Evaluating Natural Experiments in Healthcare to Improve Diabetes Prevention and Treatment (R18) | PAR 17 178

Opportunity Information: Apply for PAR 17 178

The National Institutes of Health (NIH) funding opportunity "Evaluating Natural Experiments in Healthcare to Improve Diabetes Prevention and Treatment (R18)" (Funding Opportunity Number PAR-17-178) supports research projects that evaluate real-world, large-scale healthcare policies or delivery programs that are already being rolled out and are expected to affect diabetes prevention, diabetes care, or both. The central idea is to take advantage of "natural experiments," meaning changes in healthcare systems or policy environments that happen for reasons outside the control of the research team (for example, a state Medicaid policy change, a health system adopting a new care model, or a payer implementing a new benefit design). Rather than paying organizations to create or launch a new intervention, this R18 mechanism funds the rigorous study of what happens when major policies or programs are implemented independently of NIH support, with an emphasis on producing findings that can credibly guide clinical practice and health policy decisions around diabetes.

A key feature of this FOA is what it does not fund: it is not intended to support the initiation, design, or delivery of new diabetes programs or new healthcare policies. Instead, it focuses on evaluation, effectiveness, and dissemination of evidence from policies or programs that already exist or are already planned and funded through other means. In practice, this pushes applicants toward strong quasi-experimental or experimental-leaning evaluation designs that can answer causal questions in messy real-world settings, such as differences-in-differences, interrupted time series, regression discontinuity, instrumental variables, stepped implementation comparisons, or other robust approaches suitable for health services and policy research. The end goal is practical evidence that helps decision-makers understand whether a policy or delivery change improves outcomes like diabetes incidence, screening and diagnosis, glycemic control, complication rates, access to preventive services, quality of care, equity in outcomes, patient experience, and healthcare utilization and costs.

The opportunity sits within NIH’s broader health services research and diabetes portfolios and is categorized under Health and Food and Nutrition, with CFDA number 93.847. It uses the R18 Research Demonstration and Dissemination Projects grant mechanism, which is typically aimed at applied research with clear implications for practice and policy. The listing indicates an award ceiling of $500,000, signaling that projects are expected to be substantive but still focused, often involving multi-site datasets, health system partnerships, claims and electronic health record (EHR) analyses, or evaluations tied to statewide or regional policy rollouts. While the source data shows the original closing date as February 13, 2020 (and the FOA was created February 28, 2017), the broader summary of the program’s intent remains useful for understanding what NIH was seeking to fund under this announcement.

Eligibility under this FOA is broad, reflecting the reality that healthcare policy and delivery research often requires partnerships among academic institutions, healthcare organizations, payers, public agencies, and community entities. Eligible applicants include state, county, and city or township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; public housing authorities and Indian housing authorities; and Native American tribal organizations other than federally recognized tribal governments. The FOA also allows nonprofits with and without 501(c)(3) status (outside of higher education), for-profit organizations (other than small businesses), and small businesses. In addition, it explicitly notes other eligible applicant types such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), regional organizations, eligible federal agencies, and faith-based or community-based organizations. This breadth is consistent with evaluations that may be led by universities, state Medicaid agencies, health systems, or coalitions that have access to the relevant data and implementation context.

Restrictions on foreign involvement are clearly stated. Non-domestic (non-U.S.) entities and foreign institutions are not eligible to apply, and non-domestic components of U.S. organizations are not eligible. The FOA also disallows foreign components as defined in the NIH Grants Policy Statement. In other words, while the research questions may have global relevance, this particular program is designed to fund U.S.-based applicant organizations doing U.S.-based work without foreign components.

Overall, this opportunity is aimed at generating credible, decision-ready evidence about whether major healthcare delivery and policy changes actually improve diabetes prevention and treatment in the real world. The strongest applications would typically be those that (1) identify a significant policy or program change already underway, (2) demonstrate access to appropriate data and stakeholder partners, (3) propose an evaluation strategy capable of producing defensible causal inferences, and (4) translate findings into practical guidance for clinicians, health system leaders, and policymakers focused on reducing diabetes burden and improving outcomes.

• The National Institutes of Health in the food and nutrition, health sector is offering a public funding opportunity titled "Evaluating Natural Experiments in Healthcare to Improve Diabetes Prevention and Treatment (R18)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.847.
• This funding opportunity was created on 2017-02-28.
• Applicants must submit their applications by 2020-02-13. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $500,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for PAR 17 178

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