims
that you're thinking about,
send that as your first contact
to the program officer.
So then they can become familiar
with what you're thinking about,
rather than wasting valuable
time on you trying
to orient them
for the first time.
So that is -
that's absolutely encouraged.
We would love to see that.
The second part
of the question are
about program officers
and where they're situation.
So there are generally program
officers being
within a particular institute.
And so what you'll find is a
contact from each institute
or center on each
of the announcements.
That's what we referred
to before.
In terms of more general program
announce - program officers,
thinking about dissemination
and implementation, there -
we have had involvement
and support from our Office
of Behavioral
and Social Science Research,
and so there have been contacts
who are able to look
across different institutes.
But basically you can always
feel free - you know (Russ)
and I and even other, but (Russ)
and I certainly listed
on the slides as being available
for any more general
dissemination
and implementation
research questions.
So because a number
of us have been coordinating
efforts and really collaborating
across different institutes,
I think we'd be happy
to help steer you
if you have more
general questions.
That doesn't mean
that you shouldn't be thinking
about the specific contact,
but because we all work pretty
collaboratively together,
you could include us
or you know - or not.
It it's helpful,
you can definitely ask us
as more general.
But don't pass out on -
pass the opportunity
of connecting
with the specific
institute contact.
Peyton Purcell: Great thank you.
I know we have a couple more
question on the web,
but I did want to check
in with (Brandon) to see whether
or not there was any questions
on the phone.
Coordinator:
Yes we have a question
from (Cameron Willis).
Your line is open.
(Cameron Willis): Thank you.
I just had a question
about the degree
to which applications might be
encouraged from new investigator
or other career researchers?
David Chambers:
Thanks that's a great question.
I think NIH is -
has been you know certainly
in recent years particularly
wanting to make sure
that there's the pipeline
of investigators
across all stages of the career.
And as such has been quite
interested in fostering early
stage or newer investigators.
And that's definitely the
case here.
It is the case
that for some people
who are newer to the field
that we look to some
of the smaller grant mechanisms
as an opportunity to start.
Just because frankly managing a
large research study
when you haven't had
that experience is quite
a challenge.
And so some people do choose
to start out with the small
grant, with the (RO-3)
or with the developmental
or exploratory grant,
the (R-21).
But we'd absolutely love
to see newer investigators enter
the field.
It's a field
that needs more people,
so I think it's absolutely
underscored here.
Thanks for the question.
It's also the case
that if people are interested
and aren't as sure
about their expertise
in the field that we do,
as mentioned before,
run an annual training institute
for dissemination
and implementation research
in health, which is
called TIDIRH.
There is a link I believe
on the slides
if for some reason you don't
have it, you can always type
into your favorite search
engine, T-I-D-I-R-H,
and you'll get there.
I don't think anyone else has
used that acronym.
Peyton Purcell: Great.
Any other questions
on the phone?
Coordinator:
I'm showing no further questions
on the phone lines.
Peyton Purcell: Great.
Okay then we have one
from (Susan) on the web,
and that was whether
or not we're targeting
applications
from developing countries more
than from developed countries?
David Chambers:
It's a great question.
And I think you know Josh may
also want to weigh in here.
We have not specified
that it is -
you know it's specifically
for developing countries
or for developed countries.
We think there's -
that there's a lot to learn.
That said, there is a priority
within the announcements
around trying
to understand better
implementation
within low resource settings.
So that kind
of work does potentially leave
opportunities, particularly
within low and middle
income countries.
But as far as the announcement
goes, it's really open to both.
And again you might want
to think about within your
specific area,
what are the opportunities
whether you're
within a more developed country
or a low and middle
income country.
Josh do you want
to add anything?
Joshua Rosenthal:
Only that the -
that will vary a bit
across the NIH.
I think in how those priorities
are reflect
in their own internal systems.
With - from the Fogarty Center,
our participation is exclusively
focused on low
and middle income countries,
as per our overall
funding policies.
But as you say,
across the NIH there is a
substantial number of projects
that are led by investigators
from Australia, the UK, Canada,
Japan, et cetera.
