Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)

Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional) is sponsored by National Institutes of Health (NIH). Supports research on using health IT to reduce healthcare disparities in access, communication, and outcomes.

Expired PAR-19-093: Leveraging Health Information Technology (Health IT) to Address Minority Health and Health Disparities (R01 Clinical Trial Optional) This notice has expired. Check the NIH Guide for active opportunities and notices. Part 1.

Overview Information Participating Organization(s) National Institutes of Health ( NIH ) Components of Participating Organizations National Institute on Minority Health and Health Disparities ( NIMHD ) National Cancer Institute (NCI) National Institute of Biomedical Imaging and Bioengineering ( NIBIB ) National Library of Medicine (NLM) National Institute on Alcohol Abuse and Alcoholism ( NIAAA ) National Eye Institute ( NEI ) All applications to this funding opportunity announcement should fall within the mission of the participating Institutes/Centers.

The following NIH Offices may co-fund applications assigned to those Institutes/Centers.

Office of Behavioral and Social Sciences Research ( OBSSR ) Funding Opportunity Title Leveraging Health Information Technology (Health IT) to Address Minority Health and Health Disparities (R01 Clinical Trial Optional) R01 Research Project Grant Notices of Special Interest associated with this funding opportunity March 30, 2022 - This PAR has been reissued as PAR-22-145 . October 13, 2020 - NEI Notice of Participation in PAR-19-093.

See Notice NOT-EY-21-002 . September 8, 2020 - Notice of Special Interest (NOSI): Research in the Emergency Setting. See Notice NOT-NS-20-005 .

March 10, 2020 - Reminder: FORMS-F Grant Application Forms & Instructions Must be Used for Due Dates On or After May 25, 2020- New Grant Application Instructions Now Available. See Notice NOT-OD-20-077 . Clarifying Competing Application Instructions and Notice of Publication of Frequently Asked Questions (FAQs) Regarding Proposed Human Fetal Tissue Research.

See Notice Changes to NIH Requirements Regarding Proposed Human Fetal Tissue Research. See Notice NOT-OD-19-128 . May 22, 2019 - Notice of Participation of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in PAR-19-093.

See Notice NOT-AA-19-019 . January 28, 2019 - Notice of Additional Receipt Date for PAR-19-093. See Notice NOT-MD-19-019 .

December 20, 2018 - Notice of NLM's Participation in PAR-19-093 . See Notice NOT-LM-19-002 . December 12, 2018 - Notice of NIBIB's Participation in PAR-19-093.

See Notice NOT-EB-18-035 . Funding Opportunity Announcement (FOA) Number Companion Funding Opportunity See Section III. 3.

Additional Information on Eligibility . Catalog of Federal Domestic Assistance (CFDA) Number(s) 93. 307, 93.

399, 93. 286, 93. 879, 93.

273, 93. 867 Funding Opportunity Purpose This funding opportunity announcement (FOA) seeks to support research that examines how health information technology adoption impacts minority health and health disparity populations in access to care, quality of care, patient engagement, and health outcomes.

Open Date (Earliest Submission Date) Letter of Intent Due Date(s) 30 days prior to the application due date New Dates - March 4, 2019, October 28, 2019, March 4, 2020, March 4, 2021, by 5:00 PM local time of applicant organization. All types of non-AIDS applications allowed for this funding opportunity announcement are due on these dates.

Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date. AIDS Application Due Date(s) New Dates - March 4, 2019, October 28, 2019,March 4, 2020, March 4, 2021 , by 5:00 PM local time of applicant organization.

All types of AIDS related and AIDS applications allowed for this funding opportunity announcement are due on these dates. Applicants are encouraged to apply early to allow adequate time to make any corrections to errors found in the application during the submission process by the due date.

New Dates - June 2019, February 2020, June 2020, June 2021 New Dates - October 2019, June 2020, October 2020, October 2021 Required Application Instructions It is critical that applicants follow the instructions in the Research (R) Instructions in the SF424 (R&R) Application Guide ,except where instructed to do otherwise (in this FOA or in a Notice from NIH Guide for Grants and Contracts ).

