Billing Code: 4165‑16

Department of Health and Human Services

Indian Health Service

Native American Research Centers for Health (NARCH) Grants

Announcement Type: New and Competing Continuations

Funding Announcement Number: HHS-2009-IHS-NARCHV-0001

Catalog of Federal Domestic Assistance Numbers (s): 93.933

Key Dates: Letter of Intent Deadline: March 15, 2008

Application Deadline Date: May 16, 2008

Review Date: October, 2008

Earliest Anticipated Start Date: June 1, 2009

I. Funding Opportunity Description

The Indian Health Service (IHS), in conjunction with the National
Institute of General Medical Sciences (NIGMS) and other institutes of
the National Institutes of Health (NIH) announces competitive grant
applications for Native American Research Centers for Health (NARCH), an
initiative to support new and/or continuing centers or projects funded
under the NARCH grant program. This funding mechanism will develop
further opportunities for conducting research and research training to
meet the needs of American Indian/Alaska Native (AI/AN) communities.
This program is authorized under the Snyder Act, 25 U.S.C. 13, the
Public Health Service Act, 42 U.S.C. 241 as amended, and the Indian
Health Care Improvement Act, 25 U.S.C. 1602(a)(b)(16). This program is
described at 93.933 in the Catalog of Federal Domestic Assistance.

Background Information:

The AI/AN Tribal nations and communities have long experienced health
status worse than that of other Americans. Although major gains in
reducing health disparities were made during the last half of the
twentieth century, most gains stopped by the mid-1980s (Trends in Indian
Health 1998-99) and a few diseases, e.g., diabetes, worsened. \`\'\'All
Indian\'\' rates contain marked variation among the IHS Areas or regions
(Regional Differences in Indian Health 1998-99); and variation by Tribe
exists within Areas as well. The Trends and Regional Differences
reference can be found at the IHS website at:
http://www.ihs.gov/NonMedicalPrograms/IHS_Stats. Although the AI/AN
mortality rates for all cancers are about 20 percent lower than the U.S.
rates for all races, there is variation among IHS Areas for specific
cancers. Moreover, the favorable AI/AN mortality rates for some cancers
may be due to markedly lower incidence rates partly offset by higher
case-fatality rates. Unfamiliarity with modern health care may adversely
influence health status among the elderly, the low-income elderly, and
Tribes, and also may reduce the acceptability of health research among
them. The daunting tasks confronting Tribes, researchers, and health
care and public health programs in the beginning of the twenty-first
century are to resume the reduction of health disparities that had
occurred through the 1980s, to reverse the worsening in a few diseases,
to maintain and strengthen the favorable status, and to reduce the
disparities among and within Areas and Tribes. Factors known to
contribute to health status and disparities are complex, and include
underlying biology, physiology, and genetics, as well as ethnicity,
culture, socioeconomic status, gender/sex, age, geographical access to
care, and levels of insurance.

Additional factors known to contribute to health status and disparities
include:

1\. family, home, and work environments;

2\. general or culturally specific health practices;

3\. social support systems;

4\. lack of access to culturally- appropriate health care; and

5\. attitudes toward health.

Yet none of these alone or in combination accounts for all documented
differences. Health disparities of AI/ANs may also reflect a lack of
in-depth research relevant to improving their health status. Many AI/ANs
distrust research for historical reasons. One approach that combats this
distrust is to ensure that Tribes are the managing partners in training
and research that involves them, as for example, in community-based
participatory research (CBPR) (i.e., a collaborative research process
between researchers and community representatives). This approach is
especially helpful to design both training relevant to researchers from
Tribal communities, and research relevant to the health needs of the
communities.

Research Objectives: The NARCH initiative will support partnerships
between Federally Recognized AI/AN Tribes or Tribal Organizations
(including national and area Indian Health Boards, and Tribal colleges
meeting the definition of a Tribal organization as defined by 25 U.S.C.
1603(e)) and institutions that conduct intensive academic-level
biomedical, behavioral and health services research. These partnerships
are called Native American Research Centers for Health (NARCH). Due to
the complexity of factors contributing to the health and disease of
AI/ANs, and to their health disparities compared with other Americans,
the collaborative efforts of the agencies of the Department of Health
and Human Services (HHS) and the collaboration of researchers and AI/AN
communities+ are needed to achieve significant improvements in the
health status of AI/AN people. To accomplish this goal, in addition to
objectives set by the Tribe, Tribal Organization or Indian Health
Boards, the IHS NARCH program will pursue the following program
objectives:

-   To develop a cadre of AI/AN scientists and Health Professionals-
    -Opportunities are needed to develop more AI/AN scientists and
    health professionals engaged in research, and to conduct biomedical,
    clinical, behavioral and health services research that is responsive
    to the needs of the AI/AN community and the goals of this
    initiative. Faculty/ researchers and students at each proposed NARCH
    will develop investigator-initiated, scientifically meritorious
    research projects, including pilot research projects, and will be
    supported through science education projects designed to increase
    the numbers of, and to improve the research skills of, AI/AN
    investigators and investigators involved with AI/ANs.

-   To enhance Partnerships and reduce distrust of research by AI/AN
    communities\--Recent community-based participatory research suggests
    that AI/AN communities can work collaboratively in partnership with
    health researchers to further the research needs of AI/ANs. Fully
    utilizing all cultural and scientific knowledge, strengths, and
    competencies, such partnerships can lead to better understanding of
    the biological, genetic, behavioral, psychological, cultural,
    social, and economic factors either promoting or hindering improved
    health status of AI/ANs, and generate the development and evaluation
    of interventions to improve their health status. Community distrust
    of research and researchers will be reduced by offering the Tribe
    greater control over the research process.

-   To Reduce Health Disparities\--In the Indian Health Care Improvement
    Act, Public Law Pub. L. 94-437 (as amended), IHS was legislatively
    mandated to improve the delivery of effective health care to AI/ANs.
    In the NIH Revitalization Act of 1993, NIH was encouraged to
    increase the number of under-represented minorities participating in
    biomedical, clinical, and behavioral research, including studies on
    drug abuse and alcoholism, and the examination of the role of
    resiliency in the prevention and treatment of those conditions.
    Also, the \`\`Initiative to Eliminate Racial and Ethnic Disparities
    in Health\'\' by HHS (http://www.omhrc.gov/rah) encouraged NIH to
    help reduce health disparities. In response to these priorities, the
    IHS and NIH have established a collaboration to support the NARCH.

> Reducing health disparities among AI/AN communities and individuals
> may be fostered by greater understanding of how to enhance their
> strengths and resilience. While AI/AN communities have relied on
> health research and medical science to reduce health disparities, they
> have also relied on their own psychological, organizational, and
> cultural assets and strengths to survive major harms and disruptions
> over the centuries, and to rebound from insults to health.
>
> The mission of NIH is to acquire new knowledge that will lead to
> better health by understanding the processes underlying health and
> disease that in turn will help prevent, detect, diagnose, and treat
> disease and disability. The NARCH initiative works toward the NIH
> mission by supporting research that discovers the interrelationships
> among the many factors that contribute to health and disease, and by
> helping to train and promote AI/AN researchers and researchers
> concerned with AI/AN health.

II\. Award Information

TYPE OF AWARDS: Grant.

ESTIMATED FUNDS AVAILABLE: The estimated funds (total costs) available
for the first year of support for the entire initiative is expected to
be at least \$ 3.0 million in Fiscal Year 2009. The actual amount may
vary, depending on the response to the request for applications (RFA)
and availability of funds. An applicant may request a project period not
to exceed four years of support, and direct costs not to exceed
\$1,000,000 per center or \$500,000 per project (research or training)
in the first year of each award . Direct costs to the applicant include
the total cost of each subcontract (subcontractor direct plus
subcontractor indirect costs).

ANTICIPATED NUMBER OF AWARDS: An estimated five to fifteen awards will
be made under the program.

AWARD AMOUNT: \$100,000 -\$1,000,000 per year.

III. Eligibility Information

     The new or existing NARCH must be a working partnership of the
     eligible AI/AN organization and of the research-intensive
     institution. Applicants eligible to receive the NARCH award are
     Federally recognized Tribes and Tribal organizations as defined
     under the Indian Health Care Improvement Act, 25 USC 1603(d) and
     (3), including eligible Indian Health Boards or Tribal Colleges
     applying on behalf of eligible Federally recognized Tribes or
     Tribal organizations. As the grantee, the eligible AI/AN
     organization will define criteria and eligibility for participation
     in all aspects of the partnership, consistent with this
     announcement. A minimum of 30 percent of the grant funds must be
     budgeted in the application to remain with the eligible AI/AN
     organization(s); that is, no more than 70 percent of the
     application's total budget may be contained in subcontract budgets
     of the non-eligible subcontracting partner institutions or
     organizations.

     1.  Eligible Applicants - The AI/AN applicant must be one of the
         following:

-   A Federally-recognized AI/AN Tribe, as defined under 25 USC 1603(d);
    or

-   A Tribal organization, as defined under 25 USC 1603(e), including
    Tribal Colleges or health boards meeting this definition; or

    or

```{=html}
<!-- -->
```
-   A consortium of two or more of those Tribes or Tribal organizations.

    Applicants other than Tribes must provide proof of non-profit
    status.

