The Broad PCORI Funding Announcements (PFAs) seek investigator-initiated applications for patient-centered comparative clinical effectiveness research (CER) projects aligned with our priority areas for research. This PFA covers the following four priority areas: Addressing Disparities; Assessment of Prevention, Diagnosis, and Treatment Options; Communication and Dissemination Research, and Improving Health Systems. Applications should address needs of patients, caregivers, clinicians, and other healthcare stakeholders in making personalized clinical decisions across a wide range of conditions, populations, and treatments.

These broad areas encompass the patient-centered comparative clinical effectiveness research we support. As our work progresses and we engage with a broad range of patients, caregivers, clinicians, and other healthcare stakeholders, we may develop additional national priorities for research.

In addition to these four priority areas, PCORI’s 2019 reauthorizing legislation provided additional direction about national research priorities to include research with respect to intellectual and developmental disabilities and to maternal mortality.

Special Areas of Emphasis

Beginning Cycle 3 2021, PCORI has identified two Special Area of Emphasis (SAEs) to support innovative, high-impact studies that fit clearly within our core mission of patient-engaged and patient-centered comparative clinical effectiveness research.  These SAEs are Telehealth for Chronic Disease Management among Vulnerable Populations with Complex Needs and Addressing Racism, Discrimination, and Bias in Healthcare Systems and Care Delivery.

Telehealth for Chronic Disease Management among Vulnerable Populations with Complex Needs

PCORI invites applications for comparative clinical effectiveness research of interventions to optimize telehealth for chronic disease management among vulnerable populations with complex needs. Applicants are encouraged to consider multisite and multi-health system studies (randomized controlled trials or well-designed natural experiments) as well as mixed methods designs to support the possibility of widespread implementation.

Comparisons may include different modalities of delivering telehealth (e.g., audio-only vs. video), integration of telehealth to optimize care delivery (e.g., different care delivery model elements delivered via telehealth for primary and/or specialty care), the role of support personnel to facilitate telehealth use (e.g., strategies involving the use of language translators), or different state policy interventions regarding telehealth (e.g., regulatory changes involving payment parity across states and impact on the accessibility of care and health outcomes).

Studies must include a focus on chronic disease management among vulnerable populations (elderly, rural, low income, racial/ethnic minorities, individuals with low health and/or limited digital literacy, those living in unstable circumstances, or those with limited English proficiency) and should be powered to detect differences in outcomes among one or more of these subgroups. Outcomes may include patient clinical or functional outcomes, health-related quality of life, quality of care, patient care experiences, access to care, clinician-reported outcomes, and/or healthcare utilization.

Addressing Systemic Racism, Discrimination and Bias in Healthcare Systems and Care Delivery

PCORI is allotting up to $20 million to fund comparative clinical effectiveness research on strategies to address interpersonal, organizational and/or institutional racism, discrimination and bias in healthcare systems and care delivery. In Cycle 3 2021, PCORI will focus on comparisons of multicomponent, multilevel interventions addressing racism and discrimination and bias based on race, ethnicity and/or nativity (e.g., country of birth and/or immigration status) in healthcare systems and care delivery. Interventions may include educational and psychosocial strategies to address interpersonal bias (e.g., cultural humility, structural competency, or anti-racism training/education for healthcare staff); institutional/organizational policies, practices, and processes (e.g., equity-based standard protocols, clinical algorithms, decision-making support tools, accountability dashboards, or payment models; race/ethnicity/language-concordant care); and community-based interventions (e.g., community health workers, patient ombudspersons or patient advocates; social needs screening, referral, and service provision). Outcomes of interest include health outcomes; receipt of timely, evidence-based, respectful care; patient experience of racism, discrimination, or bias; patient satisfaction with care; patient engagement in care; healthcare utilization; care continuity; organizational performance relevant to equity; and social determinants of health. Subsequent funding cycles are anticipated to focus on discrimination and bias based on factors other than race/ethnicity/nativity.

The goal of calling out these SAEs is to encourage submissions to these priority areas, not to limit submissions to these topics only.