Conformance to all requirements (both in the Application Guide and the FOA) is required and strictly enforced. Applicants must read and follow all application instructions in the Application Guide as well as any program-specific instructions noted in Section IV . When the program-specific instructions deviate from those in the Application Guide, follow the program-specific instructions.

Applications that do not comply with these instructions may be delayed or not accepted for review. Part 1. Overview Information Part 2.

Full Text of Announcement Section I. Funding Opportunity Description Section II. Award Information Section III.

Eligibility Information Section IV. Application and Submission Information Section V. Application Review Information Section VI.

Award Administration Information Section VII. Agency Contacts Section VIII. Other Information Part 2.

Full Text of Announcement Section I.

Funding Opportunity Description This funding opportunity announcement (FOA) seeks to support research that examines the impact of leveraging health information technology (health IT) to reduce disparities by increasing access to care, delivery of higher quality of care, improving patient-clinician communication, and health outcomes for minority health and health disparity populations in the U.S. Health information technology (health IT) has tremendous potential for increasing health equity for racial and ethnic populations.

Health IT tools such as electronic health records (EHRs), patient portals/patient health records (PHRs), and clinical decision support (CDS) may yield population health benefits for underserved populations by enhancing patient engagement, improving implementation of clinical guidelines, patient safety, and reducing adverse outcomes.

EHRs and CDS may help improve documentation of social determinants of health (SDoH) & inform patient care for those most vulnerable who have multiple chronic diseases and higher health risks.

Availability of real time actionable patient data , clinical care coordination, and decision support enabled by health IT tools may also reduce disparities in quality of care for underserved populations who often experience a greater burden of chronic diseases and are more likely to demonstrate signs of poor management of chronic disease.

Better clinical care coordination via health IT could improve clinician performance and adherence to clinical guidelines, reduce redundant testing due to clinician biases, detect treatment risks, and thus consequently facilitate equitable treatment for underserved populations. Of the limited studies, the findings, for example, indicate that health IT investment can reduce disparities in process of care and care standardization.

Additionally, attention to unintended consequences associated with the use of health IT needs to be monitored to ensure health disparities are not inadvertently exacerbated.

Research is needed to investigate the potential unintended consequences of health technologies such as, impact on clinician-patient communication in general and with vulnerable patients in particular, barriers that prevent the uptake and engagement with EHRs and PHRs by medically underserved patients, effective approaches and models to deliver CDS in safety net clinical settings, and the best models for the inclusion and utility of SDoH in EHR systems/CDS tools that will have the most effect of improving health equity for racial and ethnic populations.

Health IT and Primary Care Transformation : Research is also needed to explore the contributions of health IT on new models of primary care delivery such as advanced primary care and the patient-centered medical home (PCMH), in a variety of settings- particularly in safety net clinics .

Health IT tools are vital to the success of the PCMH innovation effort which holds promise for achieving the triple aim of improved population health, lower co sts, and better patient experiences in health care. For example, clinical data from patient registries can help clinicians identify gaps in care and opportunities for outreach.

EHRs can facilitate teamwork to ensure follow up of key test results are completed and care gaps of patients are addressed. E vidence-based solutions are also called for in low resource primary practice settings where the potential benefits of health IT are greater g iven challenges to utilize EHR systems for quality improvement of care processes.

Health IT tools can als o have potential for great utility in the care of complex chronic diseases (e.g., CKD/ Chronic Kidney Disease, RA/ R heumatoid Arthrit is, COPD/Chronic Obstructive Pulmonary Disease , post-solid organ transplants ) in primary care settings that serve health disparity populations who often experience a disproportionate burden of chronic diseases and require more complex care because of co-morbidit ies.

For example, CKD is often poorly detected in primary care and treatment is suboptimal. Emerging evidence indicates support for the use of electronic CKD registries to enable guideline-concordant care of CKD in primary care settings.

