RO1 Applications are open for research on Chronic Disease in the Caribbean. 

PAR-17-470 

Learn more. http://bit.ly/2vRjg6M

Research supported under this FOA will establish or extend cohort studies in the Caribbean that can be used for both ongoing population health research in the Caribbean region andfuture comparative research with US populations. Cohorts that have the potential to be continued after the NIH funding period, for example, that can be supported by governmental or other organizations within the Caribbean region, are strongly encouraged. Possible projects may involve one or more of the following approaches:

• The establishment of a cohort study that may be followed longitudinally.
• The establishment of datasets derived from electronic health records to create a retrospective cohort and facilitate prospective follow-up.
• To establish datasets from ongoing surveillance efforts by health departments or other organizations that are independent samples.
• The addition of new measures or data elements to existing or ongoing cohort studies to better align with US datasets.
• The collection of an additional wave of data collection for existing longitudinal cohort studies.

In addition to establishing or extending cohort or surveillance studies, the project is expected to conduct analyses related to population health in the Caribbean using the cohort data. Research teams that already have existing datasets that require little or no modifications or additions to use for comparison with US data sets may propose such comparisons. However, because the intent of this initiative is to build the foundation for future US-Caribbean comparative research, comparative analyses are not a requirement for this FOA. Primary data collection is limited to sites in the Caribbean. 

In order to support future comparative analyses, Caribbean-based data collection is expected to be aligned with data from publicly available datasets on US populations, particularly those that include representation from Caribbean immigrants or US-born individuals of Caribbean descent. Examples of such data sets include but are not limited to those identified in the National Partnership for Action to End Health Disparities (NPA) Federal Interagency Health Equity Team (FIHET) "Compendium of Publicly Available Datasets and Other Data-Related Resources" (see http://www.npa-rhec.org/fihet_compendium).

Potential research topics for examination in the current project as well as for future comparative analysis may include but are not limited to the following:

The incidence/prevalence of chronic disease and of risk factors for these conditions. 

• Genetic, biological, social, and environmental determinants of chronic disease outcomes.
• Reasons for of populations who experience better than expected health outcomes (e.g., lower prevalence, morbidity, or mortality related to chronic disease) despite social, economic, or environmental disadvantage.
• Type, intensity, and quality of healthcare received for chronic conditions and diseases.
• Help-seeking patterns and barriers regarding formal healthcare as well as integrative or indigenous medicine.

Research teams are expected to include both US- and Caribbean-based investigators. It is expected that Caribbean-based investigators will assume primary responsibility for the design of and data collection for the Caribbean cohort, while US-based investigators are expected to identify appropriate US datasets that the Caribbean cohort will be aligned with, and, if relevant, to provide scientific expertise and technical assistance to less research-intensive Caribbean institutions to successfully execute research activities. Given that the bulk of research activities will take place in the Caribbean, it is expected that at least 60% of direct costs will be directed to Caribbean-based institutions and personnel.

Areas of specific interest include but are not limited to the following:

• Data collection in Caribbean countries/US territories that have the highest levels of immigration to the mainland US, including Cuba, Puerto Rico, the Dominican Republic, Haiti, and Jamaica, as well as other Low and Middle Income countries or US territories (see listing of Caribbean countries by World Bank income group: http://mdgs.un.org/unsd/mdg/Host.aspx?Content=Data/Regional/latin.htm).
• Data collection at multiple sites to allow for examination of chronic disease across countries or language groups (i.e., English-, Spanish, or French-speaking).

In addition, different Institutes and Centers at NIH are interested to support research in the following specific areas:

The National Institute on Minority Health and Health Disparities (NIMHD) is interested in projects that examine the impact of different determinants (biological, behavioral, socio-cultural, environmental, physical environment, health system) at multiple levels (i.e., individual, interpersonal, community, societal) on health outcomes in Caribbean populations (see the  NIMHD Research Framework, https://www.nimhd.nih.gov/about/overview/research-framework.html, for examples of health determinants of interest).  Health conditions of particular interest include but are not limited to diabetes, chronic kidney disease, osteoarthritis/inflammatory arthritis, and HIV/AIDS, as well as behavioral risk factors (diet, physical activity, tobacco use, alcohol and substance use) that are relevant to multiple chronic diseases.                

