Subject: NIH GUIDE - RFA HS-91-02 - V20(26) 07/26/91
From: Dot Baker <[email-masked]>
To: [email-masked]
Date: Wed, 24 Jul 91 14:30 EST

Hi Paul,
   This is the third of three for the 7/26/9l NIH Guide.  Please post
this one as:
        RFAHS-91-02.910726
   Thanks.   Catch ya later.
                            Dottie
 ---------------------------- Text of forwarded message -----------------------
 
$$XID RFA HS9102 HS-91-02 P1O1 *****************************************
 
MEDTEP RESEARCH CENTERS ON MINORITY POPULATIONS
 
RFA:  HS-91-02
 
P.T. 34, FF; K.W. 1004017, 0730050
 
Agency for Health Care Policy and Research
 
Letter of Intent Receipt Date:  August 12, 1991
Application Receipt Date:  November 12, 1991
 
PURPOSE
 
The purpose of this announcement is to alert the scientific community to
a solicitation for applications from nonprofit organizations to develop
and manage research centers.  The centers will conduct and support
research, technical assistance, information dissemination, and research
training on the appropriateness and effectiveness of health care
services and procedures provided to minority populations.  Support for
these research centers will be provided through the Medical Treatment
Effectiveness Program (MEDTEP) of the Department of Health and Human
Services.  The centers will be known as MEDTEP Research Centers on
Minority Populations.  For the purposes of this announcement, minority
populations are defined to include African Americans, Hispanic
Americans, American Indians, Alaska Natives, Asians, and Pacific
Islanders.  The Agency for Health Care Policy and Research (AHCPR)
expects to award approximately $4 million in Fiscal Year 1992 for
developmental and full centers.
 
Preference will be given to applicants that currently devote a major
portion of their resources to the training of minority health care
providers, the employment of minority health care providers, and the
provision of health care to minority populations.  Comments on this
preference are being solicited through a separate notice on the program
that is being published in the FEDERAL REGISTER.
 
These awards will enable institutions to plan and establish new research
centers and operate existing and new research centers that address
patient outcomes research on topics of special importance to minority
populations.  The AHCPR expects to make separate awards for both
developmental centers and full centers.  It is expected that each
center's activities will emphasize one or more minority population(s),
including subgroups that might be characterized by such factors as urban
or rural residence or age.  Each center is expected to focus on health
conditions that are particularly problematic to minorities, in terms of
unexplained variations in the way medical treatment is practiced, the
outcomes from such practice, or the relative costliness of care.  The
overall focus of each center is to be on the health care of minority
population(s) rather than any single disease or condition.  For the
conditions studied (e.g., hypertension, low birthweight, substance
abuse), activities are to emphasize the comparative effectiveness of
strategies used for prevention, diagnosis, treatment, and management.
Work carried out by each center is to be multidisciplinary and must
address various health care providers, settings, and geographic areas.
Multidisciplinary research may involve scientists in medicine, nursing,
human behavior, statistics, economics, organizational behavior, law,
public health, and related fields.
 
Applicants must have the scientific, technical, organizational, and
physical resources necessary to carry out:  (1) multidisciplinary
patient outcomes research, including development and analyses of
national and regional databases; (2) technical assistance to health care
providers and others; (3) training of health services researchers; and
(4) dissemination of research findings and the evaluation of
dissemination strategies.
 
The centers are to be responsive to the diverse information needs of
health care providers, patients, and policymakers.  Individual projects
may include syntheses of existing literature and data, collection and
analysis of new data, development of databases, improvement of measures
of health status and methods for data collection and analysis, and
development or testing of methods to disseminate research findings.  In
addition, the centers are to train new investigators in patient outcomes
research and provide technical assistance as stated above.
 
The centers are also expected to work with the Agency for Health Care
Policy and Research (AHCPR) on analyses and studies.  Such joint
activities may involve syntheses of research findings, data analyses, or
the preparation of background information on various topics relating to
health care and minority populations.  As described below, the AHCPR
will have substantive involvement in the planning and conduct of
research, technical assistance, dissemination, and training carried out
by each center.
 
