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Health Literacy PAR R21
Understanding and Promoting Health Literacy
Examples of Research Topics
Several institutes and offices within AHRQ and NIH have joined together to support this initiative. Applications should be relevant to both the general objectives of the FOA and to the specific research interests of at least one of the participating organizations. Applications that address generic health literacy issues, but do not delineate clear relationships to the specific interests of at least one of the sponsoring organizations may not secure funding. 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.
THE AGENCY FOR HEALTHCARE RESEARCH AND QUALITY
The Agency for Healthcare Research and Quality's (AHRQ) mission is to improve the quality, safety, efficiency, and effectiveness of health care for all Americans. Information from AHRQ's research helps people make more informed health and health care decisions and improves the quality of health care services. AHRQ is interested in health literacy research that will support its portfolios of work: Comparative Effectiveness, Health Information Technology, Innovation, Patient Safety, Prevention/Care Management, and Value. For more information on the research interests in each of AHRQ’s portfolios, please see: http://grants.nih.gov/grants/guide/pa-files/PA-09-070.html.
AHRQ is particularly interested in the development and testing of interventions designed to improve: 1) patients’ understanding of their health conditions, and 2) their ability to take appropriate actions. Such improvements will ultimately enhance informed decision making, health care, and/or health outcomes for individuals with limited health literacy. These include both patient/consumer-oriented and provider-oriented interventions. AHRQ is also interested in implementation research regarding health literacy interventions, such as the adoption of health literacy universal precautions. AHRQ encourages research in under-studied areas, such as verbal health literacy and numeracy. Ideally, all intervention studies would examine costs and cost offsets of the interventions.
AHRQ also supports the development of health literacy tools, such as health literacy measurement tools, pharmacy health literacy tools, health information technology health literacy tools. To view health literacy tools supported by AHRQ, go to: http://www.ahrq.gov/browse/hlitix.htm#Literacy. Applications to develop tools should include testing and validation of the tools.
AHRQ also encourages research that addresses priority populations (minority groups, low-income groups, women, children, elderly, individuals with special health care needs - including individuals with disabilities and individuals who need chronic care or end-of-life health care). Research that could contribute to the reduction or elimination of disparities in health care or health disparities would be of great interest. For more information on disparities, see AHRQ’s National Healthcare Disparities Report at: http://www.ahrq.gov/qual/qrdr08.htm.
Agency for Healthcare Research and Quality
540 Gaither Rd.
Rockville, MD 20850
Email: firstname.lastname@example.org (preferred)
HHS encourages investigators to write Informed Consent (IC) and HIPAA Authorization documents for research to be understandable to all potential research participants, including those with low levels of literacy and limited English proficiency. HHS recommends that IC and Authorization documents be written in accordance with health literacy principles, and that IC and Authorization documents be available in multiple languages if potential research participants include individuals with limited English proficiency. HHS also recommends adopting a process to verify potential research participants’ understanding.
IC documents must contain information about the elements required in regulation in language understandable to potential participants (45 CFR 46 116). Authorization documents must include core elements and required statements in plain language (45 CFR 164.508(c)). The AHRQ Informed Consent and Authorization Toolkit for Minimal Risk Research (http://www.ahrq.gov/fund/informedconsent) provides sample forms and guidance on adapting them, and also describes an appropriate process for obtaining informed consent and authorization.
NATIONAL CANCER INSTITUTE (NCI)
Division of Cancer Control and Population Sciences (DCCPS)
The Division of Cancer Control and Population Sciences (DCCPS) both generates new knowledge and seeks to ensure that the products of cancer control research are effectively applied in all segments of the population. The division conducts and supports genetic, epidemiological, behavioral, social and applied cancer research.
DCCPS-funded research aims to understand the cause and distribution of prose, document, and quantitative health literacy in populations, and supports research ranging from basic behavioral to research on the development, testing, delivery, and dissemination of effective interventions in all segments of the population, including older individuals. Central to these activities is the approach individuals, health care systems, health plans, and communities take to understand, process and act on qualitative and quantitative health information to reduce the cancer burden in the areas of tobacco use, cancer screening and surveillance, energy balance, sun protection, survivorship and end-of-life care, virus exposure genetic influences on health behaviors, risk and patient-provider communication, patient-peer navigation, health insurance options and benefits, electronic medical records, and the health care system.