The National Cancer Institute (NCI) coordinates the National Cancer Program, which conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients.  Projects that align to cancer-related data sets like Surveillance, Epidemiology, and End Results (SEER) and The National Health and Nutrition Examination Survey (NHANES) in addition to the Federal Interagency Health Equity Team data-related resources are of interest to the NCI.  Research that investigates disparities along the cancer continuum (prevention, detection, diagnosis, treatment and survivorship) are of interest to the NCI.

The National Heart, Lung, and Blood Institute (NHLBI) provides global leadership for a research, research training, and education program to promote the prevention and treatment of heart, lung, blood, and sleep diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives.  The NHLBI encourages research designed to answer the breadth of scientific questions related to heart, lung, blood, and/or sleep diseases, disorders, and phenotypes.  The NHLBI seeks applications that will address questions relevant to the NHLBI mission, address gaps in the NHLBI's portfolio of clinical and epidemiology cohort studies, and should align with the NHLBI's Strategic Vision.  NHLBI's strategic priorities emphasize the continuum of research from basic molecular biology research to implementation science related to heart, lung, blood diseases and sleep disorders (e.g. Sickle Cell Disease and other hemoglobinopathies; cardiovascular diseases; hypertension prevention and control; asthma; chronic obstructive pulmonary disease (COPD), sleep apnea; and other cardiopulmonary diseases and conditions), self-management of symptoms and disease conditions, and prevention of these diseases and disorders in various populations.  The NHLBI also has significant interests in implementation science research for the prevention, control, and treatment of heart, lung, blood diseases and sleep disorders, particularly research that addresses the development of interventions or strategies that address the translation of proven effective evidence-based interventions into clinical, community, and/or other settings; addresses impediments to uptake,  scale up, and sustainability of evidence-based interventions in various contexts; and/or examines disparities is disease burden, models possible treatment paradigms, and/or proposes interventions in small island developing states.  Through this funding opportunity announcement, the NHLBI encourages research that will investigate innovative hypotheses, as well as innovative research; as such, applications should propose studies investigating hypotheses not addressable in the large cohort studies currently funded by the NHLBI.  Please refer to the NHLBI website for more details on the research priorities of the NHLBI: https://www.nhlbi.nih.gov/about/documents/strategic-vision.

The National Institute on Aging (NIA) is especially interested in applications for studies that would 

• Incorporate study designs and content useful for comparative studies of cognitive decline and assessment of dementia;  
• Employ designs and content useful for comparative studies of the antecedents, treatment and trajectories of multimorbidity at older ages; 
• Make use of methods and variable definitions that are harmonized to the extent possible to measures used in other NIA-funded longitudinal studies, such as the Health and Retirement Study, Midlife in the United States, and the National Health and Aging Trends Study.   The website Gateway to Global Aging Data provides a concordance: https://g2aging.org/, and many data resources can be reached through the National Archive of Computerized Data on Aging: http://www.icpsr.umich.edu/icpsrweb/NACDA/.

The mission of the National Institute of Nursing Research (NINR) is to promote and improve the health and quality of life of individuals, families, and communities. Of relevance to this FOA is that nursing science transcends the boundaries of illnesses and research disciplines to better understand the experiences of individuals and families living with illnesses and to develop personalized approaches that maximize health and well-being, reduce symptoms, and promote self-management for individuals at all stages of life, across diverse populations and settings. Additional information on NINR's research interests and focus can be found at http://www.ninr.nih.gov/AboutNINR/NINRMissionandStrategicPlan. 

Specific topics of interest to the NINR include, but are not limited to:

• Studies designed to assess behavioral, biological and genomic risk factors of chronic illnesses (e.g., genetic markers, diet, physical activity, lifestyle) in Caribbean populations
• Research on the barriers to and/or factors facilitating self-management of chronic illnesses (e.g., socioeconomic status, family and/or caregiver support, environmental determinants) in Caribbean populations
• Secondary data analysis of existing datasets: 1) to improve understanding of symptom assessment, symptom management, and/or symptom advancement associated with chronic illnesses in Caribbean populations and 2) to discover biological, clinical, psychosocial, behavioral and economic factors related to symptom burden experienced by Caribbean populations with chronic illnesses 
• Research on understanding the biological, physiological, environmental and behavioral issues in relation to women's health and wellness in Caribbean populations