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U.S. DEPARTMENT OF F I E X T H AND HI 'MAN SERVICES

V o l , 2 0 , No. 14 A p r i l 5, 1991

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NIH Guide Printing & Reproduction Branch National Institutes of Health Room B4BN08, Building 31 Bethesda, Maryland 20892

Postages & Fees Paid PHS/NIH/OD

Permit No. (3-291

N I H G U I D E - Vol. 2 0 , No. 14, A p r i l 5 , 1991

NOTICES

HUMAN LIVER CELL CULTURE FACILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 N a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney D i s e a s e s Index: DIABETES, DIGESTIVE DISEASES, K I D N E Y DISEASES *yl?

NATIONAL I:'ORKSHOPS ON "PROTECTION OF HUMAN SUBJECTS" . . . . . . . . . . . . . . . . . . . . . . . 2 N a t i o n a l I n s t i t u t e s o f Hea l th Food and Drua Admin i s t r a t i o n Index : NATIGNAL INSTITUTES OF HEALTH

FOOD AND DRUG ADMINISTRATION

NOTICES OF A V A I L A m I T Y (RFPs AND R F A s )

PROGRESSION OF JUVENILE PERIODONTITIS I N THE U.S.A. AND ASSOCIATED RISK MARKERS (RFP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 N a t i o n a l I n s t i t u t e o f Den ta l Research Index : DENTAL RESEARCH

ORAL I R O N CHELATOR TOXICITY I N ANIMALS (RFP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 N a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney Diseases Index : DIABETES, DIGESTIVE DISEASES, KIDNEY DISEASES

CELL LINES FOR HYPERTENSION RESEARCH ( R F A HL-91-05-H) . . . . . . . . . . . . . . . . . . . . . . 4 N a t i o n a l Heart , Lung, and Blood I n s t i t u t e Index : HEART, LUNG, BLOOD

STUDIES OF TESTING AND COUNSELING FOR CYSTIC FIBROSIS MUTATIONS ( R F A HG-91-01) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 N a t i o n a l Cen te r f o r Human Genome Research N a t i o n a l Cen te r f o r Nurs ing Research N a t i o n a l I n s t i t u t e o f Ch i ld Hea l th and Human DevelopmentN a t i o n a l I n s t i t u t e of Diabe tes and D i g e s t i v e and K i d n e y Diseases Index : HUMAN G E N O M E , NURSING RESEARCH, C H I L D HEALTH, HUMAN

DEVELOPMENT, DIABETES, DIGESTIVE DISEASES, K I D N E Y DISEASES

INSTITUTIONAL C L I N I C A L T R A I N I N G GUNTS: PROFESSIONAL T R A I N I N G FOR RACIAL/ETHNIC M I N O R I T Y AND DISADVANTAGED STUDENTS ( R F A MH-91-09) . . . . . . . . . . . 7 N a t i o n a l I n s t i t u t e of Mental Hea l th Index : MENTAL HEALTH J

O N G O T N G PROGRAM ANNOUNCEMENTS

COMMUNITY SUPPORT RESEARCH DEMONSTRATION PROJECTS (PA-91-39) . . . . . . . . . . . . . . . 9 N a t i o n a l I n s t i t u t e o f Mental H e a l t h Index : MENTAL HEALTH

NOTICES

HUMAN LIVER CELL CULTURE FACILTY

P.T. 34; K.W. 0780005, 0780015

N a t i o n a l I n s t i t u t e of D i a b e t e s and D i g e s t i v e and Kidney Diseases

The N a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney D i s e a s e s ( N I D D K ) announces t h e e s t a b l i s h m e n t o f a Human L i v e r C e l l C u l t u r e F a c i l i t y f o r t h e pu rpose o f making human h e p a t o c y t e s more wide ly a c c e s s i b l e t o r e s e a r c h e r s .

N I D D K s u p p o r t s t h e a c q u i s i t i o n of e x c e s s normal human l i v e r s from organt r a n s p l a n t donor s and t h e i s o l a t i o n and c u l t u r e o f h e p a t o c y t e s from t h e s e t i s s u e s . Human l i v e r c e l l s i n h i g h y i e l d are b e i n g r o u t i n e l y p r e p a r e d .Q u a l i t y c o n t r o l d a t a on i n i t i a l v i a b i l i t y , s u r v i v a l i n c u l t u r e , s e l e c t e d l i v e r s p e c i f i c f u n c t i o n s , and donor i n f o r m a t i o n ( e . g . , age , s e x , r a c e , and c a u s e o f d e a t h ) are a v a i l a b l e .

The human l i v e r c e l l s can be used i n t h e F a c i l i t y by a v i s i t i n g i n v e s t i g a t o rwho i s r e s i d e n t a t t h e l a b o r a t o r y o r who comes o n l y when c e l l s are a v a i l a b l e . I n a d d i t i o n , h e p a t o c y t e s can be sh ipped as a t t a c h e d monolayer c u l t u r e s w i t h i n 24 h o u r s o f i s o l a t i o n t o an i n v e s t i g a t o r ' s l a b o r a t o r y . S e l e c t e d expe r imen t sw i t h human h e p a t o c y t e s can be conducted f o r r e s e a r c h e r s by F a c i l i t y p e r s o n n e l ,when t i m e p e r m i t s , b u t t h e c o s t s of t h e s e s p e c i a l a s s a y s a r e n o t covered by 'W

t h e N I D D K s u p p o r t and must be r e imbursed . F a c i l i t y p e r s o n n e l are a l s o

N I H G U I D E - Vol. 2 0 , No. 14, A p r i l 5, 1991 - Page 1

a v a i l a b l e t o t r a i n i n v e s t i g a t o r s i n t h e p r e p a r a t i o n and h a n d l i n g o f human h e p a t o c y t e s .

A l l Uni ted S t a t e s r e s e a r c h e r s are e l i g i b l e t o o b t a i n human h e p a t o c y t e s .However, t h o s e whose s t u d i e s can p r o v i d e a d d i t i o n a l c h a r a c t e r i z a t i o n s o f t h e c e l l s o r c o n t r i b u t e t o t h e f u r t h e r development o f t h i s r e s o u r c e are e s p e c i a l l y

ld encouraged . Research r e q u e s t s are reviewed and p r i o r i t i z e d by a n a d v i s o r ycommit tee . To o b t a i n a p r o p o s a l form o r a d d i t i o n a l i n f o r m a t i o n about t h e F a c i l i t y c o n t a c t :

D r . Ca ro l E . Green SRI I n t e r n a t i o n a l 333 Ravenswood Avenue Menlo Park , CA 94025 Telephone: ( 4 1 5 ) 859-4083 FAX: (415) 859-3342

NATIONAL WORKSHOPS ON "PROTECTION OF HUMAN SUBJECTS"

P.T. 42; K . W . 0783005

N a t i o n a l I n s t i t u t e s o f H e a l t h Food and Drug A d m i n i s t r a t i o n

The N a t i o n a l I n s t i t u t e s o f Hea l th ( N I H ) and t h e Food and Drug A d m i n i s t r a t i o n (FDA) a r e c o n t i n u i n g t o sponsor a series o f workshops on t h e r e s p o n s i b i l i t i e so f r e s e a r c h e r s , I n s t i t u t i o n a l Review Boards ( I R B s ) , and i n s t i t u t i o n a l o f f i c i a l s f o r t h e p r o t e c t i o n o f human s u b j e c t s i n r e s e a r c h . The workshops are open t o everyone w i t h an i n t e r e s t i n r e s e a r c h i n v o l v i n g human s u b j e c t s . The mee t ings shou ld b e o f s p e c i a l i n t e r e s t t o t h o s e p e r s o n s c u r r e n t l y s e r v i n g o r about t o b e g i n s e r v i n g as a member o f an I R B . I s s u e s d i s c u s s e d a t t h e s e workshops are r e l e v a n t t o a l l o t h e r P u b l i c H e a l t h S e r v i c e a g e n c i e s . The c u r r e n t s c h e d u l e i n c l u d e s t h e f o l l o w i n g :

