Occupational Safety and Health Education and Research Centers (T42)

Occupational Safety and Health Education and Research Centers (T42) is sponsored by United States Department of Health and Human Services (HHS). This grant supports Occupational Safety and Health Education and Research Centers.

RFA-OH-25-002: Occupational Safety and Health Education and Research Centers (T42) This funding opportunity was updated to align with agency priorities. Carefully reread the full funding opportunity and make any needed adjustments to your application prior to submission. Department of Health and Human Services Part 1.

Overview Information Participating Organization(s) Centers for Disease Control and Prevention ( CDC ) CDC and CDC/NIOSH disclaimer: The policies, guidelines, terms, and conditions of the HHS Centers for Disease Control and Prevention (CDC) stated in this Notice of Funding Opportunity (NOFO) might differ from those used by the HHS National Institutes of Health (NIH).

If written guidance for completing this application is not available on the CDC website, then CDC will direct applicants elsewhere for that information. of Participating Organizations National Institute for Occupational Safety and Health (NIOSH) Funding Opportunity Title Occupational Safety and Health Education and Research Centers (T42) March 31, 2025 - This funding opportunity was updated to align with agency priorities.

Carefully reread the full funding opportunity and make any needed adjustments to your application prior to submission. April 04, 2024 - Overview of Grant Application and Review Changes for Due Dates on or after January 25, 2025.

See Notice NOT-OD-24-084 Funding Opportunity Number (FON) Companion Notice of Funding A current recipient or applicant of the NIOSH T03, Occupational Safety and Health Training Project Grants award is not eligible to apply for an award or a sub-award under this Funding Opportunity Additional Information on Eligibility .

Assistance Listing Number(s) Funding Opportunity Purpose The National Institute for Occupational Safety and Health ( NIOSH ), Centers for Disease Control and Prevention ( CDC ), invites grant applications for Education and Research Centers (ERCs) that are focused on occupational safety and health (OSH) training.

NIOSH is mandated to provide an adequate supply of qualified personnel to carry out the purposes of the Occupational Safety and Health Act, and the ERCs are one of the primary means for meeting this mandate.

ERCs are academic institutions that provide high-quality interdisciplinary graduate and post-graduate training, research training, continuing education, and outreach in the core OSH disciplines of industrial hygiene, occupational health nursing, occupational medicine, and occupational safety, as well as allied disciplines.

Research and research training are integral components of ERCs, with ERC faculty and NIOSH trainees conducting research on issues related to the NIOSH National Occupational Research Agenda ( NORA ) and emerging issues to advance the OSH field.

NIOSH ERCs have regional presence to ensure that the training and research they support is beneficial to workers across the ERCs serve as resources for our nation's workforce through continuing education, outreach and strong collaboration with professional associations, worker advocacy groups, businesses, industries, and public health agencies.

ERCs work with other institutions and organizations, including Minority Serving Institutions and other NIOSH supported training programs to have a positive impact on worker health, safety, and well-being. Publication Date: October 8, 2024 To receive notification of any changes to RFA-OH-25-002, return to the synopsis page of this announcement at www. grants.

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Open Date (Earliest Submission Date) Letter of Intent Due Date(s) 30 days prior to the application due date December 17, 2024, October 23, 2025, October 22, 2026, October 21, 2027, October 26, 2028 On-time submission requires that electronic applications be error-free and made available to CDC for processing from the NIH eRA system on or before the deadline date. Applications must be submitted to and validated successfully by Grants.

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AIDS Application Due Date(s) 2025, February 2026, February 2027, February 2028, February 2029 May 2025, May 2026, May 2027, May 2028; May 2029 July 1, 2025, July 1, 2026, July 1, 2027, July 1, 2028, It is critical that applicants follow the Multi-Project (M) Instructions in the How to Apply - Application Guide , except where instructed to do otherwise (in this NOFO or in a Notice from the NIH and Contracts ).

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Telecommunications for the Hearing Impaired: TTY The National Institute for Occupational Safety and Health (NIOSH ), Centers for Disease Control and Prevention (CDC) , invites grant applications for Education and Research Centers (ERCs) that are focused on graduate occupational safety and health (OSH) training.

NIOSH is mandated to provide an adequate supply of qualified personnel to carry out the purposes of the Occupational Safety and Health Act, and the ERCs are one of the primary means for meeting this mandate.

