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U.S. Department of Health and Human Services: Improving Outcomes for Disorders of Human Communication (R21)

Deadline: June 16, 2017

The Improving Outcomes for Disorders of Human Communication initiative seeks to improve the health outcomes for individuals with deafness and other communication disorders through effectiveness and health services research in the National Institute on Deafness and Other Communication Disorders (NIDCD) mission areas of hearing, balance, smell, taste, voice, speech, and language. The following types research studies will be are of interest:

Effectiveness research seeks to measure, evaluate, and/or improve patient-centered outcomes following intervention for communication disorders. Effectiveness research seeks to determine to what degree an intervention works in patients/populations in general, real-world settings, such as in diverse populations and diverse provider and clinical practice settings. Research outcomes are usually broader in range than typical patient-oriented research studies and include an expanded assessment of outcome compared to traditional clinical research metrics. For example, an outcomes study would measure functional status, well-being, quality of life, cost, health care resource use, etc., (as opposed to/or in conjunction with traditional clinical metrics such as measures of language, or speech discrimination in noise). Effectiveness research typically employs broader inclusion criteria and has fewer restrictions for participation than traditional clinical study/clinical trial/efficacy research performed under a tightly controlled research setting. Effectiveness research addresses patient-centered outcomes in practice relevant environments, focuses on quality of life, patient experience of and satisfaction with health care, and the social and economic consequences of care. It may include evaluation of economic impacts linked to health outcomes, and may be performed at either the patient or population level, or both.

Health services research examines the impact of the organization, financing, and management of health care services on the delivery, quality, cost, access to, and outcomes of such services, including demographic, social, economic, and health system factors as they relate to providing preventive, screening, diagnostic, treatment, and rehabilitative services and patient outcomes of care. Research may focus on any/all of the different factors that impact access, utilization, and quality as related to outcomes of health care services. Variations in care (e.g., ethnic, cultural, provider, geographic based) are also considered. The structure, processes, and outcomes of health services are evaluated in order to determine the degree to which individuals receiving health care services actually experience measurable benefits (http://www.hsrd.research.va.gov/funding/what-is-hsr.cfm)

Dissemination and implementation research seeks to understand how health information and scientifically based clinical practices are/are not adopted in a variety of settings. This includes research on health promotion and approaches to increase use of evidence-based guidelines by both individuals and health care providers. These studies focus on implementing research findings into practice. Individuals interested in applying for research support in implementation and dissemination research should apply under the NIDCD-participating competition “Dissemination and Implementation Research in Health (R01).” (https://grants.nih.gov/grants/guide/pa-files/PAR-16-238.html)

Applications must focus on NIDCD mission areas, and research topics must be justified in terms of potential clinical/public health impact. Appropriate studies include, but are not limited to:

  • Identifying patient and provider variables that predict patient satisfaction and improved outcomes for adults with communication disorders, including quality of life and psychosocial adjustment
  • Identifying patient or system factors that influence health care utilization, including patient motivation and perceived need
  • Determining the potential costs and impact of insufficient care (untreated or under- treated) on real world function and outcomes, including quality of life, depression, and community engagement
  • Investigating the value and effectiveness of current treatments for communication disorders on real world function and outcomes
  • Evaluating the relation between the system of care and outcomes for individuals with communication disorders
  • Determining the cost-effectiveness as it relates to health outcome of an intervention for a particular communication disorder
  • Investigating the role of patient, family, and community engagement on outcomes
  • Investigating the value of differing service delivery models for communication disorders (e.g., multidisciplinary management teams vs. single practitioner models) on outcomes
  • Examining the impact of the delivery of services on the cost, access, and patient utilization of care
  • Evaluating innovative delivery systems (e.g., telehealth, internet, and emerging technologies) and various delivery models (e.g., group or family)
  • Evaluating the effectiveness of the provision of services and outcomes for patients with multiple chronic disabilities and conditions (e.g., complex needs)
  • Examining adherence, compliance, decision-making, or patient education
  • Investigating ways to promote equity and reduce or eliminate health disparities/inequities in treatment services for individuals with communication disorders

There is substantial overlap among the above-mentioned research areas and all require collaborative multidisciplinary investigations. Applicants are encouraged to create collaborative teams which may include clinical experts not only in the traditional NIDCD mission areas, but also in other medical specialties and health care professions as well as experts in sociology, health services, health outcomes, economics, biostatistics, public health, health care financing and organization, survey research, psychometrics, epidemiology, and evaluation.

Applications are expected to be multidisciplinary, focus on practice-relevant questions, and may focus on the population or individual across the lifespan in diverse real-world settings. Applicants are encouraged to utilize community-based participatory research methods (i.e., alignments with patient, provider, or advocacy groups). Studies that utilize existing infrastructure (e.g., practice-based research networks, electronic medical records, existing data bases or patient registries) are also encouraged. Primary outcome measures should be validated and generally accepted by the field.

The R21 activity code is intended to encourage exploratory and developmental research projects by providing support for the early and conceptual stages of these projects. These studies may involve considerable risk but may lead to a breakthrough in a particular area, or to the development of novel techniques, agents, methodologies, models, or applications that could have a major impact on a field of biomedical, behavioral, or clinical research. A similar program is available that utilizes the R01 activity code, designated for a discrete research project.

Amount: Awards may range up to $200,000 in any single year, but the combined budget for direct costs for the two year project period may not exceed $275,000.

Eligibility: Higher education institutions; nonprofits other than institutions of higher education; for-profit organizations; governments; and other, including independent school districts, Public Housing Authorities/Indian Housing Authorities; Native American tribal organizations; faith-based or community-based organizations, and regional organizations.

Link: https://grants.nih.gov/grants/guide/pa-files/PA-17-140.html

Note: There is an additional deadline on October 16, 2017.

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