Multi-sectoral preventive interventions that address social determinants of health in populations that experience health disparities is sponsored by National Institutes of Health (NIH). This Notice of Funding Opportunity (NOFO) supports projects to test prospective multi-sectoral preventive interventions that address social determinants of health (SDOH) in populations experiencing health disparities.

Expired PAR-24-053: Multi-sectoral preventive interventions that address social determinants of health in populations that experience health disparities (UG3/UH3, Clinical Trial Required) This notice has expired. Check the NIH Guide for active opportunities and notices. Department of Health and Human Services Part 1.

Overview Information Participating Organization(s) National Institutes of Health ( NIH ) Components of Participating Organizations Division of Program Coordination, Planning and Strategic Initiatives, Office of Disease Prevention ( ODP ) National Heart, Lung, and Blood Institute ( NHLBI ) National Institute on Alcohol Abuse and Alcoholism ( NIAAA ) February 6, 2024 - Participation Added ( NOT-AR-24-012 ) National Institute of Arthritis and Musculoskeletal and Skin Diseases ( NIAMS ) National Institute of Dental and Craniofacial Research ( NIDCR ) National Institute on Drug Abuse ( NIDA ) National Institute of Nursing Research ( NINR ) National Institute on Minority Health and Health Disparities ( NIMHD ) National Center for Complementary and Integrative Health ( NCCIH ) National Cancer Institute ( NCI ) All applications to this funding opportunity announcement should fall within the mission of the Institutes/Centers.

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

Office of Dietary Supplements ( ODS ) Sexual and Gender Minority Research Office ( SGMRO ) Office of Research on Women's Health ( ORWH ) Funding Opportunity Title Multi-sectoral preventive interventions that address social determinants of health in populations that experience health disparities (UG3/UH3, Clinical Trial Required) UG3 / UH3 Exploratory/Developmental Phased Award Cooperative Agreement May 2, 2024 - Notice of Question and Answer "Office Hours" with NIH Staff for the Multi-Sectoral Preventive Interventions (MSPI) Research Network: PAR-24-053 (UG3/UH3, Clinical Trial Required) and RFA-OD-24-006 (U24, Clinical Trial Not Allowed).

See Notice NOT-OD-24-120 February 6, 2024 - Notice of NIAMS' Participation in PAR-24-053, "Multi-sectoral preventive interventions that address social determinants of health in populations that experience health disparities (UG3/UH3, Clinical Trial Required)".

See Notice NOT-AR-24-012 December 20, 2023 - Notice of Pre-Application Webinar and FAQs for the Multi-Sectoral Preventive Interventions (MSPI) Research Network: PAR-24-053 (UG3/UH3, Clinical Trial Required) and RFA-OD-24-006 (U24, Clinical Trial Not Allowed). See Notice NOT-OD-24-050 August 31, 2022 - Implementation Changes for Genomic Data Sharing Plans Included with Applications Due on or after January 25, 2023.

See Notice NOT-OD-22-198 . August 5, 2022 - Implementation Details for the NIH Data Management and Sharing Policy. See Notice NOT-OD-22-189 .

Funding Opportunity Number (FON) Companion Funding Opportunity Resource-Related Research Project (Cooperative Agreements) See Section III. 3. Additional Information on Eligibility .

Assistance Listing Number(s) 93. 307, 93. 361, 93.

213, 93. 121, 93. 273, 93.

313, 93. 837, 93. 838, 93.

839, 93. 840, 93. 233, 93.

399, 93. 279, 93. 846 Funding Opportunity Purpose The purpose of this NOFO is to support projects to test prospective multi-sectoral preventive interventions that address social determinants of health in populations that experience health disparities.

These research projects will be part of the Multi-Sectoral Preventive Interventions (MSPI) Research Network, which will also include a Coordinating Center ( RFA-OD-24-006 ). Funded under a cooperative agreement, projects participating in the MSPI Research Network will collaborate to share approaches, methods, and data, working closely with NIH Institutes, Offices and Centers.

