Implementation Research on Noncommunicable Disease Risk Factors among Low- and Middle-Income Country and Tribal Populations Living in City Environments (R61/R33 Clinical Trial Required) | PAR 23 043

Frequently Asked Questions (FAQs)

What is this funding opportunity?

This is an NIH funding opportunity announcement (FOA) PAR 23-043, developed in collaboration with the Global Alliance for Chronic Diseases (GACD). It supports implementation research focused on reducing major noncommunicable disease (NCD) risk factors in city environments.

What is the main purpose of the FOA?

The FOA is designed to move beyond showing that an intervention can work under ideal conditions. Instead, it supports research on how to get evidence-based interventions, tools, policies, and guidelines adopted, integrated into real-world practice, scaled up, and sustained in urban settings, especially where inequities and limited resources affect what is feasible.

What type of research does the FOA emphasize?

The FOA emphasizes implementation research. Applications should focus on practical implementation challenges and solutions, such as adoption, adaptation, integration into systems, scale-up, and long-term sustainability of proven approaches to reduce NCD risks.

What kinds of implementation challenges are in scope?

Based on the FOA description, in-scope challenges include: fitting interventions into local health systems and community settings; adapting programs without losing effectiveness; improving uptake by providers and communities; and supporting long-term delivery after the study ends.

Does the FOA support work that advances dissemination and implementation (D&I) science methods?

Yes. The announcement encourages projects that strengthen dissemination and implementation science itself, including testing or refining implementation strategies, methods, and measures that could be used broadly across settings.

What settings and populations are prioritized?

The FOA prioritizes implementation research in city environments for two priority population settings: (1) people living in World Bank-defined low- and middle-income countries (LMICs) and (2) American Indian/Alaska Native (AI/AN) Tribal Nation populations living in cities within the United States.

How does the FOA define "cities"?

"Cities" is defined broadly. It includes formal urban centers as well as informal settlements, slums, and periurban areas.

What urban realities should projects account for?

Applicants are expected to design studies that reflect real-world urban conditions such as dense living environments, mobility, environmental exposures, changing food and physical activity environments, limited access to preventive services, and the involvement of multiple actors (governmental, private-sector, and community) that influence health in urban spaces.

What health focus areas are included?

The FOA targets major NCD risk factors in city environments. The provided information does not list specific diseases or specific risk factors, but it frames the work around preventing and/or managing NCDs by addressing major NCD risks through implementation of proven approaches.

What is the overall goal of the research supported by this FOA?

The goal is to generate evidence that policymakers, health leaders, and practitioners can use to prevent and/or manage NCDs among disadvantaged populations in urban settings, including LMIC urban communities and AI/AN Tribal Nation populations living in U.S. cities.

What funding mechanism is used?

Funding is provided through a bi-phasic, milestone-driven R61/R33 mechanism.

How long is the R61 phase and what is it for?

The R61 phase lasts up to two years and supports structured start-up activities tied to clear milestones. Examples mentioned include finalizing partnerships, refining implementation strategies, completing pilot testing needed to confirm feasibility, establishing data systems, and meeting other readiness targets.

How long is the R33 phase and what is it for?

The R33 phase can provide up to three additional years and is focused on fuller implementation and evaluation, after the project has met predefined scientific milestones and award requirements.

Is transition from R61 to R33 automatic?

No. Transition depends on successfully achieving the predefined scientific milestones and meeting award requirements.

Do applicants need to propose both phases in their application?

Yes. Applications must propose and justify both phases from the start, including what will be accomplished in the R61 phase, what milestones will trigger transition, and what the R33 phase will deliver.

Is a clinical trial required?

Yes. The FOA states that a clinical trial is required.

Who is eligible to apply?

Eligibility is broad and includes many U.S. and non-U.S. organizations. Examples listed in the FOA summary include state/county/city/township/special district governments; independent school districts; public housing authorities/Indian housing authorities; public and private institutions of higher education; nonprofit organizations (with or without 501(c)(3) status); for-profit organizations (other than small businesses) and small businesses; federally recognized Native American tribal governments; and other tribal organizations.

Are community-based and faith-based organizations eligible?

Yes. The FOA explicitly mentions faith-based and community-based organizations among eligible applicant types.

Are tribal entities and tribal-serving institutions eligible?

Yes. The FOA includes federally recognized Native American tribal governments and other tribal organizations, and it explicitly calls out tribally controlled colleges and universities as eligible. It also mentions Alaska Native and Native Hawaiian Serving Institutions.

Are U.S. territories or non-U.S. (foreign) entities eligible?

Yes. The FOA includes U.S. territories or possessions as eligible, and it also states that non-domestic (foreign) entities are eligible.

Are federal agencies eligible to apply?

Yes. The FOA summary includes eligible federal agencies among eligible applicants.

What is the CFDA/assistance listing information for this opportunity?

The opportunity includes CFDA/assistance listings 93.233, 93.242, 93.837, 93.838, 93.839, 93.840, and 93.989.

What category is this opportunity listed under?

It is described as a discretionary NIH grant opportunity in the health category.

When was the opportunity created and what is the closing date listed in the provided details?

The opportunity was created on 2022-12-07 and the provided details list an original closing date of 2023-03-09.

Is the award ceiling provided? Is the expected number of awards provided?

No. The provided source details do not specify an award ceiling or the expected number of awards.

Where should applicants look for budget expectations and institute-specific requirements?

Because the award ceiling and expected number of awards are not specified in the provided summary, applicants would typically consult the full FOA and any NIH institute- or center-specific guidance for budget expectations, scope, and other requirements tied to participating Institutes and Centers.