MIDWEST WORKSHOP

DATES: A p r i l 11-12? 1991

PLACE : Ramada I n n , Lakeshore 4900 South Lake Shore Dr ive Chicago, I L 60615

SPONSORS : U n i v e r s i t y o f Chicago 970 East 5 8 t h S t r e e t Chicago, I L 60637

Chicago S t a t e U n i v e r s i t y 9 5 t h S t r e e t a t King Dr ive Chicago, I L 60628

REGISTRATION CONTACT: M r . Arnold L . Aronoff A s s o c i a t e D i r e c t o r F a c u l t y and A d m i n i s t r a t i v e S e r v i c e s U n i v e r s i t y Research A d m i n i s t r a t i o n U n i v e r s i t y o f Chicago 970 Eas t 5 8 t h S t r e e t Chicago, I L 60637 Telephone: (312) 702-8669

TOPIC: C u l t u r a l D i v e r s i t y , E t h i c s , and Research: A Workshop on Human S u b j e c t P r o t e c t i o n

NIH/FDA have p lanned workshops on human s u b j e c t p r o t e c t i o n s i n o t h e r p a r t s of t h e Uni ted S t a t e s . For f u r t h e r i n f o r m a t i o n r e g a r d i n g t h e s e workshops c o n t a c t :

Dar lene Marie Ross Execu t ive A s s i s t a n t f o r Educat ion D i v i s i o n o f Human Subject P r o t e c t i o n s O f f i c e f o r P r o t e c t i o n from Research R i sks Nat iona l I n s t i t u t e s o f Hea l th 9 0 0 0 R o c k v i l l e P ike (B ldg . 31, Room 5B59)

dsi Bcthcsda , MD 20892 Telephone: ( 3 0 1 ) 496-8101

N I H G U I D E - V o l . 20, No. 1 4 , A p r i l 5, 1991 - Page 2

NOTICES OF AVAILABILITY (RFPs AND RFAs)

PROGRESSION OF JUVENILE PERIODONTITIS I N THE U.S.A. AND ASSOCIATED RISK -~PIARKERS

RFP AVAILABLE: NIH-NIDR-2-91-7R

P .T. 34; K.W. 0715148, 1002027, 0765035, 0413001

N a t i o n a l I n s t i t u t e o f D e n t a l Research

The N a t i o n a l I n s t i t u t e o f D e n t a l Resea rch ( N I D R ) h a s a r equ i r emen t f o r a t h r e e - y e a r , fo l low-up s t u d y o f t h e N I D R Survey o f Oral H e a l t h o f Un i t ed S t a t e s C h i l d r e n t h a t was c a r r i e d o u t i n 1986-1987. The a n a l y s i s o f d a t a from t h e s u r v e y i d e n t i f i e d a number o f i n d i v i d u a l s w i t h j u v e n i l e p e r i o d o n t i t i s . The o b j e c t i v e s o f t h i s proposed p r o j e c t a r e : ( 1 ) t o assess t h e p r o g r e s s i o n o f p e r i o d o n t a l d e s t r u c t i o n among t h e c a s e s o f j u v e n i l e p e r i o d o n t i t i s , ( 2 ) t o c h a r a c t e r i z e t h e m i c r o b i a l eco logy o f t h e s u b g i n g i v a l p l a q u e , (3) t o d e s c r i b e p e r i o d o n t a l d e s t r u c t i o n and t h e p r e s e n c e o f b i o l o g i c and non-b io log ic p u t a t i v e r i s k markers among t h e p robands ' s imi la r aged s i b l i n g s , and ( 4 ) t o compare t h e p r e s e n c e and c o n c e n t r a t i o n o f s e l e c t e d p u t a t i v e pa thogens , h o s t - r e s i s t a n c e f a c t o r s , and n o n - b i o l o g i c f a c t o r s among i n d i v i d u a l s w i t h j u v e n i l e p e r i o d o n t i t i s t o i n d i v i d u a l s w i t h o u t t h e d i s e a s e , c o n t r o l l i n g f o r demographic o r o t h e r confounding v a r i a b l e s .

T h i s i s a n announcement f o r a n a n t i c i p a t e d Reques t f o r P r o p o s a l s (RFP). RFP No. NIH-NIDR-2-91-7R w i l l b e a v a i l a b l e approx ima te ly A p r i l 19, 1991, w i t h a t e n t a t i v e c l o s i n g d a t e f o r p r o p o s a l s s e t f o r J u n e 3, 1991. Reques t s f o r t h e RFP must be s u b m i t t e d i n w r i t i n g t o :

Marion L . B l e v i n s C o n t r a c t Management S e c t i o n N a t i o n a l I n s t i t u t e o f D e n t a l Research N a t i o n a l I n s t i t u t e s o f H e a l t h Nestwood B u i l d i n g , Room 521 Bethesda , MD 20892

ORAL I R O N CHELATOR TOXICITY I N ANIMALS

RFP AVAILABLE: NIH-NIDDK-91-5

P .T . 34; K.W. 1007009, 0715032, 0740020

N a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney Diseases

The N a t i o n a l I n s t i t u t e o f D i a b e t e s , and D i g e s t i v e and Kidney D i s e a s e s ( N I D D K ) , D i v i s i o n o f Kidney, U r o l o g i c , and Hematologic D i s e a s e s , i s s e e k i n g t o p r o c u r e t h e p r e c l i n i c a l t o x i c o l o g i c e v a l u a t i o n o f s e l e c t e d o r a l i r o n c h e l a t i n g compounds f o r u s e i n t h e s a fe and e f f e c t i v e removal o f i r o n d e p o s i t s i n p a t i e n t s w i t h i r o n o v e r l o a d c o n d i t i o n ( e . g . , Coo lcy ' s Anemia and orphan d i s e a s e s ) . A c l i n i c a l e v a l u a t i o n is n o t d e s i r e d a t t h i s t i m e . The c o n t r a c t o r s h a l l conduc t t o x i c o l o g i c and r e l a t e d s t u d i e s o f s e l e c t e d i r o n c h e l a t i n g compounds i n r a t s , dogs , and o t h e r a n i m a l s , as d i r e c t e d by t h e Government, and s h a l l p r o v i d e r e s u l t i n g t o x i c o l o g i c i n f o r m a t i o n t o t h e N I D D K f o r u s e i n p r e p a r i n g submiss ions t o t h e Food and Drug A d m i n i s t r a t i o n f o r a p p r o v a l o f e v e n t u a l c l i n i c a l s t u d i e s . The d r u g s under development a re c o n s i d e r e d t o be orphan d r u g s . T h i s Reques t f o r P r o p o s a l s (RFP) N I H - N I D D K - 9 1 - 5 , w i l l be i s s u e d on or abou t A p r i l 1 1 , 1991, w i t h a c l o s i n g d a t e s e t f o r May 29 , 1991. The N I D D K e x p e c t s t o award one c o n t r a c t from t h i s s o l i c i t a t i o n .

To r e c e i v e a copy o f t h i s RFP, p l e a s e supp ly t h i s o f f i c e w i t h two s e l f - a d d r e s s e d m a i l i n g l a b e l s and c i t e t h e RFP number r e f e r e n c e d above . Reques t s must be i n w r i t i n g and a d d r e s s e d t o :

Mrs. Linda Cameron C o n t r a c t Spec i a l i st C o n t r a c t s Management Branch N a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney Diseases N a t i o n a l I n s t i t u t e s o f l l e a l t h Vestwood B u i l d i n g . Room 6 0 2 5333 li 'estbard Avenue Bethesda , P1D 20892

N I f I G U I D E - Vol, 20, No. 14 , A p r i l 5 , 1991 - Page 3

Telephone r e q u e s t s w i l l n o t be--honored. t h e Government t o make a n award.