    1.  Cost Sharing or Matching ‑ The NARCH program does not require
        matching funds or cost sharing.

> 3\. The Research-Intensive Partner:
>
> The Research-Intensive Partner must be an accredited public or private
> nonprofit university or other institution that has an established
> record of conducting research into the health problems of AI/AN; has
> demonstrated a commitment to enhancing the capability of AI/AN
> faculty/researchers, students, investigators, and communities to
> engage in biomedical, behavioral, clinical and health services
> research; and has demonstrated a commitment to mentoring AI/AN
> faculty/researchers, students, and investigators.
>
> 4\. Principal Investigator:
>
> The Principal Investigator, the individual responsible for the
> administration (including fiscal management) of the overall project,
> must have his/her primary appointment with the AI/AN applicant
> organization. Special arrangements of employment, such as
> inter-organizational personnel agreements, are permissible. The
> Principal Investigator may be, but is not required to be, the NARCH
> Program Director or a Research Project Investigator. The NARCH
> Principal Investigator may or may not have formal academic/research
> credentials, but if not, then the NARCH Program Director must be so
> qualified.
>
> The traditional NIH research project grant consists of a single
> Principal Investigator (PI) working with a small group of subordinates
> on an independent research project. Although this model clearly
> continues to work well and encourages creativity and productivity, it
> does not always work well for multidisciplinary efforts and
> collaboration. Increasingly, health-related research involves teams
> that vary in terms of size, hierarchy, location of participants,
> goals, disciplines, and structure. There is growing consensus that
> team science would be encouraged if more than one PI could be
> recognized on individual awards. The NIH has adopted a multiple-PI
> model, as recently directed by the Office of Science and Technology
> Policy. All agencies that have research and research-related programs
> must offer the multiple-PI model as an option. Note, it is only an
> option, not a requirement. The traditional NARCH division of roles
> between Principal Investigator and Project Director will usually
> address these issues to a satisfactory degree. For additional
> information regarding the new multiple-PI model, please click on the
> following website: http://grants.nih.gov/grants/multi_pi/index.htm.
>
> 5\. NARCH Program Director:
>
> The NARCH Program Director is the individual responsible for the
> day-to-day leadership and management of the research and training
> programs within the proposed NARCH. The Program Director may be, but
> is not required to be, the Student and Faculty/Researcher Development
> Director or a Research Project Investigator. The NARCH Program
> Director may or may not have formal academic/research credentials, but
> if not, then the Principal Investigator must be so qualified.
>
> 6\. Student and Faculty/Researcher Development Director and
> Participants:
>
> The NARCH initiative is an institutional developmental grant mechanism
> that places an emphasis on the continual development of students and
> faculty/researchers. If a new Student and/or Faculty/Researcher
> Development Program is proposed in the current application, then the
> Principal Investigator of that project is expected to be the NARCH
> Student and Faculty Development Director. In order to be included as
> the Student and Faculty Development Director, the prospective director
> must have a faculty/researcher appointment at the research-intensive
> institution (or equivalent appointment at the AI/AN organization or
> other consortium partner) and must demonstrate that he/she has the
> knowledge, skills, and capabilities to mentor students and faculty/
> researchers and to generate and direct development and mentoring
> programs.
>
> The Student and Faculty Development Director may be the NARCH Program
> Director. Faculty/researchers and students should be supported in
> research education activities that improve their skills and abilities
> to be successful at the next stage of their professional development.
> To be included as a participant for faculty/researcher development in
> the proposed NARCH, the individual must have a faculty/ researcher
> appointment at the research-intensive institution or equivalent
> appointment at the AI/AN organization or consortium partner.
>
> 7\. Research Project Investigators:
>
> The NARCH initiative is an institutional developmental grant mechanism
> that places an emphasis on continual improvement of the research
> competitiveness of the research investigators. In order to be included
> as a research project investigator in the NARCH, a prospective
> investigator must have a faculty appointment at the research-intensive
> institution or equivalent appointment at the AI/AN organization or
> other consortium partner, and must show that he/she has the need,
> based on institutional, departmental, and professional development
> plans, to enhance his/her research knowledge, skills, and capabilities
> by engaging in the proposed research program and associated
> activities.
>
> 8\. Tribal Approval of the Application:
>
> It is the policy of the IHS that all research involving AI/AN Tribes
> be approved by the Tribal governments with jurisdiction. Therefore,
> the following documentation is required as part of the application for
> new or continuing centers or additional NARCH projects:

-   Tribal Resolution:

> If the applicant is an Indian Tribe or Tribal organization, a
> resolution from the Tribal government of all Tribes to be served
> supporting the project must accompany the application submission.
> Applications by Tribal organizations will not require resolutions if
> the current Tribal resolutions under which they operate would
> encompass the proposed activities. In this instance a copy of the
> current resolution must accompany the application. The listed Tribes
> to be served by the project in the proposal must match the set of
> appended resolutions. If a resolution from an appropriate
> representative of each Tribe to be served is not submitted prior to
> November 1, 2008, the application will be considered incomplete and
> will not be considered for funding.
>
> An official signed resolution must be received by November 1, 2008 to
> the Division of Grants Operations by (DGO), IHS, at the Reyes
> Building, 801 Thompson Avenue, TMP 360, Rockville, MD 20852. A grant
> will not be awarded unless the signed resolution is received. Please
> include the funding opportunity number, as a reference to this
> announcement, if the resolutions are submitted as a separate mailing.
>
> 9\. Mechanism of Support:
>
> Awards under this initiative will be administered using the competing
> institutional grant mechanism of the IHS, and will be reviewed using
> the NIH S06 mechanism.

IV. Application and Submission Information

    1\. Address To Request Application Package: NARCH Program Official,
    Reyes Building, 801 Thompson Avenue, Rockville, MD 20852 or by email
    to narch@ihs.gov. Applicants are strongly encouraged to establish
    eligibility of their proposed applications prior to submission.
    Inquiries about eligibility should be addressed to Alan
    Trachtenberg, MD, MPH, at (301) 443-0578 or by email to
    narch@ihs.gov. The application package, including supplemental
    instructions will be posted on the IHS Research Program Website, at:
    <http://www.ihs.gov/MedicalPrograms/Research/narch.cfm>.

> The NIH PHS 398 application instructions are available in an
> interactive format at:
> <http://grants.nih.gov/grants/funding/phs398/phs398.html>. Applicants
> must use the currently approved version of the PHS 398. For further
> assistance contact GrantsInfo, Telephone (301) 435-0714, Email:
> GrantsInfo@nih.gov Telecommunications for the hearing impaired: TTY
> 301-451-0088.
>
> Submit a typed and signed original application, including the
> Checklist, and one (1) single-sided photocopy of the entire
> application (including Appendices and supporting documents) in one
> package to: Division of Grants Operations, Indian Health Service,
> Reyes Building, 801 Thompson Avenue, TMP 360, Rockville, MD 20852-1627
> (zip code is unchanged for express/courier services), Telephone: (301)
> 443-5204.
>
> At the time of submission, applicants must also send four (4)
> additional single- sided photocopied and signed applications,
> including the Checklist, Appendices, and supporting documentation to:
> Center for Scientific Review (CSR), National Institutes of Health,
> 6701 Rockledge Drive, Room 6160- -MSC 7892, Bethesda, MD 20892-7720,
> Bethesda, MD 20817 (for express or courier service). Telephone: (301)
> 435-0715. The CSR no longer accepts hand delivered applications.

The RFA label available at
http://grants1.nih.gov/grants/funding/phs398/label-bk.pdf in the PDF
format, must be affixed to the bottom-face page of the application. Type
this RFA number: \`\`NOT GM-08-115\'\' on the label. Failure to use this
label could delay processing the application and it may not reach the
review committee in time for review. In addition, the \`\`Native
American Research Centers for Health\'\' and the RFA number must be
typed on line 2 of the face page of the application form and the YES box
must be marked.

> E‑mail or other electronic applications will not be accepted under
> this announcement.
>
> Specific supplementary instructions for the PHS 398 application and
> budget preparation for the NARCH program may be obtained from the
> initiative contacts listed under VII. Agency Contacts, and will be
> posted at: <http://www.ihs.gov/MedicalPrograms/Research/narch.cfm>.

There will be no acknowledgment of receipt of the application.

2\. Content and Form of Application Submission:

A proposed NARCH may include any or all of the following components:
student development projects; faculty/researcher development projects;
research projects (including pilot projects); and "core" administrative
facilities.

The content of the application should explain the components of the
application, and how they help meet the purposes of the NARCH
initiative. A description should be provided of the current state of the
research and research training enterprise at the proposed NARCH and its
institutional and community partners, including faculty/researcher and
student profiles.

A clear statement should be presented of the overall goals, specific
measurable objectives, and anticipated milestones. These elements should
be presented in the context of needed improvements in the partners\'
organizational infrastructure and environment for research.

Documentation should be provided to establish that the
research-intensive partner is an institution with a record of conducting
research into the health of AI/ANs, and that it has a demonstrated
commitment to the special encouragement of, and assistance to, AI/AN
faculty/researchers, students, investigators, and communities for
enhancing their capacity to engage in biomedical, behavioral and health
services research. Documentation about the nature of the partnership
itself should be included, such as: the process to develop the
application and proposed NARCH itself, the past and future efforts to
increase the capacity of the partners to improve their partnership, and
efforts to contribute to the success of the NARCH.

A plan for assessment of the benefits of the activities by the proposed
NARCH on specific, measurable outcomes identified in the application
should be provided. IHS and NIGMS recognize that Tribes, Tribally-based
organizations, and research-intensive institutions are diverse in their
missions, their health and economic status, and their cultures. Such an
assessment could include a self-study by the proposed NARCH and its
partners, which focuses on fact-finding, program evaluation, and
recommendations for improvement in key areas.

Strategies for determining the initial and ongoing success of their
efforts for organizational development should also be presented. It is
expected that each proposed NARCH will develop its own set of strategies
that best match its circumstances. Guidance and suggestions for program
evaluation of a proposed NARCH can be obtained from
http://www.the-aps.org/education/promote/promote.html

Applicants are strongly urged to contact NARCH initiative staff at an
early stage to request the specific supplementary instructions for the
PHS 398 for the NARCH grants. Supplementary instructions may be obtained
from the initiative contacts listed under VII. Agency Contacts, and will
be posted at:

http://www.ihs.gov/MedicalPrograms/Research/narch.cfm.

If Student Development Projects are proposed, the NARCH application
should describe new programs or modifications or additions to existing
programs of the partners that encourage and facilitate AI/AN students to
enter, advance, and remain in research careers. Such projects might
include, but are not limited to, providing employment as research
assistants in research projects of research-active mentors with an
explicit mentoring plan, providing other mentoring with an explicit
mentoring plan, providing workshops to improve technical or
communication skills, providing motivating seminars or journal clubs
highlighting problems of interest to students, providing contact with
role models, and providing opportunities to travel to present results at
national scientific meetings. If research mentorships or apprenticeships
are proposed, the application should clearly document the experience,
proposed commitment, and quality of the mentors in providing guidance
and advice to students (including responsible conduct of research and
research integrity, teaching, and protection of human subjects), and in
fostering the development of academic and/or community-based AI/AN
researchers.

The application should describe how the development plans for the
student will meet both the individual\'s professional development goals,
and one purpose of the NARCH initiative: to develop a cadre of AI/AN
scientists and health professionals. The application must have an
evaluation plan for the project(s) that indicates the anticipated
outcomes relative to the current baseline data. For example, one outcome
might be the improved retention of AI/AN students in science majors. The
application should indicate the anticipated (quantitative) improvement
relative to the current retention rate.