ERCs are academic institutions that provide high-quality interdisciplinary graduate and post-graduate training, research training, continuing education, and outreach in the core OSH disciplines of industrial hygiene, occupational health nursing, occupational medicine, and occupational safety, as well as allied disciplines.

Research and research training are integral components of ERCs, with ERC faculty and NIOSH trainees conducting research on issues related to the NIOSH National Occupational Research Agenda (NORA) and emerging issues to advance the OSH field. NIOSH ERCs have regional presence to ensure that the training and research they support is beneficial to workers across the nation.

ERCs serve as resources for our nation's workforce through continuing education, outreach and strong collaboration with professional associations, worker advocacy groups, businesses, industries, and public health agencies. ERCs work with other institutions and organizations, including Minority Serving Institutions and other NIOSH supported training programs to have a positive impact on worker health, safety, and well-being. of Support.

This is a grant. Available and Anticipated Number of Awards. The number of awards is contingent upon CDC / NIOSH appropriations and the submission of a sufficient number of meritorious applications.

CDC / NIOSH anticipates funding up to 18 awards. The total amount of funds to be awarded under this program is approximately $32 million dollars each year. and Period of Performance.

New applicants must submit for 3 years of support. Renewal applications must submit for 5 years of support. Revision applications must not exceed the length of the current award and must be for a period of at least two years.

No revision applications allowed for centers entering their final year of the period of performance. and Period of Performance. The estimated total funding (direct and indirect) for the first budget year (12 months) is $1.

8 million. The estimated total funding (direct and indirect) for the entire Period of Performance, 3-5 years, is $5. 4 million - $9 million.

Research Strategy Length. Page limits for the Research Strategy and Program Plan are specified in Section IV. Application and Submission Information of this announcement.

Institutions/Organizations. Institutions/organizations listed in Section III. 1 are eligible to apply.

Project Directors/Principal Investigators (PDs/PIs). Individuals with the skills, knowledge, and resources necessary to carry out the proposed research and training are invited to work with their institution/organization to develop an application for support. CDC does not make awards to individuals of PDs/PIs.

Only 1 PI is allowed for the NOFO. of Applications. Only 1 application is allowed.

PLEASE NOTE: Effective April 4, 2022, applicants must have a unique entity identifier (UEI) at the time of application submission. The UEI replaced the Data Universal Numbering System (DUNS) and is generated as part of SAM. gov registration.

Current SAM. gov registrants have already been assigned their UEI and can view it in SAM. gov and Grants.

gov. Additional information is available on the GSA website , SAM. gov , and Grants. gov-Finding the UEI .

Type. New, Renewal, Resubmission and Revision. Materials.

See Section IV. 1 for application materials. Impaired.

Telecommunications for the hearing impaired are available at: TTY: 1-888-232-6348. There are several options available to submit your application through Grants. gov to NIH and Department of Health and Human Services partners.

You must use one of these submission options to access the application forms for this opportunity. Use the NIH ASSIST system to prepare, submit and track your application online. Use an institutional system-to-system (S2S) solution to prepare and submit your application to Grants.

gov and eRA Commons to track your application. Check with your institutional officials regarding availability. Part 1.

Overview Information Part 2. Full Text of the Announcement I. Notice of Funding Opportunity Description Section II.

Award Information Section III. Eligibility Information Section IV. Application and Submission Section V.

Application Review Information Section VI. Award Administration Information Section VII. Agency Contacts Section VIII.

Other Information Full Text of Announcement Section I. Notice of Funding Opportunity Description Occupational Safety and Health Act of 1970, Section 20(a) and 21(a), 29 US Code 669(a) & 670 (a); Federal Mine Safety and Health Act, Section 501(a), 30 US Public Health Service Act, Section 301(a) and 405, 42 US 1.

Background and Purpose The United States Public Health Service (USPHS) is committed to achieving a society in which all people live long, healthy lives. The vision, mission, and goals are found in Healthy People 2030 , a USPHS-led national activity to achieve better health in the United States by the year 2030.

This Notice of Funding Opportunity (NOFO) is linked to the goals of Healthy People 2030, that are intended to prevent work-related diseases, injuries, and deaths while improving worker health, safety, and well-being. People 2030 , the health and well-being of the U.S. workforce is central to the strength of the economy. Because people spend so much time working, their work environment has a major impact on their health.

