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Health & Behavior
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Adherence
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Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors) External Exit Disclaimer
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Home > Scientific AreasHealth Behavior > Adherence


Practical Interventions to Improve Medication Adherence in Primary Care (PA 12-022 and PA-12-023)

Examples of Research Topics

Several Institutes within the National Institutes of Health (NIH) have joined together to support this Funding Opportunity Announcement (FOA). Applications should be relevant to both the objectives of the FOA and to at least one of the participating organization's general research interests. Researchers are strongly encouraged to review the general research interests of the participating organizations and the following examples of topics of specific interest to the participating entities. Because additional research areas are welcome, prospective applicants are encouraged to contact the relevant program administrator for this FOA as listed in Section VII prior to preparing an application.

Below is a list of other institutes supporting this Funding Opportunity Announcement (FOA):


National Cancer Institute (NCI)

NCI Utilizes the R01 mechanism only for this funding announcement

The National Cancer Institute (NCI) is interested in basic and applied research in the behavioral, social, and population sciences to create or enhance interventions that reduce cancer risk, incidence, morbidity and mortality, and improve quality of life. Specifically, NCI is interested in research on developing and testing interventions in areas such as medication adherence, tobacco use, screening, dietary behavior, physical activity, and sun protection. NCI also focuses on research to enhance the quality and length of survival of all persons diagnosed with cancer, and to minimize adverse events experienced during cancer survivorship.

Contact:
Wendy Nelson, Ph.D.
National Cancer Institute (NCI)
6130 Executive Blvd
Rockville, MD 20892
Telephone: 301.435.4590
Email: Wendy.Nelson@NIH.gov


National Center for Complementary and Alternative Medicine (NCCAM)

NCCAM utilizes the R21 and R01 mechanisms for this funding announcement

The National Center for Complementary and Alternative Medicine (NCCAM) is the Federal Government's lead agency for research on complementary and alternative medicine (CAM). NCCAM defines CAM simply as a group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine. The mission of NCCAM is to define, through rigorous scientific investigation, the usefulness and safety of complementary and alternative medicine interventions and their roles in improving health and health care. More information can be found on NCCAM's website (www.nccam.nih.gov).

NCCAM's strategic plan gives increased emphasis to advancing the science of symptom management and to the development of effective, practical, personalized strategies for promoting health and well-being. Increased adherence to recommended medication regimens would lead to substantial improvements in public health. Poor adherence to prescribed treatments results in a high disease burden and represents an unmet scientific opportunity for complementary and alternative approaches. Integrative Medicine is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing. CAM approaches that hold promise for reducing symptoms associated with certain medications may be useful for improving adherence rates in certain disease entities and integrative approaches to care have preliminary evidence of improved patient outcomes. For the purpose of this program announcement, NCCAM is interested in applications proposing research testing complementary and alternative medicine approaches (including, but not limited to, acupuncture, mindfulness-based therapies, and yoga) to improving medication adherence. Examples of research projects include:

  • Projects with proximal endpoints such as reducing medication-induced symptomatology and the more distal endpoint of increasing medication adherence.
  • Projects testing integrated care models in medical settings with focus on improving medication adherence for chronic medical conditions.
  • Projects identifying individuals who are non-adherent and testing targeted interventions to improve adherence, particularly in groups at high risk for non-adherence such individuals with complex medical conditions or regimens.
  • Research to test developmentally and/or culturally appropriate medication adherence interventions among specific risk groups. For example, interventions to address racial and ethnic disparities in treatment adherence and outcomes or to target high risk age groups such as adolescents/young adults and the elderly.

Contact:
Kristen Huntley, Ph.D.
Program Officer
Division of Extramural Research
National Center for Complementary & Alternative Medicine
National Institutes of Health
6707 Democracy Boulevard, Suite 401
Bethesda, MD 20892-5475
(for FedEx delivery use 20817)
phone: 301-594-9346
huntleyk@mail.nih.gov


National Eye Institute (NEI)

NEI utilizes the R21 and R01 mechanisms for this funding announcement.

The National Eye Institute supports innovative research that tests the feasibility, efficacy or effectiveness of interventions to prevent and treat blinding eye diseases.  NEI encourages research that will improve the initiation and maintenance of interventions to manage chronic diseases which threaten vision health.  NEI will support projects in which basic and applied researchers collaborate in creating novel interventions that target vision problems, utilizing methods, processes, and theories of their respective disciplines. Areas of NEI research interests include but are not limited to the following:

  • Utilize new discoveries in basic behavioral science to guide development of innovative vision-related, effective personalized behavioral therapies
  • Identify and model basic and behavioral processes that mediate behaviors or outcomes to promote and/or maintain vision health
  • Utilize approaches to interventions approaches to improve adherence to medical recommendations.  For example, improved adherence to eye drops to treat glaucoma.