And for research there
or in the U.S., the -
perhaps I would just suggest
that you pay special attention
in those cases to the criteria
that David pointed out earlier
in the slides,
about making it clear what the
particular value of doing
that research is
by European investigator
or in a European setting.
It's clear in the -
for cases in the developing
world, but less so perhaps -
just a little bit higher
thresholds you might have
to meet with peer review.
Is that fair David?
David Chambers:
Yes and I think again it's great
within the particular situation,
because there can be some
variation across institutes
and centers to connect
with your program officer,
you know early on that.
Because I think they can give
you a nice read
within the given research topic.
Peyton Purcell: Great.
So there's two questions
that are around sort
of success rate,
The first is success rate
for the international groups
that are funded.
And then second one came
in that's a little more broadly,
just generally what's the
success rate
for DNI applications?
I'll start with you
with David on that.
David Chambers:
Sure so I will say that -
and it was referenced
in an earlier question
about looking
on the specific NCI web site
and not necessarily seeing the
international applications,
that to this point we have had
very few applications submitted
that - from investigators
studying populations outside
of the U.S.
So with a small sample size,
there isn't as much
to draw from.
Hence the reason why we're
on today.
On the OBSSR web site you'll see
a few more applications.
We haven't to this point I think
calculated the success rate
for those global applications.
But I think you know we have
seen a few of the smaller grants
funded, and we're encouraged
by your attendance here
that there will be
more forthcoming.
But right now I think it's too
small numbers to be able
to give an accurate success rate
versus the overarching pool.
The second question being
about the more general
acceptance, the success rate.
What is important
to recognize actually
at this point --
and this may transition
into another question --
is that all of the responses
to the program announcement,
do come to a standing review
committee that only focuses
really on dissemination
and implementation research.
And so they have their own base
for percentiling,
which does give the opportunity
to ensure that an equivalent
number of studies that come
through this announcement do get
funded to those
of the success rates
across all of NIH.
That has been a concern
because there are certain
complexities
in conducting this research
that may make it seem
like it might be harder.
So by having a standing
committee, it means
that the committee percentiles
reviews against the
other applications.
And so it means
that it will have just
as natural a shot -
an opportunity to get funded.
Now in terms
of the specific success rates,
right now they're differing
so much across the individual
institutes that certain
institutes given funding
constraints,
are at a tighter funding band,
and others are able
to go further.
In the past the rough success
rates of applications have been
in the 20s%, 25%.
And that's estimated,
but it's going to differ
by institute,
it's going to differ by types
of applications.
But just to give you a frame,
that's roughly what we think
about in terms of success rates.
Peyton Purcell: Great.
A question from (John)
about the review committee
that you mentioned
and the DNI specific
review committee.
And how many individuals are
familiar - or you know are
individuals familiar
with the context
of international health issues?
David Chambers:
Yes I think it's a
good question.
And I think one thing that's
helpful to think
about with the standing review
committee and just how review
committees are developed
or staffed in general is
that there's a set
of standing members
and then there's the opportunity
with any given round
for the person
who heads the review -
the scientific review officer
to bring on additional expertise
as needed.
During the early years
when there hasn't been as much
of a set of international
applications coming in,
there hasn't been
as clear a need
to have the standing members.
So there have been -
while there are standing members
who have international
expertise, it hasn't necessarily
been that they would choose the
person whose primary
identification is
as an international
dissemination
and implementation researcher.
However I think
as more applications will come
in, the membership
of the committee is going
to vary according
to what they see.
So in the short term,
we work very closely
with the scientific review
officer and she does bring
on individual members to ensure
that she has the adequate
expertise and has done
that each time
that we've seen an international
application come on.
If there is an influx
of applications,
I'm sure that they will adjust
the standing membership
to reflect that.
Peyton Purcell: Great.
A question from (J.D.)
about whether
or not we can provide any
additional examples or criteria
of how NIH is assessing the
benefit of these international
projects to the U.S.
So for example is a study is
looking specifically at DNI
of cardiovascular disease care
in low and middle income
countries, but not
in the U.S. Is
that still appropriate?
David Chambers:
Yes it's a great question.
I think there's a couple
of different ways that we think
about the generalizability
of the U.S. populations
that might be useful.