Applicants applying to this NOFO are encouraged to review the Coordinating Center NOFO to fully understand the MSPI Research Network structure and activities. This NOFO solicits bi-phasic research projects proposed in UG3/UH3 Phased Innovation Awards Cooperative Agreement applications.

Funding for the UG3 phase (phase I) will be used to demonstrate sufficient preparation, feasibility and capacity to meet foundational milestone targets specific to the work proposed. A UG3 project that meets its milestones will be administratively considered by NIH and prioritized for transition to the UH3 award (phase II). Applicants responding to this NOFO must address specific aims and milestones for both the UG3 and UH3 phases.

Open Date (Earliest Submission Date) Letter of Intent Due Date(s) Renewal / Resubmission / Revision (as allowed) AIDS - New/Renewal/Resubmission/Revision, as allowed All applications are due by 5:00 PM local time of applicant organization. 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.

Required Application Instructions It is critical that applicants follow the instructions in the Research (R) Instructions in the How to Apply - Application Guide , except where instructed to do otherwise (in this NOFO or in a Notice from NIH Guide for Grants and Contracts ). Conformance to all requirements (both in the Application Guide and the NOFO) 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.

Notice of 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.

Notice of Funding Opportunity Description The purpose of this NOFO is to support projects to test prospective multi-sectoral preventive interventions that address social determinants of health in populations that experience health disparities. These research projects will be part of the Multi-Sectoral Preventive Interventions (MSPI) Research Network, which will also include a Coordinating Center (RFA-OD-24-006 ).

Funded under a cooperative agreement, projects participating in the MSPI Research Network will collaborate to share approaches, data, and methods, working closely with NIH Institutes, Offices and Centers. Applicants applying to this NOFO are encouraged to review the Coordinating Center NOFO to fully understand the MSPI Research Network structure and activities.

Key Definitions for this NOFO Preventive intervention : For the purposes of this NOFO, preventive interventions include both primary and secondary prevention. Primary prevention involves interventions or policies designed to prevent or reduce risk factors for developing a new health condition before health effects occur.

Secondary prevention involves interventions or policies designed to prevent the recurrence of a health condition or progression of an early-stage health condition. Preventive interventions are inclusive of interventions to prevent or reduce risk factors, screen for risk factors or signs of early disease, or provide referrals or brief treatment to prevent disease onset or progression of early-stage conditions.

Projects developing technologies, such as devices and algorithms, as part of risk factor screening or preventive interventions also fall within this definition. Populations that experience health disparities (HD Populations) : Populations defined in section 464z-3(d)(1) of the Public Health Service Act, 42 U.S.C.

285t(d)(1) as health disparity populations based on higher overall rates of disease incidence, prevalence, morbidity, mortality, or survival rates in the population as compared to the health status of the general population.

NIH-designated U.S. health disparity populations currently include Black Americans/African Americans, Hispanics/Latinos, American Indians/Alaska Natives, Asian Americans, Native Hawaiians/Pacific Islanders, socioeconomically disadvantaged populations, underserved rural populations, sexual and gender minorities, and people living with disabilities.

Social determinants of health (SDOH): The conditions in which people are born, grow, learn, work, play, live, and age, and the wider set of structural factors shaping the conditions of daily life.

These structural factors include social, economic, and legal forces, systems, and policies that determine opportunities and access to high quality jobs, education, housing, transportation, built environment, information and communication infrastructure, food, and health care; the social environment; and other conditions of daily life. See https://www. ninr.

nih. gov/researchandfunding/nih-sdohrcc for additional detail on the NIH SDOH Conceptualization. Multi-sectoral intervention: An intervention involving two or more service sectors (e.g., health, public health, education, housing, labor, social services, child welfare, transportation, parks and recreation, commerce, justice, environmental protection, etc.).

These sectors may include neighborhood, city, county, regional, state, national, or tribal governmental or non-governmental organizations. For the purposes of this NOFO, research teams from academic institutions or research organizations are not considered as a service sector. However, institutions of higher learning would be considered as a service sector for multi-sectoral interventions directed towards students of those institutions.