Contact:
Eleanor B. Schron, PhD, RN
Vision Research Program
Division of Extramural Research
National Eye Institute/NIH
Suite 1300, 5635 Fishers Lane, MSC 9300
Bethesda, MD 20892-9300
Telephone: 301-451-2020
Email: schrone@nei.nih.gov


National Heart, Lung, and Blood Institute (NHLBI)

NHLBI utilizes the R21 and R01 mechanisms for this funding announcement

The National Heart, Lung, and Blood Institute supports research concerning the behavioral, psychosocial, and sociocultural factors related  to the prevention and treatment of heart, lung, blood and sleep diseases and disorders. As stated in the NHLBI Strategic Plan , studies relevant to the mission and goals of NHLBI include those that "complement bench discoveries and clinical trial results with focused behavioral and social research to (a) develop and evaluate new approaches to implement proven preventive and lifestyle interventions, (b) develop and evaluate policy, environmental, and other approaches for use in community settings to encourage and support lifestyle changes, and (c) develop and evaluate interventions to improve patient, provider, and healthcare system behavior and performance in order to enhance quality of care and health outcomes."

NHLBI is interested in supporting studies that develop, optimize, test and refine strategies to improve adherence to medications used to prevent or treat cardiovascular, lung, blood, and sleep diseases and disorders.  Of particular interest is interventional research that:

  • Tests and optimizes novel interventions using theories & findings from basic behavioral research (e.g., behavioral economics, risk communication, self-regulation, cognition, perception & motivation).
  • Identifies better methods for measuring adherence outcomes in intervention studies.
  • Intervenes on the broader social & structural context (e.g., use of social, structural, environmental & system-level intervention targets).
  • Uses new technologies - e.g., web-based and mobile health technologies - and innovative study designs and methods
  • Tailors the intervention to the individual's lifestyle, needs, preferences and barriers
  • Involves everyday settings in which adherence-promoting strategies can be used, including the family, neighborhood, workplace, and community settings
  • Targets psychosocial risk factors such as social isolation or lack of social support, stress, and depression or depressive symptoms
  • Focuses on the patient-provider relationship, including aspects such as communication and decision-making, in order to increase medication-taking adherence (providers are defined broadly and can include physicians, nurses, other non-physician health care workers, and pharmacists)
  • Promotes maintenance of adherence over time
  • Improves adherence in vulnerable patient groups (minorities, low-income patients, those with mental health conditions or cognitive decline) & for those with multiple comorbidities
  • Develops feasible, cost-effective interventions & translates findings to "real world" settings (HMO'’s, community and clinical practice settings)

Contact:
Susan M. Czajkowski, Ph.D.
National Heart, Lung and Blood Institute (NHLBI)
6701 Rockledge Dr
Bethesda, MD 20892
Telephone: 301-435-0406
Email: czajkows@mail.nih.gov


National Institute on Aging (NIA)

NIA utilizes the R21 and R01 mechanisms for this funding announcement

The National Institute on Aging leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. NIA’s mission is to support and conduct genetic, biological, clinical, behavioral, social, and economic research related to the aging process, diseases and conditions associated with aging.

To enhance this mission, and for the purposes of this FOA, NIA is particularly interested in supporting studies that use behavioral and social science research to test interventions with the potential to significantly improve medication adherence in the aging population.  NIA is interested in interventions that are based on established or novel behavior change theory and are focused on the long-term maintenance of behavior change rather than just the initial change.  Studies that are directly related to medication adherence interventions that address treatment of older patients with complex, multiple diseases and disability, including particular attention to those issues related to multiple morbidity and multiple treatments are of particular interest to the institute.  Applicants are encouraged to integrate caregiver and physician aspects into the intervention design and to test their interventions in novel health-care delivery systems that emphasize the team approach.

Contact:
Sidney Stahl, PhD
National Institute on Aging (NIA)
Telephone: (301) 496-3131
Email: Sidney_Stahl@nih.gov


National Institute on Deafness and Other Communication Disorders (NIDCD)

NIDCD utilizes the R21 and R01 mechanisms for this funding announcement

The National Institute on Deafness and Other Communication Disorders sponsors and conducts research and research training in biomedical and behavioral normal and disordered conditions of hearing, balance, taste, smell, voice, speech and language.

Contact:
Gordon B. Hughes, M.D.
Program Director, Clinical Trials
Division of Scientific Programs
National Institute on Deafness and Other Communication Disorders, NIH
 6120 Executive Blvd., EPS-400C MSC 7180
Bethesda, MD 20892-7180
Phone (301) 435-4085
Email  hughesg@nidcd.nih.gov



National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIDDK utilizes the R01 mechanism only for this funding announcement.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is interested in supporting research to improve medication adherence relevant to the diseases of interest to the NIDDK (http://www2.niddk.nih.gov/) such as type 1 diabetes, type 2 diabetes, gestational diabetes, and chronic kidney disease. Approaches tested to improve adherence should have the potential to have a significant effect on a clinical outcome such as glycemic control. 