This announcement does not represent an ongoing solicitation, nor is it
expected that the announcement will be reissued on a periodic basis
unless significant changes are anticipated in the program's structure or
objectives.
 
HEALTHY PEOPLE 2000
 
The Public Health Service (PHS) is committed to achieving the health
promotion and disease prevention objectives of "Healthy People 2000," a
PHS-led national activity for setting priority areas.  This
announcement, "MEDTEP Research Centers on Minority Populations,"
addresses health services and protection objectives 21.3-21.8 and other
special populations objectives targeting minorities.  Potential
applicants may obtain a copy of "Healthy People 2000" (Full Report:
Stock No. 017-001-00474-0 or Summary Report:  Stock No. 017-001-00473-1)
through the Superintendent of Documents, Government Printing Office,
Washington, DC 20402-9325 (telephone 202-783-3238).
 
BACKGROUND
 
The AHCPR has the lead responsibility for the MEDTEP within the
Department of Health and Human Services.  Under MEDTEP, projects are
supported that systematically study the relationship between health care
and patient outcomes.  Findings of this research contribute to the
knowledge base used by non-Federal experts and consumer representatives
in developing clinical practice guidelines, as mandated by Sections 902
and 912 of the Public Health Service Act (42 USC 299a and 299b-1).  In
addition, findings will help to identify questions suitable for further
study.
 
Research conducted under MEDTEP addresses fundamental questions about
the effects of medical care:  Do patients benefit?  What treatments work
best?  Are health care resources well spent?  MEDTEP research projects
build on work that documents numerous and substantial variations in
patterns of care that can neither be attributed to patient need or
preferences nor clearly linked to patient outcomes (Wennberg, 1987;
Connell, 1981).  MEDTEP is concerned with those practice variations that
result from uncertainty or controversy about the relative effectiveness
or appropriateness of alternative interventions and those that result
from differences in the knowledge, skill, and "practice styles" of
health care providers.  Serious questions arise about the quality,
appropriateness, and cost effectiveness of health care when practice
variations are associated with disparate patient outcomes or equivalent
outcomes but significant differences in resource use.
 
The objectives of the MEDTEP Research Centers on Minority Populations
are to support research, information dissemination, technical
assistance, and research training to improve the effectiveness of health
care services provided to minority patients.  Minority populations have
been found to be in poorer health than other population groups.
Elevated morbidity and mortality rates among minorities have been well
documented, with the highest disparities among low-income, rural, and
elderly populations (DHHS, 1985).  Minorities have higher mortality
rates due to heart disease, cancer, pneumonia, and low birthweight.  For
example, in 1987 African-American infants were twice as likely to die
than white infants, and African-American males had an average life
expectancy approximately seven years less than white males (DHHS, 1989).
 
Differences in access to and availability of services contribute to
these statistics.  Are there, however, existing strategies for
prevention, diagnosis, treatment, and management that are more
beneficial than other strategies?  Are there health care resources that
can be used in a more cost-effective manner in the delivery of health
care services and procedures for minority populations?  What difference
do alternative clinical interventions make with respect to minority
patient outcomes, including functional status and quality of life?
 
Examples of questions and issues relevant to the expected activities of
a MEDTEP Center on Minority Populations include:
 
  o  What does the existing literature indicate about the relative
     effectiveness of various combinations of medical and educational
     strategies in prenatal care in reducing low birthweight and related
     disability in minority populations?
 
  o  How are variations in clinical practices for specific minority
     populations and conditions associated with differences in
     reimbursement policies, Medicaid eligibilty criteria, medical
     liability, locus of care, and provider characteristics?
 
  o  What are the most effective methods for disseminating research
     findings in order to change provider and patient behavior
     concerning the use of health care services for minority
     populations?
 
  o  What are the steps required to assemble a data base appropriate for
     analysis of the outcomes of care provided to minority populations
     in rural areas?
 
  o  What aspects of research findings about minority health care and
     outcomes need to be incorporated in the training of primary care
     physicians and health services researchers?
 