T h i s a d v e r t i s e m e n t d o e s n o t commit

CELL LINES FOR HYPERTENSION RESEARCH

RFA AVAILABLE: HL-91-05-H d'

P . T . 34; K . W . 0715115, 0780015, io02004, io02008

N a t i o n a l Heart, Lung, and Blood I n s t i t u t e

A p p l i c a t i o n R e c e i p t Date: September 6, 1991

The D i v i s i o n o f H e a r t and V a s c u l a r Diseases, N a t i o n a l H e a r t , Lung, and Blood I n s t i t u t e ( N H L R I ) , announces t h e a v a i l a b i l i t y o f a Request f o r A p p l i c a t i o n s(RFA) on t h e above s u b j e c t . The purpose o f t h i s RFA i s t o encourage r e s e a r c h ,u s i n g b o t h t h e c o n v e n t i o n a l and molecular approaches , t o d e v e l o p and c h a r a c t e r i z e p r i m a r y o r immorta l ized c e l l l i n e s a p p l i c a b l e t o t h e s t u d y o f h y p e r t e n s i o n . P a r t i c u l a r emphasis i s p l a c e d on maintenance o f t h e phenotypeo f c e l l s d e r i v e d from a d r e n a l , r e n a l , e n d o t h e l i a l , and o t h e r v a s c u l a r c e l l t y p e s . S p e c i f i c phenotypes i n c l u d e hormone p r o d u c t i o n and/or r e p o n s i v e n e s s , t r a n s p o r t f u n c t i o n s , e x p r e s s i o n o f key s t r u c t u r a l g e n e s , o r o t h e r p r o p e r t i e sr e l e v a n t t o t h e s t u d y o f b lood p r e s s u r e .

The P u b l i c H e a l t h S e r v i c e (PHS) is committed t o a c h i e v i n g t h e h e a l t h promotionand d i s e a s e p r e v e n t i o n o b j e c t i v e s o f H e a l t h y People 2000, a PHS-led n a t i o n a l a c t i v i t y f o r s e t t i n g p r i o r i t y a r e a s . T h i s RFA, " C e l l L i n e s f o r H y p e r t e n s i o nResearch", i s r e l a t e d t o t h e p r i o r i t y a r e a o f H e a r t D i s e a s e and S t r o k e . P o t e n t i a l a p p l i c a n t s may o b t a i n a copy o f "Heal thy People 2000" ( F u l l R e p o r t :S t o c k No. 017-001-00474-0) o r "Heal thy People 2000" (Summary R e p o r t : S t o c k No. 017-001-00473-1) t h r o u g h t h e S u p e r i n t e n d e n t o f Documents, Government P r i n t i n g Off ice , Washington, D . C . 20402-9325 ( t e l e p h o n e 202-783-3238).

MECHANISM OF SUPPORT

The s u p p o r t mechanism f o r t h i s program w i l l b e t h e t r a d i t i o n a l , i n d i v i d u a l r e s e a r c h g r a n t . Although a p p r o x i m a t e l y $1 .25 m i l l i o n i n t o t a l c o s t s f o r t h i s program i s i n c l u d e d i n t h e f i n a n c i a l p l a n s f o r f i s c a l y e a r 1992, award o f g r a n t s p u r s u a n t t o t h i s RFA i s c o n t i n g e n t upon r e c e i p t o f f u n d s f o r t h i s p u r p o s e . I t i s a n t i c i p a t e d t h a t 5 g r a n t s w i l l be awarded under t h i s program.

Id The s p e c i f i c number t o be funded , however, w i l l depend on t h e merit and scopeo f t h e a p p l i c a t i o n s r e c e i v e d and t h e a v a i l a b i l i t y o f f u n d s .

SPECIAL INSTRUCTIONS FOR INCLUSION OF WOMEN AND MINORITIES I N C L I N I C A L RESEARCH STUDIES

For p r o j e c t s i n v o l v i n g c l i n i c a l r e s e a r c h , N I H r e q u i r e s a p p l i c a n t s t o g i v e s p e c i a l a t t e n t i o n t o t h e i n c l u s i o n o f women and m i n o r i t i e s i n s t u d y p o p u l a t i o n s . If women o r m i n o r i t i e s a re n o t i n c l u d e d i n t h e s t u d y p o p u l a t i o n s f o r c l i n i c a l s t u d i e s . a s p e c i f i c j u s t i f i c a t i o n f o r t h i s e x c l u s i o n must be p r o v i d e d . A p p l i c a t i o n s w i t h o u t such documentat ion w i l l n o t be a c c e p t e d �or r e v i e w .

I n q u i r i e s r e g a r d i n g t h i s program and r e q u e s t s f o r t h e comple te RFA document s h o u l d be a d d r e s s e d t o :

Michael C . L in , Ph.D Hyper tens ion and Kidney Diseases Branch D i v i s i o n o f H e a r t and V a s c u l a r Diseases N a t i o n a l H e a r t , Lung, and Blood I n s t i t u t e F e d e r a l B u i l d i n g , Room 4C10 N a t i o n a l I n s t i t u t e s o f H e a l t h Bethesda , MD 20892 Telephone: ( 3 0 1 ) 496-1857 Fax: ( 3 0 1 ) 496-9882

For f i s c a l and a d m i n i s t r a t i v e m a t t e r s , c o n t a c t :

J a n e R . Davis G r a n t s O p e r a t i o n s Branch D i v i s i o n o f Ext ramura l Af fa i r s N a t i o n a l Heart, Lung, and Blood I n s t i t u t e Westwood B u i l d i n g , Room 4A15C Bethesda , MD 20892

3- Telephone : ( 3 0 1 1 496-7255

N I H G U I D E - Vol. 2 0 , No. 14, A p r i l 5, 1991 - Page 4

STUDIES OF TESTING AND COUNSELING FOR CYSTIC FIBROSIS MUTATIONS

RFA AVAILABLE: HG-91-01

P . T . 34; K . W . 1002019, 1002028, 0404021, 0414014

N a t i o n a l Cen te r f o r Hurr.an Genome Research N a t i o n a l Cen te r f o r Nurs ing Research N a t i o n a l I n s t i t u t e of Ch i ld Hca l th and Human DevelopmentN a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney D i s e a s e s

L e t t e r o f I n t e n t R e c e i p t Date: May 1 , 1991 A p p l i c a t i o n R e c e i p t Date: June 7 , 1991

The N a t i o n a l Cen te r f o r Human Genome Research , t h e N a t i o n a l Cen te r f o r Nurs ing Resea rch , t h e N a t i o n a l I n s t i t u t e o f Ch i ld Hea l th and Human Development, and t h e N a t i o n a l I n s t i t u t e o f D i a b e t e s and D i g e s t i v e and Kidney D i s e a s e s i n v i t e a p p l i c a t i o n s f o r a s s i s t a n c e awards f o r s t u d i e s o f t h e c l i n i c a l d e l i v e r y o f e d u c a t i o n a l and c o u n s e l i n g s e r v i c e s f o r i n d i v i d u a l s and f a m i l i e s r e l a t e d t o DNA-based t e s t i n g f o r t h e g e n e t i c m u t a t i o n s t h a t c a u s e c y s t i c f i b r o s i s .