Level of Influence: The socio-ecological levels (e.g., individual, interpersonal, organizational, community, or societal) at which specific determinants operate to influence risk factors and subsequent health outcomes (see the NIMHD Research Framework, https://www. nimhd. nih.

gov/about/overview/research-framework. html , for examples of health determinants at different levels of influence). To constitute an intervention at the interpersonal, organizational, community, or societal level, the intervention must directly alter determinants at that level, not just be delivered in a setting at that level or help individuals manage the consequences of determinants at that level.

For example, an intervention to promote better nutrition among school-aged children by adjusting available food options in the school cafeterias would be an organizational-level intervention; an intervention providing nutrition information to students within schools would be an individual-level intervention.

The NIH Office of Disease Prevention (ODP) within the Office of the Director, Division of Program Coordination, Planning, and Strategic Initiatives (DPCPSI) is coordinating the new trans-NIH research effort, ADVANCE: Advancing Prevention Research for Health Equity, which grew out of the ODP’s portfolio analysis of NIH research.

In an examination of NIH-funded grants and cooperative agreements between fiscal years 2012 and 2017, the ODP found that only 8. 5% of all projects focused on preventing the leading risk factors or causes of death and disability (e.g., poor nutrition, low physical activity, smoking), falling well below their burden on the nation’s health.

An additional analysis of the NIH research portfolio showed that between fiscal years 2016 and 2019, only 3. 6% of NIH-funded prevention projects included a randomized intervention to address a leading risk factor in populations that experience health disparities.

To address this research gap, this ADVANCE initiative will support research projects to test preventive interventions addressing risk factors for chronic or acute health conditions in populations that experience health disparities.

Prevention or reduction of leading risk factors in HD populations requires moving beyond addressing knowledge, attitudes, and behaviors of individuals to intervene upon social determinants of health (SDOH) that drive inequities, such as limited access to healthy food options, limited opportunities for physical activity, lack of access to healthcare, and exposure to stigma, discrimination, and violence.

Multi-sectoral collaborations that span multiple service sectors and community-based organizations have great potential to develop, implement, and sustain preventive interventions that address SDOH and promote health equity.

Projects will be part of a research network to share approaches, data, and methods to facilitate the generation of research evidence about the prevention of common risk factors for multiple health conditions across different populations.

Proposed intervention projects are expected to have the following features: Designed to prevent, reduce, or screen for one or more risk factors for one or more chronic or acute health conditions, including at least one common risk factor shared across multiple conditions (e.g., poor nutrition; high body mass index; low physical activity; tobacco, alcohol, or other substance use; air pollution; occupational risks; high systolic blood pressure; high fasting plasma glucose level; high LDL cholesterol level; impaired kidney function; poor sleep quality, etc.).

Modifies one or more SDOH beyond the individual level of influence (e.g., interpersonal, organizational, community, societal) as a mechanism of action to prevent or reduce risk factors.

Interventions that only offer referrals to address an individual’s social needs (e.g., providing a patient with a referral to a food bank) rather than directly modifying SDOH beyond the individual level (e.g., improving the food environment in a community) are not responsive to this NOFO.

Guided by a conceptual model identifying hypothesized pathways between the SDOH and other determinants being addressed, the risk factors to be modified, and health outcomes. Tests new or adapted interventions, novel combinations of multiple interventions, and/or new strategies to implement evidence-based interventions.

Involves collaboration with organizations from two or more service sectors (e.g., health, public health, education, housing, labor, social services, child welfare, transportation, parks and recreation, commerce, justice, environmental protection, etc.), with representatives from these organizations serving as key personnel on the project.

Additional collaborations with other types of community-based organizations, such as patient or consumer advocacy organizations, professional societies, faith-based organizations, or neighborhood associations, are strongly encouraged.

Study designs are expected to include the following features: Be adequately powered to identify intervention effects for the HD population(s) of focus and/or the impact of the intervention on reducing or eliminating disparities in health outcomes.

Designed to measure and test hypothesized pathways, using appropriate methods for examining the impact of multi-level or higher-level (i.e., interpersonal, organizational, community, or societal) mechanisms of action on health outcomes.

Use appropriate intervention study designs, such as a parallel group- or cluster-randomized trial, a stepped-wedge group- or cluster randomized trial, a rigorous quasi-experimental design such as a group- or cluster-level regression discontinuity design or an interrupted time-series design, or a rigorous alternative.