In addition, attention needs to be given to those factors associated
with the differences in patient outcomes that vary both between and
within minority groups.  This heterogeneity within identified minority
groups is an important aspect of research design, interpretation of
data, and dissemination of results (DHHS, 1984).
 
With respect to the analytic methods to be employed by the centers, it
is important to develop or adapt existing research strategies that will
take into account the social context, medical risk factors, utilization
patterns, and practice variations within ethnic communities (Zambrana,
1991).  Data collection techniques must be sensitive to cultural
differences, and aid in a systematic and rigorous approach to the
accumulation of information (Brown, 1988).  For example, survey
instruments need to be acceptable to the intended audience and, whenever
appropriate, designed to supplement existing data and aggregate data
from multiple sources.  Comparability of information can be enhanced by
standardizing operational definitions of race, ethnicity, class, and
nativity (Cramer, 1987; Zambrana, 1991).  Further research is required
on the identification of adequate proxy measures for low-income status.
For example, Medicaid enrollment status may be misleading if temporarily
unemployed or disabled individuals and graduate students are included
(Zambrana, 1991).  Efforts can be made to collect information regarding
patient educational level on the medical record in order to better
understand socioeconomic status (Cramer, 1987).  Improved information
about genetic, environmental, nutritional, cultural, and socioeconomic
factors that affect severity and progression of disease would be useful
in the design and evaluation of strategies to determine treatment
variation.
 
The literature on minority health innovations suggests the need to
consider the sociocultural characteristics of the population in the
development of any social program and related research (DHEW, 1979;
Harwood, 1981; Payton, 1981).  Multicultural health care professional
representation is important in order to minimize cultural biases and to
facilitate access to the subgroup of interest (White, 1977).  The
literature on disease prevention/health promotion demonstrates the value
of employing subgroup members in data collection activities (Nickens,
1990).  The varying of methods, involving rigorous application of both
quantitative and qualitative strategies, has been shown to be useful in
the design and interpretation of studies of minority populations (Green
et al., 1980).
 
CENTER STRUCTURE AND MECHANISM OF SUPPORT
 
The AHCPR funds are intended to provide basic support for each center
and to allow it to function effectively.  Core funding will be provided
by a full center or developmental center award in which the recipient is
reimbursed for administrative and staff support, the provision of
technical assistance, dissemination mechanisms such as center-sponsored
newsletters, and a program of training in patient outcomes research.
Research projects also may be supported in their initial stages with
core funds, although it is expected that research projects will
ultimately be sponsored with funds obtained from sources other than the
AHCPR award.  As noted below, review criteria include reference to the
proposed center's plans to attract and retain other funding sources in
support of its research projects.
 
It is expected that each funded center will have an advisory committee
and that the committee will meet at least annually.  Core funds may be
used to support costs associated with an advisory committee to each
research center, including the convening of periodic committee meetings
to advise the center director about the center's management and its
programs.  This advisory committee would typically be composed of
representatives from the center's parent institution and senior national
and regional representatives from outside of the parent institution,
including health care policymakers, researchers, health care providers,
and consumers.
 
The center director must be a manager who can provide strong
administrative leadership.  The center director will be responsible for
the organization and operation of the center; liaison with the research
community and outside entities such as professional societies,
subcontractors, and consumer groups; and communication with the AHCPR on
scientific and operational matters.  Personnel and institutional
resources capable of developing and maintaining a substantial commitment
to patient outcomes research must be available.  The center may consist
of core staff with significant time commitments to the center and
affiliate staff with lesser time commitments.  Multidisciplinary
collaboration among researchers working within the center is essential;
each application must contain a plan to assure continuing interaction
and participation among the center's researchers.
 
In addition, the applicant institution and pertinent department(s) must
show a strong commitment to the center and its development, including
plans to support the organizational and management structure of the
center.  Each center is generally expected to share common resources
with other components or departments of the applicant institution,
including technical, clerical, and administrative personnel,
instrumentation, computer resources, subject populations, and data
bases.
 
The center may be a consortium of organizations, although preference
will be given to primary applicants who currently devote a major portion
of their resources to the training of minority health care providers,
the employment of minority health care providers, and the provision of
health care to minority populations.  It is expected that members of a
consortium will provide collateral or supplemental support to the
applicant organization.
 
