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

Opportunity Information: Apply for PAR 23 043

This NIH funding opportunity (PAR 23-043), developed in collaboration with the Global Alliance for Chronic Diseases (GACD), supports implementation research that tackles major noncommunicable disease (NCD) risk factors in city environments. The focus is on 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. The core idea is to move beyond proving whether an intervention works in principle and instead study how to get evidence-based interventions, tools, policies, and guidelines adopted and sustained in real-world urban conditions, especially where inequities and resource constraints shape what is feasible.

The FOA is centered on the practical barriers and solutions involved in adoption, adaptation, integration, scale-up, and long-term sustainability of proven approaches to reduce NCD risks. That means applications should be oriented toward implementation challenges such as how to fit interventions into local health systems and community settings, how to adapt programs without losing effectiveness, how to improve uptake by providers and communities, and how to support long-term delivery once a study ends. The announcement also encourages work that strengthens dissemination and implementation science itself, for example by testing or refining implementation strategies, methods, and measures that can be used broadly across settings.

A key feature is the urban emphasis. In this FOA, "cities" is defined broadly to include not only formal urban centers but also informal settlements, slums, and periurban areas. Applicants are expected to design studies that recognize the realities of dense living conditions, mobility, environmental exposures, changing food and activity environments, limited access to preventive services, and the complex mix of governmental, private-sector, and community actors that influence health in urban spaces. The overall goal is to generate evidence that policymakers, health leaders, and practitioners can use to prevent and/or manage NCDs among disadvantaged populations in these settings.

Funding is provided through a bi-phasic, milestone-driven R61/R33 mechanism and a clinical trial is required. The first phase (R61) lasts up to two years and is meant for structured start-up work tied to clear milestones, such as finalizing partnerships, refining implementation strategies, completing pilot testing needed to confirm feasibility, establishing data systems, or meeting other readiness targets. Projects that successfully achieve the predefined scientific milestones and meet award requirements can transition to the second phase (R33), which supports up to three additional years focused on fuller implementation and evaluation. Importantly, applications must propose and justify both phases from the start, including what will be accomplished in R61, what milestones will trigger transition, and what the R33 implementation phase will deliver.

Eligibility is broad and includes many U.S. and non-U.S. organizations, reflecting the global and community-engaged nature of the work. Eligible applicants include state, county, city, township, and 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; and federally recognized Native American tribal governments as well as other tribal organizations. The FOA also explicitly calls out additional eligible groups such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISI institutions, Hispanic-serving institutions, HBCUs, tribally controlled colleges and universities, faith-based and community-based organizations, regional organizations, U.S. territories or possessions, eligible federal agencies, and non-domestic (foreign) entities.

Administratively, this is a discretionary NIH grant opportunity in the health category, with CFDA listings that include 93.233, 93.242, 93.837, 93.838, 93.839, 93.840, and 93.989. The opportunity was created on 2022-12-07 and listed an original closing date of 2023-03-09. The award ceiling and expected number of awards are not specified in the provided source details, so applicants would typically look to the full FOA and NIH institute-specific guidance for budget expectations, scope, and any additional requirements tied to participating Institutes and Centers.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "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)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.233, 93.242, 93.837, 93.838, 93.839, 93.840, 93.989.
• This funding opportunity was created on 2022-12-07.
• Applicants must submit their applications by 2023-03-09. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• 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 23 043

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