And again, any individual
example would probably benefit
from a specific talk
with the program officer.
One way is thinking
about does it generalize
to populations within the U.S.
So if you're targeting a
particular subpopulation
within a country,
or that population has an
associated similar population
within the U.S.,
that can be one.
If there's a particular
subpopulation within the U.S.
where you say,
well in this country,
it's an enriched opportunity
to learn about that population.
That's one.
With dissemination
and implementation it can often
be related to similarities
in terms of the setting.
So it is one
where you might be able to learn
from low resource settings
in a particular country,
that generalizes nicely
to low resource settings
within the U.S.
Or as a third one,
there might be similar ways
in which care is organized
that gives you a chance to learn
about how does one improve
that care within a U.S. context
where there's a similar
structure of care.
So I think whether it's the
population or it's the sort
of broad context
in which care is delivered
or the specific system
in which care is organized.
Those are three opportunities
that one can think about.
And I'm sure that you can come
up with others.
Peyton Purcell: Great.
Before we get
to the last two questions
that I see on the web,
I just wanted to check again
if there's any questions
on the phone?
Coordinator:
I'm showing no questions
on the phone line.
Peyton Purcell: Great.
Then there's a (Barb) again,
saying that the presentation
tended to focus
on health care systems
and individual patients.
Is the review panel also open to
and familiar with population
and public health DNI research?
David Chambers:
Yes it's a great question.
The answer is absolutely
that is the case.
Sometimes in shorthand we tend
to emphasize certain things,
but not everything What you'll
see if you read
through the announcement is
certainly reference to
and the importance
of both population health
and specifically public
health efforts.
So we were very broad in terms
of thinking about what is it
that we'd be interested
in learning
about the implementation of.
So that includes policy level
interventions,
it includes interventions
targeting public health,
just as we may see more focus
on clinical
or community settings.
So all of which are important
for us in the announcement.
Peyton Purcell:
And last question as we come
up on the hour is from (Raphael)
and whether or not -
what are the chances
of being successfully accepted
to participate in TIDIRH
for international applicants.
And is it a big bonus
for an international application
to succeed?
David Chambers:
So in terms of the TIDIRH,
it's shifted each of the years.
The applications the first year
were huge.
I think it's been -
I'm going to estimate
that it's sort of been
around a quarter --
is that about right --
of the applications
that have been submitted.
I think there's enough spots
for about a quarter
of the people
who are interested.
It may differ year
to year though,
because as some have
successfully taken part
in the training,
obviously they would leave the
applicant pool,
because you wouldn't
specifically do it twice.
I think within the application,
though, there are specific
opportunities to talk
about why you might be
particularly well positioned
to gain from the institute
as well as to provide
certain things.
So there are -
there sort of have been bonuses
that one can think
about in terms of being able
to talk about the ability
to advance DNI research
in settings
that maybe haven't had
as much experience there.
So we would very much encourage
you to apply.
We would love to see sort
of the increase global element.
We do have people from WHO
who have been part
of the TIDIRH training
from the beginning.
And so we would love
to see more work
and more people interested
on the global side.
Peyton Purcell: Great.
And we'll just end
with one last question that's
specific to the (PAR)
from (Paula)
about whether DNI research
for psychosocial interventions
with populations
at risk is relevant
to this program announcement?
David Chambers: Yes I -
so the answer
to that is absolutely.
Certainly the National Institute
of Mental Health has a long
history of focusing
on psychosocial interventions
as do a number
of the other institutes,
whether it's the National
Institute on Drug Abuse
or Alcoholism and Alcohol Abuse,
Cancer Institute, et cetera.
There's a lot of scope
for different kinds
of interventions
and psychosocial are absolutely
in there.
Peyton Purcell: Great.
Well we'd like to thank you all
again for joining us
from around the globe
at all different times of day
for you all.
And just encourage you all
that if you do have any other
questions to please the contact
the program officers
in that program announcement.
We'll also be sending
around a link
to an evaluation survey,
which will include these slides
for the presentation.
So thank you so much
for your participation,
and have a good day.
Coordinator:
This now concludes
today's conference.
You may disconnect at this time.
END