There are two types of MEDTEP research centers that the AHCPR intends to
fund:  full and developmental centers.  These are described below.  All
of the additional information in this announcement, i.e., special
instructions, provisions of the cooperative agreement, review
procedures, application preparation, method of applying, proposed
conference of prospective applicants, and timetable are the same for
both full and developmental centers.
 
I. Full Centers
 
A maximum of $750,000 first year total costs (direct plus indirect) may
be requested for full center support, and a maximum of $3,750,000 in
total costs may be requested per application for full centers for the
entire project period, which is not to exceed five years.
 
In preparing budget requests for full centers, applicants are reminded
that the reasonableness of proposed budgets is among the criteria to be
used in the peer review of applications.  Applicants for full centers
should seriously consider whether the scope of their applications calls
for the full $750,000 funding amount, especially during the startup
phase of their programs.
 
The AHCPR expects to commit approximately $3 million in competitive
awards for full MEDTEP Research Centers on Minority Populations in
Fiscal Year 1992.  Approximately four full centers are expected to be
awarded in Fiscal Year 1992.
 
The issuance of awards will be contingent on the availability of funds
and on the quality of the applications.  No awards will be made if, in
the judgment of the reviewers, applications do not merit funding.  The
initial review committee may recommend funding for less than the
requested period or amount, with continued funding contingent on
submission of a competitive continuation application.
 
II.  Developmental Centers
 
Applicants may request developmental funding of up to $400,000 total
annual costs for each of a minimum of two years and a maximum of three
years if the proposed center needs time to develop and is not likely to
meet initially all performance criteria.  For example, such applicants
may need time to develop an organizational structure, may be lacking a
minimal complement of staff, linkages with the research, policy, or
provider communities, or the capability to undertake significant
research immediately.  Such developmental applications would need to
show considerable promise in these areas.  Funded developmental centers
would need to demonstrate continuous improvement in performance and
organization throughout their developmental period, and would be
expected to apply competitively for funding to become full centers by
the end of their developmental period.
 
In preparing budget requests for developmental centers, applicants are
reminded that the reasonableness of proposed budgets is among the
criteria to be used in the peer review of applications.  Applicants for
developmental centers should seriously consider whether the scope of
their applications calls for the full $400,000 funding amount,
especially during the startup phase of their programs.
 
The AHCPR expects to commit approximately $1 million in competitive
awards for developmental MEDTEP Research Centers on Minority Populations
in Fiscal Year 1992.  Approximately three developmental centers are
expected to be awarded in Fiscal Year 1992.
 
The issuance of awards and the relative numbers of full and
developmental center awards will depend on the availability of funds and
on the quality of the applications.  No awards will be made if, in the
judgment of the reviewers, applications do not merit funding.  The
initial review committee may recommend funding for less than the
requested period, with continued funding contingent on submission of a
competitive continuation application.
 
Each year's continuation award to both full and developmental centers is
subject to a progress review by the AHCPR, in addition to the
availability of funds.  The progress review may involve a site visit to
the center by AHCPR staff and non-Federal expert advisers to the AHCPR.
The progress review will address the center's productivity, general
compliance with the basic review criteria listed below, and adherence to
the provisions of its applicable approved grant application.  If such a
continuation review indicates that insufficient progress has been made,
the AHCPR may withhold the continuation award prior to completion of the
full grant period.
 
Awards for both full and developmental centers will be in the form of
cooperative agreements (UO1).  Under the terms of these cooperative
agreements, the awardee determines the organization and management of
the research center as specified by this announcement and retains
responsibility for all aspects of performance of the center.  The AHCPR,
however, anticipates substantial programmatic involvement in the
research, technical assistance, training, and dissemination activities
of each center.
 
