Specific Research Objectives and Scope by Institute

National Cancer Institute (NCI)

Native American populations have the lowest 5-year cancer survival rate and highest percentage of disseminated and ill-defined cancers of any subpopulation in the U.S. Poorer cancer survival rates have been attributed to many factors, among them inadequate access to health care, geographic isolation, later stage of detection, underutilization of treatment, poverty, and social and cultural barriers.

The National Cancer Institute (NCI) is interested in applications that focus on both individual and community interventions relating to primary and secondary (screening) cancer prevention. It is important that researchers consider the context in which people live (place, built environment, etc.) and develop interventions that can improve overall health and result in improved health outcomes as they relate to cancer and cancer survivorship.

National Institute on Alcoholism and Alcohol Abuse (NIAAA)

When considering Native Americans as a whole, the epidemiologic data suggests a pattern of risky alcohol use including heavy, binging, and early onset drinking. The CDC reported that from 2001 to 2005, alcohol attributed deaths accounted for 11.7% of Native American deaths. The National Institute on Alcoholism and Alcohol Abuse (NIAAA) is interested in prevention interventions that seek to:

• Reduce high risk drinking and alcohol use;
• Promote moderate drinking;
• Postpone onset of drinking among youth; and
• Prevent any alcohol use among pregnant women

National Institute on Drug Abuse (NIDA)

The National Institute on Drug Abuse (NIDA) supports interventions to prevent the onset of drug use, prevent the escalation from drug use to abuse and dependence, and prevent the occurrence of drug-related HIV-risk behavior. Investigators should specifically aim to prevent drug use, drug abuse, and (as relevant) associated comorbid conditions including, but not limited to, HIV/sexually transmitted infections, child abuse and neglect, injuries, violence, and suicide. Drug abuse prevention research involving these outcomes and/or outcomes reflecting positive adjustment, such as educational achievement, is of interest to NIDA.

National Institute on Mental Health (NIMH)

The National Institute of Mental Health (NIMH) is interested in applications relevant to preventive interventions in Native American communities in both non-AIDS and AIDS research areas.

Examples of specific areas of interest for NIMH are included below. NIMH recommends, for both non-AIDS and AIDS, that applications proposing an adaptation to existing interventions should provide an empirical rationale for the need for and focus of the adaptation, consistent with NAMHC Workgroup Report recommendations on intervention adaptation (https://www.nimh.nih.gov/sites/default/files/documents/about/advisory-boards-and-groups/namhc/reports/fromdiscoverytocure.pdf) and consult with relevant Institute Program Staff. 

a) Non-AIDS-related Research Areas

• Develop and test empirically informed preventive strategies and implementation approaches to support sustained use of science-based interventions;
• Explore the expansion of science-based interventions that preempt or prevent mental disorders, including suicide;
• Develop culturally appropriate interventions for increasing engagement in mental health services and linkage to care across Tribes and geographical regions;
• Use mobile or IT interventions to increase use of evidence-based mental health care for individuals in hard-to-reach remote communities; 
• Explore which factors promote resilience and prevent mental disorders in persons at extreme social disadvantage to develop preventive intervention targets.

b) AIDS-related Research Areas

• Develop and test interventions to address the prevention, care and treatment needs for gay men, men who have sex with men (MSM) and other high-risk vulnerable individuals from indigenous communities;
• Develop and test interventions based on the mechanisms that explain HIV-related disparities (e.g., factors like stigma, social/sexual networks, access to and quality of health care, characteristics of health biology);
• Develop novel multilevel preventive interventions and/or combination biomedical-behavioral approaches to advance HIV prevention and care within those Tribal communities most impacted by HIV;
• Explore operations research to focus on barriers, facilitating factors, and outcomes of scaling-up HIV prevention interventions with known efficacy; and improve uptake and effectiveness of efficacious interventions, particularly for individuals in hard-to-reach remote communities.