BACKGROUND

Given t h e pace o f advances i n human g e n e t i c s , t h e r e i s a s p e c i a l need f o r c l i n i c a l s t u d i e s t h a t u s e c y s t i c f i b r o s i s ( C F ) c a r r i e r t e s t i n g t o deve lopg e n e r i c models f o r t h e long-range i n t e g r a t i o n o f g e n e t i c s e r v i c e s i n t o h e a l t h c a r e . CF is one o f t h e most common autosomal r e c e s s i v e d i s o r d e r s , w i t h a car r ie r f r equency o f about 1 i n 25 among Uni ted S t a t e s c i t i z e n s o f European a n c e s t r y . An i n c r e a s i n g r ange o f m u t a t i o n s r e s p o n s i b l e f o r t h e d i s e a s e a r e now b e i n g i d e n t i f i e d , making it p o s s i b l e t o d e t e c t a h i g h p e r c e n t a g e o f t h o s e a t r i s k o f hav ing c h i l d r e n w i t h CF. The purpose of such CF car r ie r t e s t i n gwould be t o b e t t e r inform i n t e r e s t e d peop le o f t h e i r r e p r o d u c t i v e h e a l t h r i s k s . However, e v a l u a t i o n s o f a l t e r n a t i v e approaches t o g e n e t i c e d u c a t i o n , t e s t i n g . and c o u n s e l i n g are needed i n o r d e r t o e s t a b l i s h t h e p r o f e s s i o n a lp r a c t i c e s t h a t shou ld govern t h e p r o v i s i o n o f DNA-based t e s t i n g f o r CF car r ie r s t a t u s . Recent e x p e r i e n c e w i t h t h e widespread i n t r o d u c t i o n o f o t h e r g e n e t i c t e s t s s u g g e s t s t h e v a l u e o f such s t u d i e s i n h e l p i n g t o e s t a b l i s h p r a c t i c e st h a t would improve p r o f e s s i o n a l i n t e r p r e t a t i o n and p a t i e n t u n d e r s t a n d i n g of CF t e s t i n g and t e s t r e s u l t s .

RESEARCH GOALS

The pu rpose o f t h i s Request f o r A p p l i c a t i o n s (RFA) is t o s o l i c i t r e s e a r c h p r o j e c t s t h a t i d e n t i f y c l i n i c a l p r a c t i c e s t h a t b e s t i n c r e a s e p a t i e n tu n d e r s t a n d i n g o f d i sease -gene car r ie r t e s t i n g and t e s t r e s u l t s , and b e s t p r o t e c t i n d i v i d u a l s and f ami l i e s from t e s t - r e l a t e d p s y c h o l o g i c a l harm,s t i g m a t i z a t i o n , and d i s c r i m i n a t i o n . Research q u e s t i o n s t h a t are a p p r o p r i a t e l ya d d r e s s e d i n a p p l i c a t i o n s r e spond ing t o t h i s RFA cou ld i n c l u d e , b u t are n o t l i m i t e d t o :

o What are t h e l e v e l s o f u n d e r s t a n d i n g of and i n t e r e s t i n CF car r ie r t e s t i n g among d i f f e r e n t p o p u l a t i o n s ?

o What are t h e optimum forms and l e v e l s o f p r e - t e s t e d u c a t i o n f o r d i f f e r e n t p o p u l a t i o n s ?

o What p o s t - t e s t c o u n s e l i n g s t r a t e g i e s are most e f f e c t i v e i n terms of t h e u n d e r s t a n d i n g and p s y c h o l o g i c a l h e a l t h o f i n d i v i d u a l s and f a m i 1 ies ?

o What are t h e optimum s e t t i n g s f o r p r o v i d i n g CF ca r r i e r t e s t i n gs e r v i c e s ?

o What r eco rd -keep ing and r e p o r t i n g p o l i c i e s b e s t p r o t e c t a g a i n s tb r e a c h e s o f c o n f i d e n t i a l i t y , s t i g m a t i z a t i o n , and d i s c r i m i n a t i o n ?

o What are t h e accu racy and c o s t e f f e c t i v e n e s s o f v a r i o u s t y p e s o f t e s t s ?

A p p l i c a t i o n s r e spond ing t o t h i s RFA need n o t a t t e m p t t o a d d r e s s a l l o f t h e s e r e s e a r c h q u e s t i o n s . For a l l approaches a s s e s s e d , however, q u e s t i o n s o f r e l a t i v e e f f e c t i v e n e s s , r e l a t i v e c o s t s , and r e l a t i v e a b i l i t y t o meet t h e demand f o r s e r v i c e s need t o be e v a l u a t e d .


N I H G U I D E - Vol . 20, No. 1 4 , A p r i l 5, 1991 - Page 5

T U ’

For p r o j e c t s i n v o l v i n g c l i n i c a l r e s e a r c h , N I H r e q u i r e s a p p l i c a n t s t o g i v es p e c i a l a t t e n t i o n t o t h e i n c l u s i o n o f women and m i n o r i t i e s i n s t u d yp o p u l a t i o n s . If women o r m i n o r i t i e s are n o t i n c l u d e d i n t h e s t u d y p o p u l a t i o n sf o r c l i n i c a l s t u d i e s , a s p e c i f i c j u s t i f i c a t i o n f o r t h i s e x c l u s i o n must be p rov ided . A p p l i c a t i o n s wi thou t such documentat ion w i l l n o t be a c c e p t e d f o r r ev iew.


The RFA i s a one-time s o l i c i t a t i o n f o r a p p l i c a t i o n s f o r r e s e a r c h p r o j e c t g r a n t s ( R o l l . The award p e r i o d w i l l b e f o r up t o t h r e e y e a r s and i s renewable . It i s a n t i c i p a t e d t h a t $ 1 m i l l i o n w i l l be a v a i l a b l e d u r i n g f i s ca l y e a r 1991 f o r approx ima te ly f i v e s t u d i e s , a l t hough t h e number o f awards i s c o n t i n g e n t upon t h e q u a l i t y , s cope , and c o s t o f t h e a p p l i c a t i o n s r e c e i v e d and t h e a c t u a l a v a i l a b i l i t y o f a p p r o p r i a t e d f u n d s .

REVIEW PROCEDURES AND AWARD C R I T E R I A

A p p l i c a t i o n s s u b m i t t e d i n r e sponse t o t h i s RFA w i l l be reviewed i n acco rdance wi th t h e u s u a l N I H p e e r rev iew p r o c e d u r e s . The a p p l i c a t i o n s w i l l be reviewed f o r s c i e n t i f i c mer i t by a n i n i t i a l rev iew group ( I R G ) o r g a n i z e d f o r t h i s purpose by t h e O f f i c e o f S c i e n t i f i c Review, N a t i o n a l Cen te r f o r Human Genome Research . A s econd- l eve l rev iew w i l l be conducted by t h e a p p r o p r i a t e n a t i o n a l a d v i s o r y c o u n c i l . Funding d e c i s i o n s w i l l be based on t h e recommendations o f t h e I R G and t h e a d v i s o r y c o u n c i l r e g a r d i n g t h e s c i e n t i f i c meri t and programr e l e v a n c e o f t h e proposed r e s e a r c h .

I n o r d e r t o make r e l i a b l e comparisons p o s s i b l e between s t u d i e s , it is d e s i r a b l e t h a t t h e r e s e a r c h teams e v e n t u a l l y suppor t ed under t h i s RFA work t o g e t h e r t o c o o r d i n a t e t h e i r e f f o r t s . To f a c i l i t a t e such c o o r d i n a t i o n , g r a n t e e workshops w i l l b e a r r anged a f te r awards have been made. The w i l l i n g n e s s o f a p p l i c a n t s t o p a r t i c i p a t e i n such p l a n n i n g and t h e i r a b i l i t y t o c o n t r i b u t e u n i q u e l y t o t h e mix o f s t u d i e s w i l l be c o n s i d e r e d b e f o r e a n award is made.