Pre-post designs that lack comparison conditions or sites (e.g., an intervention implemented in a single clinic or neighborhood) are strongly discouraged.

Whenever participants are assigned to study arms in groups or clusters (e.g., families, clinics, schools, worksites, communities, counties, states) and observations taken on individual participants are analyzed for intervention effects, special methods are required for analysis and sample size calculation. Methods consistent with plans for assignment of participants and delivery of interventions should be documented in the application.

Additional information is available at https://researchmethodsresources. nih. gov/ .

Assess health outcomes at the individual, interpersonal, organizational, or community level, or a combination. Individual health outcomes are not required if higher level health outcomes are of primary interest.

Include changes in risk factors (e.g., improvements in nutrition or physical activity) as the primary health outcome, or as an intermediate outcome that impacts downstream outcomes (e.g., onset of a health condition, engagement in health care). Employ a common set of tools and resources that will promote the collection of comparable data on SDOH across studies.

In particular, studies are strongly encouraged to use SDOH measures from the Core and Specialty collections that are available in the Social Determinants of Health Collection of the PhenX Toolkit as relevant ( www. phenxtoolkit. org ).

MSPI Research Network Structure The MSPI Research Network will consist of the awarded UG3/UH3 Research Projects and a Coordinating Center (CC) (see RFA-OD-24-006 ). The CC and each of the Research Projects will also work collaboratively with one or more Project Scientists and Program Officers from NIH institutes, centers, and offices (ICOs).

The MSPI Research Network priorities and activities will be governed by a Steering Committee (SC) which at a minimum will include at least two representatives from each Research Project (e.g., research and community organizational MPI or key personnel), the CC, and at least one NIH representative. The MSPI Research Network Steering Committee will meet at least monthly and be chaired by personnel from the CC.

Based on the priorities set by the Steering Committee, relevant workgroups will be established to carry out cross-project activities or consultation. For example, NIH anticipates there will be at least three workgroups: methodology and data analysis, data harmonization, and dissemination. UG3/UH3 Phased Innovation Awards This UG3/UH3 Phased Innovation Award supports bi-phasic projects for up to seven years.

The UG3 (Phase 1) will be a two-year award for a milestone-driven developmental/exploratory study that can demonstrate sufficient preparation, feasibility, capacity and leveraging of foundational activities needed for the implementation studies planned in Phase 2 (UH3).

Phase 1 includes scientific, operational and collaborative planning activities as well as tangible deliverables/preliminary findings that could be informative to the field as appropriate.

Scientific planning activities may include development, adaptation or refinement of interventions or strategies; feasibility, acceptability and pilot testing of a proposed intervention or strategy; and development and testing of engagement and implementation strategies (e.g., fidelity monitoring, training).

Operational planning activities may include development of the intervention, strategy or model protocol; the intervention manual or equivalent (as appropriate); data collection and management safety and operational oversight plans; recruitment, engagement and retention strategies; obtaining all regulatory approvals prior to the end of the UG3 award (e.g., single IRB ( sIRB ), Data and Safety Monitoring Plan (DSMP)); and other essential documents and procedures.

Collaborative planning activities may include finalizing MOUs with collaborators, forming additional partnerships as needed with community-based organizations or service providers, forming advisory boards, and other related activities. The UH3 phase will provide support for five additional years to conduct the implementation phase of research that will advance knowledge of multi-sectoral preventive interventions with HD populations.

The UH3 phase award will support the implementation and evaluation of the interventions or strategies planned or developed in the UG3 phase. UG3 projects that have met the milestones for the first phase (e.g., scientific, operational, collaborative) will be programmatically considered and prioritized for transition to the UH3 phase.

Funding of the UG3 (Phase 1) does not guarantee support of the UH3 (Phase 2) award for research implementation, and all funded UG3 projects may not transition to the UH3 phase.

