NCIs Center for Global Health Funded Research Portfolio - - PowerPoint PPT Presentation

NCI’s Center for Global Health Funded Research Portfolio

Implications for Future Dissemination and Implementation Research

James R. Alaro, Ph.D.

December 5, 2017

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NIH Dissemination and Implementation Research in Health

• DIRH PAR is a trans-NIH funding opportunity for D&I - First issued in 2006,

renewed 2009, 2013, 2016

• PAR-16-238, R01 Research Project Grant
• PAR-16-236, R21 Exploratory/Developmental Grant
• PAR-16-237, R03 Small Grant Program
• Current NIH participants: 16 Institutes and Centers, ODP and OBSSR
• Eligibility: US Institutions, Foreign Institutions

Cycle I Cycle II Cycle III Applications Due Dates Jan 25- May 7 May 25-Sept 7 Sept 25-Jan 7 Scientific Review Jun - Jul Oct - Nov Feb - Mar Advisory Council Review Aug Jan May

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NIH DIRH PAR Portfolio: 2008 - 2017

$10 $19 $14 $13 $25 $25 $34 $39 $40 $41 27 44 34 33 59 69 84 83 84 81

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Total Dollars Number of Awards

 598 Research Grants funded: 433 R01, 132 R21, 31 R03  NIH funding levels has increased from $10M - $41M

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10 7 200 4 51 6 28 151 51 2 13 3 64 4

Number of Awards

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NCI DIRH PAR Portfolio: 2008 - 2017

Foreign Components 10 R01, 2 R21,1 R03 Direct Foreign Grants 1 R01 NCI: 145 R01, 43 R21, 12 R03

Neta G. et al. Implementation science (2015) 10:4

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NCI’s Center for Global Health

Established in 2011 to support and accelerate NCI’s mission to reduce the global burden of cancer

• CGH collaborates with:
• NCI Divisions, Offices and Centers and NIH
• NCI-designated Cancer Centers
• U.S. government agencies
• Research Institutions
• Foreign governments
• Non-governmental organizations
• Pharmaceutical and biotechnology companies

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NCI’s Center for Global Health Research Programs

Program Funding Opportunity (Number of Awards) Administrative Supplements 1. Admin Supp. to promote cancer prevention and control research in LMICs (n=10) 2. Admin Supp. to promote clinical research studies on pediatric Burkitt Lymphoma in LMICs (n=6) Research Programs (RFP/RFAs) 1. Pilot global cancer research collaborations between NCI-designated cancer centers and LMICs (n=13) 2. Affordable cancer technologies for global health - develop/test/adapt cancer technologies to address the rising burden of cancers in LMICs (n=21) 3. Planning grants for regional centers of excellence in non-communicable diseases in LMICs (n=11) Small Grants Research Program Research contracts to support pilot projects to stimulate specific areas of research and foster research careers of young investigators in LMICs: 1. Beginning Investigator Grant for Catalytic Research (BIG Cat) in Africa with AORTIC (n=18) 2. Awards for Cancer Research in the Caribbean with Caribbean Public health Association (n=6) 3. U.S.- Mongolia Liver Cancer grants (n=3)

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NCI’s Center for Global Health D&I Activities

• Global D&I Training:
• In-country training - Argentina (2014); Morocco, AORTIC (2015); India (2017)
• D&I Masters Course at World Cancer Congress in Melbourne (2014); Paris

(2016)

• Collaboration with USAID PEER Health Program: SE Asia (2015) and

MENA (2016)

• Support for LMICs trainees to TIDIRH
• We see increased requests for D&I Training globally
• Global D&I Research:
• The center is exploring how to best support/promote D&I research

globally

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Analysis of the NCI’s Center for Global Health’s Research Portfolio Purpose of Analysis

1. Identify projects that sought to address D&I research questions 2. Identify projects that employed D&I research frameworks and methodologies to address the D&I research questions 3. Identify opportunities to advance D&I research in global settings

Note: None of the CGH funding opportunities was a direct call for D&I research applications

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Methods

1. Grants that sought to address D&I questions A. Employed D&I frameworks/methodologies B. Did not employ D&I frameworks/methodologies 2. Grants that did not seek to address D&I questions A. Presented clear opportunity for D&I B. Did not present clear opportunity for D&I Research Programs Administrative Supplements (n=16) Research Programs (RFP/RFAs) (n=45) Small Grants (n=27)

Trans-NIH Codebook for D&I Research Portfolio Analysis (Adapted)

Implementation Phase Frameworks Study Designs Strategies Outcome measures Study Settings

• Each grants was independently reviewed by 2-3 NCI program staff and

conflicts resolved by consensus

n=88

Neta G. et al. Implementation science (2015) 10:4

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Results

• 1. 34% (30) of grants sought to address D&I research questions
• 2. 66% (58) of grants did not seek to address D&I research questions

Grants that sought to address D&I questions Grants that did not seek to address D&I questions

34% (30) 66% (58)

1. Grants that sought to address D&I questions

• A. Employed D&I frameworks and methodologies
• B. Did not employ D&I frameworks and

methodologies 2. Grants that did not seek to address D&I questions

• A. Presented clear opportunity for D&I
• B. Did not present clear opportunity for D&I

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• 1A. Grants that Sought to Address D&I Questions and employed

D&I Frameworks and Methodologies

• Proposed to identify (n=1), develop (n=2),

evaluate (n=5) and test (n=8) implementation strategy

• Mentioned D&I frameworks (n=2)
• All studies measured implementation outcomes,

most commonly feasibility, acceptability, appropriateness, and cost effectiveness

• Study designs: pre-post (n=3), observational

(n=3), experimental (n=2), quasi-experimental (n=3), mixed methods (n=1)

• Majority conducted in healthcare settings (8/12)

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• A. Employed

D&I Tools

40%(12)

• B. Did not

Employ D&I Tools

60%(18) 30

Grants that sought to address D&I questions Grants that did not seek to address D&I questions

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• 1B. Grants that Sought to Address D&I Questions and DID

NOT employ D&I Frameworks and Methodologies

• Majority of the studies were in the pre-

implementation phase (15/18)

• All but one study were in healthcare settings
• None of the studies mentioned D&I frameworks
• All studies measured at least one

implementation outcome, commonly, feasibility, acceptability, appropriateness, cost considerations

• Study designs included pre-post, Observational,

Experimental, Quasi-Experimental

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• A. Employed

D&I Tools

40%(12)

• B. Did not

Employ D&I Tools

60%(18) 30

Grants that sought to address D&I questions Grants that did not seek to address D&I questions

13

30

• A. Presented

clear

• pportunity for

D&I

48% (28)

• B. Did not

present clear

• pportunity for

D&I

52%(30)

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Grants that sought to address D&I questions Grants that did not seek to address D&I questions

• 2. Grants that Presented Clear Opportunity for D&I
• A. 48% of the grants that did not seek

to address D&I research question presented clear opportunities for D&I studies

• Many were trying to adapt/improve an

intervention

• Majority were conducted in healthcare

settings

• B. The other 52% did not present clear
• pportunities for D&I studies

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Summary

• Investigators seeking to address cancer control priorities in global settings are

asking questions that seek to adapt evidence from research to benefit communities and bring improvements and efficiencies to delivery of cancer prevention and control services

• This is not always done using tools developed by the D&I research community
• There is need to advance sustainable D&I training and mentored-research
• pportunities to improve the capacity of both the established and early-stage

investigators in global settings to generate context-specific data that informs evidence translation

cancer.gov cancer.gov/espanol