FULL RFA AND LETTER OF INTENT

P r o s p e c t i v e a p p l i c a n t s shou ld r e q u e s t and rev iew a copy o f t h e f u l l RFA from t h e program s t a f f , and t h e n submit a l e t t e r o f i n t e n t by May 1 , 1 9 9 1 . T h i s l e t t e r shou ld i d e n t i f y t h e key p e r s o n n e l and i n c l u d e a d e s c r i p t i v e t i t l e o f t h e proposed r e s e a r c h . The l e t t e r o f i n t e n t is r e q u e s t e d i n o r d e r t o p r o v i d e an i n d i c a t i o n o f t h e number and scope o f a p p l i c a t i o n s t o be rev iewed. The l e t t e r o f i n t e n t does n o t commit t h e s e n d e r t o submit a n a p p l i c a t i o n , n o r i s it a requ i r emen t f o r submiss ion o f an a p p l i c a t i o n . P l e a s e send l e t t e r s o f i n t e n t and r e q u e s t s f o r t h e f u l l RFA o r a d d i t i o n a l i n f o r m a t i o n t o :

E r i c T . J u e n g s t , Ph.D. Program D i r e c t o r E t h i c a l , Legal and S o c i a l I m p l i c a t i o n s ProgramN a t i o n a l Cen te r f o r Human Genome Research N a t i o n a l I n s t i t u t e s o f H e a l t h B u i l d i n g 38A, Room 612 Bethesda, MD 20892 Telephone: ( 3 0 1 ) 496-7531 E - m a i l : [email protected]

For i n f o r m a t i o n about PHS Gran t s P o l i c y , a p p l i c a n t s may c o n t a c t :

Ms. Alice Thomas C h i e f , Gran t s and C o n t r a c t s ManagementN a t i o n a l Cen te r f o r Human Genome Research N a t i o n a l I n s t i t u t e s o f Hea l th B u i l d i n g 38A, Room 613 Bethesda , MD 20892 Telephone: ( 3 0 1 ) 402-0733

T h i s program i s d e s c r i b e d i n t h e Ca ta log o f F e d e r a l Domestic A s s i s t a n c e 9 3 . 8 6 5 , Research f o r Mothers and C h i l d r e n . Awards w i l l be made under t h e a u t h o r i t y o f t h e P u b l i c Hea l th S e r v i c e A c t . S e c t i o n 301 and t i t l e 4 ( P u b l i c Law 78-410, a s amended 42 U.S.C. 241 and 2 8 4 ) and a d m i n i s t e r e d under PHS g r a n t s p o l i c i e s and F e d e r a l R e g u l a t i o n s 42 CFR P a r t 5 2 and 45 CFR P a r t 7 4 . T h i s program is n o t s u b j e c t t o t h e in t e rgove rnmen ta l rev iew requ i r emen t o f Execu t ive Order 12372 o r t o Hea l th Systems Agency r ev iew.

N I H G U I D E - Vol. 2 0 , No. 1 4 , A p r i l 5 , 1991 - Page 6

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INSTITUTIONAL C L I N I C A L TRAINING GRANTS: PROFESSIONAL TRAINING FOR RACIAL/ETHNIC M I N O R I T Y AND DISADVANTAGED STUDENTS

RFA AVAILABLE: MH-91-09

P .T . 4 4 , FF; K . W . 0720005, 0715095, 0715129, 0414000, 0414004, 0785185

N a t i o n a l I n s t i t u t e o f Mental H e a l t h

A p p l i c a t i o n R e c e i p t Date: J u n e 1 2 , 1991

INTRODUCTION

R a c i a l and e t h n i c m i n o r i t i e s a r e soon e x p e c t e d t o become o n e - q u a r t e r o f t h e Un i t ed S t a t e s p o p u l a t i o n . P r o j e c t i o n s are t h a t t h e need f o r menta l h e a l t h s e r v i c e s w i l l r i s e p r o p o r t i o n a t e l y , p a r t i c u l a r l y i n t h e p u b l i c s e c t o r where most m i n o r i t y p e r s o n s a r e s e r v e d . The re i s a l s o i n c r e a s i n g e v i d e n c e t h a t when m i n o r i t y p e r s o n s r e q u i r e menta l h e a l t h s e r v i c e s t h e y most o f t e n s e e k menta l h e a l t h p r o f e s s i o n a l s o f a race or e t h n i c i t y s imi l a r t o t h e i r own o r choose s e t t i n g s s t a f f e d by menta l h e a l t h p r o f e s s i o n a l s who demons t r a t e r e s p o n s i v e n e s s t o t h e i r n e e d s . C u r r e n t l y , m i n o r i t i e s r e p r e s e n t l e s s t h a n 1 0 p e r c e n t o f menta l h e a l t h p r o f e s s i o n a l s . The need t o i n c r e a s e t h e numbers o f r a c i a l and e t h n i c m i n o r i t y menta l h e a l t h p r o f e s s i o n a l s i s c lear so t h a t t h e y may s e r v e n o t o n l y t h e i r own communit ies b u t a l s o c o n t r i b u t e t o improving t h e o v e r a l l q u a l i t y o f t h e menta l h e a l t h sys tem by promot ing i t s r e s p o n s i v e n e s s t o t h e un ique needs o f c u l t u r a l l y d i v e r s e g r o u p s .

The P u b l i c H e a l t h S e r v i c e (PHS) is commit ted t o a c h i e v i n g t h e h e a l t h promot ionand d i s e a s e p r e v e n t i o n o b j e c t i v e s o f "Heal thy Peop le 200OV7,a PHS-led n a t i o n a l a c t i v i t y f o r s e t t i n g p r i o r i t y a r eas . T h i s RFA, " I n s t i t u t i o n a l C l i n i c a l T r a i n i n g G r a n t s : P r o f e s s i o n a l T r a i n i n g f o r R a c i a l l E t h n i c Minor i ty and Disadvantaged S t u d e n t s , " i s r e l a t e d t o t h e p r i o r i t y a r e a o f menta l h e a l t h and d i s o r d e r s . P o t e n t i a l a p p l i c a n t s may o b t a i n a copy o f "Heal thy People 2000" ( F u l l Repor t : S t o c k No. 017-001-00474-0) o r "Heal thy Peop le 2000 '1 (SummaryR e p o r t : S t o c k N o . 017-001-00473-1 ) t h r o u g h t h e S u p e r i n t e n d e n t o f Documents, Government P r i n t i n g Office, Washington, D.C. 20402-9325 ( t e l e p h o n e202-783-3238).

PURPOSE

T h i s program is d e s i g n e d t o s u p p o r t r e c r u i t m e n t and e d u c a t i o n o f r a c i a l / e t h n i cm i n o r i t y and d i s a d v a n t a g e d s t u d e n t s t o become p r o f e s s i o n a l s i n t h e c o r e menta l h e a l t h d i s c i p l i n e s o f s o c i a l work, p s y c h i a t r i c n u r s i n g , psychology,p s y c h i a t r y , and m a r r i a g e and f a m i l y t h e r a p y . The term "minor i ty" i n t h i s announcement r e f e r s t o B l a c k s , H i s p a n i c s , A s i a n / P a c i f i c I s l a n d e r s ( i n c l u d i n gN a t i v e Hawaiians and Samoans), and American I n d i a n s / A l a s k a N a t i v e s . The d e f i n i t i o n o f d i s a d v a n t a g e d s t u d e n t s i s l e f t t o t h e a p p l i c a n t i n s t i t u t i o n t o j u s t i f y . I t c o u l d i n c l u d e t h e h e a r i n g impa i red o r t h o s e w i t h o t h e r hand icapp ing c o n d i t i o n s b u t would n o t e x t e n d t o i n d i v i d u a l s whose s o l e d i s a d v a n t a g e i s economic.

TR4INING ISSUES

For t h e s e s t u d e n t s , t h e N a t i o n a l I n s t i t u t e o f Mental H e a l t h ( N I M H ) o f f e r s c l i n i c a l t r a i n i n g programs t h a t a r e i n t e n d e d t o enhance t h e q u a l i t y and e f f e c t i v e n e s s o f s e r v i c e s t o p e r s o n s w i t h major menta l d i s o r d e r s . A p p l i c a n t sunde r t h i s Reques t f o r A p p l i c a t i o n s ( R F A ) must f o c u s i n d e p t h on one o r more o f t h e p r i o r i t y p o p u l a t i o n s d e s c r i b e d be low. Programs m u s t demons t r a t e t h a t t h e y i n c o r p o r a t e t h e l a t e s t d i a g n o s t i c and t r e a t m e n t p r o c e d u r e s and t h e l a t e s t r e l e v a n t r e s e a r c h f i n d i n g s .