Transition to the UH3 phase will be determined by the availability of funds and the outcome of a programmatic evaluation at NIH that is based on 1) appropriate sustainability plans with successful engagement of local collaborating agencies and partners and 2) Go/No-Go Transition Milestone accomplishment specific to the project being proposed [e.g.; establishment of relevant collaborations with community and other sector partners needed to advance achievement of the research objectives as demonstrated by the execution of necessary agreements with these agencies for committed financial and/or human resources, data sharing, etc.; demonstrated ability to recruit appropriate individual and/or organizational population samples, conduct data collection, access to data for appropriate data linkages, etc.].

Continued programmatic priorities and availability of funds will impact the decision to transition to the UH3 award. Appeals of the transition decision will not be accepted. Applications Not Responsive to the NOFO Applications that do not include specific aims for both a UG3 and a UH3 phase.

Applications that do not specify Go/No-Go transition milestones for the planning phase (UG3), the transition to the UH3 phase, and annual milestones for the implementation phase (UH3). Projects that do not prospectively test a preventive intervention focused on NIH-designated HD populations. Observational studies and natural experiments are not responsive.

Projects that only intervene at the individual level or use an individual-level randomized trial design. Projects that use, collect or analyze exclusively individual-level data or are exclusively qualitative (though mixed-methods are encouraged).

Projects that do not involve collaborations with organizations from two or more service sectors, as indicated by the inclusion of organizational representatives as key personnel and/or proposed subcontracts to the organizations. Non-responsive applications will not be reviewed. Applicants are strongly encouraged to reach out to the relevant scientific contacts to discuss whether their applications are responsive.

Pre-application technical assistance Information regarding a pre-application webinar and frequently asked questions (FAQs) will be provided in a forthcoming Notice published in the NIH Guide. Areas of Research Interest: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Musculoskeletal diseases are the leading cause of disability and health care expenditures in the United States.

NIAMS is interested in receiving research applications that design, adapt, test and/or implement culturally appropriate, multi-sectoral interventions for the primary and secondary prevention of arthritic, other rheumatic, musculoskeletal, and skin diseases, among populations experiencing health disparities.

Applications centered on improving access to evidence-based interventions and strategies and with a focus on sustainability are encouraged. Applicants are strongly encouraged to discuss their proposed research interest with NIAMS program staff. National Cancer Institute (NCI) In the US, there are approximately 18 million cancer survivors, which includes individuals diagnosed with cancer from the time of diagnosis until the end of life.

Cancer survivors from racial and ethnic minority groups and other medically underserved populations are more likely to experience cancer recurrence, secondary malignancies, multiple chronic comorbidities, physical and psychological side effects, poorer health-related quality of life and health behaviors, and higher financial toxicity than other cancer survivors.

The cases of disparities in cancer prevention, screening, and management of onset of other health conditions, reoccurrence, and secondary malignancies can be attributable to factors beyond the healthcare system into other SDOH.

For example, the neighborhood built and social environments shape how communities are connected via public transportation that enables timely access to healthcare, affect the walkability, safety, availability of green space or gardens, fast food density, and access to full-service grocery stores that promote physical activity and healthy eating; and determine the availability of quality healthcare services, providers, and resources.

SDOH can, directly and indirectly, impact the ability of cancer survivors to engage in positive health behaviors (e.g., walking, eating healthy, survivorship care visits) to reduce their risk through various mechanistic pathways at multiple levels of influence .

These direct, indirect, and synergistic interactions cause health disparities and require the collaboration of multiple sectors, including health, public health, social services, transportation, parks and recreation, environmental protection, and community-based organizations, to address and alter SDOH.

NCI invites research applications that design and test cancer preventive and survivorship interventions to address the mechanistic pathways by which SDOH impact modifiable risk factors, thereby increasing the risk for multiple chronic comorbidities or health conditions and poor health-related quality of life.

Interventions must be multilevel and use the Socioecological Framework to target SDOH that indirectly, directly, and synergistically lead to poor health outcomes at two or more levels of influence (e.g., interpersonal, organizational, community, or societal). Research studies that integrate trans-disciplinary expertise are of particular interest.