Specifically, the AHCPR role in the cooperative agreement with full and
developmental centers will include:
 
o providing technical assistance in the areas of program development and
priority setting;
 
o providing technical assistance and support in the dissemination of the
centers' research findings through the AHCPR publication program and
assisting in selecting the most effective mechanisms for their
dissemination;
 
o providing technical assistance in gaining access to relevent data
bases for research on medical treatment effectiveness;
 
o providing technical assistance in monitoring the centers' individual
research projects;
 
o providing technical assistance in the conduct of research projects,
including adjustments to study designs and protocols;
 
o providing technical assistance in the centers' research training
activities and educational seminars.
 
It is expected that each center will collaborate with the AHCPR on
research or data analysis, the preparation of research background
information, or other analytical activities relating to the
appropriateness and effectiveness of health care for minority
populations.
 
SPECIAL INSTRUCTIONS TO APPLICANTS CONCERNING INCLUSION OF WOMEN AND
MINORITIES IN RESEARCH STUDY POPULATIONS
 
The AHCPR adheres to NIH and ADAMHA policy requiring applicants for
research grants to include minorities and women in study populations, so
that research findings can be of benefit to all.  This announcement
obviously addresses that policy with regard to minorities.  Additional
emphasis, however, must be placed on the need to include women of all
ages in studies of diseases, disorders, and conditions that affect them.
If women are excluded or inadequately represented in research to be
undertaken by these MEDTEP research centers, particularly in proposed
population-based studies, a clear compelling rationale must be provided.
 
The composition of any proposed population group for study by MEDTEP
research centers must be described in terms of gender.  In addition,
gender must be addressed in developing the research design and sample
size appropriate for the scientific objectives of any study.
 
All applications for MEDTEP research centers submitted to AHCPR are
required to address this policy with respect to the inclusion of women
as subjects of their research, and AHCPR will not award grants for
applications that do not comply.  If the required policy is not
reflected in the application, the application will be returned without
review.
 
REVIEW PROCEDURES
 
The receiving office at the Division of Research Grants, National
Institutes of Health will determine if an application is complete.
Applications for MEDTEP research centers will be evaluated competition
by the AHCPR grant peer review process.  Applications will be assessed
by AHCPR staff for responsiveness to this announcement.  Any
applications judged incomplete or nonresponsive will be returned to the
applicant without further consideration.  The determination of any
application as nonresponsive will be the sole responsibility of the
AHCPR.
 
All responsive applications will undergo peer review for scientific
merit by a chartered review committee of non-Federal experts convened by
the AHCPR, and those applications recommended for approval will
subsequently be considered by the National Advisory Council for Health
Care Policy, Research, and Evaluation.  The peer review committee may
recommend approval, disapproval, approval with modifications, or may
defer its recommendation until its next scheduled meeting, while more
information is obtained from the applicant.
 
Whenever the committee recommends approval, it also will assign a
priority score to the approved application.  The application and the
recommendations of the peer review committee are then reviewed by the
National Advisory Council.  It is expected that some applications
recommended for approval will not be funded because they do not receive
a high enough priority score.  The peer review process is rigorous, and
only those applications judged of greatest merit are recommended for
approval with highest priority.
 
Applicants must clearly indicate whether they are initially applying for
full or developmental center support.  Developmental centers are
expected to demonstrate, over time, the ability to perform as a full
center.
 
The following are the review criteria to be used in the review of all
applications responding to this announcement:
 
  o  The proportion of resources currently devoted by the applicant
     organization to the training of minority health care providers, the
     employment of minority health care providers, and the provision of
     health care to minority populations.
 
  o  The appropriateness of the proposed budget and the extent to which
     the fiscal plan provides assurance that effective use would be made
     of the funds awarded.
 
  o  The quality of the organizational and institutional arrangements to
     operate the proposed center, including plans for the use of an
     advisory committee by the center.  Also, in the case of consortium
     applications, the degree of clarity in the differentiation of
     activities and in the description of coordination efforts among
     organizational participants.  This description must include the
     nature and extent of collateral or supplemental support provided to
     the applicant organization by other consortium members.
 
  o  The qualifications, achievements, commitment, and number of the
     senior personnel of the proposed center, including the
     appropriateness of their specific time commitments.
 