Areas of interest include, but are not limited to:

  • Approaches to improve adherence in individuals at high risk for non-adherence or at higher risk for poor clinical outcomes. A few examples include: adolescents and young adults with diabetes, women at risk for or with a history of gestational diabetes, or underserved populations, and individuals with low health literacy/numeracy. 
  • NIDDK is interested in interventions that target individuals, families, healthcare providers, healthcare systems or some combination of these targets.

Contact:
Christine Hunter, Ph.D., ABPP
National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK)
6707 Democracy Blvd
Bethesda, MD 20892
Telephone: 301-594-4728
Email: hunterchristine@niddk.nih.gov



National Institute of Mental Health (NIMH)

NIMH utilizes the R21 and R01 mechanisms for this funding announcement

In HIV/AIDS, these include but are not limited to:

  • Research to develop and test novel antiretroviral adherence interventions or highly innovative augmentations of existing interventions for the purpose of achieving a strong and sustained impact on both behavioral adherence and biological treatment outcomes.
  • Research designed to incorporate measures/assessments of antiretroviral medication adherence into routine primary care to facilitate the targeting/delivery of adherence interventions to patients in need of adherence support.
  • Research to develop and test interactive computer/tablet, internet, smart-phone, or other technology-based or technology-enhanced adherence interventions which would augment outpatient HIV clinic capacity to address antiretroviral/polypharmacy adherence with patients.
  • Research to develop and test interventions to enhance provider communication skills and messaging to patients (and patient-provider communication more generally) regarding antiretroviral adherence.
  • Research designed to evaluate clinic-level or systems-level factors (e.g., adherence programs in standard care, comprehensive care team composition, etc.) in relationship to patient antiretroviral adherence, for the purpose of informing policy and clinic practice.
  • Research to develop and test novel antiretroviral adherence interventions tailored to the developmental needs of child/adolescent or older (age 50 and above) HIV infected populations.

In mental health services and interventions, these include but are not limited to:

  • Research on low-cost adherence interventions, including those that capitalize on existing primary care system resources and/or prescription refill technologies to improve adherence to medications for mental disorders.
  • Research on personalized approaches to improve adherence to medications for mental disorders.
  • Research that incorporates shared decision making into strategies to improve adherence to medications for mental disorders.
  • Research that capitalizes on information and communication technologies to create innovative medication adherence technologies.

Note:

  • Applicants that propose adaptations to existing adherence interventions (e.g., for a new target group or new indication/condition) should provide an empirical rationale for the need for and focus of the adaptation, consistent with NAMHC Workgroup Report recommendations on intervention adaptation (http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/reports/fromdiscoverytocure.pdf) and consult with relevant Institute Program Staff in advance of submission.
  • It is understood that many mental disorders do not have biological health-related indicators that could be readily measured.  Thus, applications on research to improve adherence to medications for mental disorders are not required to include biological health-related indicators that would be expected to change as a result of an adherence intervention if such indicators cannot be feasibly measured or have not been well-established. Where such indicators do exist and could be readily measured, applicants are encouraged to include them. All applications should include an appropriate health-related outcome measure that would be expected to improve as a result of the adherence intervention, whether biological or not.

Contact:
For HIV/AIDS applications:
Michael J. Stirratt, Ph.D.
Division of AIDS Research
National Institute of Mental Health
6001 Executive Blvd, MSC-96196001
Bethesda, MD 20892-9631
Tel: 301-443-6802
Email: stirrattm@mail.nih.gov

For mental health applications:
Susan T. Azrin, Ph.D.
Division of Services and Intervention Research
National Institute of Mental Health
6001 Executive Blvd., Room 7168
Bethesda, MD 20892-9631
Tel: 301-443-3267
Email: Susan.Azrin@nih.gov


National Institute on Nursing Research (NINR)

NINR utilizes the R21 and R01 mechanisms for this funding announcement

The National Institute on Nursing Research (NINR) is seeking applications that will define behaviors which support medication adherence in persons with complex acute and chronic illnesses. Applications that develop and test self-management decision-making strategies and technologies to promote medication adherence are also encouraged.

Contact:
Joan Wasserman, DrPH, RN
Program Director
Division of Extramural Activities
National Institute of Nursing Research
National Institutes of Health
6701 Democracy Blvd, Rm 710
One Democracy Plaza
Bethesda, MD 20892-4870
Email: wassermanje@mail.nih.gov
Phone: 301-594-2154



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Adherence