Opportunity Information: Apply for RFA NR 11 008
Apply for RFA NR 11 008
- The National Institutes of Health in the education health sector is offering a public funding opportunity titled "Acute Life Threatening Conditions and Opportunities for Palliative and End of Life Care Research (R01)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.361 Nursing Research.
- This funding opportunity was created on Jan 11, 2011 and posted on Jan 11, 2011.
- Applicants must submit their applications by Apr 14, 2011. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $2,000,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $300,000.00 in funding.
- Eligible applicants include: State governments Others (see text field entitled Additional Information on Eligibility for clarification) For profit organizations other than small businesses Native American tribal organizations (other than Federally recognized tribal governments) Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education Small businesses Public housing authorities/Indian housing authorities Special district governments County governments City or township governments Public and State controlled institutions of higher education Native American tribal governments (Federally recognized) Independent school districts Nonprofits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education Private institutions of higher education.
- Other Eligible Applicants include the following Alaska Native and Native Hawaiian Serving Institutions Eligible Agencies of the Federal Government Faith based or Community based Organizations Hispanic serving Institutions Historically Black Colleges and Universities (HBCUs) Indian/Native American Tribal Governments (Other than Federally Recognized) Regional Organizations Tribally Controlled Colleges and Universities (TCCUs) U.S. Territory or Possession.
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Opportunity Summary:
The Acute Life Threatening Conditions and Opportunities for Palliative and End of Life Care Research (R01) funding opportunity (RFA-NR-11-008) is a National Institutes of Health grant announcement focused on improving how clinicians and researchers understand, predict, and respond to situations where an acute illness becomes life threatening, especially when it occurs on top of existing chronic disease or other risk factors. The central idea is that many patients do not reach the end-of-life phase through a single, straightforward disease path. Instead, they may experience a sudden acute event or complication that rapidly worsens their health, interacts with chronic conditions, and triggers complex palliative and end-of-life needs for both patients and caregivers. This initiative supports research that clarifies those pathways and produces practical tools and interventions to improve quality of life, care planning, symptom management, and caregiver support.
A major emphasis of the opportunity is identifying predictors and early warning signals that an acute illness is likely to progress toward severe, life-limiting outcomes. The announcement encourages studies that examine which patient factors, clinical features, comorbidities, or adverse health risk variables (for example, advanced age or other vulnerabilities) are linked to rapid deterioration, end-of-life concerns, and death. In addition to identifying predictors, applicants are encouraged to develop algorithms or other predictive approaches that can detect or estimate risk of adverse progression. In practice, this could include clinical decision support models, risk stratification tools, or analytic methods that help clinicians recognize when an acute episode is likely to shift from treatable to life-threatening, and when palliative or end-of-life care planning should be introduced.
Another key goal is understanding the burden created when acute illness is superimposed on chronic disease or other negative variables. The announcement highlights that acute conditions can amplify the severity of an underlying chronic disease, worsen prognosis, and intensify symptom distress, functional decline, and psychosocial strain. Research supported under this initiative is meant to capture the full burden of illness in these combined scenarios, not only in terms of medical outcomes and survival, but also quality of life and day-to-day functioning. It also calls for work that maps disease trajectories over time, meaning the patterns of decline, recovery, relapse, and transition that patients experience, and how these trajectories relate to covariates such as comorbidities, socioeconomic conditions, or access to services. Importantly, these trajectories are not only about the patient; the opportunity explicitly includes studying the evolving needs and experiences of caregivers who often carry substantial responsibilities during acute crises and end-of-life transitions.
The opportunity also underscores the complexity that arises from multifactorial causes and co-occurring conditions. It encourages research that identifies palliative and end-of-life issues that emerge specifically because two or more conditions or adverse variables interact, creating care needs that do not fit neatly within one disease specialty. This includes studying the medical, physical, and psychosocial interrelationships among disease status, symptom patterns, functional capacity, psychosocial well-being, and spiritual concerns, and how these domains influence both length of life and quality of life. In other words, the announcement is not limited to biomedical outcomes; it explicitly supports research that integrates symptom science, mental health and social dimensions, functional outcomes, and spiritual or existential concerns as meaningful components of serious illness and end-of-life experience.