A student in a NARCH Student Development Project must be a full- time or
part-time student officially enrolled in an educational program leading
to an undergraduate or graduate degree, or in a post-doctoral
educational program, or (if well justified) in late high school. A
helpful book about mentoring science students is found at
http://books.nap.edu/catalog/5789.html.

If Faculty/Researcher Development Projects are proposed, the NARCH
application should describe the need, proposed activity, and anticipated
outcomes. Faculty/researcher development projects might include, but are
not limited to, short-term mentored research experiences in the lab of
an active NIH-extramurally-funded researcher with an explicit mentoring
plan, long-term general mentoring under an explicit mentoring plan, or
attendance at workshops or courses or national meetings needed for
acquiring specific skills or methodologies needed for prospective
research. As with student development projects, the application should
document the experience, proposed commitment, and quality of the
mentors, teachers, or experience in providing guidance and advice to
faculty/researchers, and in fostering the development of academic and
community-based AI/AN research. The application must also describe the
evaluation plan for the faculty/researcher development project. The
application must clearly describe how the development plans for
faculty/researchers will meet both the individual\'s professional
development goals, and two purposes of the NARCH initiative:

> • to develop a cadre of AI/AN scientists and health professionals, and
>
> • to enhance the partnership of the proposed NARCH.
>
> NARCH applications may include a maximum of five (5) regular Research
> Projects and a maximum of five (5) Pilot Research Projects. Unlike
> regular research projects, a pilot research project is limited in
> scope and is not expected to have preliminary data. It is also limited
> to a budget of no more than \$50,000 direct costs per year for four
> years. The pilot research project is intended for faculty/researchers
> without current federal research support. Support for
> faculty/researchers participating in pilot research projects is
> preparatory to seeking more substantial funding from NIH research
> grant programs (e.g., Academic Research Enhancement Award, K, and R01
> awards), as well as funding from other agencies and private sources.
> Funds received from the proposed NARCH to support pilot research
> projects may not be used to supplement ongoing research projects. A
> NARCH application need not include both research projects and pilot
> research projects. Applications for only pilot research projects or
> for only research projects may be submitted. Individual project
> investigators may propose either a research project or a pilot
> research project, but not both.
>
> Each research project or pilot research project should follow the
> instructions provided in PHS 398 (Revised 9/2004, Interim Revision
> 4/2006) for preparing research grant applications. The professional
> development goals must clearly describe specific objectives and
> milestones which should include, but are not limited to, improving
> competitiveness in acquiring grant support. The applicant should
> describe how successful completion of the proposed research project
> will improve the research skills and will help develop the students
> and faculty/researchers, thus contributing to the overall goals and
> specific measurable objectives of the proposed NARCH.
>
> Each research project or pilot research project must follow the IHS
> policy concerning Tribal approval, that all research involving AI/AN
> Tribes be approved by the Tribal governments with jurisdiction. That
> is, each grantee must include a resolution of approval from the Tribal
> government(s), or (if applicable) a letter of support signed by the
> director of the eligible AI/AN organization, or both (if applicable)
> for projects that involve people or community(ies) of an AI/AN Tribe,
> or an eligible Tribal organization.
>
> Research projects (including pilot research projects) proposed under
> this initiative must be in research areas normally funded by any of
> the NIH or other research agencies in the HHS. Research projects
> addressing health disparities and the health priorities of the AI/AN
> partner are especially encouraged.
>
> A listing of grants recently funded by NIH may be found at Computer
> Retrieval of Information on Scientific Projects (CRISP), a searchable
> database of Federally funded biomedical research projects conducted at
> universities, hospitals, and other research institutions. It may be
> accessed at <http://ott.od.nih.gov/crisp.html>.
>
> The following agencies, institutes, offices and centers have stated
> particular interests in supporting research under the NARCH Program as
> follows:

NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH (NIDCR)

**[Oral Health Research]{.underline}:**

NIDCR is committed to reducing the disproportionate burden of oral
diseases experienced by AI/ANs. The focus of NIDCR's health disparities
research is on improving oral health status and quality of life by
understanding and addressing oral diseases that are prevalent in AI/AN
communities, specifically caries (including early childhood caries),
oral and pharyngeal cancer, and periodontal disease. Interdisciplinary
research teams and the full participation of communities are viewed by
NIDCR as essential components of any health disparities research.

Data that document oral disease prevalence are readily available for
some populations, but not for others. Homogeneity in subgroups of
populations cannot be assumed. For instance, there are national data for
Mexican Americans, but not for the numerous other Hispanic subgroups.
Similarly, data regarding the oral health status of various AI/AN Tribes
are unavailable. Moreover, available data provide little insight into
the etiology or determinants of oral disease and oral health. The
paucity of quality data and conceptual models concerning the broad array
of potential determinants and risk-factors inhibits progress toward
preventing disease, and improving oral health status and quality of
life. The NIDCR invites applications that, in preparation for
intervention research, explore the complex array of social, behavioral,
psychological, contextual, environmental and biological factors and
their interactions that may contribute to oral health disparities within
AI/AN communities. Including oral health status measures within broader
epidemiologic studies is encouraged. However, applications that are
limited to the assessment of disease prevalence and that explore a very
limited range of potential determinants will be considered
non-responsive.

The NIDCR has particular interest in intervention research that will
provide clinically meaningful outcomes and essential information needed
to inform clinical practice, public health policy, health care
provision, community and/or individual action. Intervention studies that
are grounded in theory are needed. Both basic and applied intervention
research applications are invited. Studies may need to intervene at
multiple levels within communities. The NIDCR encourages the use of the
strongest research design possible and recognizes that not all
intervention research is amenable to randomized clinical trials.
Examples of health disparities intervention research of interest to the
NIDCR includes but are not limited to:

-   Effectiveness studies that tailor/target preventive approaches to
    communities/individuals;

-   Research that intervenes in novel ways on macro- or intermediate
    level determinants of oral health status;

-   Health services research that explores alternative approaches to
    delivering preventive oral health care;

-   Studies that intervene on common risk factors or that take a systems
    approach;

-   Studies that explore multifaceted strategies to intervene at several
    levels within society;

-   Dissemination and implementation research at multiple organizational
    levels; and

-   Research that uses appropriate technology for translation,
    implementation, adoption, adherence and acceptance of oral disease
    prevention programs in defined populations, clinics, and
    communities.

Intervention research should be reasonably applicable to a specific
AI/AN population. To facilitate adequate enrollment and
generalizability, intervention studies may need to be conducted at
multiple sites. While small clinical trials are not permitted, studies
may be conducted at a single site if enrollment is adequate and if
sufficient numbers of participants are available to allow extrapolation
of clinically meaningful results to the specific AIAN population of
interest.

Pilot research projects that are designed to lead to larger research
projects funded as part of a center or as free-standing NIH grants may
be proposed.

For additional information about oral health research contact:

Ruth Nowjack-Raymer, M.P.H., Ph.D.

Director, Health Disparities Research Program

National Institute of Dental and Craniofacial Research

45 Center Drive, Room 4AS-43F

Bethesda, MD 20892-6401

Phone: (301) 594-5394

Fax: (301) 480-8322

E-mail: nowjackr@mail.nih.gov

NATIONAL INSTITUTE ON DRUG ABUSE (NIDA):

**[Neuroscience and Drug Abuse Research]{.underline}:**

AI/ANs demonstrate higher rates of drug abuse, particularly
methamphetamine, tobacco and alcohol abuse, relative to other racial
subgroups. According to 2002-2006 National Survey on Drug Use and Health
(NSDUH) data, AI/AN past year methamphetamine use was 1.4% compared to
0.1% for African Americans, 0.6% for Hispanics or Latinos and 0.7% for
Whites. Prevalence of use is high in both men and women.

Drug abuse patterns among AI/AN are complex and can vary by factors such
as Tribe and geographic location. While some datasets are available that
can provide general epidemiological data regarding use and abuse rates
in this group, data are needed that better clarify where use rates are
highest, among which Tribes, age and gender groups and the factors that
predict drug abuse in these locales and groups. These data will assist
in developing more targeted interventions and in identifying mechanisms
related to drug abuse which can then serve as focal points for
intervention.

In addition to scarce data on patterns of use, limited data are
available assessing drug abuse prevention and treatment interventions
for AI/AN. The matrix model has been proposed in particular to address
methamphetamine abuse, but few data are available to assess the efficacy
of this approach with this population. Several preventive interventions
have been designed particularly for this population and results from
them indicate their value, but more research is needed to clarify why
these sometimes don't work in expected ways and whether the
interventions that are being used but have not been evaluated are
working to reduce drug use.

The NIDA is committed to reducing health disparities in drug abuse and
related health and social consequences among AI/AN. Further, the
Institute supports methodologies required by the NARCH, expecting that
studies be developed and implemented using community participatory
approaches.

Research topics of interest include but are not limited to:

-   Studies that explore a range of behavioral, cultural, environmental
    and individual factors that contribute to drug abuse;

-   Studies that explore the consequences of drug abuse among AI/AN;

-   Studies that consider the full context of drug abuse, including
    poverty, family factors, school factors, intergenerational trauma,
    etc.;

-   Studies that explore the role of traditional practices and
    spirituality in protecting against drug abuse;

-   Studies that explore other factors that that protect against use in
    those groups for whom use rates are lower;

-   Studies that explore the efficacy and/or effectiveness of culturally
    relevant preventive interventions;

-   Studies that explore the efficacy and/or effectiveness of culturally
    relevant treatment interventions;

-   Studies that assess factors related to service utilization,
    including use rates and access to services, either in reservation or
    urban settings; and

-   Studies that explore the organization, management and delivery and
    of interventions

For additional information about neuroscience or drug abuse research
contact:

Kathy Etz, Ph.D.\
National Institute on Drug Abuse\
6001 Executive Blvd.\
Room 5153 MSC 9589\
Bethesda, MD 20852\
Phone: (301) 402-1749\
Fax: (301) 480-2543

NATIONAL CANCER INSTITUTE (NCI)

**[Tobacco Control Research:]{.underline}**

AI/ANs have been documented to have the highest smoking rate of any
major racial/ethnic group in the U.S. According to the 2005 National
Health Interview Survey of adults 18 and over, 32% of AI/AN are current
smokers, compared with 21.9% of non-Hispanic whites, 21.5% of
non-Hispanic blacks, 13.3% of Asians and 16.2% of Hispanics. Prevalence
of smoking is high among both men (37.5%) and women (26.8%).^(1)^ A
similar pattern can be seen among youth, where AI/AN youth have
substantially higher smoking prevalence (23.1%) than non-Hispanic whites
(14.9%), Hispanics (9.3%), non-Hispanic blacks (6.5%), and Asians
(4.3%), according to data from the National Survey on Drug Use and
Health. These data also show that non-smoking AI/AN youth demonstrated
higher susceptibility to experimenting with smoking than most other
racial/ethnic groups.^(2)^

At the same time, however, tobacco use patterns among the AI/AN
population are complex and can vary substantially among subgroups of
this population. Smoking rates among AI/ANs vary widely by region, being
highest in the northwestern United States, in Canada, and in Alaska.
Additionally, use of smokeless tobacco is higher among AI/AN adults
compared with other racial/ethnic groups. Some studies have found
particularly high rates of smokeless tobacco use (greater than 50%)
among AN populations, including pregnant women, due to the use of Iqmik,
a traditional form of smokeless tobacco.^(3)^

Understanding tobacco use among Native American populations is also
complicated by the fact that tobacco has had a substantial role in
Native American culture and tradition. Historically, tobacco has been
used in medicinal and healing rituals and in ceremonial and religious
practices. It is important to distinguish the traditional, ceremonial
uses of tobacco, which are limited to specific occasions, from addictive
use of tobacco products. However, the relationship between these
different contexts of tobacco use and their impact on behavior has not
received sufficient scientific study.