Research is needed to explore the potential of decision support tools, and new technologies such as artificial intelligence and natural language processing on EHR platforms , to improve health outcomes for complex chronic diseases . Limited studies exist that investigate RA outcome improvements via EHR interventions in clinical care in diverse settings.

Primary care EHR data and CDS tools to improve the uptake of COPD guidelines also warrants further investigation to determine the practice patterns most effective for disease management in diverse primary care settings . I mple mentation models that leverage health IT to manage the health outcomes of vulnerable patients who have received solid organ transplants in partnership with transplant specialists are also needed.

Health IT and Patient-Clinician Communication: The complexities of patient-clinician communication in the era of EHRs will also need to be evaluated with ethnically diverse vulnerable populations with chronic disease since communication barriers during medical encounters may further augment health disparities via decreased patient participation in shared decision making.

Additionally, changes such as information overload, documentation burden, and stress that EHRs bring to relationships between patients and clinicians or between clinicians warrant further investigation in the context of minority health and health disparity populations . Patients of safety net clinics often face challenges of limited digital and health literacy, and/or English proficiency, that impede their usability of patient portals.

This disparity in usability of patient health portals raises the concern that a digital divide may exclude the most vulnerable patients from the benefits of portal use. The issue of a digital divide will also need to be investigated in other specialty settings such as oncology to determine how patients from vulnerable populations access incoming portal data.

Health IT and Social Determinants of Health (SDoH) : Finally, the inclusion of SDoH in EHR/CDs is critical for advancing population health equity. R esearch is needed to explore the optimal approaches of collecting and integrating SDoH into EHRs /CDs to effectively guide clinical care and increase shared decision making between physicians and patients .

The American College of Physicians published a position statement on SDoH (https://www. acponline. org/acp_policy/policies/addressing_social_determinants_to_improve_patient_care_2018.

pdf ) recommending the development of best practices of utilizing EHRs to screen and collect SDoH data to assist in health impact assessment and inform evidence driven decisions. Documentation of SDoH into EHRs is also supported by the National Academy of Medicine (2014). SDoH, as defined by healthyPeople.

gov ( https://www. healthypeople. gov/2020/topics-objectives/topic/social-determinants-of-health ) are conditions in the environment in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

Examples of SDoH factors of interest include finance (e.g., employment, income, debt, food security) , neighborhood/built environment (e.g., housing, transportation, public safety, walkability, parks, social capital, access to local food markets, residential segregation) , education (e. g, literacy, access to job training) , and a ccess to health care services .

Advances in big data, geospatial technology, and public access to large data sets that provide contextual information also make it feasible to embed community level geocoded data into EHRs.

Having this geocoded data readily available would allow healthcare teams to see for example, if patients live in a high poverty area, have access to healthy food sources, walkable streets, social capital, and how these resources (or lack of) predict increase risks for adverse health outcomes and impact treatment adherence.

CDS tools could provide alerts to healthcare teams of patients who, for example, may need to be screen or monitored for depression based on a community level predictor (e.g. high unemployment) or public health concern. Research is needed to examine when and how in the clinical workflow geocoded community level data can be utilized with CDS tools to have the most impact on health outcomes of vulnerable patients.

In addition, individual perception of community level metrics such as perceived safety, access to healthy food and community cohesion, may be utilized in a similar manner.

This funding opportunity announcement (FOA) seeks to support the use of clinical trials, comparative effectiveness research, observational studies, and implementation science to investigate how to leverage health information technology (health IT) to improve minority health care and reduce health disparities by increasing access to care, delivery of higher quality care, improving patient-clinician communication and health outcomes for minority health and health disparity populations in the U.S. Projects should include a focus on one or more NIH-designated health disparity populations in the United States, which include Blacks/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asians, Native Hawaiians and other Pacific Islanders, socioeconomically disadvantaged populations of any race, underserved rural populations, and sexual and gender minorities.