National Institute of Dental and Craniofacial Research (NIDCR)

The prevalence of oral disease in Native American populations is amongst the highest in the U.S. The National Institute of Dental and Craniofacial Research (NIDCR) is interested in interventions that focus on dental caries, periodontal disease, oral cancer, and untreated decay. Oral diseases share protective and risk factors with numerous other diseases and conditions, making holistic approaches to health promotion and disease prevention particularly important. Determinants of oral health exist at individual, family, health care systems, community, organizational/institutional, and policy levels. Reliable access to and use of sustainable preventive and telehealth approaches to oral health care; self-management strategies such as fluoridated toothpaste and water; healthful foods and beverages; and healthy tribal policy are examples. The NIDCR welcomes applications for studies that propose multi-level approaches to improve oral health status and reduce inequalities.

NOTE: NIDCR does not support the development or efficacy testing of clinical products with this funding opportunity announcement. Investigators interested in conducting such clinical trials should refer to https://www.nidcr.nih.gov/research/clinical-trials

National Institute of Nursing Research (NINR)

The National Institute on Nursing Research (NINR) is interested in research across the lifespan targeting wellness, management of illness related symptoms, enhancement of palliative and end-of-life care interventions, with an emphasis on individuals, families, communities, underserved, hard-to-reach, and vulnerable populations. Additional information on NINR’s research interests can be found at https://www.ninr.nih.gov/aboutninr/ninr-mission-and-strategic-plan. Specific topics of interest to the NINR include, but are not limited to:

• Develop innovative behavioral interventions that promote health and prevent illness across the lifespan in diverse and underserved populations, (e.g., families with special needs, parents or caregivers of persons with chronic illness or developmental disabilities);
• Elucidate mechanisms underlying health disparities and design interventions to eliminate them with particular attention to geographic and environmental issues, minority status, and persons whose chronic or temporary disabilities limit their access to care;
• Assess behavioral, biological and genomic mechanisms (e.g., neurohumoral markers for differential responses to behavioral interventions);
• Improve quality of life by promoting personalized health strategies (e.g., promoting healthy lifestyles, prevention of obesity; prevention of HIV/AIDS transmission);
• Improve understanding of the complex issues and choices underlying palliative and end-of-life care (e.g., reducing physical and psychological burdens of caregivers) in underserved populations.

National Institute of Environmental Health Sciences (NIEHS)

The National Institute of Environmental Health Sciences (NIEHS) is interested in interventions aimed to reduce the impact of environmental exposures on diseases and disorders among NA populations. In addition to testing impacts of interventions on exposure reduction, applicants also are encouraged to examine impacts on interim preclinical markers of disease when possible. Proposals may include, but are not limited to, projects focused on:

• Development and testing of culturally-sensitive health promotion strategies and interventions designed to educate tribal leaders and tribal members about historical and emerging environmental hazards
• Adaptation of proven strategies or existing risk messaging for specific targeted audiences, e.g., for specific age groups, for specific audiences such as health care providers and community health workers, or in formats and media that will be effective in low literacy/health literacy settings;
• Development and testing of interventions that encourage behavior change to reduce or eliminate exposure;
• Development and testing of existing low cost, sustainable methods that address indoor air pollution; or that provide safe alternatives to contaminated drinking water and food and/or remediation of contaminated water, air and/or soil;
• Testing the impacts of policy-level decisions and interventions which are likely to influence environmental exposure levels and associated health outcomes;
• Development and testing of programs to train and build the capacity of community health workers and local health care professionals to assist tribal members in identifying unhealthy environments and/or environmentally-induced illness and ways to intervene.

National Institute on Minority Health and Health Disparities (NIMHD)

The NIMHD is interested in funding intervention projects that address the social determinants of health promotion and disease prevention. Obesity and chronic disease prevention are of high priority. Projects are encouraged to integrate ethically sound data-driven community health promotion interventions that could be used to help support community resilience in the face of a range of social stresses (environmental, social, and economic determinants). The central goal is to enhance social determinants of health as the primary guiding principle to identify groundbreaking community-driven projects that can truly enhance the ability of indigenous communities to thrive.

NIMHD encourages ethical principles to be incorporated from the outset when designing or assessing community-based health promotion and intervention projects. An understanding of place and sociocultural diversity of indigenous populations should be built into the project’s scientific framework.