Moreover, limited data are available on the effectiveness of tobacco use
cessation interventions targeted to AI/ANs. Preliminary focus group
studies suggest that Native American smokers are more likely to have
negative attitudes towards pharmacotherapies, such as concerns about
side effects and lack of trust in conventional medicine.^(4)^ Thus,
there is a need to develop culturally-appropriate interventions targeted
to this population.

The NCI Tobacco Control Research Branch is committed to supporting
transdisciplinary research aimed at reducing disparities in tobacco use
and related health outcomes. The NARCH provides a unique mechanism to
support collaborative research involving researchers from multiple
disciplines to address a complex scientific and public health challenge.

Sample research areas of interest include but are not limited to the
following:

-   Studies to understand the role of a range of behavioral, cultural
    and environmental factors that lead to initiation of tobacco use
    among AI/AN populations.

-   Development and evaluation of culturally appropriate interventions
    for tobacco use prevention and cessation targeted to AI/AN
    populations;

-   Studies of how tobacco related attitudes and behaviors in youth and
    adults are influenced by ceremonial tobacco use and other cultural
    factors;

-   Studies of tobacco use behavior in relation to different products,
    including dual use of cigarettes and smokeless tobacco;

-   Research on the characteristics, use and health effects of
    traditional tobacco products, such as Iqmik;

-   Research to understand disparities in tobacco use within AI/AN
    populations given substantial variations by region and other
    factors; and

-   Studies to identify and address barriers to treatment among AI/ANs.

References

1\. Tobacco Use Among Adults \-- United States, 2005. MMWR. October 27,
2006; 55: 1145-1148.

2\. Racial/Ethnic Differences Among Youths in Cigarette Smoking and
Susceptibility to Start Smoking \-- United States, 2002 \-- 2004. MMWR.
December 1, 2006; 55; 1275 1277.

3\. Renner CC, Patten CA, Day GE, Enoch CC, Schroeder DR, Offord KP,
Hurt RD, Gasheen A, Gill L. Tobacco use during pregnancy among Alaska
Natives in western Alaska. Alaska Med. 2005;47:12-6.

4\. Burgess D, Fu SS, Joseph AM, Hatsukami DK, Solomon J, van Ryn M.
Beliefs and experiences regarding smoking cessation among American
Indians. Nicotine Tob Res. 2007; 9 Suppl 1: S19-28.

For additional information about NCI tobacco research contact:

Mark Parascandola, PhD

Epidemiologist

Tobacco Control Research Branch

National Cancer Institute

6130 Executive Blvd. MSC 7337

Executive Plaza North, Room 4039

Bethesda, MD 20892

Phone: 301-451-4587

Fax: 301-496-8675

paramark@mail.nih.gov

NATIONAL HEART, LUNG, AND BLOOD INSTITUTE (NHLBI)

**[Cardiovascular and Respiratory Research]{.underline}:**

The NHLBI has a strong history of supporting research to document and
intervene on health disparities among AI/ANs, including the Strong Heart
Study, Pathways, Genetics of Coronary Artery Disease in Alaska Natives
(GOCADAN), the Stop Atherosclerosis in Native Diabetics Study (SANDS),
and Community-Responsive Interventions to Reduce Cardiovascular Risk in
AI/AIs.

The Strong Heart Study showed that many AI/AN communities bear a heavy
burden of cardiovascular disease (CVD) and cardiovascular risk factors
(e.g., obesity, diabetes) that could be reduced through effective
interventions on modifiable risk factors. The high burden of disease
will worsen unless behaviors and lifestyles affecting CVD risk can be
changed. Prevalence of obesity in AI/AN communities is about 50% higher
than in the U.S. general population in which obesity is often described
as being of epidemic proportions. In some AI/AN communities, cigarette
smoking, sedentary lifestyle, and stress augment the adverse effects of
obesity. AI/AN are particularly vulnerable to Type II diabetes, a
problem exacerbated by high rates of obesity. Diabetes prevalence is
3-20 fold higher among AI/AN than in the general U.S. population. It is
an important cause of coronary heart disease, cardiomyopathy, end-stage
renal disease, non-traumatic amputation, and vision impairment. Lipid
abnormalities also are common in Type II diabetics, particularly high
triglycerides and low HDL-cholesterol levels. Dyslipidemia and blood
pressure can be improved by appropriate changes in diet and by increased
exercise. CVD risk is also substantially improved by smoking cessation.
In addition, attention to high stress levels, untreated sleep disordered
breathing, short sleep duration, and depression may be warranted because
of evidence that they may influence the health behaviors of interest.
For example, poorer diet, higher smoking rates, and physical inactivity
are more prominent in those with high stress, sleep disorders, or
depression. These psychosocial factors also are associated with CVD
progression in observational epidemiologic studies, and there is
evidence from smaller clinical studies they may affect mechanisms
leading to CVD. NHLBI is interested in supporting research in AI/AN
communities that promote the adoption of healthy lifestyles and/or
improve behaviors related to cardiovascular (CV) risk, such as weight
reduction, regular physical activity, and smoking cessation. These
behaviors and lifestyles are known to affect biological cardiovascular
risk factors, such as hypertension, dyslipidemia, obesity, glucose
intolerance, and diabetes. In addition, control of these risk factors by
guideline-based use of antihypertensive, lipid lowering, and
hypoglycemic drugs can reduce their adverse consequences. However, these
pharmacological interventions are often suboptimally utilized in AI/AN
communities. The NHLBI is interested in reducing cardiovascular disease
mortality and morbidity in AI/AN, whether by lifestyle changes, drug
interventions, or combinations thereof.

Lifestyles characterized by sleeping less than 5-6 hours per night are
associated with increased risk of CVD, obesity, and diabetes.
Insufficient sleep as a behavioral stressor is associated with risk of
new onset substance abuse and relapse, and depression risk and relapse.
Intervention studies to assess the efficacy of improving sleep as part
of a healthy lifestyle or assessing how improving sleep disorders could
improve CVD outcomes would be of interest to NHLBI.

AI/AN also have been documented to exhibit high rates of chronic
respiratory disease. AI/AN adults have the highest asthma rate among
single-race groups. Recent evidence suggests that 11.6 percent of AI/AN
suffer from asthma. This is significantly higher than the national
average of 7.5 percent, and much higher than every other single racial
or ethnic group. Chronic obstructive pulmonary disease (COPD), which
includes emphysema and chronic bronchitis, is the eight leading cause of
death from chronic disease for AI/AN men and the sixth leading cause of
death for women. AI/AN have the second highest rates of cystic fibrosis
following whites. One in 10,500 AI/AN has cystic fibrosis compared with
one in 3,500 whites. Pueblo Indians and Zuni Indians have higher
incidence than among other AI/AN Tribes. Sleep disordered breathing
appears to be 30-60% more common among American Indians than other
racial and ethnic groups. NHLBI is interested in supporting research in
AI/AN communities that includes studies of approaches to improve
clinical delivery of efficacious treatments of chronic lung disease and
their risk factors, improved methods of chronic lung disease
self-management, studies to promote or maintain respiratory health or
improved methods of rehabilitation for diseases of the lungs and
airways, such as asthma, emphysema, cystic fibrosis; sleep disordered
breathing, occupational lung diseases, pulmonary vascular disease or
pulmonary complications of Acquired Immune Deficiency Syndrome (AIDS).

In addition to these areas of research, the NHLBI recognizes a unique
and compelling need to promote diversity in the biomedical, behavioral,
clinical, and social sciences research workforce. The NHLBI expects
efforts to diversify the workforce to lead to:

-   the recruitment of the most talented researchers from all groups;

-   an improvement in the quality of the educational and training
    environment;

-   a more balanced perspective in the determination of research
    priorities;

-   an improved capacity to recruit subjects from diverse backgrounds
    into clinical research protocols; and

-   an improved capacity to address and eliminate health disparities.

For more information, please contact:

Jared B. Jobe, Ph.D. (Cherokee)

Program Director

Clinical Applications and Prevention Branch

Division of Prevention and Population Sciences

National Heart, Lung, and Blood Institute

6701 Rockledge Drive, Suite 10018, MSC 7936

Bethesda, Maryland 20892-7936 (20817 express)

Phone: (301) 435-0407

Fax: (301) 480-5158

JobeJ@mail.nih.gov (email)

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES
(NIAMS)

[**Research in Osteoporosis and other Bone Diseases, Osteoarthritis,
Rheumatoid Arthritis and Skin Disease within the NIAMS
Mission**:]{.underline}

The NIAMS supports efforts to conduct research into the causes,
treatment, and prevention of arthritis and musculoskeletal and skin
diseases; the training of basic and clinical scientists to carry out
this research; and the dissemination of research progress to improve the
public health.  Goals specific to the AI/AN communities involve research
addressing the training of underrepresented minority AI/AN researchers
and ensuring inclusion of Native communities in clinical research
studies.  NIAMS actively monitors the inclusion of minority populations
in clinical research and will highlight any grants that specifically
target AI/AN populations. The mission of the NIAMS is to support
research into the causes, treatment, and prevention of arthritis and
musculoskeletal and skin diseases, the training of basic and clinical
scientists to carry out this research, and the dissemination of
information on research progress in these diseases.  Studies in these
mission areas as they relate to the AI/AN population may be proposed.