Projects should involve collaborations from relevant stakeholders in U.S. health disparity population groups, such as researchers, community organizations, healthcare systems or clinics, clinicians, public health organizations, consumer advocacy groups, and faith-based organizations.

Projects that focus exclusively on mHealth interventions at the patient level (e.g., the use of fitness related mobile applications), in the absence of incorporation of health IT elements within a healthcare system, are not targeted for support in this FOA.

Projects that examine the financing of health care or the cost and efficiency of health care service delivery, without linking such economic analysis to measurable health outcomes, are considered outside of NIH's mission and will not be supported. See NOT-OD-16-025 for more information.

Specific Areas of Research Interest Areas of research interest include but are not limited to the following: Implementation models of delivering CDS in diverse settings (e.g. small, rural, safety net clinics) and the usability of these tools to determine what is working & what is missing in reducing disparities in quality of care and outcomes; Multi-level (system, clinician , patient) i nterventions that leverage health IT to improve the care of complex chronic diseases in diverse primary care settings including PCMH- that serve health disparity populations ; Implementation models of leveraging health IT for quality improvement in less resourced primary care practices that serve health disparity populations; Enable interoperability of health IT tools (e.g., mobile apps, wearables, and other devices) with EHR systems to support the integration across high and low-resource clinical settings, health systems, to screen, communicate, share data, and enhance decision support for patients and providers.

Advance human-centered design methodologies to develop multilevel communication tools to translate, transcribe and analyze patient information into digital platforms. Studies may include examination of implementation and systems integration of digital health technologies within existing health care workflows and home/community settings and organizational and policy impact.

The unintended negative effects of EHR use on patient clinician & clinician-clinician communication , relationships, and health outcomes and the impact on underserved health disparity populations; The impact of using automated algorithms to inform disease risk assessment, detection, diagnoses, and treatment decision-making on disparities in healthcare quality or outcomes; Interventions that address the health literacy demands of EHR driven conversations on shared decision making and the health outcomes of patients in safety net clinics ; Disparities in adoption rates of patient portals/PHRs especially among older minority users, rural residents, low-income patients, persons with LEP and/or limited health literacy, and racial/ethnic minority patients; The types of interventions/personalization needed to foster patient engagement of patient portals/PHRs in a sustained and relevant way for underserved populations; The utility and effectiveness of the inclusion of SDoH & community level geocoded data and/or perceived community level measures in EHRs/CDS on health outcomes; Evaluation of when in the clinical workflow can SDoH & community level geocoded data in EHRs/CDS have the most beneficial impact on health outcomes; National Cancer Institute ( NCI ) The National Cancer Institute encourages submission of applications designed to study development, testing and implementation of multi-level digital health technology interventions aimed at improving cancer prevention and control along any aspect of the cancer control continuum to reduce cancer health disparities and promote health equity.

These digital health technologies should enable identification or monitoring of health disparities, integration of social determinants of health in patient care and public health (without exacerbating existing disparities), or enable the delivery of interventions to reduce health disparities.

Importantly, NCI defines multi-level broadly, to include studies that incorporate interventions addressing two or more of the following levels: individual (patient, caregiver, clinical provider), clinical team (two or more providers including primary and specialty care and support staff), Health care institution ( Collection of primary and specialty care providers, and support staff, health care administrators, medical facilities, and organizational structures.

Together these people, institutions and resources provide the environment for the comprehensive delivery of healthcare services) , home, workplace, social network, community setting, , public health, social service, and policy environments.

NCI encourages intervention components to be clearly specified and explicitly linked to new, refined, or existing multi-level theories and the digital health technology should be used to connect data, information, communication, interventions across levels.

The use of novel and alternative research and intervention designs (e.g., sequential multiple assignment randomized trial (SMART), multiphase optimization strategy (MOST), hybrid effectiveness and implementation designs and factorial experimental designs, human centered design approaches are highly encouraged. Note, NCI’s definition for health disparities and health equity: https://cancercontrol. cancer.

gov/research-emphasis/health-disparities. html NCI is interested in diverse submissions - including but not limited to those that: Develop and test effectiveness, acceptability, and adoption of health communication platforms tailored to different environments among racial/ethnic populations and underserved low resource communities for cancer prevention and control.