The p r i o r i t y s e r v i c e p o p u l a t i o n s f o r t h i s RFA are :

o S e v e r e l y and p e r s i s t e n t l y m e n t a l l y ill a d u l t s

o C h i l d r e n and a d o l e s c e n t s w i t h s e v e r e menta l d i s o r d e r s

o E l d e r l y w i t h menta l d i s o r d e r s

o Men ta l ly ill i n r u r a l a r e a s

o R a c i a l / e t h n i c m i n o r i t i e s w i t h menta l d i s o r d e r s

Other c r o s s - c u t t i n g p r i o r i t i e s a r e l i n k a g e s between academic programs and Sta te /communi ty s e r v i c e s y s t e m s , i . e . , publ ic -academic l i n k a g e s and l i n k a g e sw i t h c l i n i c a l r c s e a r c h c r s and rcsear.ch t r a i n e r s .

E L I G I B I L I T Y

N I H G U I D E - Vol . 20 , No. 14 , A p r i l 5 , 1991 - Page 7

A c c r e d i t e d and/or approved d e p a r t m e n t s / d i v i s i o n s i n t h e mental h e a l t h c o r e d i s c i p l i n e s of p s y c h i a t r i c n u r s i n g , p s y c h i a t r y , psychology, s o c i a l work, and mar r i age and f ami ly t h e r a p y i n c o l l e g e s or u n i v e r s i t i e s o f t h e Uni ted S t a t e s ,i n c l u d i n g t e r r i t o r i e s and p o s s e s s i o n s , are e l i g i b l e t o a p p l y .M u l t i d i s c i p l i n a r y a p p l i c a t i o n s a r e encouraged . A p p l i c a t i o n s may be f o r p r e d o c t o r a l and/or p o s t d o c t o r a l t r a i n i n g i n any o f t h e s e f i e l d s .

-0 APPLICATION CHARACTERISTICS

A p p l i c a t i o n s must i n c l u d e a b r i e f d e s c r i p t i o n o f t h e a p p l i c a n t e d u c a t i o n a l i n s t i t u t i o n and , i f a p p r o p r i a t e , a s s o c i a t e d s e r v i c e and c l i n i c a l r e s e a r c h s e t t i n g s , i n c l u d i n g background, h i s t o r y , programmatic f o c u s , o r g a n i z a t i o n , r e s o u r c e s , p e r s o n n e l , and r e c o r d o f educational/service/research l i n k a g eachievements . Each a p p l i c a t i o n m u s t i n c l u d e d e s c r i p t i o n s o f :

o t h e poo l from which m i n o r i t y and/or d i sadvan taged t r a i n e e s w i l l be r e c r u i t e d , r e c r u i t m e n t s t r a t e g i e s , s e l e c t i o n c r i t e r i a

o g o a l s and o b j e c t i v e s o f t h e t r a i n i n g

o c u r r i c u l a c o n t e n t t h a t a d d r e s s e s e t h n i c and c u l t u r a l i s s u e s

o s p e c i f i c s t eps t o be t a k e n f o r t h e r e c r u i t m e n t , r e t e n t i o n , and g r a d u a t i o n o f m i n o r i t y and/or d i sadvan taged t r a i n e e s

o key f a c u l t y members and c l i n i c a l s u p e r v i s o r s

TERMS AND CONDITIONS OF SUPPORT

I n f i s c a l y e a r 1991, approx ima te ly $ 1 . 0 m i l l i o n w i l l be a v a i l a b l e t o fund approx ima te ly 1 0 t o 15 awards under t h i s RFA. Suppor t may be r e q u e s t e d f o r up t o t h r e e y e a r s . Awards w i l l be l i m i t e d t o a maximum o f $ 8 0 , 0 0 0 ( t o t a l c o s t s ) ,w i th t h e e x c e p t i o n o f m u l t i d i s c i p l i n a r y awards t h a t may be funded up t o $120,000 ( t o t a l c o s t s ) .

Payback P r o v i s i o n s

Any t r a i n e e who r e c e i v e s a c l i n i c a l t r a i n e e s h i p i n psychology, p s y c h i a t r y ,p s y c h i a t r i c n u r s i n g , s o c i a l work, o r marriage and f a m i l y t h e r a p y , i n a n

.'& e s t a b l i s h e d t r a i n i n g program, des igned t o be f o r a p e r i o d o f 180 days o r more under an N I M H c l i n i c a l t r a i n i n g g r a n t , m u s t pay back a p e r i o d of o b l i g a t e ds e r v i c e e q u a l t o t h e l e n g t h o f t h e t r a i n e e s h i p .

APPLICATION PROCEDURES

P r o s p e c t i v e a p p l i c a n t s are s t r o n g l y encouraged t o c o n s u l t N I M H s t a f f r e g a r d i n ge l i g i b i l i t y and a s s i s t a n c e i n deve lop ing a p p l i c a t i o n s . A p p l i c a t i o n s k i t s (FHS398, r e v . 1 0 / 8 8 ) c o n t a i n i n g t h e n e c e s s a r y forms and S p e c i a l I n s t r u c t i o n s maybe o b t a i n e d by c o n t a c t i n g t h e Educat ion and T r a i n i n g Branch s ta f f l i s t e d a t t h e end o f t h i s announcement.

REVIEW OF APPLICATIONS

A d u a l rev iew system i s used t o e n s u r e e x p e r t , o b j e c t i v e rev iew o f t h e qual i tyo f a p p l i c a t i o n s . The f i rs t s t e p , p e e r rev iew for e d u c a t i o n a l and t e c h n i c a l m e r i t , i s by p r i m a r i l y non-Federa l e x p e r t s compr is ing i n i t i a l rev iew groups( I R G s ) . The f i n a l rev iew i s by t h e Na t iona l Advisory Mental Hea l th Counc i l . Only a p p l i c a t i o n s recommended f o r approva l by t h e Counci l w i l l b e c o n s i d e r e d f o r f u n d i n g .

RECEIPT AND REVIEW SCHEDULE

N a t i o n a l AdvisoryRece ip t o f I n i t i a l Mental Hea l th E a r l i e s t A p p l i c a t i o n Review Counci l Review Award Date

June 12, 1991 J u l y September September 1

AWARD OF GRANTS

Awards w i l l be made on t h e b a s i s of t h e f o l l o w i n g c r i t e r i a :

o q u a l i t y o f proposed e d u c a t i o n / t r a i n i n g programs as de termined byt h e rev iew p r o c e s s

N I H G U I D E - Vol. 20, No. 1 4 , A p r i l 5, 1991 - Page 8

o b a l a n c e among programs d i r e c t e d t o t h e p r i o r i t y p o p u l a t i o n s , amongt h e d i s c i p l i n e s and , where a p p r o p r i a t e , among geograph ic ,e s p e c i a l l y r u r a l , l o c a t i o n s

o a v a i l a b i l i t y o f funds

STAFF CONSULTATION

S t a f f c o n s u l t a t i o n on c l i n i c a l t r a i n i n g g r a n t s is a v a i l a b l e from t h e f 011owing :

Lemuel B . C l a r k , M . D . C h i e f , Educa t ion and T r a i n i n g Branch D i v i s i o n of C l i n i c a l Research N a t i o n a l I n s t i t u t e of Mental Hea l th 5600 F i s h e r s Lane, Room 7C-02 R o c k v i l l e , PJD 20857 Telephone: ( 3 0 1 ) 443-5850

For f i s c a l and a d m i n i s t r a t i v e m a t t e r s ,

Stephen Hudak C h i e f , Gran t s Management S e c t i o n N a t i o n a l I n s t i t u t e o f Mental Hea l th Parklawn B u i l d i n g , Room 7C23 5600 F i s h e r s Lane R o c k v i l l e , MD 20857 Telephone: ( 3 0 1 ) 443-4456

c o n t a c t :

O N G O I N G PROGRAM ANNOUNCEMENTS

COMMUNITY SUPPORT RESEARCH DEMONSTRATION PROJECTS

PA: PA-91-39

P .T . 34 ; K . W . 0715129, 0403004, 0414014

N a t i o n a l I n s t i t u t e of Mental Hea l th

BACKGROUND

S i n c e 1978, t h e N a t i o n a l I n s t i t u t e o f Mental Hea l th ( N I M H ) Community Suppor tProgram (CSP) h a s been working w i t h S t a t e s and communities t o promote t h e development o f t h e most a p p r o p r i a t e and e f f e c t i v e comprehensive,community-based s e r v i c e s and s e r v i c e sys tems for a d u l t s w i t h s e v e r e and p e r s i s t e n t menta l d i s o r d e r s . These e f f o r t s have been r e i n f o r c e d by t h e r e c e n t s t a t u t o r y r e q u i r e m e n t s o f P . L . 99-660.