For additional information about research in these areas contact:

Madeline Turkeltaub, CRNP, PhD

Deputy Director, Extramural Program

National Institute of Arthritis and Musculoskeletal and Skin Diseases

6701 Democracy Blvd., Suite 800

Bethesda, MD  20912

Phone:  (301) 594-2463

Fax: (301) 480-4543

E-mail:  mturkeltaub@mail.nih.gov

NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE (NCCAM)

**[Research on Traditional Healing Practices]{.underline}:**

Many AI/AN communities use traditional healing practices to prevent
and/or treat diseases and to maintain health.  NCCAM is interested in
supporting research on traditional healing practices with these goals in
mind.  NCCAM is also interested in research on the safe and effective
integration of conventional care with traditional healing practices for
AI/AN communities.  The methodological feasibility for integration has
yet to be addressed for many traditional healing practices. 
Consequently, NCCAM is interested in supporting developmental studies to
identify and address difficult methodological and design issues
particular to traditional healing practices, as well as to allow for the
development of contextually and culturally sensitive research mirroring
the values of AI/AN communities.  

Examples of study areas of interest include, but are not limited to:

-   Qualitative research to characterize and document healing practices
    and diagnostic approaches of indigenous peoples, and study the
    feasibility of research on those practices and approaches in future
    clinical studies;

-   Observational studies to explore patient and care provider
    preferences, beliefs, attitudes, and patient-provider interactions;

-   Case-control, observational, and other studies to understand
    traditional healing strategies from multiples perspectives,
    including: (a) optimal dosing, duration, and frequency of
    treatment; (b) type of treatment; (c) examinations of different
    healing practices to treat a particular disease/condition; (d)
    comparisons of complex versus simple interventions; (e) evaluation
    of adherence among patient populations to interventions with varying
    levels of complexity; and (f) examination of potentially important
    individual differences that mediate or moderate treatment outcome;

-   Studies to determine if traditional healing practices can be
    translated into a broader clinical setting, in terms of: 
    reliability, responsiveness and utility; assessment procedures,
    instruments, and tools in psychosocial, functional, and
    physiological domains;

-   Studies to construct and validate culturally sensitive data
    collection instruments; to design and pilot outcome measures
    consistent with the tenets of traditional, indigenous systems of
    medicine and comparisons of these outcome measures to those commonly
    used by conventional biomedicine; and

-   Health services research of established AI/AN traditional healing
    practices to explore the factors that influence access to and use of
    such therapies; the nature, cost effectiveness, and quality of such
    care; and ultimately the effects on health and well-being.

For additional information on NCCAM-supported research topics, contact:

Peter J. Kozel, Ph.D.

National Center for Complementary and Alternative Medicine

6707 Democracy Boulevard, Suite 401, MSC 5475

Bethesda MD, 20892-5475

Phone: (301) 496-8004

Fax: (301) 480-3621

kozelp@mail.nih.gov

OFFICE OF RESEARCH ON WOMEN\'S HEALTH (ORWH)

**[Women's Health Research]{.underline}:**

The ORWH at the NIH supports research related to women\'s health and the
study of sex and gender differences. Detailed information about the NIH
Research Priorities for Women\'s Health, can be found at
http://orwh.od.nih.gov/research.html.

For additional information on women's health research, contact:

Lisa Begg, DrPH., RN,

Director of Research Programs,

NIH Office of Research on Women's Health

6707 Democracy Blvd. Suite 400\
Bethesda, MD 20892-5484

Phone: (301) 496-7853 Fax: (301) 402-1798

beggl@od.nih.gov.

NATIONAL INSITUTE OF MENTAL HEALTH (NIMH)

**Research projects aimed at understanding the burden, treatment or
prevention of mental disorders and Human Immunodeficiency Virus
(HIV)/AIDS in AI/AN populations.**

Indigenous people in the United States are disproportionately affected
by mental illness and HIV infection, as are the larger racial and ethnic
populations such as African Americans and Latinos. AI/ANs are highly
underrepresented in the physician workforce and as researchers in health
research in general, numbering fewer than one hundred. Other factors
that contribute to disparities that affect these communities include
geographic isolation, poor access to health services, underutilization
of health services, insufficient screening and partner management
services, unique social norms, stigma and gender dynamics. Research is
needed to identify and address the impact as well as the specific and
unique aspects of mental disorders and HIV infection upon Native
American communities. A critical component of response to mental health
and HIV infection in Native American communities will be to identify,
train, mentor, and develop Native American investigators. Towards these
ends, a promising model is community-based participatory research
together with community capacity building.

Some NIMH research areas that can contribute to scientific knowledge
about mental health and HIV interventions in Native Americans includes:

-   research methods/community assessment;

-   studies of the impact of traumatic stressors, studies of patient,
    provider and contextual factors;

-   intervention research to evaluate the effectiveness of
    pharmacologic, psychosocial (psychotherapeutic and behavioral),
    somatic, rehabilitative and combination interventions on mental and
    behavior disorders-including acute and longer-term therapeutic
    effects on functioning for children, adolescents, and adults;

-   studies of services organization, delivery (process and receipt of
    care), and related health economics at the individual, clinical,
    program, community and systems levels in specialty mental health,
    general health, and other delivery settings (such as the workplace);

-   interventions to improve the quality and outcomes of care (including
    diagnostic, treatment, preventive, and rehabilitation services);

-   studies to enhance the research infrastructure for conducting
    services research; studies of clinical epidemiology of mental
    disorders across all clinical and service settings;

-   scientifically rigorous investigation of culturally appropriate
    prevention and control strategies;

-   adaptation, evaluation, safety and costs of proven interventions;

-   dissemination and implementation strategies; and,

-   the role of community stakeholders in the research process,
    especially readiness for change.

For additional information on NIMH NonAIDS Applications contact:

Carmen P. Moten, Ph.D.\
Chief, Primary Care, Socio Cultural and Disparities Research Programs\
Division of Services and Intervention Research\
National Institute of Mental Health\
6001 Executive Boulevard, Room 7131, MSC 9631\
Bethesda, MD  20892-9631\
Telephone: (301) 443-3725\
FAX: (301) 443-4045\
Email: cmoten@mail.nih.gov

For additional information on NIMH HIV/AIDS-related applications
contact:

David M. Stoff, Ph.D.\
Chief: HIV/AIDS Neuropsychiatry Program, AIDS Research Training and
HIV/AIDS Disparities Program\
Division of AIDS and Health and Behavior Research\
National Institute of Mental Health\
6001 Executive Boulevard, Room 6210, MSC 9619\
Bethesda, MD  20892-9619\
Telephone: (301) 443-4625\
FAX: (301) 443-9719\
Email: dstoff@mail.nih.gov

NATIONAL LIBRARY OF MEDICINE (NLM)

**[Biomedical Informatics and Knowledge Management]{.underline}:**

­NLM supports research into how computers and networks can best be used
to capture, represent, store, retrieve, manipulate, manage, and
disseminate information for use in health care and public health, health
education, and biomedical research. These informatics research projects
must be user-centered, aimed at meeting needs of health care providers,
consumers, students, researchers, and policy makers. To be user
centered, information systems must be usable and useful, and information
must be understandable to the audience for whom it is intended,
accurate, and timely. The knowledge people need to participate in their
own health care and the care of others is complex and comes from many
sources. Important research questions remain to be answered about the
most effective ways to bring these different sources together when and
where they are needed.

Informatics is by nature an interdisciplinary field, and the training of
researchers for informatics careers involves coursework in the concepts
and practices of information and computer science as well as in domains
of health and biomedicine. NLM offers training programs at 18 academic
organizations, for pre and post-doctoral trainees who wish to pursue a
career in informatics. Many of these organizations offer special
short-term traineeships of three months that provide a trainee with an
introduction to informatics research.

For additional information about NLM programs contact:

Valerie Florance, Ph.D.\
Deputy Director, NLM Extramural Programs\
Rockledge 1, Suite 301\
6705 Rockledge Drive, Bethesda, MD 20892\
Phone: (301) 594.4882

Fax: (301) 402.2952\
Website: http://www.nlm.nih.gov/ep   NLM/NIH/DHHS 

NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING (NIBIB)

**[Research in Technology for Health]{.underline}**:

The National Institute of Biomedical Imaging and Bioengineering (NIBIB)
is committed to reducing health disparities through the development of
new and affordable biomedical technologies.  To this end, the NIBIB is
interested in supporting the translation of biomedical technologies that
target the health needs of AI/AN communities.  Specifically, the NIBIB
is interested in supporting the development of technologies that have
broad therapeutic and interventional applications as well as
technologies that complement technology development in all program areas
of the NIBIB, http://www.nibib.nih.gov/Research/ProgramAreas.

For additional information about NIBIB programs contact:

John W. Haller, PhD

National Institute of Biomedical Imaging and Bioengineering

NIH/DHHS

6707 Democracy Blvd. Suite 200

Bethesda, MD 20892-5649

Email: hallerj@mail.nih.gov

Phone: (301) 451.4780

Fax: (301) 480.1614

NATIONAL EYE INSTITUTE (NEI)

**[Vision Research]{.underline}:**

The NEI supports research and health information dissemination with the
goal of protecting and prolonging the vision of the American people.
Examples of such activity that may be of interest include, but are not
limited to:

-   Epidemiological studies to determine the prevalence and possible
    risk factors of eye diseases and disorders among AI/AN populations;

-   Basic research studies into the causes and mechanisms of eye
    diseases and visual impairments in AI/AN, research into disparities
    in access to ophthalmic/optometric health services; and,

-   Development and evaluation of culturally appropriate health
    education and intervention.

For additional information on vision research topics contact:

Jerome R. Wujek, Ph.D.

National Eye Institute

2020 Vision Place\
Bethesda, MD 20892-3655

Phone: (301) 451-2020

Fax: (301) 402-0528

Email: wujekjer@nei.nih.gov

**[The omission above of any NIH institute, center, office, or research
area should not be taken as a lack of availability of support for
projects in those areas.]{.underline}** NARCH is an NIH-wide
partnership, led at NIH by the National Institute of General Medical
Sciences (NIGMS). General research priorities for all of the individual
NIH Institutes, Centers, Divisions and Offices can be found on their
respective websites at: http://www.nih.gov/icd/index.html. However,
applicants and potential academic partners are reminded that that the
NARCH program is focused on the research needs of the Tribes and not
those of the Federal or academic partners.