Applicants are encouraged to consult DCCPS’s Research Funding Priorities web page http://cancercontrol.cancer.gov/brp/index.html
Erica S. Breslau, Ph.D.
Behavioral Research Program
Division of Cancer Control and Population Sciences
National Cancer Institute
6130 Executive Boulevard, Room 4098
Bethesda Maryland 20892
Telephone: (301) 435-2839
Fax: (301) 480-6637
NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING (NIBIB)
The National Institute of Biomedical Imaging and Bioengineering is dedicated to improving health by leading the development and accelerating the application of biomedical technologies. NIBIB will consider applications that are relevant to its core mission and which study and promote clinical imaging and bioengineering literacy to improve outcomes. Areas of study which would be of interest to the Institute include: technologies and tools to advance the study of health literacy, disparities in the outcome of imaging-based preventative and/or intervention strategies and health literacy as a variable in the adoption and impact of biomedical technologies.
Examples of NIBIB-supported health literacy research areas could include, but are not limited to:
John Haller, Ph.D.
- Assessment of appropriate technologies to improve disease management (e.g., culturally appropriate point-of-care diagnostics, simple language for self-administered STD tests, easy-to-use home health monitors, etc.)
- Research that improves communication between radiologists and patients to improve diagnosis.
- Software, databases and other technological improvements that strengthen health literacy.
- Studies that improve understanding of the costs/benefits/alternatives of radiation exposure (e.g., x-ray radiation)
- Telehealth technologies that enhance health literacy
National Institute of Biomedical Imaging & Bioengineering
6707 Democracy Blvd., Suite 200, MSC 5469
Bethesda, MD 20892
NATIONAL INSTITUTE ON CHILD HEALTH AND HUMAN DEVELOPMENT (NICHD)
The NICHD has research interests in health literacy and the multiple components associated with health literacy including: access, skills, knowledge, attitudes, abilities, demographics, and features of health care providers and public and private health systems. Relevant to the NICHD are studies linking health literacy to health promotion, disease prevention, injury prevention and treatment, health conditions and diseases, health behaviors; treatment seeking, selection, and adherence, and the improvement of health or health care outcomes within populations of infants, children, adolescents, pregnant women, and families.
NICHD invites applications involving basic and applied/intervention research, secondary data analyses, methodology and measurement, implementation and dissemination, and public health research examining health literacy as a determinant of population health and health disparities. In addition to the broad topics listed above, the NICHD encourages applicants to consider research on health literacy and its role in or association with: Promoting health and preventing and managing diseases (e.g., asthma, diabetes, and HIV), injuries,developmental disabilities, physical disabilities, and early antecedents of adult chronic diseases (e.g., obesity and hypertension) from the fetal period through emerging adulthood; Influencing the health of pregnant women and pregnancy outcomes, and reducing infant, childhood, and maternal morbidity and mortality; Promoting healthy cognitive, social, emotional, and behavioral development, and school readiness in children and adolescents; Reducing risk behaviors including intentional and unintentional injuries, substance abuse, and unprotected sexual behaviors; Reducing violence, child abuse, and child neglect; Enhancing research on reproductive health, pediatric pharmacology, and medical rehabilitation; Promoting cognitive development (including the developmental neuroscience) of learning reading, mathematics, science, and language (including the influence of bilingualism); Developing studies that consider the impact of social, environmental, economic, and behavioral factors on health, and/or Considering systems level influences on health and health behaviors; Research examining interventions in the community for persons with physical disabilities to avoid secondary conditions ( e.g., skin ulcers, vascular disease, depression, etc.) and sustain health and healthy lifestyles.