Many people get injured or die on the job, and develop health conditions from exposure at work, such as hearing loss, skin diseases and lung problems. Tailored interventions can help reduce work-related injuries, illnesses, and deaths, and promote worker The Occupational Safety and Health Act of 1970 mandates that NIOSH provide an adequate supply of qualified personnel to carry out the purposes of the Occupational Safety and Health Act.

NIOSH ERCs have a key role in meeting this mandate and contribute to the Institute’s core mission of preventing workplace injuries and illnesses. In 1977, NIOSH supported 9 ERCs in 9 states and 5 Health and Human Services ( HHS ) Federal Regions. Presently, NIOSH supports 18 ERCs across all 10 HHS Regions.

Over 20,700 individuals graduated from ERCs in the core and allied disciplines in occupational safety and health (OSH) from 1977 - 2023. As capacity in OSH practice and research has increased, the number and rates of work-related injuries, illnesses, and fatalities have decreased ( BLS, The far-reaching impact of the COVID-19 pandemic highlights the vital role OSH has in the United States and beyond.

From occupational exposures that led to illness and death to the mental and economic stressors the pandemic placed across individuals, workplaces and communities, ERCs responded rapidly to the needs of their students, staff and faculty and regional stakeholders by providing broad-based approaches to protection from the virus.

This included guidance on proper use and decontamination of personal protective equipment, respirator fit testing, social distancing for worksites, and the use of physical protective barriers. Many ERCs developed communication products, resource guides, online courses, and webinars on safe work practices during the pandemic.

ERCs will continue to train OSH practitioners and researchers with the knowledge and skills to respond to natural, man-made, environmental, and public health disasters.

Historically, ERCs have provided expertise in worker health and safety following events such as hurricanes (Katrina, Maria, and Harvey), the Deepwater Horizon oil spill, illicit drug exposures to law enforcement and emergency medical services, and Ebola and influenza outbreaks. ERC's responses have included outreach activities and research training opportunities that highlighted the expertise of ERC's faculty, staff, and trainees.

People 2023 and other National Strategic Priorities People 2030 , more than 160 million people participate in the U.S. labor force, and their work has an intrinsic connection to their safety, health, and well-being. Decades of public health surveillance and research have demonstrated that work-related injuries adversely affect employers, workers, and communities.

Workplace settings vary widely in size, sector, design, location, processes, culture, and resources. In addition, workers themselves have different ages, genders, education levels, cultural backgrounds, health practices, vulnerabilities, and levels of access to preventive health care. This translates into great diversity and disparity in the safety and health risks for each industry sector and the need for tailored interventions.

Work-related illnesses continue to have a significant public health impact, and part of NIOSH's mission is to train the next generation of OSH practitioners and researchers. Recent et al (2020 ) speaks to the 'rapid and profound changes in the future of work that will have significant implication for the education and training of OSH professionals and the workforce'.

NIOSH's network of ERCs is critical in developing OSH professionals prepared to respond to the changing nature of work. These changes are the result of technological advances, globalization, new and emerging risks, occupational health disparities associated with the changing demographics of the US workforce, climate and other factors.

The ERCs provide well-trained graduates and professionals for federal, state, and local government agencies; not-for-profit agencies; industry; academia; business; healthcare; and labor organizations. ERCs strive to improve the safety and health of workers across settings through training, research training, continuing education, and outreach.

ERC key personnel and trainees collaborate with stakeholders to develop innovative approaches to improving workplace safety and health, by the translation of Research to Practice through Design (PtD) . NIOSH ERCs translate scientific discoveries into practice through effective training, research, continuing education (CE), and outreach.

To learn more about the breadth and depth of NIOSH ERCs, visit NIOSH s ERCs are located in accredited academic institutions across the country. ERCs provide graduate, post-graduate degree and academic certificate training in core and allied disciplines of OSH. ERCs provide interdisciplinary research training to identify, assess, address, and improve OSH.

Through outreach activities ERCs engage communities to increase awareness in OSH. Through comprehensive, integrated programs, ERCs improve the safety, health, and well-being of our nation’s workforce. Assessment.

ERCs must document that their proposed academic, research training, CE programs and outreach programs meet specific regional or national workforce needs and demands. Surveys of employers, alumni, participants (from CE and/or Outreach activities), and other stakeholders may be used to document these needs. Presence.