I n f i s c a l y e a r s 1989 and 1990, N I M H i s s u e d a Request f o r A p p l i c a t i o n s f o r r e s e a r c h demons t r a t i o n p r o j e c t s t o i n c r e a s e knowledge i n p s y c h o s o c i a lr e h a b i l i t a t i o n , c a s e management, and c r i s i s r e sponse s e r v i c e s . I n f i s c a l y e a r1991, CSP is i s s u i n g a new Program Announcement t o s u p p o r t r e s e a r c h demons t r a t ion p r o j e c t s i n t h e b roade r community s u p p o r t and r e h a b i l i t a t i o n S e r v i c e s area.

The p o p u l a t i o n o f concern �or CSP g r a n t s i n c l u d e s i n d i v i d u a l s 18 y e a r s and ove r w i t h a s e v e r e and p e r s i s t e n t menta l d i s o r d e r t h a t s e r i o u s l y i m p a i r sf u n c t i o n i n g i n i n t e r p e r s o n a l r e l a t i o n s , l i v i n g a r r angemen t s , o r employment.N I M H encourages r e s e a r c h e r s t o pay p a r t i c u l a r a t t e n t i o n t o s t u d y i n g e f f e c t i v e approaches f o r s e r v i n g h i g h - p r i o r i t y subgroups o f t h e p o p u l a t i o n t h a t i n c l u d e i n d i v i d u a l s w i t h a s e v e r e and p e r s i s t e n t mental d i s o r d e r who are e l d e r l y ,homeless or a t r i s k o f becoming homeless , l i v e i n r u r a l a r e a s , o r a r e members o f e t h n i c m i n o r i t y groups ( s p e c i f i c a l l y , American I n d i a n s o r Alaskan N a t i v e s ,A s i a n / P a c i f i c I s l a n d e r s , B lacks , and H i s p a n i c s ) .

N I M H i s i n t e r e s t e d i n expanding t h e lcnowledge b a s e on t h e r e l a t i v e b e n e f i t s and c o s t s o f d i f f e r e n t approaches t o o r g a n i z i n g and p r o v i d i n g community s u p p o r t s e r v i c e s t h a t r educe f r a g m e n t a t i o n , i n c r e a s e c l i e n t s a t i s f a c t i o n w i t h s e r v i c e s , s u s t a i n i n d i v i d u a l s i n community s e t t i n g s , improve t h e i r q u a l i t y o f l i f e , and enhance t h e i r a b i l i t y t o f u n c t i o n as p r o d u c t i v e l y and independen t lyi n s o c i e t y as p o s s i b l e .

RESEARCH ISSUES

The r e s e a r c h i s s u e s l i s t e d below i s n o t e x h a u s t i v e ; it is expec ted t h a t a p p l i c a n t s w i l l i d e n t i f y o t h e r impor t an t t o p i c s .

N I H G U I D E - Vol. 20, No. 1 4 , A p r i l 5 , 1991 - Page 9

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The e f f e c t i v e n e s s of d i f f e r e n t approaches f o r a d d r e s s i n g t h e s y s t e m i c and e x t e r n a l f a c t o r s t h a t i n f l u e n c e t h e o p e r a t i o n o f community s u p p o r t sys t ems , such a s mechanisms t o c o o r d i n a t e c l i n i c a l t r e a t m e n t , r e h a b i l i t a t i o n s e r v i c e s , i n fo rma l s u p p o r t s , and mainstream s e r v i c e s

The compara t ive e f f e c t i v e n e s s o f d i f f e r e n t s t r a t e g i e s f o r i n t e g r a t i n g f ami l i e s and consumers i n t o system improvement e f f o r t s

The r e l a t i v e e f f i c a c y of d i f f e r e n t models o f case managements e r v i c e s ( e . g . , c l i n i c a l c a s e management v e r s u s t h e minimal and c o o r d i n a t i o n models , c l i n i c a l l y based v e r s u s r e h a b i l i t a t i o n - b a s e d models, team v e r s u s i n d i v i d u a l models, p rov ide r -based v e r s u s fami ly-based models, consumer - s t a f f ed v e r s u s p r o f e s s i o n a l l ys t a f f e d ) i n h e l p i n g i n d i v i d u a l s a c h i e v e l i v i n g , l e a r n i n g , working,and s o c i a l i z a t i o n g o a l s

%

The r e l a t i v e e f f i c a c y o f v a r i o u s hous ing o p t i o n s ( e . g . , s t r u c t u r e d s p e c i a l r e s i d e n t i a l s e t t i n g s v e r s u s normat ive i n t e g r a t e d communityhous ing w i t h v i s i t i n g s u p p o r t s )

The compara t ive e f f e c t i v e n e s s o f v a r i o u s community r e s i d e n t i a l a l t e r n a t i v e s f o r i n d i v i d u a l s w i t h s e v e r e mental d i s o r d e r s d i v e r t e d o r d i s c h a r g e d from n u r s i n g home p lacements i n accordance w i t h t h e l e g i s l a t i v e r e q u i r e m e n t s o f t h e Omnibus Budget R e c o n c i l i a t i o n A c t o f 1987

The d i f f e r e n t i a l e f f e c t i v e n e s s o f a l t e r n a t i v e approaches t o p r o v i d i n g p s y c h o s o c i a l r e h a b i l i t a t i o n s e r v i c e s t h a t assist i n d i v i d u a l s t o a c q u i r e t h e l i v i n g , l e a r n i n g . working, and s o c i a l i z a t i o n s k i l l s t h e y need t o f u n c t i o n i n t h e community

The d i f f e r e n t i a l e f f e c t i v e n e s s o f a l t e r n a t i v e c r i s i s r e sponses e r v i c e s , i n c l u d i n g t h e t a i l o r i n g needed f o r v a r i o u s s e t t i n g s , as r e f l e c t e d by outcomes such as t i m e l i n e s s o f i n t e r v e n t i o n ,development o f r e l e v a n t t r e a t m e n t p l a n s , e f f e c t i v e s t a b i l i z a t i o n , a p p r o p r i a t e fo l lowup care, and maintenance o f i n d i v i d u a l s i n t h e commun ity

Comparat ive e f f e c t i v e n e s s o f approaches t o meet ing t h e s p e c i a lneeds o f f a m i l y members and engaging them i n t h e r e h a b i l i t a t i o n p r o c e s s ( e . g . , p r o v i d i n g e d u c a t i o n , emot iona l s u p p o r t , and p e r i o d i cr e s p i t e c a r e and o t h e r s u p p o r t i v e s e r v i c e s where t h e i n d i v i d u a l i s l i v i n g w i t h i n t h e f a m i l y environment; deve lop ingprofessional/family/client c o l l a b o r a t i o n ; a s s i s t i n g i n t r a n s i t i o n i n g t h e f a m i l y member t o more independent hous ing )

Comparative e f f e c t i v e n e s s o f d i f f e r e n t approaches t o p r o v i d i n gs e l f - h e l p s e r v i c e s ( e . g . , d rop - in c e n t e r s , s o c i a l i z a t i o n c l u b s , and p e e r s u p p o r t s ) , employing consumers w i t h i n t h e formal menta l h e a l t h sys tem ( e . g . , case managers , mobile o u t r e a c h teams, j o b coaches ,and r e s i d e n t i a l s t a f f ) , and i n c o r p o r a t i n g t h e consumer p e r s p e c t i v ei n a l l a s p e c t s o f r e h a b i l i t a t i o n from ph i losophy and s t r u c t u r e t o t h e n a t u r e of s e r v i c e s and s e r v i c e p r o v i d e r s