Develop and test digital health tools that enable integration of geospatial information and technology designed to facilitate health-related uses of social and environmental data that are spatially linked, including integration that allows for studies examining barriers to accessing health care services and/or cancer care and prevention.

Development of data visualization, NLP, AI and other products that facilitate communication of electronic health information for prevention or control of cancer or cancer co-morbidities to patients, caregivers and providers in clinical settings.

These may include integration of innovative combinations of data (e.g., genetic information, environmental exposures, contextual factors) to inform the design of multi-level interventions aimed at cancer prevention and control.

Develop and test digital health tools for monitoring and surveillance of health care treatment disparities and racial/ethnic, socioeconomic, gender, and sexual orientation/identity bias, to enhance quality of care for cancer patients and survivors.

Develop and test IT-based interventions that improve information sharing and care coordination across time and space among clinicians delivering care to cancer patients, especially in rural and other under-served areas.

Examination of implementation outcomes (e.g., adaptation, acceptability) in developing tools for implementation of decision support tools, mobile health behavioral monitoring protocols, and cancer symptom management platforms.

Integrate novel patient-generated data capture tools (i.e., wearable technology) to identify clinically-relevant, actionable information to improve patient care and outcomes for cancer health disparities related outcomes.

Develop, test and or implement tools that enable and enhance patient engagement in chronic disease management and prevention among cancer survivors across age, sociodemographic, health and digital literacy and linguistic barriers.

Develop and test the efficacy of digital health tools (mobile, EHR) that can be used collectively to promote recruitment, enrollment and data collection for clinical trials, particularly for groups underrepresented in clinical trials. Office of Behavioral and Social Sciences Research ( OBSSR ) See Section VIII. Other Information for award authorities and regulations.

Section II. Award Information Grant: A support mechanism providing money, property, or both to an eligible entity to carry out an approved project or activity. Application Types Allowed The OER Glossary and the SF424 (R&R) Application Guide provide details on these application types.

Optional: Accepting applications that either propose or do not propose clinical trial(s) Need help determining whether you are doing a clinical trial? Funds Available and Anticipated Number of Awards The number of awards is contingent upon NIH appropriations and the submission of a sufficient number of meritorious applications. Application budgets are not limited but need to reflect the actual needs of the proposed project.

The scope of the proposed project should determine the project period. The maximum project period is 5 years. NIH grants policies as described in the NIH Grants Policy Statement will apply to the applications submitted and awards made from this FOA.

Section III.

Eligibility Information Higher Education Institutions Public/State Controlled Institutions of Higher Education Private Institutions of Higher Education The following types of Higher Education Institutions are always encouraged to apply for NIH support as Public or Private Institutions of Higher Education: Hispanic-serving Institutions Historically Black Colleges and Universities (HBCUs) Tribally Controlled Colleges and Universities (TCCUs) Alaska Native and Native Hawaiian Serving Institutions Asian American Native American Pacific Islander Serving Institutions (AANAPISIs) Nonprofits Other Than Institutions of Higher Education Nonprofits with 501(c)(3) IRS Status (Other than Institutions of Higher Education) Nonprofits without 501(c)(3) IRS Status (Other than Institutions of Higher Education) For-Profit Organizations (Other than Small Businesses) City or Township Governments Special District Governments Indian/Native American Tribal Governments (Federally Recognized) Indian/Native American Tribal Governments (Other than Federally Recognized) U.S. Territory or Possession Independent School Districts Public Housing Authorities/Indian Housing Authorities Native American Tribal Organizations (other than Federally recognized tribal governments) Faith-based or Community-based Organizations Non-domestic (non-U.S.) Entities (Foreign Institutions) are not eligible to apply Non-domestic (non-U.S.) components of U.S. Organizations are not eligible to apply.