Public Policy Requirements: All Federal‑wide public policies apply to
IHS grants with exception of Lobbying and Discrimination public policy.

3.  Submission Dates and Times:

> A. Letter of Intent Deadline: March 15, 2008.
>
> Prospective applicants are asked to submit a letter of intent that
> includes the title of the new project(s) proposed, the name, address,
> and telephone number of the project Principal Investigator(s), the
> identities of the partners and of key personnel, and the number and
> title of this RFA. The letter of intent should be received before 5
> p.m. Eastern Standard Time on March 15, 2008, by Mushtaq A. Khan,
> D.V.M., Ph.D., Chief, Digestive and Respiratory Sciences IRGs, Center
> for Scientific Review, MSC 7818, Room 2176; 6701 Rockledge Drive;
> Bethesda, MD 20892 (20817 for Fed Ex)
>
> Phone: (301) 435-1778; Fax (301) 451-2043; E-Mail: KHANM@CSR.NIH.GOV.
>
> Letters may be submitted by mail, fax or e- mail. Although a letter of
> intent is not required, is not binding, and does not enter into the
> review of a subsequent application, the information that it contains
> allows the IHS and NIH Center for Scientific Review (CSR) staffs to
> estimate the potential review workload and avoid conflict of interest
> in the review.
>
> B. Application Deadline: May 16, 2008.
>
> The applications must be received before 5 p.m. Eastern Standard Time
> on May 16, 2009 at the Center for Scientific Review (CSR, National
> Institutes of Health, 6701 Rockledge Drive, Room 6160- -MSC 7892,
> Bethesda, MD 20892-7720, Bethesda, MD 20817 (for express or courier
> service). Telephone: (301) 435-0715.) **and** at the IHS Division of
> Grants Operations (DGO, Indian Health Service, Reyes Building, 801
> Thompson Avenue, TMP Suite 360, Rockville, MD 20852-1627 \[zip code is
> unchanged for express/courier services\], Telephone: (301) 443-5204).
> Applications received after this date will be returned to the
> applicant. Competing applications not meeting the deadline date
> specified in the announcement are considered late applications and
> will not be considered for funding under this announcement. 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 introductory letter addressing the previous critique.

4.  Intergovernmental Review:

> This funding opportunity is not subject to Executive Order 12372,
> "Intergovernmental Review of Federal Programs." A State approval is
> not required.

5.  Funding Restrictions:

-   Pre‑award costs are allowable pending prior approval from the
    awarding agency. However, in accordance with 45 CFR Part 74 all
    pre‑award costs are incurred at the recipient's risk. The awarding
    office is under no obligation to reimburse such costs if for any
    reason the applicant does not receive an award or if the award to
    the recipient is less than anticipated.

-   The available funds are inclusive of direct and appropriate indirect
    costs.

-   Only one grant/cooperative agreement will be awarded per applicant
    under this announcement.

-   IHS will not acknowledge receipt of applications.

-   Grantees are allowed a reasonable period of time in which to submit
    required financial and performance reports. Failure to submit
    required reports within the time allowed may result in suspension or
    termination of an active grant, withholding of additional awards for
    the project, or other enforcement actions such as withholding of
    payments or converting to the reimbursement method of payment.
    Continued failure to submit required reports may result in the
    imposition of special award provisions, or cause other eligible
    projects or activities involving that grantee organization, or the
    individual responsible for the delinquency to not be funded. Failure
    to obtain prior approval for change in Scope, Principal
    Investigator, Grantee Institutions, Successor in Interest, or
    Recipient Institute Name, undertaking any activities disapproved or
    restricted as a condition of the award, may result in fund
    restrictions.

    5.  Other Submission Requirements

> Each submitted research project (including pilot research projects)
> should be budgeted so that it could stand on its own. That is, each
> project should be fundable under its own budget so that it could be
> completed even if the rest of the NARCH is not funded. All things
> vital to each project should be included in the budget of that project
> and not included in the core. The NARCH core should include only
> administrative, training or other items that are non-essential to the
> research projects. Each subcontractor participating in each project
> should submit its budget as part of that project's budget, using
> appropriate form pages from the PHS 398. Each project submission
> should include a set of budget pages from each of the institutional
> partners participating in that project. Each research project budget
> should explicitly include that portion of the grantee's indirect costs
> that are associated with activities under that project.
>
> Submit a typed and signed original application, including the
> Checklist, and one single-sided photocopy of the entire application
> (including Appendices and supporting documents) in one package to:
> Division of Grants Operations, Indian Health Service, Reyes Building,
> 801 Thompson Avenue, TMP Suite 360, Rockville, MD 20852-1627 (zip code
> is unchanged for express/courier services), Telephone: (301) 443-5204.
>
> At the time of submission, applicants must also send four additional
> single- sided photocopied and signed applications, including the
> Checklist, Appendices, and supporting documentation to: Center for
> Scientific Review, National Institutes of Health, 6701 Rockledge
> Drive, Room 6160- -MSC 7892, Bethesda, MD 20892-7720, Bethesda, MD
> 20817 (for express or courier service). Telephone: (301) 435-0715. The
> Center for Scientific Review no longer accepts hand delivered
> applications.
>
> E‑mail or other electronic applications will not be accepted under
> this announcement.
>
> Specific supplementary instructions for the PHS 398 application and
> budget preparation for the NARCH program may be obtained from the
> initiative contacts listed under VII. Agency Contacts, and will be
> posted at <http://www.ihs.gov/MedicalPrograms/Research/narch.cfm>.

**[DUNS NUMBER]{.underline}**

Applicants are required to have a Dun and Bradstreet (DUNS) number to
apply for a grant or cooperative agreement from the Federal Government.
The DUNS number is a nine‑digit identification number, which uniquely
identifies business entities. Obtaining a DUNS number is easy and there
is no charge. To obtain a DUNS number, access
http://www.dunandbradstreet.com or call 1‑866‑705‑5711. Interested
parties may wish to obtain their DUNS number by phone to expedite the
process.

A DUNS number is required before Central Contractor Registry (CCR)
registration can be completed. Many organizations may already have a
DUNS number. Please use the number listed above to investigate whether
or not your organization has a DUNS number. Registration with the CCR is
free of charge.

Applicants may register by calling 1‑888‑227‑2423. Please review and
complete the CCR Registration Worksheet located at
http://www.grants.gov/CCRRegister.

More detailed information regarding these registration processes can be
found at http://www.grants.gov.

V. Application Review Information

> Upon receipt, IHS and NIH staff will administratively review
> applications for completeness and responsiveness. Applications that
> are incomplete, non-responsive to this RFA, not from existing NARCH
> programs, or do not follow the guidelines of the PHS form 398 (revised
> 9/2004) or of the supplementary instructions for NARCH grants
> (available at:
> [http://www.ihs.gov/MedicalPrograms/Research/narch.cfm]{.underline}),
> may be returned to the applicant without further consideration.
> Applications will be evaluated in accordance with the criteria stated
> below for scientific and technical merit by appropriate peer review
> groups convened by the CSR. The National Advisory General Medical
> Sciences Council will conduct the second level of review.
>
> 1\. Criteria
>
> Priorities for funding will be based on the scientific and technical
> merit of the application, the assessed potential of investigators in
> the developmental stages of their careers, and the likelihood that the
> proposed project(s) can further the purposes of the NARCH initiative.
> Awards will be made only to organizations with financial management
> systems and management capabilities that are acceptable under HHS
> policy. Awards will be administered under the HHS Grants Policy
> Statement, January 2007.
>
> A. Review of Student and Faculty/Researcher Development Plans:
>
> The anticipated effectiveness of the proposed NARCH in making a
> difference relative to the current base-line data (based in part on
> previous experience of the NARCH) will be assessed. Factors to be
> considered include:

-   The appropriateness of the content, phasing, quality, and duration
    of the student or faculty/researcher development plans in the NARCH
    application to achieve the scientific development of the
    faculty/researcher, post-doctoral, pre-doctoral, undergraduate, and
    (if well justified) high school students; and

-   The research experience and expertise, proposed commitment, and
    quality of the mentoring plan and of individual mentors of the
    partners in providing mentoring, guidance, and advice to candidates
    (including training in responsible conduct of research and research
    integrity, teaching, and protection of human subjects), and in
    fostering the development of academic and community-based AI/AN
    researchers.

> B. Review of Research Projects:
>
> The NIH has announced procedures to be used for the review of research
> grant applications (NIH Guide, Volume 26, Number 22, June 27, 1997 or
> see http://grants.nih.gov/grants/guide/notice-files/not97-010.html and
> http://grants.nih.gov/grants/guide/notice-files/NOT-OD-05-002.html for
> additional updated information. For NARCH applications, the five
> criteria listed in this announcement will be used for the scientific
> review of research projects and pilot research projects. The review of
> research projects and pilot research projects will be the same except
> that applications for pilot studies may be smaller in scope and would
> not be expected to have preliminary data.
>
> In the written comments, reviewers will be asked to discuss the
> following aspects of the application in order to judge the likelihood
> that the proposed research will have a substantial impact on the
> pursuit of these purposes. Each of these criteria will be addressed
> and considered in assigning the overall score, weighting them as
> appropriate for each application.

-   Significance: Does this study address an important problem? If the
    aims of the application are achieved, how will scientific knowledge
    or clinical practice be advanced? What will be the effect of these
    studies on the concepts, methods, technologies, treatments,
    services, or preventative interventions that drive this field?

-   Approach: Are the conceptual or clinical framework, design, methods,
    and analyses adequately developed, well integrated, well reasoned,
    and appropriate to the aims of the project? Does the applicant
    acknowledge potential problem areas and consider alternative
    tactics?

-   Innovation: Is the project original and innovative? For example:
    Does the project challenge existing paradigms or clinical practice;
    address an innovative hypothesis or critical barrier to progress in
    the field? Does the project develop or employ novel concepts,
    approaches, methodologies, tools, or technologies for this area?

-   Investigators: Are the investigators 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? Does the investigative team bring complementary and
    integrated expertise to the project (if applicable)?

-   Environment: Does the scientific environment in which the work will
    be done contribute to the probability of success? Do the proposed
    studies benefit from unique features of the scientific environment,
    or subject populations, or employ useful collaborative arrangements?
    Is there evidence of institutional support?

> In addition to the above criteria, in accordance with NIH policy, all
> applications will also be reviewed with respect to the following:

-   The adequacy of plans, if research on human subjects is involved, to
    include both genders and children as appropriate for the scientific
    goals of the research. Plans for the recruitment and retention of
    subjects will also be evaluated.

