Letters of Intent for this PCORI funding announcement were due Tuesday, February 14, 2017. Those selected to submit a full application were notified by Wednesday, March 15, 2017. Full applications were due Wednesday, May 17, 2017, by 5:00 p.m. (ET)

Table of Contents Summary Introduction Background Research of Interest Targeted Populations Priority Areas Community Health Worker and Navigator Projects

Summary

In this PCORI Funding Announcement (PFA), we seek to fund comparative clinical effectiveness research (CER) studies that evaluate and compare interventions to reduce or eliminate disparities in health and healthcare. Studies in the Addressing Disparities Program should focus on overcoming barriers that may disproportionately affect the outcomes of specific groups of patients or should identify best practices for reducing disparities.

Funds Available: $8 million

Maximum Project Budget (Total Direct Costs): $1.5 million

Maximum Research Project Period: Three years

Return to the Broad PCORI Funding Announcements page for key dates.

Introduction

The Patient-Centered Outcomes Research Institute (PCORI) invites applications for comparative clinical effectiveness research (CER) designed to evaluate interventions intended to reduce or eliminate disparities in health and healthcare. Patients and other stakeholders often lack the appropriate evidence required to make the best choices regarding prevention, screening, diagnosis, monitoring, or treatment. Applications to the Addressing Disparities Program should focus on overcoming barriers that may disproportionately affect health outcomes or focus on identifying best practices for reducing disparities in target populations (racial and ethnic minority groups; low-income groups; residents of rural areas; individuals with special healthcare needs, including individuals with disabilities; patients with low health literacy, numeracy, or limited English proficiency; and lesbian, gay, bisexual, and transgender [LGBT] persons).

Background

The health disparities literature has largely been devoted to describing disparities, including identifying their potential sources and drivers. Previous research has identified pervasive disparities in access to high-quality healthcare and worse health outcomes for specific populations across multiple conditions and multiple settings—outcomes that are based on race or ethnicity, gender, geographic location, socioeconomic status, disability, and other factors. These disparities have been well-documented. Thus, PCORI’s Addressing Disparities Program is seeking applications that compare evidence-based interventions to improve health outcomes and reduce disparities for target populations. (See the section below on Targeted Populations.)

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Research of Interest

PCORI seeks to fund studies that provide evidence to help guide decisions about how to eliminate disparities in health and healthcare, as well as how to ensure that people receive care according to their needs and have the opportunity to achieve the best-possible health outcomes.

The Addressing Disparities Program is interested in funding CER of evidence-based interventions aimed at reducing and eliminating disparities in health and healthcare. Interventions to reduce persistent disparities have been understudied and are multifactorial, complex, and context-specific. Often, evidence-based interventions have been shown to be effective in the general population, but lack evidence for effectiveness in populations at risk for disparities. The Addressing Disparities Program is interested in studies that tailor and test these types of interventions in these populations.

PCORI’s Addressing Disparities Program seeks to fund investigator-initiated research that:

• Compares evidence-based interventions to reduce or eliminate disparities in patient-centered outcomes (PCOs), including health, healthcare, and patient-reported outcomes—e.g., by accounting for possible differences at the patient, provider, or systems level. We are interested in research to determine which interventions can be most effective for eliminating disparities in outcomes.
• Compares benefits and risks of treatment, diagnostic, prevention, or service options, with a focus on eliminating disparities.
• Compares and identifies practices for tailoring evidence-based interventions to patient populations at risk for disparities.

PCORI strongly encourages applicants to review the funded research on our website to ensure that their proposed research is not duplicative of projects we have already funded.

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Targeted Populations

PCORI’s Addressing Disparities Program is interested in studies focusing on previously understudied populations for whom effectiveness information is needed. Proposed research must focus on at least one of the following groups:

• Racial and ethnic minority groups
• Low-income groups
• Residents of rural areas
• Individuals with special healthcare needs, including individuals with disabilities
• Patients with low health literacy, numeracy, or limited English proficiency
• LGBT persons

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Priority Areas

The Addressing Disparities Program is interested in applications that include team-based care or strategies to enhance family and caregiver involvement in patient care to reduce disparities and improve patient-centered and clinical outcomes. The Addressing Disparities Program is also interested in funding CER studies that focus on:

• Interventions to address disparities in human immunodeficiency virus (HIV) prevention and treatment
• Interventions to reduce sleep disorder disparities among racial and ethnic minorities
• Pharmacologic and non-pharmacologic treatments for Alzheimer’s disease and other forms of dementia
• Interventions to improve communication between clinicians and people with disabilities

Applications that cover any of these high-priority areas must also focus on one or more of the following Addressing Disparities target populations: racial and ethnic minority groups; low-income groups; residents of rural areas; individuals with special healthcare needs, including individuals with disabilities; patients with low health literacy, numeracy, or limited English proficiency; and LGBT persons.

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Community Health Worker and Navigator Projects

The Addressing Disparities Program has funded many projects focusing on community health worker and navigator interventions. Applications aiming to study these types of interventions must focus on one of the following areas, which are based on existing evidence gaps:

• Comparing different community health worker and patient navigator program models, worker functions, training and certification levels, and implementation approaches across different settings, conditions, and populations[1]
• Examining the integration of community health workers and patient navigators into the care team, determining specifically the organizational strategies and components that are essential to well-functioning teams and the factors that increase acceptance by care teams[2]

Applications that propose research focusing on community health workers or navigators as a primary component of interventions being studied will undergo substantial scrutiny to ensure that the studies do not overlap significantly with previously funded studies or concurrent applications, and that they fill a gap within the program’s portfolio. PCORI encourages applicants to review the current portfolio to avoid redundancy with funded projects.

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