Foreign components, as defined in the NIH Grants Policy Statement , are not allowed. Applicant organizations must complete and maintain the following registrations as described in the SF 424 (R&R) Application Guide to be eligible to apply for or receive an award. All registrations must be completed prior to the application being submitted.

Registration can take 6 weeks or more, so applicants should begin the registration process as soon as possible. The NIH Policy on Late Submission of Grant Applications states that failure to complete registrations in advance of a due date is not a valid reason for a late submission. Dun and Bradstreet Universal Numbering System (DUNS) - All registrations require that applicants be issued a DUNS number.

After obtaining a DUNS number, applicants can begin both SAM and eRA Commons registrations. The same DUNS number must be used for all registrations, as well as on the grant application. System for Award Management (SAM) (formerly CCR) Applicants must complete and maintain an active registration, which requires renewal at least annually.

The renewal process may require as much time as the initial registration. SAM registration includes the assignment of a Commercial and Government Entity (CAGE) Code for domestic organizations which have not already been assigned a CAGE Code. NATO Commercial and Government Entity (NCAGE) Code Foreign organizations must obtain an NCAGE code (in lieu of a CAGE code) in order to register in SAM.

eRA Commons - Applicants must have an active DUNS number and SAM registration in order to complete the eRA Commons registration. Organizations can register with the eRA Commons as they are working through their SAM or Grants. gov registration.

eRA Commons requires organizations to identify at least one Signing Official (SO) and at least one Program Director/Principal Investigator (PD/PI) account in order to submit an application. Grants. gov Applicants must have an active DUNS number and SAM registration in order to complete the Grants.

gov registration. Program Directors/Principal Investigators (PD(s)/PI(s)) All PD(s)/PI(s) must have an eRA Commons account. PD(s)/PI(s) should work with their organizational officials to either create a new account or to affiliate their existing account with the applicant organization in eRA Commons.

If the PD/PI is also the organizational Signing Official, they must have two distinct eRA Commons accounts, one for each role. Obtaining an eRA Commons account can take up to 2 weeks.

Eligible Individuals (Program Director/Principal Investigator) Any individual(s) with the skills, knowledge, and resources necessary to carry out the proposed research as the Program Director(s)/Principal Investigator(s) (PD(s)/PI(s)) is invited to work with his/her organization to develop an application for support.

Individuals from underrepresented racial and ethnic groups as well as individuals with disabilities are always encouraged to apply for NIH support. For institutions/organizations proposing multiple PDs/PIs, visit the Multiple Program Director/Principal Investigator Policy and submission details in the Senior/Key Person Profile (Expanded) Component of the SF424 (R&R) Application Guide.

This FOA does not require cost sharing as defined in the NIH Grants Policy Statement. 3. Additional Information on Eligibility Applicant organizations may submit more than one application, provided that each application is scientifically distinct.

The NIH will not accept duplicate or highly overlapping applications under review at the same time. This means that the NIH will not accept: A new (A0) application that is submitted before issuance of the summary statement from the review of an overlapping new (A0) or resubmission (A1) application.

A resubmission (A1) application that is submitted before issuance of the summary statement from the review of the previous new (A0) application. An application that has substantial overlap with another application pending appeal of initial peer review (see NOT-OD-11-101 ) Section IV. Application and Submission Information 1.

Requesting an Application Package Buttons to access the online ASSIST system or to download application forms are available in Part 1 of this FOA. See your administrative office for instructions if you plan to use an institutional system-to-system solution. 2.

Content and Form of Application Submission It is critical that applicants follow the instructions in the Research (R) Instructions in the SF424 (R&R) Application Guide except where instructed in this funding opportunity announcement to do otherwise. Conformance to the requirements in the Application Guide is required and strictly enforced.

Applications that are out of compliance with these instructions may be delayed or not accepted for review. For information on Application Submission and Receipt, visit Frequently Asked Questions Application Guide, Electronic Submission of Grant Applications .