  o  The quality of the proposed center's program and general approach,
     including its proposed research agenda and publications, technical
     assistance, dissemination, and training activities.  The degree to
     which the center's agenda reflects a realistic and well-conceived
     program in view of available skills, funding resources, and health
     care issues pertinent to the particular minority population(s) to
     be addressed.
 
  o  The actual and planned level of commitment of the applicant
     institution to the proposed center, including its specific plans to
     support the organizational and management structure of the center.
 
  o  The past success and future potential of the proposed center's
     staff in receiving research and organizational funding support from
     sources other than the core AHCPR grant, and the center's potential
     to remain productive after the term of award ends.
 
  o  The extent to which the proposed center's research plan reflects an
     awareness of significant methodological and data problems in
     medical treatment effectiveness research, and incorporates the
     concerns of pertinent constituents.
 
  o  The strength of the relationship(s) the proposed center has, or is
     likely to develop, with the particular health care system in which
     research projects will be conducted and research findings tested;
     the demonstrated ability or potential of the center to reach its
     target populations for research.
 
  o  The coordination of the proposed center's research and training
     efforts, and the degree to which multiple scientific disciplines
     are represented in its program.
 
APPLICATION PREPARATION
 
The most recent revision of the research grant application form PHS 398
(revised 10/88) must be used in applying for MEDTEP research center
support.  These forms are available at most institutional business
offices, from the Office of Grants Inquiries, Division of Research
Grants, National Institutes of Health, Room 449, Westwood Building, 5333
Westbard Avenue, Bethesda, MD 20892, and from the AHCPR Office of
Scientific Review as specified below.  (Applicants from State and local
governments may use form PHS 5161, Application for Federal Assistance).
 
Complete information about the proposed research center must be
submitted with the application.  Consortium arrangements typically take
the form of a contract between the grantee and other organization(s).
In the grant application, a separate budget and signed form PHS 398
"face page" must be included for these other organizations involved in
the proposed consortium arrangement.
 
Applications must be authored by the principal participants in the
proposed center.
 
Follow the instructions for form PHS 398 where appropriate.  However,
the form PHS 398 was developed primarily for research project grants
rather than research centers.  Therefore, substitute the following
headings for Sections A through I in Section 2 of the application:
 
A. Introduction and background; any special emphases of the proposed
center.
 
B. Currently available organizational resources.  What resources (e.g.,
people, expertise, ongoing research, organizational support and
relationships, funds, equipment) are available now to develop and
implement the proposed center?
 
C. Organizational changes that will be implemented to develop the
proposed research center.  What activities and organizational alignments
will be undertaken to institute the proposed center?
 
D. The nature of proposed and existing organizational relationships of
the center.  Include, for example, the proposed center's relationship
with health care providers, State and local governments and other
policymakers, the proposed center's advisory committee, and the research
community.
 
E. The proposed center's agenda in research, training, technical
assistance, and dissemination.  What activities and projects are
currently in place?  What will be developed?
 
F. The process of decision making and lines of authority within the
proposed center.
 
G. The expected accomplishments of the proposed center.
 
H. Human subjects (the same as in "E" in the application form).
 
I. Consultants/collaborators (the same as in "G" in the application
form).
 
J. Consortium/contractual arrangements (the same as in "H" in the
application form).
 
K. Literature cited (the same as in "I" in the application form).
 
ELIGIBILITY
 
Only nonprofit organizations are eligible to apply.  Foreign
institutions are not eligible to apply.
 
METHOD OF APPLYING
 
Check the "Yes" box in line 2 of the application face page and write
"RFA HS-91-02" and "MEDTEP RESEARCH CENTERS ON MINORITY POPULATIONS".
The RFA label contained in the form PHS 398 application kit must be
affixed to the bottom of the face page of the original copy of the
application.  Failure to use this label could result in delayed
processing and review of the application.
 
The completed application (original and five copies) is to be mailed to:
 
Application Receipt Office
Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD  20892**
 
Completed applications must be received at the Division of Research
Grants on or before the receipt date specified in the announcement.
Late applications will be returned without review.
 
