The Agency for Healthcare Research and Quality (AHRQ) seeks applications that develop and test strategies to improve the capacity of primary care and ambulatory care settings to provide evidence-based, patient-centered care for people who misuse opioids and other substances.
Donor Name: Agency for Healthcare Research and Quality (AHRQ)
State: All States
County: All Counties
U.S. Territories: American Samoa, Guam, Commonwealth of Puerto Rico, Commonwealth of the Northern Mariana Islands, U.S. Virgin Islands
Type of Grant: Grant
Deadline: 04/14/2023
Size of the Grant: $625,000
Grant Duration: 4 years
Details:
The purpose of this initiative is to support the development of scalable knowledge on how to increase the uptake of evidence-based interventions to prevent, diagnose, and treat SUD in the context of person-centered care delivered in primary care. The initiative will fund up to 4 projects to produce evidence on effective models of care and strategies to implement effective treatments that will lead to sustainable changes in care delivery and develop lasting partnerships between primary care and other care settings. Applicants will be required to describe the approach and strategies for implementation, how they will evaluate the intervention, how the intervention will improve health equity, and plans for sustainability.
Objectives
Applicants must describe the intervention and how it will be integrated into ongoing person-centered primary care, the SUD prevention or treatment need it addresses, preliminary data to support the feasibility of the intervention, document that it is currently underutilized, and explain why expanding its use in primary care would improve patient outcomes and achieve other goals such as equity, accessibility, and efficiency.
Their approach must address the following requirements:
- Identify the under-used evidence-based treatment(s) that are the focus of the intervention, models of care delivery that will be used, and their implementation strategies for increasing access to and effectiveness of SUD prevention, diagnosis and treatment in primary or ambulatory care settings. Describe strategies to increase the uptake of evidence-based treatments such as shared, collaborative, and stepped care models within primary care and define the support and partnerships that will be needed for success. In addition, discuss how the social, economic, and psychological factors that contribute to SUD might be addressed in the context of care delivery to improve outcomes as well as how these factors may differ across the life course. Discuss how the intervention will be delivered in consideration of whole person care, ongoing comprehensive primary care, including among those with multiple chronic conditions.
- Describe a theory of change, maturity model, or logic model depicting how the proposed project will improve patient outcomes, why primary care practices (and other necessary partners) would be interested in adopting the innovation, and the pathway to broader adoption (active initiatives to scale and spread, regulation, policy, and coverage).
- Describe the role of the primary care team and how the workforces (including non-medical staff such as community health workers and peer counselors) will be organized to support the intervention.
- Establish a process for stakeholder engagement in intervention design, implementation and evaluation. Stakeholders must be chosen with consideration for diversity and equity. Stakeholders should include:
- Patients or people with lived experience and/or family members of patients or people with lived experience
- Clinicians who would implement the evidence-based medicine (EBM)
- Organizations and institutions that have the power to sustain the intervention; these may include health systems, state government, state and local public health departments, payers, academic institutions, health professional associations and community-based organizations and social services agencies.
- Describe a plan for recruiting a sufficient number of practices, clinicians, or sociodemographically diverse patients for rigorous evaluation of results. Applicants are encouraged to partner with practices using innovative approaches to performance improvement including co-production of the intervention design and evaluation, evidence generation from practice-based data, rapid cycle evaluation and adaptive designs.
- Describe a plan for developing and testing the implementation strategy in primary care or other ambulatory care settings. The number of clinics must be adequate to demonstrate statistically significant changes in key outcomes and represent or overrepresent priority populations such as communities with high proportions of racial/ethnic minorities, rural areas and/or practices that serve sexual minorities. Applicants are encouraged to engage in pre-existing practice-based research networks or learning health systems.
- Describe a risk mitigation strategy to minimize the impact of the COVID pandemic on recruitment and data collection.
- Describe a mixed methods approach for evaluating the effectiveness of the intervention in terms of both implementation and impact on patient centered outcomes. Implementation should be assessed using a validated implementation model such as RE-AIM or CFIR, and should include internal and external costs for implementation and sustainment. Patient centered outcomes should be meaningful to patients and achievable within the study period. Follow up reporting on patient engagement in treatment should be long enough to support meaningful conclusions about the likelihood of sustained response. The evaluation plan should describe the quantitative and qualitative data that will be captured to help assess the effectiveness and impact of the implementation, data sources, data collection (including how and from where data will be collected), and analysis plan. Recognizing the challenges of designing and evaluating implementation interventions, applicants may apply a range of methods including agile design, adaptive trials, or rapid cycle evaluation approaches as well as methods drawn from complexity science.
- Develop a plan for sustainability of the intervention after the grant ends, including documentation that collaborations are in place to support continuation of the intervention once the research study has ended (if the evidence supports continuation). Describe how the implementation process and data collected will build the conditions for sustainment.
- Describe plans for sharing project progress, insights into the implementation, and/or findings from the evaluation. The plan must address dissemination to multiple stakeholder groups and should not be limited to peer-reviewed publications and presentations at the end of the project. The final report should also describe how the project could be replicated in other regions/practice groups.
Funding Information
The total costs (direct and indirect) for a project awarded under this NOFO will not exceed $625,000 in any given year and $2.5 million for the entire project period.
Project Period
The project period may not exceed 4 years.
Eligibility Criteria
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)
Local Governments
- State Governments
- County Governments
- City or Township Governments
- Special District Governments
- Indian/Native American Tribal Governments (Federally Recognized)
- Indian/Native American Tribal Governments (Other than Federally Recognized)
Federal Governments
- Eligible Agencies of the Federal Government
- U.S. Territory or Possession
Other
- 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
- Regional Organizations
Foreign Institutions
- 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.
For more information, visit Grants.gov.