-   The reasonableness of the proposed budget and duration in relation
    to the proposed research.

-   The adequacy of the proposed protection for humans, animals or the
    environment, to the extent they may be adversely affected by the
    project proposed in the application.

-   The adequacy of the proposed plan to share data, if appropriate.

VI\. Award Administration Information

1.  Award Notices

> The Notice of Award (NoA) will be initiated by the IHS Division of
> Grants Operations (DGO) and will be mailed via postal mail to each
> entity that is approved for funding under this announcement. The NoA
> will be signed by the Grants Management Officer and this is the
> authorizing document for which funds are dispersed to the approved
> entities. The NoA will serve as the official notification of the grant
> award and will reflect the amount of Federal funds awarded, the
> purpose of the grant, the terms and conditions of the award, the
> effective date of the award, and the budget/project period. The NoA is
> a legally binding document. Applicants who are approved but unfunded
> or disapproved based on their objective review score will receive a
> copy of the Executive Summary which identifies the weaknesses and
> strengths of the application submitted.

2.  Administrative and Policy Requirements

> A. Grants are administrated in accordance with the following
> documents:

-   This Announcement.

```{=html}
<!-- -->
```
-   Administrative Requirements: 45 CFR Part 92, (Uniform Administrative
    Requirements for Grants and Cooperative Agreements to State, Local
    and Tribal Governments,( or 45 CFR Part 74, (Uniform Administrative
    Requirements for Awards to Institutions of Higher Education,
    Hospitals, Other Non‑Profit Organizations, and Commercial
    Organizations.

```{=html}
<!-- -->
```
-   Grants Policy Guidance: HHS Grants Policy Statement, January 2007.

-   Cost Principles: OMB Circular A‑87, (State, Local, and Indian (Title
    2 Part 225).

-   Cost Principles: OMB Circular A‑122, (Non‑profit Organizations
    (Title 2 Part 230).

-   Audit Requirements: OMB Circular A‑133, (Audits of States, Local
    Governments, and Non‑profit Organizations.

    B. Inclusion of Women and Minorities in Research Involving Human
    Subjects:

    It is the policy of the NIH that women and members of minority
    groups and their subpopulations must be included in all NIH
    supported biomedical, clinical, behavioral and health services
    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 P.L. 103-43). Because
    the NARCH initiative targets AI/AN people and communities, a
    minority population, only the policy of inclusion of women applies
    to this RFA. The IHS has fully accepted the Office for Human
    Research Protections (OHRP) policy regarding human subjects. The
    OHRP website is http://www.hhs.gov/ohrp/. All investigators
    proposing research involving human subjects should read the Updated
    NIH Guidelines for Inclusion of Women and Minorities as Subjects in
    Clinical Research, published in the NIH Guide for Grants and
    Contracts on August 2, 2000.

```{=html}
<!-- -->
```
-   (http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-048.html).
    The complete Guidelines are available at:
    http://grants1.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.
    The revisions relate to NIH defined Phase III clinical trials and
    require:

-   All applications or proposals and/or protocols to provide a
    description of plans to conduct analyses, as appropriate, to address
    differences by sex/gender and/or racial/ethnic groups, including
    subgroups if applicable; and

-   All investigators to report accrual, and to conduct and report
    analyses, as appropriate, by sex/gender and/or racial/ethnic group
    differences.

    C. 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 or
    ethical reasons not to include them. This policy applies to all
    initial (Type 1) applications submitted. All investigators proposing
    research involving human subjects should read the NIH Policy and
    Guidelines on the Inclusion of Children as Participants in Research
    Involving Human Subjects that was published in the NIH Guide for
    Grants and Contracts, March 6, 1998, and is available at the
    following URL address:
    http://grants.nih.gov/grants/guide/notice-files/not98-024.html.
    Investigators may obtain copies of these policies from the
    initiative staff listed under VII. Agency Contacts. Initiative staff
    may also provide additional relevant information concerning the
    policy.

    D. URLS in NIH Grant Applications or Appendices:

    All applications and proposals for NIH funding must be
    self-contained within specified page limitations. Unless otherwise
    specified in an NIH solicitation, Internet addresses (URLs) should
    not be used to provide information necessary to the review because
    reviewers are under no obligation to view the Internet sites.
    Reviewers are cautioned that their anonymity may be compromised when
    they directly access an Internet site.

    E. Allowable Administrative Costs:

    Certain administrative costs for managing a comprehensive program
    are allowable and may vary, depending upon the size and complexity
    of the program\'s activities. The costs budgeted for NARCH grants
    and subcontracts may not duplicate items already budgeted in other
    cost centers of the AI/AN, research- intensive, and subcontracted
    organizations and institutions, such as accounts which make up the
    Facilities and Administration (F&A) cost pool. The grantee
    organization receiving the award must be prepared to provide
    documentation showing the direct relationship of proposed costs to
    the program, and that costs of this type are charged in a uniform
    manner to all other grants at all institutions and organizations
    participating in the award.

    Limited salary support for secretarial or clerical help is allowable
    only when in direct support of the proposed NARCH project. For
    guidance, applicants should refer to the OMB Circular appropriate
    for them, A-87 (Cost Principles for State, local, and Indian Tribal
    Governments), at http://www.whitehouse.gov/omb/circulars or A-122
    (Cost Principles for Non-Profit Organizations), at
    http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?from=leavingFR.html&amp;log=linklog&amp;to=http://http://www.whitehouse.gov/omb/circulars,
    or should contact the grants management officer listed under VII.
    Agency Contacts.

    Costs for evaluation activities are allowable, as are costs for the
    Community and Scientific Advisory Council. All applications must
    include costs associated with one annual meeting per year in
    Rockville, MD, of the project Principal Investigator(s) and their
    key scientific personnel. Applications should also include costs
    associated with attendance at the annual Indian Health Research
    Conference for key personnel and trainees.

    Student Development Costs: Student (graduate, undergraduate, and
    high school if well justified) remuneration through salary/wages for
    participation in research experiences may be requested, provided all
    the following conditions are met:

I.  The student is performing necessary work involved in the research;

II. There is an employer-employee relationship between the student and
    the proposed NARCH or its partners;

III. The total compensation is reasonable for the work performed; and

IV. It is the practice of the proposed NARCH or its partners to provide
    compensation for all students in similar circumstances, regardless
    of the source of support for the activity.

    Graduate students, but not undergraduate students, are allowed
    tuition costs as part of a compensation package. When requesting
    support for a graduate student, the NARCH application should
    provide, in the budget justification section of the application, the
    basis for the compensation level. The IHS staff will review the
    requested compensation level and, if it is reasonable and justified,
    will provide compensation up to a maximum of \$45,000
    (http://grants.nih.gov/grants/guide/notice-files/not98-168.html).
    Post-doctoral students should be compensated at a rate commensurate
    with that of other post-doctoral employees with similar degrees and
    experience at the research-intensive institution. It is the
    expectation of the IHS and NIGMS that students who are enrolled in a
    accredited graduate program, as part of a proposed NARCH, will not
    be excluded from support from other non-Federal or Federal graduate
    training sources (such as loans and assistance under the Veterans\'
    Adjustment Benefit Act or Pell Grants) for which they are eligible.

    Graduate and post-doctoral students cannot concurrently hold other
    Federally-sponsored stipends or fellowship or any other Federal
    award that duplicates the NARCH support.

    Faculty/Researcher Development Costs:

    Costs to support faculty/researcher development activities, such as
    workshops or courses, national meetings, or short-term research
    experiences in the laboratory of an active NIH-extramurally-funded
    researcher needed for acquiring specific skills or methodologies
    needed for prospective research, are allowable. Such costs might
    include tuition, travel and per diem costs, as well as salary
    support appropriate to the percent effort needed for the activity.

    Research Project Costs:

    Direct costs associated with research and pilot research projects
    are allowable when adequate justification is provided. These include
    faculty/researcher salaries, reimbursed according to percent effort.
    Summer salary support can be paid provided the institution\'s
    academic schedule permits such release and when the institution
    approves. The maximum summer-salary support provided by the program
    cannot exceed the equivalent of three months at 100 percent effort,
    or time specified by the institution as its policy. Grant funds may
    not be used to increase or supplement faculty/ researcher academic
    year salaries. Salary support for technical assistance and costs for
    consultants, if justified, are allowable. Costs for equipment to be
    used to carry out the proposed research are allowable.

    Cost for Supplies:

    Costs for supplies, including costs for animals necessary to carry
    out the proposed research, may be included. Travel costs for the
    investigator(s) are permitted when direct benefits to the program
    are expected, and when adequate justification is provided.
    Alterations and renovations costs (up to \$40,000) are allowable
    only when essential for conduct of the proposed research. Other
    permitted costs include animal maintenance (unit care costs and
    number of care days), donor fees, publication costs, computer
    charges, rentals and leases, equipment maintenance, and service
    contracts.

    Consortium and Contract Arrangements:

    Consortium arrangements that may involve personnel costs, supplies,
    and other allowable costs, including F&A costs; contractual costs
    for support services, such as the laboratory testing of biological
    materials, clinical services, data processing, or core
    administrative services, are allowable expenses. Consortia and
    contractual costs with Native health organizations, Tribes and/or
    research institutions in Canada or Mexico are allowable expenses.

    Pilot Research Projects:

    The intent of pilot research projects is to lead to regular research
    projects funded as part of the center grant or as freestanding
    grants. For pilot research projects, applications may request
    support for up to \$50,000 (direct costs) per year for up to four
    years. This pilot research support is non-renewable. However, NARCH
    research projects based on prior NARCH pilot research projects are
    encouraged.

    Subcontracts:

    The grant recipient may issue subcontracts to other organizations
    (such as the research-intensive institution of the partnership), as
    long as a minimum of 30 percent of the grant funds are budgeted in
    the application to remain with the eligible AI/AN organization(s);
    that is, no more than 70 percent of the application's total budget
    may be contained in subcontract budgets of the non-eligible
    subcontracting partner institutions or organizations.

    F. Unallowable Costs:

    Unallowable costs for research projects (including for pilot
    projects) include costs for student development, textbooks,
    journals, memberships, and Internet subscription costs, as well as
    other costs prohibited by OMB Circulars A-87 or A-122 as applicable.
    Employees of the applicant organization may not serve as paid
    consultants but may be paid. The pilot research project is intended
    for faculty/researcher without current Federal research support.
    Therefore, investigators with significant current support from other
    mechanisms such as the R01 and research funding from other
    extramural sources are not eligible, and the costs therefore are not
    allowable. Release time for preparing proposals or mini-research
    projects, not submitted as pilot projects, is not allowed.