As centers of excellence in OSH training, education, and research training, ERCs serve as valuable regional and national resources. ERCs should demonstrate collaborative efforts by working with a diverse and broad range of organizations, institutions, businesses, federal, state, and / or local public health and regulatory agencies, labor, worker advocacy groups and professional associations.

ERCs are strongly encouraged to engage diverse partners in their region and to facilitate synergistic Applicants must identify other ERCs, NIOSH-supported Training Project Grants ( TPGs ) and other NIOSH-supported centers in their HHS Federal Region , and describe how they will collaborate and build OSH capacity, while avoiding overlap of services. / Outcomes.

Centers may have different strengths, experiences, research training opportunities, capacities and focus areas on training, education, and outreach, but all should have objectives and outcomes that positively impact the US workforce. The objectives and outcomes should help NIOSH provide an adequate supply of highly qualified personnel to carry out the purposes of the OSH Act.

NIOSH ERCs have a key role in helping meet this mandate and contribute to the NIOSH’s core mission of providing leadership to prevent workplace injuries and illnesses. Population. Through the NIOSH ERCs a broad range of worker populations may be positively impacted.

The applicant should clearly describe the potential public health impact of their ERC through their academic training, outreach, continuing education, and research training (if / Partnerships. ERCs should have a regional presence through collaborations and partnerships with key stakeholders in OSH, such as professional associations, worker advocacy groups, businesses, industries, and public health agencies.

ERCs should work with other institutions and organizations, including Minority Serving Institutions (MSIs) and other NIOSH supported training programs to have a positive impact on worker health, safety, Measurement. Each ERC must have an Evaluation and Planning Core to carry out the specific aims and objectives of the ERC and plan for new, dynamic situations to promote worker health, safety, and well-being.

Evaluation activities should be center-wide and for each ERC component. The ERC should define the metrics that will be used to measure and track outputs and outcomes. Specific information on evaluation can be found at CDC's Office of Policy, Performance, and Evaluation.

Plan. When relevant to the goals of the ERC, applicants should describe how the findings and or training may be used to promote, enhance or advance the translation of the research into practice or may be used to inform public health policy to move the OSH field forward.

NIOSH has to Practice (r2p) approach to reduce or eliminate occupational illnesses and injury by increasing the transfer and translation of knowledge, interventions, and technologies into highly effective prevention practices and products in the workplace. Commitment. Institutional commitment and the sustainability of an ERC should be demonstrated.

While the stability of an ERC may be enhanced by an institutional commitment of full-time faculty and administrative staff (ERC Center Director, Deputy Director and Program Directors), NIOSH recognizes the changing nature of work in academia. Justification should be provided if key personnel (ERC Center Director, Deputy Director, and Program Directors) are not full-time employees of the institution.

Recognizing many Americans are working longer and enjoying productive work, NIOSH has not made succession planning for ERC leadership a requirement in this funding NIOSH funds may be used to defray the costs of salary support for faculty and staff directly related to ERC activities. Faculty salary support may not exceed 50% (. 50 FTE) for any one faculty member.

An exception is the CE Program Director. The CE Program Director may be faculty or administrative staff and may receive up to 75% salary support (. 75 FTE).

Salary support for administrative personnel is not limited but should be clearly justified and within a distribution of 70/30 with 70% of funds allocated for trainee costs and 30% allowed for trainee related costs, for ERC Leadership. ERC Leadership should plan to participate in annual meetings to foster collaboration and strong communication with NIOSH and other NIOSH-supported programs.

Center Directors should budget travel support for one meeting each year in the Evaluation and Planning Core budget. Program Directors for other components should include travel support for one meeting each year in their program's budget. Applicants may request up to $1.

8 million each year in total costs (direct and indirect costs). Indirect costs are limited to 8% of modified total direct costs as defined in 2 CFR 200. 1.

This is a training grant, and funds are not authorized for renovation of facilities. Requests for purchasing equipment must be strongly justified and shown to add to the success of the overall training objectives of More information on a complete application is provided in ERCs are comprised of required and optional components.

Required components are (1) Academic Training Programs, 2) an Evaluation and Planning Core, (3) a Continuing Education Program and, (4) an Outreach Program. Optional components include a Pilot Project Research Training Program and a Targeted Research Training Program. ERCs must provide high-quality graduate training in a minimum of three academic programs.