Areas of research interest include, but are not limited to: Develop and test multilevel, multicomponent, multisectoral interventions that directly target and alter structural factor(s) and SDOH to prevent or reduce modifiable risk factors (e.g., lack of physical activity, high body mass index or adiposity, alcohol consumption, tobacco use) at various levels of influence, such as the interpersonal, community, organizational, or societal level, to mitigate adverse health outcomes among cancer survivors.

Design and test interventions that address SDOH beyond the individual level of influence to address related social risks and lead to improved health outcomes (e.g., improving the food environment in a community).

For example, food insecurity, housing instability, and transportation-related barriers at the community level hinder access, utilization, and timely delivery of quality cancer care and can lead to adverse health outcomes for cancer survivors.

Develop and test interventions that target SDOH (e.g., income, housing, employment, food deserts or swamps) to improve diet quality, reduce comorbidities, and improve cancer outcomes at the community or societal level, such as increasing access to fruits and vegetables through the Supplemental Nutrition Assistance Program (SNAP), establishing community gardens and food pantries that can provide medically tailored meals, and providing healthy food packages/groceries among cancer survivors.

Interventions that only offer referrals to address an individual’s social needs (e.g., providing a patient with a referral to a food bank) rather than directly modifying SDOH beyond the individual level (e.g., improving the food environment in a community) are not responsive to this NOFO. Cancer outcomes must be specified.

Develop and test interventions that target SDOH at the interpersonal, organizational, community, and societal levels that directly impact access to timely and quality healthcare for cancer survivors. Areas of interest related to cancer survivorship include access to oral health screening, health insurance, employment-related mandates, laws, or regulations that reduce the economic burden of healthcare among cancer survivors.

Evaluate policy interventions that target SDOH at the societal and organizational level to improve healthcare and health outcomes and reduce health disparities. Policy interventions involve a new law, act, or program mandated by a national or state government that impacts SDOH among cancer survivors.

National Center for Complementary and Integrative Health (NCCIH) Investigators are encouraged to review the NCCIH Clinical Research Toolbox to learn more about NCCIH's requirements, policies, guidelines, and required templates for clinical trials.

Applicants are strongly encouraged to discuss their proposed research interest with the designated NCCIH Scientific/Research Contact listed below to confirm its relevance to the NCCIH mission areas. National Heart, Lung, and Blood Institute (NHLBI) The NHLBI is interested in supporting multisectoral interventions that focus on heart, lung, blood, and/or sleep (HLBS) risk factors, diseases, and conditions.

NHLBI has a strong interest in dissemination and implementation science studies that aim to utilize evidence-based interventions and strategies that: Improve access to care and resources (e.g., healthy food sources, physical activity/exercise, etc.) Improve screening, diagnosis, treatment, and/or management of HLBS conditions Promote the adoption and adherence to appropriate HLBS evidence-based guidelines Investigators planning to submit an application are strongly encouraged to consult with the NHLBI Scientific Contact listed in Section VII of this NOFO.

National Institute on Alcohol Abuse and Alcoholism (NIAAA) The Surgeon General’s Report on Alcohol, Drugs, and Health published in 2016 calls for a public health model for addressing substance misuse and related consequences.

This report identified risk and protective factors at the individual, family, school, and community levels, provided a list of evidence-based prevention programs and policies , and highlighted evidence-based community coalition-based prevention models , such as the Communities That Care and the Communities Mobilizing for Change on Alcohol.

NIAAA-developed Alcohol Screening and Brief Intervention for Youth: A Practitioner’s Guide provides a tool and resources for identifying youth at risk for alcohol-related problems. CollegeAIM provides intervention matrices for addressing alcohol issues in college, and some interventions are relevant to young adults who are not in college.

The Healthcare Professional’s Core Resource on Alcohol provides evidence-based context to help healthcare professionals to overcome barriers to care for patients with alcohol-related concerns. The Alcohol Policy Information System (APIS) supported by NIAAA provides detailed information on alcohol-related and recreational cannabis policies at both State and Federal levels.

The Community Preventive Services Task Force reviewed and recommended numerous interventions to reduce excessive alcohol consumption in communities. Countermeasures That Work by the National Highway Traffic Safety Administration provides evidence-based interventions and policies for alcohol-impaired driving.