Lynne Haverkos, MD, MPH
Program Director, Pediatric Behavior and Health Promotion
Eunice Kennedy Shriver National Institute of Child Health and Human Development
6100 Executive Blvd., Room 4805G
Bethesda, MD 20892-7510
Telephone: (301) 435-6881
Fax: (301) 480-
THE NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS (NIDCD)
The National Institute on Deafness and Other Communication Disorders (NIDCD) conducts and supports research and research training on disorders of hearing and other communication processes, including diseases affecting hearing, balance, smell, taste, voice, speech, and language through cooperation and collaboration with professional, academic, commercial, voluntary, and philanthropic organizations concerned with research and training that is related to deafness and other communication disorders, disease prevention and health promotion, and the special biomedical and behavioral problems associated with people having communication impairments or disorders. NIDCD also supports efforts to create devices that substitute for lost and impaired sensory and communication function and supports the ongoing collection and dissemination of information to health professionals, patients, industry, and the public on research findings in these areas. In response to this FOA, NIDCD is especially interested in research addressing health literacy with a goal of improving health outcomes for individuals with communication disorders.
Amy Donahue, Ph.D.
Division of Scientific Programs
National Institute on Deafness and Other Communication Disorders
6120 Executive Blvd, EPS 400C MSC 7180
Bethesda, MD 20892-7180
Telephone: (301) 402-3458
Fax: (301) 402-6251
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
Despite remarkable improvements in the oral health of many, not everyone in the nation has benefited equally. Oral, dental and craniofacial conditions remain among the most common health problems for low-income, disadvantaged, disabled and institutionalized individuals across the life span. Dental caries, periodontal disease, and oral and pharyngeal cancer are of particular concern.
The NIDCR’s 2009-2013 Strategic Plan underscores the Institute’s continued commitment to addressing disparities by focusing one of its four goals specifically on this research. ‘The NIDCR supports studies that 1) provide a better understanding of the basis of health disparities; 2) develop and test interventions tailored to underserved populations; and 3) explore approaches to the dissemination and implementation of effective findings to assure rapid translation into practice, policy and action in communities. Such studies require multi- and inter-disciplinary teams, multiple levels of analysis and intervention, and strong community partnerships.
Research that seeks to understand a broadened array of determinants of inequalities in oral health status and care are a priority. Studies that explore the root causes of oral health inequality/disparities at multiple levels as discussed in this FOA are needed. To be responsive to this FOA, such research must be focused on informing tailored/targeted interventional research to address oral health disparities.
The NIDCR supports interventional research designed to have a meaningful impact on caries, oral and pharyngeal cancer, periodontal disease, or oral health related quality of life and that influences action in the broad areas of this FOA: public policy, health care, or disease/disability prevention. Intervention research grounded in behavioral and social theory should explore mechanisms of action. The NIDCR supports research that utilizes new technologies and approaches that are culturally appropriate and sustainable, and that can be utilized by individuals, caregivers and workers that are readily available in communities. Investigators who wish to propose a randomized clinical trial must follow the guidelines that are found at http://www.nidcr.nih.gov/Research/DER/ClinicalResearch/ClinTrials.htm
Investigators are encouraged to refer to the NIDCR 2009-2013 Strategic Plan and contact the Program Official. http://www.nidcr.nih.gov/Research/ResearchPriorities/StrategicPlan/
Ruth Nowjack-Raymer, MPH, PhD
Director, Health Disparities Research Program
Center for Clinical Research
National Institute of Dental and Craniofacial Research
6701 Democracy Blvd. Room 640, MSC 4878
Bethesda, Maryland 20892-4878
NATIONAL LIBRARY OF MEDICINE
NLM is interested in research relating to the ways computers can be used to help health disparity populations or minority and other underrepresented populations make informed decisions about their health. Research topics of interest include computerized health literacy tools for information organization, visualization and decision-making. For any proposed project to be competitive for NLM funding, an evaluation arm must be included that assesses validity and reliability of findings, or efficacy of a proposed intervention
Hua-Chuan Sim, MD
Division of Extramural Programs
National Library of Medicine/NIH
6705 Rockledge Drive, Suite 301
Bethesda, MD 20892-7968
(For Courier Service, use zip code: 20817)
Telephone Number: 301.594.4882