Grant Program 2012 - NIH:Development and Translation of Medical Technologies to Reduce Health Disparities

Posted by Shofi Fida Tuesday, March 13, 2012 0 comments
The purpose of this funding opportunity is to reduce health disparities through the development and translation of appropriate medical technologies.  The NIH defines health disparities as differences in the incidence, prevalence, morbidity, mortality, and burden of diseases and other adverse health outcomes that exist among specific population groups.  These population groups are African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, Native Hawaiians, and other Pacific Islanders, subpopulations of all of these racial/ethnic groups, socioeconomically disadvantaged individuals, and medically underserved populations including individuals residing in rural and urban areas.  Appropriate medical technologies must have the following basic characteristics: effective, affordable, culturally acceptable, and easily accessible to those who need them.  Responsive grant applications must, during Phase I and Phase II, involve a formal collaboration with a healthcare provider or other healthcare organization serving a health disparity population.  This announcement supports applications to develop medical devices, imaging systems, and other technologies that adequately address the healthcare needs of health disparity populations.  It is expected that responsive grant applications will result in advances in medical technologies that will be invaluable in reducing health disparities within and across the priority areas of cardiovascular disease, stroke, cancer, diabetes, HIV/AIDS, infant mortality, mental health, and obesity, as well as lung, liver, and kidney diseases, psoriasis, scleroderma, and other diseases, illnesses, and conditions of public health importance.
Medical and scientific advances have introduced new opportunities for the continued improvement of health for all Americans. However, in spite of notable improvements gained as a result of the technological advancement, there continues to be an alarming disproportionate burden of illness among minority and other health disparity populations.  Overcoming persistent disparities in healthcare access and health outcomes remains a foremost challenge. To meet this challenge, the NIH is committed to supporting a wide range of research, aimed at the development of innovative diagnostics, treatments, and preventative strategies to reduce, and eventually eliminate, health disparities.
Research Objectives and Scope
The primary objective of this funding opportunity is to support the translation of medical technologies, new or existing, that can have a significant impact on healthcare access and health outcomes for health disparity populations.  Small business concerns (SBCs) are invited to submit grant applications proposing to develop and deliver appropriate technologies to health disparity populations.  Responsive applications, during Phase I and Phase II, must involve collaborations with underserved populations and/or collaborations with clinics in an underserved community. A requisite component of the research plan is a description of the healthcare requirements and needs of the population and the existing barriers to adequate healthcare delivery. Several of these barriers have been identified and are described below. Applications submitted to this funding opportunity must address one or more of these barriers in developing technologies that will impact health disparities:
  • Physical Barriers—factors such as proximity to healthcare facilities and transportation may limit access to healthcare

  • Knowledge Barriers—health literacy and language barriers can inhibit healthcare delivery, as well as a lack of patient information for the healthcare provider

  • Infrastructure Barriers—rural hospitals and community health centers may not have the same resources and expertise of large hospitals, and may not be able to afford advanced medical technologies

  • Economic Barriers—lack of insurance coverage or financial resources may also contribute to disparities in healthcare access

  • Cultural Barriers—religious beliefs and social customs often deter certain populations from seeking healthcare
Appropriate technologies may be new and innovative, or they may be existing technologies that have been redesigned based on the needs of a specific health disparity population.  Appropriate technologies have been defined as effective, affordable, culturally acceptable, and deliverable to those who need them. To be effective, a technology must provide an improvement over the current quality of care for a health disparity population by overcoming one or more of the barriers. The technology must also be low-cost, so as to be affordable to the local hospital, community health center, primary care physician, or individual patient in need.  For a medical technology to be adopted by a health disparity population, the technology development must be amenable to the population’s cultural beliefs and social customs.  Acceptance of the technology by the population is critical to the successful delivery of quality healthcare.  To be physically delivered to those in need, a technology must be developed within the specifications of the operating environment of the end-user.  The technology must be able to function given the existing resources and expertise within health disparity populations. Keeping in mind the barriers that contribute to health disparities, a non-inclusive list of appropriate medical technologies that might achieve the objectives of this initiative may be found below:
  • Telehealth technologies for remote diagnosis and monitoring

  • Sensors for point-of-care diagnosis

  • Devices for in-home monitoring

  • Mobile, portable diagnostic and therapeutic systems

  • Devices which integrate diagnosis and treatment

  • Diagnostics or treatments that do not require special training

  • Devices that can operate in low-resource environments

  • Non-invasive technologies for diagnosis and treatment

  • Integrated, automated system to assess or monitor a specific condition
Some examples include, but are not limited to
  • Inexpensive diabetic test strip and/or blood sugar monitoring.  With the growing obesity epidemic and the growing incidence and prevalence of type 2 diabetes, health disparity communities struggle with diabetes and its many sequelae (#1 cause of blindness, dialysis, and amputations).

  • Use of currently available basic technology (e.g. phone lines, televisions with remote controls, cellphones, weight scales, diabetic glucometers, thermometers) within underserved settings to promote self-management and patient education, increase patient-clinician communication and surveillance of chronic disease conditions.

  • Telemedicine to improve access to specialty care which would normally not be accessible because of high cost and transportation.  This would also link up academic tertiary-oriented health centers with community-based primary care homes.

  • Improved early detection (via saliva testing, breath testing, blood testing) of diseases where there are significant health disparities.

  • Low-cost portable imaging for prevention and early detection of conditions where there are significant health disparities (e.g. breast cancer screening and portable retinal imaging).
The National Institute of Mental Health (NIMH) seeks applications that develop or translate technologies that reduce disparities in care in the areas of autism spectrum disorders, severe mental illness (e.g., major depression, bipolar disorder, schizophrenia), suicide risk and completed suicide, and the prevention, detection, and treatment of HIV/AIDS.  Specifically, the NIMH encourages research projects that: (a) discover, develop, or apply innovative technologies to expand access to services and enhance the way mental health services are delivered, assessed, and improved over time; (b) utilize innovative technologies that improve mental health outcomes by augmenting or replacing traditional in-person care for populations with disparate access to care; (c)  discover, develop, or refine the use of novel technologies to capture, communicate, and apply patient-, organizational-, and systems-level information for enhancing mental health treatment, prevention, monitoring, and quality; (d) discover, develop or apply technologies to improve the dissemination and implementation of evidence-based interventions to disparity populations; (e) develop and test technologies designed to reduce disparities in HIV infection and HIV/AIDS treatment outcomes. It is expected that all applications submitted in response to this initiative should have strong commercial potential.

Eligible Organizations
Only United States small business concerns (SBCs) are eligible to submit applications for this opportunity. A small business concern is one that, at the time of award of Phase I and Phase II, meets all of the following criteria:
  1. Is organized for profit, with a place of business located in the United States, which operates primarily within the United States or which makes a significant contribution to the United States economy through payment of taxes or use of American products, materials or labor;

  2. Is in the legal form of an individual proprietorship, partnership, limited liability company, corporation, joint venture, association, trust or cooperative, except that where the form is a joint venture, there can be no more than 49 percent participation by foreign business entities in the joint venture;

  3. Is at least 51 percent owned and controlled by one or more individuals who are citizens of, or permanent resident aliens in, the United States, or it must be a for-profit business concern that is at least 51% owned and controlled by another for-profit business concern that is at least 51% owned and controlled by one or more individuals who are citizens of, or permanent resident aliens in, the United States, except in the case of a joint venture, where each entity to the venture must be 51 percent owned and controlled by one or more individuals who are citizens of, or permanent resident aliens in, the United States; and;

  4. Has, including its affiliates, not more than 500 employees.
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