Although a letter of intent is not required, is not binding, and does not enter into the review of a subsequent application, the information that it contains allows IC staff to estimate the potential review workload and plan the review. By the date listed in Part 1.

Overview Information , prospective applicants are asked to submit a letter of intent that includes the following information: Descriptive title of proposed activity Name(s), address(es), and telephone number(s) of the PD(s)/PI(s) Names of other key personnel Participating institution(s) Number and title of this funding opportunity Beda Jean-Francois, Ph. D.

National Institute on Minority Health and Health Disparities ( NIMHD ) All page limitations described in the SF424 Application Guide and the Table of Page Limits must be followed Instructions for Application Submission The following section supplements the instructions found in the SF424 (R&R) Application Guide and should be used for preparing an application to this FOA.

All instructions in the SF424 (R&R) Application Guide must be followed. SF424(R&R) Project/Performance Site Locations All instructions in the SF424 (R&R) Application Guide must be followed. SF424(R&R) Other Project Information All instructions in the SF424 (R&R) Application Guide must be followed.

SF424(R&R) Senior/Key Person Profile All instructions in the SF424 (R&R) Application Guide must be followed. All instructions in the SF424 (R&R) Application Guide must be followed. All instructions in the SF424 (R&R) Application Guide must be followed.

PHS 398 Cover Page Supplement All instructions in the SF424 (R&R) Application Guide must be followed. All instructions in the SF424 (R&R) Application Guide must be followed, with the following additional instructions: Research Strategy. Describe how the project will contribute to understanding the impact of leveraging health technology (health IT) to reduce health disparities among health disparity populations.

Identify the health disparity populations included in the study and provide a rationale for this population focus.

Describe how the project uses a multidisciplinary approach, including integration of the disciplines and expertise of the research team, to understand the challenges of leveraging health IT to reduce disparities in access to care, delivery of higher quality of care, improving patient clinician communication, and health outcomes for minority health and health disparity populations in the U.S. If there are foreign component(s), describe how the proposed activities at foreign sites will improve minority health and/or help reduce health disparities in the United States.

Resource Sharing Plan : Individuals are required to comply with the instructions for the Resource Sharing Plans as provided in the SF424 (R&R) Application Guide. The following modifications also apply: All applications, regardless of the amount of direct costs requested for any one year, should address a Data Sharing Plan.

Generally, Resource Sharing Plans are expected and are applicable for this FOA Only limited Appendix materials are allowed. Follow all instructions for the Appendix as described in the SF424 (R&R) Application Guide.

PHS Human Subjects and Clinical Trials Information When involving NIH-defined human subjects research, clinical research, and/or clinical trials (and when applicable, clinical trials research experience) follow all instructions for the PHS Human Subjects and Clinical Trials Information form in the SF424 (R&R) Application Guide, with the following additional instructions: If you answered Yes to the question Are Human Subjects Involved?

on the R&R Other Project Information form, you must include at least one human subjects study record using the Study Record: PHS Human Subjects and Clinical Trials Information form or Delayed Onset Study record. Study Record: PHS Human Subjects and Clinical Trials Information All instructions in the SF424 (R&R) Application Guide must be followed. All instructions in the SF424 (R&R) Application Guide must be followed.

PHS Assignment Request Form All instructions in the SF424 (R&R) Application Guide must be followed. 3. Unique Entity Identifier and System for Award Management (SAM) See Part 1.

Section III. 1 for information regarding the requirement for obtaining a unique entity identifier and for completing and maintaining active registrations in System for Award Management (SAM), NATO Commercial and Government Entity (NCAGE) Code (if applicable), eRA Commons, and Grants. gov 4.

Submission Dates and Times Part I. Overview Information contains information about Key Dates and times. Applicants are encouraged to submit applications before the due date to ensure they have time to make any application corrections that might be necessary for successful submission.

When a submission date falls on a weekend or Federal holiday , the application