One copy labeled "Advance Copy" is to be submitted simultaneously to:
 
Agency for Health Care Policy and Research
Center for Medical Effectiveness Research
MEDTEP Research Centers Program
6001 Montrose Road, Suite 704
Rockville, MD  20852
 
Potential applicants are urged to submit a letter of intent to Dr.
Miriam A. Kelly at the Rockville address below by August 12, 1991.
Although a letter of intent is neither required nor binding and does not
enter into the review of subsequent applications, the information that
it contains is helpful in planning for the review of applications.  It
allows AHCPR to estimate the potential review workload and to avoid
possible conflict of interest in its selection of peer reviewers.  The
letter of intent should include the name(s) of the proposed Principal
Investigator, principal collaborators, and the organization(s) involved.
 
Grant application materials may be obtained from:
 
Office of Scientific Review
Office of Planning and Resource Management
Agency for Health Care Policy and Research
Room 18A20
5600 Fishers Lane
Rockville, MD  20857
Telephone:  (301) 443-3091
 
PROPOSED CONFERENCE FOR PROSPECTIVE APPLICANTS
 
The AHCPR plans to convene a conference to take place prior to the
receipt date for applications, if there is sufficient interest from
prospective applicants.  At this proposed conference, the AHCPR will
discuss the programmatic and administrative details of the program and
respond to questions concerning this announcement.  Attendance at the
conference is not a prerequisite for applying for MEDTEP research center
support, as essentially all aspects of the program are contained in this
announcement.  Individuals with questions concerning this announcement,
or unable to attend the conference, may call or write the staff members
listed below for further technical and/or administrative assistance.
The AHCPR will make available to interested parties a listing of the key
questions and answers concerning the program that are addressed at the
conference.  Those interested in attending the conference should mail
their addresses and telephone numbers to Dr. Kelly at the address listed
below.  AHCPR will inform interested parties of the date and location of
the conference.  All personal travel costs and accommodations are the
responsibility of the attendees.
 
TIMETABLE
 
Letter of intent receipt date:  August 12, 1991
Application receipt date:  November 12, 1991
Initial (scientific) review date:  February 7, 1992
National Advisory Council meeting date:  May 1992
Earliest grant award and start date:  July-September 1992
 
Potential applicants interested in obtaining further program information
may write or call:
 
Miriam A. Kelly, Ph.D.
Health Scientist Administrator
Center for Medical Effectiveness Research
Agency for Health Care Policy and Research
6001 Montrose Road, Suite 704
Rockville, MD  20852
Telephone:  (301) 443-0782
 
Potential applicants with questions concerning administrative and
budgetary matters may write or call:
 
Ralph L. Sloat
Chief, Grants Management Branch
Office of Planning and Resource Management
Agency for Health Care Policy and Research
5600 Fishers Lane, Room 18A27
Rockville, MD  20857
Telephone:  (301) 443-4033
 
The requirements of Executive Order 12372 "Intergovernmental Review of
Federal Programs" are not applicable to the AHCPR research grant
program.  This program is described as Catalog of Federal Domestic
Assistance number 93.180.  Funded projects will operate under the PHS
Grants Policy Statement (10/1/90 Edition) and Title 42, Part 67, Subpart
A, Code of Federal Regulations.
 
REFERENCES
 
Brown, S.S.(Ed.) (1988).  Prenatal Care:  Reaching Mothers, Reaching
Infants.  National Academy Press:Washington, DC.
 
Connell, FA, Day, RW, and Logerfo, JP (1981).  Hospitalization of
medicaid children:  analysis of small area variations in admission
rates.  American Journal of Public Health, 71 (6):  606-613.
 
Cramer, J.C. (1987).  Social factors and infant mortality:  Identifying
high risk groups and proximate causes.  Demography, 24(3):299-322.
 
DHEW (1979).  Guidelines for Analysis of Socio-Cultural Factors in
Health Planning.  DHEW Publication 79-50083.
 
DHHS (1985).  Report of the Secretary's Task Force on Black and Minority
Health.
 
DHHS (1984).  Development of Diffusion Strategies Among Culturally
Diverse Populations.  Final Report prepared under NHLBI contract
N01-HO-2-7003.
 
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