    G. Research Subjects Protection:

    Under governing policy, Federal funds administered by the HHS shall
    not be expended for research involving live vertebrate animals
    without prior approval by the NIH Office of Laboratory Animal
    Welfare (OLAW), of an assurance to comply with the Public Health
    Service (PHS) Policy on Humane Care and Use of Laboratory Animals.
    This restriction applies to all performance sites (e.g.,
    collaborating institutions, subcontractors, subgrantees) without
    OLAW-approved assurances, whether domestic or foreign. Funds
    included in this award may not be used to support studies using live
    vertebrate animals until approval from the Institutional Animal Care
    and Use Committee (IACUC) has been received by the IHS Grants
    Management Officer (GMO).

    Federal Regulations (45 CFR, Pt. 46) require that applications and
    proposals involving human subjects must be evaluated with reference
    to the risks to the subjects, the adequacy of protection against
    these risks, the potential benefits of the research to the subjects
    and others, and the importance of the knowledge gained or to be
    gained. Under governing regulations 45 CFR Part 46, found at
    http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm, Federal
    funds administered by HHS shall not be expended for research
    involving human subjects, and individuals shall not be enrolled in
    such research, without prior approval by the Office for Human
    Research Protections (OHRP), of an appropriate Federal Wide
    Assurance (FWA) and prior approval by an Institutional Review Board
    (IRB) recognized and listed by the OHRP. Funds included in this
    award may not be used to support studies using human subjects until
    evidence of IRB approval has been received by the IHS GMO.
    Applicants are expected to provide their own institutional FWA.

    H. Research Integrity - Grantees shall comply with Public Health
    Service Policies on Research Misconduct (42 CFR Part 93) which
    require grantees to have procedures for responding to allegations of
    research misconduct that comply with those policies, to submit their
    procedures to the Office of Research Integrity (ORI)
    (http://ori.hhs.gov) upon request for review, and revise their
    procedures in accordance with ORI comments. In addition, grantees
    shall file the Annual Report on Possible Research Misconduct with
    ORI at
    http://www.ori.dhhs.gov/assurance/electronic_submission.shtml.

    Grantees shall file documentation of their Annual Reports with the
    IHS GMO.

    I. Healthy People 2010:

    The Public Health Service (PHS) is committed to achieving the health
    promotion and disease prevention objectives of Healthy People 2010,
    a PHS led national activity for setting priority areas. This RFA
    announcement is related to one or more of the priority areas.
    Potential applicants may obtain a copy of Healthy People 2010 at:
    [http://www.healthypeople.gov](http://www.healthypeople.gov/).

```{=html}
<!-- -->
```
3.  Indirect Costs: This section applies to all grant recipients that
    request reimbursement of indirect costs in their grant application,
    but not to the indirect costs that may be negotiated by the grantees
    with their subcontractors (which become direct costs to the
    grantee). In accordance with HHS Grants Policy Statement, Part
    II‑27, IHS requires applicants to have a current indirect cost rate
    agreement in place prior to award. The rate agreement must be
    prepared in accordance with the applicable cost principles and
    guidance as provided by the cognizant agency or office. A current
    rate means the rate covering the applicable activities and the award
    budget period. If the current rate is not on file with the DGO at
    the time of award, the indirect cost portion of the budget will be
    restricted and not available to the recipient until the current rate
    is provided to DGO.

> Generally, indirect costs rates for IHS grantees are negotiated with
> the Division of Cost Allocation (DCA) http://rates.psc.gov/ and the
> Department of Interior (National Business Center)
> http://www.nbc.gov/acquisition/ics/icshome.html . If your organization
> has questions regarding the indirect cost policy, please contact the
> DGO at (301) 443‑5204.

4.  Reporting

    A.  Progress Report. Program progress reports are required semi
        annually. These reports will include a brief comparison of
        actual accomplishments to the goals established for the period,
        or, if applicable, provide sound justification for the lack of
        progress, and other pertinent information as required. A final
        progress report, cumulative from the beginning of the project
        period, must be submitted within 90 days of expiration of each
        budget period.

    B.  Financial Status Report. Quarterly financial status reports must
        be submitted within 30 days of the end of each quarter. Final
        financial status reports are due within 90 days of expiration of
        the budget/project period. Standard Form 269 (long form) will be
        used for financial reporting.

    C.  Reports. Grantees are responsible and accountable for accurate
        reporting of the Progress Reports and Financial Status Reports.
        Financial Status Reports (SF‑269) are due 90 days after each
        budget period and the final SF‑269 must be verified from the
        grantee records on how the value was derived. Grantees must
        submit reports in a reasonable period of time.

> Failure to submit required reports within the time allowed may result
> in suspension or termination of an active grant, withholding of
> additional awards for the project, or other enforcement actions such
> as withholding of payments or converting to the reimbursement method
> of payment. Continued failure to submit required reports may result in
> one or both of the following: (1) the imposition of special award
> provisions; and (2) the non‑funding or non‑award of other eligible
> projects or activities. This applies whether the delinquency is
> attributable to the failure of the grantee organization or the
> individual responsible for preparation of the reports.

5.  Telecommunication for the hearing impaired is available at:
    TTY (301) 443‑6394.

VII\. Agency Contact(s)

> 1\. Questions on the initiative, regarding IHS NARCH issues and
> policies, may be directed to: Alan Trachtenberg, MD, MPH, Division of
> Planning, Evaluation and Research, Indian Health Service, 801 Thompson
> Avenue, TMP Suite 450, Rockville, MD 20852, Telephone: (301) 443-4700,
> Fax: (301) 443-0114, e-mail: narch@ihs.gov.
>
> 2\. Questions on grants management and fiscal matters may be directed
> to: Sylvia Ryan, Division of Grants Operations, Indian Health Service,
> Reyes Building, 801 Thompson Avenue, TMP Suite 350, Rockville, MD
> 20852, Telephone: (301) 443-5204, Fax: (301) 443-9602, e-mail:
> narch@ihs.gov.
>
> 3\. Questions on NIGMS issues and policies, may be directed to:
> Clifton A. Poodry, Ph.D., Minority Opportunities in Research Division,
> National Institute of General Medical Sciences, 45 Center Drive, Suite
> 2AS.37, MSC 6200, Bethesda, MD 20892, Telephone: (301) 594-3900, Fax:
> (301) 480-2753, e-mail: poodryc@nigms.nih.gov.
>
> 4\. Questions on the review of applications may be directed to:
> Mushtaq A. Khan, D.V.M., Ph.D., Chief, Digestive and Respiratory
> Sciences IRGs, Center for Scientific Review, MSC 7818, Room 2176; 6701
> Rockledge Drive; Bethesda, MD 20892 (20817 for courier or express
> service)
>
> Telephone: (301) 435-1778; Fax: (301) 451-2043; e-mail:
> khanm@csr.nih.gov.

VIII\. Other required documents:

> If the applicant is a Federally-recognized Tribe, Tribal organization,
> or a Tribal college letters of support from the Chairman, President,
> Governor or Tribal Health Director is required of all Tribes to be
> served to show their support of the grant project. Letters of support
> are intended to document that applicants have Tribal support for the
> specific grant for which they are applying. All letters of support
> must accompany the grant application.

IX\. Other Information

> References for Background Information:
>
> Anderson, N.B. Levels of analysis in health science: A framework for
> integrating sociobehavioral and biomedical research. Annals of the New
> York Academy of Sciences, 1998, 840, 563-576.
>
> Ballantine, B., Ballantine, I. (Eds.), Thomas, D.H., Miller, J.,
> White, R., Nabokov, P., Deloria, P.J. (Text by), Joseph, A.M. (Intro.)
> The Native Americans: An Illustrated History. Turner Publishing, Inc.
> Atlanta, GA, 1993.
>
> Freeman, W.L. The role of community in research with stored tissue
> samples. Weir R (Ed.) Stored tissue samples: Ethical, legal, and
> public policy implications. University Iowa Press. Iowa City, IA,
> 1998, 267- 301.
>
> Gazmararian, J.A., Baker, D.W., Williams, M.V., Parker, R.M., Scott,
> T.L., Green, D.C., Fehrenbach, S.N., Ren, J. & Koplan, J.P. Health
> literacy among Medicare enrollees in a managed care organization.
> Journal of the American Medical Association, 1999, 281, 545-551.
>
> Haynes, M.A. & Smedley, B.D. (Eds.) The Unequal Burden of Cancer: An
> Assessment of NIH Programs for Ethnic Minorities and the Medically
> Underserved. Institute of Medicine. National Academy Press.
> Washington, DC, 1999.
>
> Macaulay, A.C., Commanda, L.E., Freeman, W.L., Gibson, N., McCabe,
> M.L., Robbins, C.M., & Twohig, P.L., (for the) North American Primary
> Care Research Group. Participatory research maximizes community and
> lay involvement. British Medical Journal, 1999, 319, 774-778.
>
> Minority Economic Profiles. U.S. Bureau of the Census, Population
> Division. Issued July 24, 1992. (Tables 1990 CPH -L-92, 93, 94 and
> 95).
>
> NIH Publication 98-4247. Women of Color Health Data Book. Office of
> Research On Women\'s Health, Office of the Director, National
> Institutes of Health, 1998.
>
> Trends in Indian Health 1998-99. Program Statistics Team, Office of
> Public Health, Indian Health Service, 2001.
>
> Regional Differences in Indian Health 1998-99. Program Statistics
> Team, Office of Public Health, Indian Health Service, 2000.
>
> Weiss, B.D., Reed, R.L., & Kligman, E.W. Literary skills and
> communication methods of low-income older persons. Patient Education
> and Counseling, 1995, 25, 109-119.
>
> Williams, D.R. & Collins, C. U.S. Socioeconomic and Racial Differences
> in Health: Patterns and Explanations. Annual Review of Sociology,
> 1995, 21, 349-386.
>
> Williams, M.V., Parker, R.M., Baker, D.W., Parikh, N.S., Pitkin, K.,
> Coates, W.C., & Nurss, J.R. Inadequate functional health literacy
> among patients at two public hospitals. Journal of the American
> Medical Association, 1995, 274, 1677-1682.

Date: \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Robert G. McSwain,

Acting Director,

Indian Health Service