At least two of the Academic Training Programs must be in the disciplines of Industrial Hygiene (IH), Occupational Health Nursing (OHN), Occupational Medicine (OM), or Occupational Safety (OS). Applicants should clearly identify each academic programs as core or an allied Table 1 provides a summary of the funding information for the ERC required and optional components. 1.

Summary of ERC Components There is a required minimum of 3 Academic Training Programs. At least 2 academic training programs must be from the core disciplines of IH, OHN, OM, or OS. Additional academic programs may be in either a core or an allied discipline.

There should be no more than 10 academic programs proposed. Applicants may request support for allied disciplines which they determine are, and justify as being, closely related and relevant to their regional or national OSH training needs. No minimum number of trainees is required for any one academic program.

Applicants must fully justify the need for all programs and their capacity to meet training Applicants may request trainee support for academic certificate training programs in core and allied disciplines. Trainee support for academic certificate programs is limited to tuition and fees and is included in the minimum 70% allocation toward trainee direct costs.

Academic certificate trainees should be clearly identified in academic training A minimum of 70% of the Academic Training Programs' budget must go to trainee costs that provide stipends, tuition and fees, and travel. A maximum of 30% of the Academic Training Core budget may go to support training-related expenses that include salary support for faculty and staff, supplies, equipment, and non-trainee travel.

This 70/30 allocation of funding may be applied across all academic training programs in aggregate (core, allied and certificate programs) and need not be applied to each individual academic training program. This 70/30 allocation applies to direct and Planning Core includes Center Administration, Evaluation and Planning, Interdisciplinary Activities, Advisory Council, and Executive Committee.

Issues Program is optional under the Evaluation and Up to $280,000 direct costs / year Education (CE) Program supports activities that provide high-quality learning opportunities and professional growth to OSH practitioners and other allied disciplines. Up to $150,000 direct costs/year.

Program supports activities with businesses, community groups, worker advocacy groups, local, state, and federal agencies, or other institutions within the region to implement innovative strategies that meet area needs in awareness and positively impact worker health, safety, and Up to $75,000 direct costs/year.

Project Research Training Program supports pilot projects of new investigators from the applicant institution or other research institutions in the ERC’s region. Up to $100,000 direct costs /year; each funded pilot project may receive up to $20,000 for a period of 12-18 months.

Research Training Program supports the research training needs of trainees and students from other disciplines who receive NIOSH support during their academic training program. TRT funds may also be used to support post-doctoral training in an OSH core or allied Up to $300,000 direct costs/year. A minimum of 70% of requested funds must go to support trainee costs that provide stipends, tuition and fees, and travel.

Tuition and fees for post-doctoral trainees should be limited to coursework that enhances their learning experience. A maximum of 30% may go toward training-related expenses that include salary support for faculty and staff, supplies, and non-trainee travel. Centers will have different strengths, focus areas, experiences and capacities.

NIOSH ERCs are essential to moving the OSH field forward. Developing highly skilled and knowledgeable OSH practitioners and researchers to advance worker health, safety and well-being is crucial to address issues that are multi-regional, national, and global in scope. ERCs focus on the core OSH disciplines of IH, OHN, OM, and OS and must support at least 2 of the core disciplines through their academic training program.

Allied disciplines are also offered through many of the ERCs. Allied disciplines include, but not limited to, occupational health psychology, Total Worker Health, mining safety, agricultural safety and health, ERCs serve as resources for our nation's workforce through continuing education and outreach in their region.

ERCs have strong collaborations with professional associations, worker advocacy groups, businesses, industries and public health agencies. ERCs may also support research training programs through Pilot Project Research Training Programs and Targeted Research Training. ERCs conduct research on priorities in NORA and emerging issues.

The applicant must provide an overall description of the ERC addressing the burden of occupational injuries and illnesses within the region, the regional and national need to an ERC in their region and the ERC's impact or potential for impact to improve worker health, safety, and well-being. The narrative should address significance, investigators, innovation, approach, and environment.

Applicants may indicate this in the Research Strategy of their Training Programs (Required) Our nation’s workforce and workplaces are dynamic, with challenges that require solutions to eliminating and preventing work-related injuries and illnesses.