C o n s i s t e n t w i t h t h e p r o v i s i o n s and p r o t e c t i o n s o f t h e Americans w i t h D i s a b i l i t i e s A c t , t h e e f f e c t i v e n e s s o f d i f f e r e n t approachesf o r p r o v i d i n g r e a s o n a b l e accommodations i n t h e workplace f o r an i n d i v i d u a l ' s mental d i s o r d e r ( e . g . , f l e x i b l e l e a v e p o l i c i e s , j o br e s t r u c t u r i n g , p a r t - t i m e or modif ied work s c h e d u l e s , a d j u s t m e n t s t o s u p e r v i s i o n , and s p e c i a l i z e d t r a i n i n g )

The d i f f e r e n t i a l e f f e c t i v e n e s s o f a l t e r n a t i v e s i n d e c r e a s i n g t h e use o f i n v o l u n t a r y i n t e r v e n t i o n s such as i n p a t i e n t or o u t p a t i e n tcommitment and i n v o l u n t a r y med ica t ion ( e . g . , working w i t h f a m i l ymembers, management o f v i o l e n t and o t h e r t roublesome b e h a v i o r , e a r l y cr is is i n t e r v e n t i o n , consumer-run s a f e houses , in-home a s s i s t a n c e , p e e r s u p p o r t s . and temporary placement i n f o s t e r f a m i l y c a r e 1

Comparative e f f e c t i v e n e s s o f o u t r e a c h and o t h e r formal and in fo rma l s e r v i c e s t o i n d i v i d u a l s i n r u r a l communities where t h e r e a r e few fo rma l s e r v i c e s

The r e l a t i v e e f f e c t i v e n e s s o f approaches t o a s s i s t s e v e r e l ym e n t a l l y ill i n d i v i d u a l s i n t h e c o r r e c t i o n a l system such a s d i v e r s i o n t o community t r e a t m e n t ; t r a i n i n g p o l i c e . c o r r e c t i o n a l

NIH GUIDE - Vol. 20, No. 14, A p r i l 5, 1991 - Page 1 0

guards , o r p a r o l e o f f i c e r s ; o r o f f e r i n g t r e a t m e n t and s e r v i c e s t o i n d i v i d u a l s i n j a i l s and a f t e r re lease.

E L I G I B I L I T Y

Only S t a t e menta l h e a l t h a u t h o r i t i e s a r e e l i g i b l e t o app ly f o r CSP CommunityResearch Demonst ra t ion G r a n t s . I t is expec ted , however, t h a t t h e pr imaryr e s e a r c h e r w i l l b e t h e P r i n c i p a l I n v e s t i g a t o r , and t h e S t a t e s t a f f member w i t h p r o j e c t o v e r s i g h t r e s p o n s i b i l i t y w i l l be t h e P r o j e c t C o o r d i n a t o r . Women and m i n o r i t y i n v e s t i g a t o r s are encouraged t o a p p l y .


For p r o j e c t s i n v o l v i n g c l i n i c a l r e s e a r c h , ADAMHA r e q u i r e s a p p l i c a n t s t o g i v es p e c i a l a t t e n t i o n t o t h e i n c l u s i o n o f women and m i n o r i t i e s i n s t u d yp o p u l a t i o n s . If women and m i n o r i t i e s are n o t i n c l u d e d i n t h e s t u d yp o p u l a t i o n s f o r c l i n i c a l s t u d i e s , a s p e c i f i c j u s t i f i c a t i o n f o r t h i s e x c l u s i o n must be p r o v i d e d . A p p l i c a t i o n s wi thou t such documenta t ion w i l l no t be a c c e p t e d f o r r ev iew.


Suppor t f o r t h i s program w i l l b e th rough r e s e a r c h demons t r a t ion p r o j e c t g r a n t s( R 1 8 ) . Suppor t may be r e q u e s t e d f o r a p e r i o d o f up t o t h r e e y e a r s ( renewablef o r subsequent p e r i o d s ) . I n FY 1990, $2 m i l l i o n w a s a v a i l a b l e t o suppor t s i x p r o j e c t s . Annual awards w i l l be made s u b j e c t t o c o n t i n u e d a v a i l a b i l i t y o f funds and p r o g r e s s a c h i e v e d . A compet ing c o n t i n u a t i o n ( i . e . . r enewa l )a p p l i c a t i o n may be s u b m i t t e d b e f o r e t h e end o f an approved p e r i o d o f s u p p o r ti n o r d e r t o r e q u e s t a d d i t i o n a l funds t o c o n t i n u e a p r o j e c t .

APPLICATIONS PROCEDURES

A p p l i c a n t s must u s e t h e g r a n t a p p l i c a t i o n form f;’HS 398 ( r e v . 10 /88 ) . The number and t i t l e o f t h i s Program Announcement, PA-91-39 Community SupportResearch Demonst ra t ion P r o j e c t s ” , must be t y p e d i n i tem number 2 on t h e f a c e page o f t h e PHS 398 a p p l i c a t i o n form.

A p p l i c a t i o n s t o be c o n s i d e r e d f o r f i s c a l y e a r 1991 fund ing , w i t h a n expec ted s t a r t d a t e o f September 3 0 , 1991, m u s t be r e c e i v e d ( n o t post-marked) by June 1 , 1991.

REVIEW PROCEDURES AND C R I T E R I A

A p p l i c a t i o n s r e c e i v e d under t h i s announcement w i l l be a s s i g n e d t o an I n i t i a l Review Group ( I R G ) and a PHS fund ing component i n accordance w i t h e s t a b l i s h e d PHS R e f e r r a l G u i d e l i n e s . A p p l i c a t i o n s w i l l r e c e i v e a second- l eve l rev iew byt h e a p p r o p r i a t e N a t i o n a l Advisory Counci l whose rev iew may be based on p o l i c yc o n s i d e r a t i o n s as w e l l as s c i e n t i f i c m e r i t . Only a p p l i c a t i o n s recommended f o r approva l by t h e Counci l may be c o n s i d e r e d f o r f u n d i n g . A p p l i c a t i o n s w i l l be e v a l u a t e d f o r t h e s i g n i f i c a n c e o f t h e s e r v i c e problem and s t u d y q u e s t i o n s t o be a d d r e s s e d and t h e s c i e n t i f i c q u a l i t y and r i g o r o f t h e r e s e a r c h d e s i g n .

A p p l i c a t i o n s submi t t ed i n r e sponse t o t h i s announcement a r e s u b j e c t t o t h e i n t e r g o v e r n m e n t a l rev iew requ i r emen t s o f Execu t ive Order 12372, as implementedth rough Department o f Hea l th and Human S e r v i c e r e g u l a t i o n s a t 45 CFR P a r t 1 0 0 .

INQUI R I ES

Neal Brown. C h i e f , o r F rances Randolph, Dr .P .H. P r o j e c t O f f i c e r , Community Suppor t S e c t i o n System Development and Community Suppor t Branch D i v i s i o n of Applied and S e r v i c e s Research N a t i o n a l I n s t i t u t e o f Mental Hea l th Parklawn B u i l d i n g , Room 11C-22 5600 F i s h e r s Lane R o c k v i l l e , MD 20857 Telephone: ( 3 0 1 ) 443-3653

For f i s c a l and a d m i n i s t r a t i v e m a t t e r s , c o n t a c t :

Stephen Hudak C h i e f , Gran t s Management S e c t i o n N a t i o n a l I n s t i t u t e o f f l en ta l Hea l th Parklawn B u i l d i n g , Room 7C23 5600 F i s h e r s Lane Roc l<v i l l e , PlD 20857 Telephone: ( 3 0 1 1 443-4456

N I H G U I D E - Vol . 20 , No. 1 4 , A p r i l 5, 1991 - Page 1 1 *U.S.G.P.0:1991-281-826~20040

’W

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1c