The Sequential Intercept Model by the Substance Abuse and Mental Health Services Administration (SAMHSA) is a tool that helps communities develop strategies to divert people with substance use disorders away from the justice system into treatment. SAMHSA’s Evidence-Based Practices Resource Center provides a collection of scientifically based tools for the public to quickly identify approaches for their needs.

A wide variety of resources are available, but much more needs to be done to test or implement prevention interventions and policies in the context of SDOH and assess outcomes in HD populations.

SDOH can impact the likelihood of alcohol misuse and alcohol use disorder (AUD), such as social and community context (e.g., discrimination, racism, social isolation, growing up in a home with parental AUD), neighborhood and built environment (e.g., alcohol outlet density, exposure to violence, housing affordability), health care access and quality (e.g., receiving evidence-based preventive care), economic stability (e.g., job and food security, income), and education access and quality (e.g., educational opportunities and attainment).

Adverse SDOH serve as allostatic loads on the body’s stress systems, increase vulnerability to mental and physical conditions, and contribute to health disparities and inequities. Such stressors can drive alcohol misuse to cope which, in turn, exacerbates the initial problems, further fueling alcohol misuse.

Under this PAR, NIAAA is interested in multilevel and multisectoral preventive interventions that are not feasible to accomplish with the Research Project Grant (R01) mechanism. Study designs are expected to include process evaluation, assessment of barriers and facilitators to implementation and sustainability, and evaluation of any unintended negative effects.

Contingent upon funding availability, NIAAA may prioritize applications with scientifically meritorious scores in the following research areas of interest: Comprehensive or multicomponent community-based programs focusing on environmental interventions (e.g., public policy changes, enhanced enforcement of laws, changing social norms, media advocacy, community mobilization, data-driven campaigns) for preventing or reducing underage drinking, alcohol misuse and related harms (e.g., alcohol-impaired driving, assaults, overdoses) in general and HD populations.

Comprehensive interventions to promote abstinence from alcohol at the time surrounding pregnancy and breastfeeding, reduce stigmatization associated with AUD, alcohol use, and related conditions (e.g., fetal alcohol spectrum disorders), and improve identification and access to effective services for individuals with fetal alcohol spectrum disorders and their families.

Community-engaged interventions to prevent alcohol misuse or treat AUD tailored to the complex and multifaceted challenges faced by youth in the juvenile justice system or the child welfare system.

Integrative interventions and whole person health approaches to enhance neighborhood and community resources and facilitate positive changes in health and behavior in an aging population, such as screening and brief intervention for alcohol misuse, promoting drinking reduction or abstention, and increasing knowledge of common alcohol-interactive medications , in combination with smoking cessation, physical activity, and increasing health care access and quality such as screening and management of chronic conditions.

Applications submitted to NIAAA are expected to adhere to NIAAA’s expectations for Data Management and Sharing Plans described in NOT-AA-23-001 , as appropriate. National Institute on Drug Abuse (NIDA) NIDA is interested in research to determine the extent to which interventions at the policy, community, organizational, or individual levels that address SDOH prevent substance use and associated negative outcomes.

Applicants may choose to study a single intervention or a combination of interventions that impact substance use. NIDA studies must include a substance use outcome. Specific outcomes of interest include substance use risk, substance use initiation, substance misuse, and escalation from misuse to substance use disorder (SUD).

NIDA prioritizes research that examines the mechanisms through which addressing the SDOH will have an impact on substance use outcomes. Examples of research areas that would be of interest to NIDA include, but are not limited to: Studies of the effects on substance use of policies that enhance financial well-being within a population.

Policy interventions may include implementation by multiple community-based organizations, and include efforts to provide direct cash payments, address food insecurity, promote workforce engagement, increase health insurance coverage, or other reforms to reduce economic insecurity. Studies of community policing and other reforms to address discrimination against racially and/or ethnically minoritized populations.

Policy reforms may include efforts by police, community empowerment organizations, crisis response providers, educational entities, and other sectors. Studies to test the impact on substance use of policies or programs to prevent violence, including efforts by police, education, community groups, public health, and recreation organizations to reduce firearms access, increase