State-of-the-art approaches to training and education are encouraged to ensure that ERC graduates are well-equipped to respond to the ever-changing needs for protecting our nation’s workforce. NIOSH ERCs should provide high-quality graduate training in a minimum of three academic programs. At least two academic training programs must be in the core disciplines of IH, OHN, OM, or OS.

The other academic training programs may be core disciplines or allied disciplines relevant to the field of OSH. This should be clearly stated in the Overall section of the For each academic training program, the applicant should A documented need for the program. The Program Director’s qualifications in managing an effective academic training program.

The program’s curriculum, with core competencies that will fully prepare trainees to be effective and successful in OSH. The program’s faculty and their qualifications and history of success in OSH academic training, research, mentoring and/or practice. The program’s accreditation status (if applicable).

Graduates' experiences with career advancements including job placement and certifications earned (if applicable).

The program’s academic certificate program (if applicable), to include application process, curriculum, and completion and placement history; An evaluation plan to determine the program’s effectiveness and NIOSH funding may be used to support OM residents (OMR) in the following pathways, as described by The American Board of Preventive Medicine under Certification Requirements: Residency Pathway, Complementary Pathway, and Special Pathway.

Physicians in the Complementary and Special Pathways are eligible for NIOSH support to encourage more qualified physicians to enter the field of occupational medicine. The Complementary and Special Pathways must be administered by an occupational medicine program accredited by the Accreditation Council for Graduate Medical disciplines are important and relevant to the OSH field and in preventing work-related injury and illnesses.

As with core disciplines, training programs in allied disciplines should be approved plans of study by the institution.

These may include, but are not limited to, ergonomics, industrial toxicology and biomarkers, construction safety and health, occupational injury prevention, occupational epidemiology, occupational health psychology, occupational health services research, occupational health physics, Total Worker Health, mine safety, and agricultural safety and health.

Applicants may request support for allied disciplines which they determine are, and justify as being, closely related and relevant to their regional or national OSH training needs. Components. Academic training programs should have a history of attracting highly qualified and motivated applicants and of maintaining a critical mass of students for a viable, sustainable program.

Academic programs should have highly qualified faculty with a strong teaching record and history of independent research support or occupational health The academic training program curriculum should be comprehensive and fully prepare trainees to advance the OSH field. Occupational medicine residency programs must be fully accredited by the ACGME.

Accreditation of other training programs is not required but is encouraged if appropriate to the field (for example, ABET accreditation for engineering and industrial hygiene programs). An ERC may provide training in core or allied OSH programs for which needs are documented and available resources allow. This funding opportunity allows support for up to 10 academic training programs.

Each academic program should provide trainees with core competencies to be successful in their field of study. Clinical rotations and field experiences across settings are encouraged to provide trainees with a broad understanding of the working environment.

Applicants are also encouraged to consider non-discipline specific competencies (leadership, management, surveillance, strategic foresight, and communication skills), see Felknor, et al (2020).

NIOSH funding may be used to support graduate training in core and allied disciplines for advanced degrees at the master's and doctoral levels in relevant academic programs, including, but not limited to: MSN, MOH, MSPH, MPH, MS, DrPH, ScD, PhD, and DNP. NIOSH funding may also be used to support students in academic certificate programs in core and allied disciplines of OSH.

Undergraduate degrees and non-academic certificate programs are not authorized under this program. Academic Content. Trainees must be instructed in the responsible conduct of research .

NIOSH follows the NIH policies for this requirement.

Topics include research misconduct and questionable research practices; data management; scientific rigor and reproducibility; responsible authorship and publication; peer review; conflicts of interest in research; mentor/mentee responsibilities and relationships; collaborative science; civility issues in research environments, including but not limited to, harassment, bullying, and inappropriate behavior; policies regarding laboratory safety, biosafety, and human and animal research subjects; views about scientists as responsible members of society; social and environmental impacts of research; and contemporary ethical issues in Certificate Programs.

Academic certificate programs in core and allied disciplines at the graduate level may use NIOSH funds to provide trainee support for tuition and fees only. NIOSH certificate trainees must meet the admission requirements for the academic certificate program of the institution. NIOSH funds may not be used for stipends, travel, or other non-tuition expenses.

The certificate program must be described and recognized as a formal academic program by the applicant institution, with courses and experiences to enhance professionals' skills, knowledge, and practice in