A practical, action-oriented component of the initiative is the development and testing of palliative and end-of-life care interventions tailored to people who become severely ill due to an acute condition layered onto chronic disease or major risk factors. The intent is to move beyond description into solutions, including interventions that can be delivered in real-world settings to address symptom burden, communication and decision-making, care coordination, psychosocial and spiritual support, and planning for transitions across settings such as hospital, intensive care, nursing facilities, home care, or hospice. The announcement also specifically calls for research comparing patients whose progression to end-of-life is sudden with those whose decline is gradual. This comparison is important because sudden deterioration can leave little time for discussions about goals of care, advance planning, or caregiver preparation, and may involve different barriers, resource needs, and support strategies than a slower decline.
Caregivers are a defined focus throughout the opportunity. The announcement invites studies that examine the impact of acute life-threatening events and complex end-of-life trajectories on caregivers, identify caregiver needs, and test caregiver-focused interventions. That can include evaluating caregiver burden, stress, preparedness, mental health outcomes, and the effectiveness of supports that improve caregiver coping, knowledge, and capacity to provide care during high-acuity episodes and end-of-life phases.
From an administrative standpoint, this is a discretionary NIH grant using the R01 mechanism, listed under CFDA 93.361 (Nursing Research). The program did not require cost sharing or matching. The total estimated funding amount was listed as 2,000,000, with an award ceiling of 300,000. Key dates in the posted notice included a posted and creation date of January 11, 2011, an original and current closing date of April 14, 2011, and an archive date of May 15, 2011. Eligibility was broad and included a wide range of organizations such as state and local governments, tribal governments and tribal organizations, public and private institutions of higher education, nonprofits (with and without 501(c)(3) status), for-profit organizations (including small businesses), independent school districts, public housing authorities, and special district or regional organizations. The eligibility text also explicitly referenced categories such as faith-based and community-based organizations, eligible federal agencies, U.S. territories or possessions, and institutions serving specific populations (for example, HBCUs, Hispanic-serving institutions, Alaska Native and Native Hawaiian serving institutions, and tribally controlled colleges and universities).
Overall, the grant opportunity is designed for research that connects prediction, trajectory mapping, and intervention development in the context of acute illness plus chronic disease or other vulnerabilities, with the explicit goal of improving palliative and end-of-life care for patients and strengthening supports for caregivers during some of the most medically and emotionally complex periods of serious illness.
Frequently Asked Questions (FAQs)
What is the funding opportunity RFA-NR-11-008?
RFA-NR-11-008, titled "Acute Life Threatening Conditions and Opportunities for Palliative and End of Life Care Research (R01)," is a National Institutes of Health (NIH) grant opportunity that supports research on how acute illnesses become life threatening, especially when they occur alongside chronic disease or other risk factors, and how palliative and end-of-life care can be improved in those situations.
What is the main purpose of this grant program?
The purpose is to improve understanding, prediction, and response when an acute illness rapidly worsens and creates complex palliative and end-of-life needs for patients and caregivers. The program emphasizes mapping pathways and trajectories, identifying predictors and early warning signals, and producing practical tools and interventions that improve quality of life, care planning, symptom management, care coordination, and caregiver support.
What kinds of clinical situations is this opportunity focused on?
The focus is on scenarios where a sudden acute event or complication occurs on top of existing chronic disease or other adverse health risk factors (such as advanced age or other vulnerabilities), causing rapid deterioration and potentially leading to life-limiting outcomes, end-of-life concerns, or death.
Why does the opportunity emphasize acute illness on top of chronic disease?
Because many patients do not approach end-of-life through a single straightforward disease pathway. An acute condition can amplify chronic disease severity, worsen prognosis, and intensify symptom distress, functional decline, and psychosocial strain. Research is encouraged to capture and explain this combined burden and its implications for palliative and end-of-life care.
What research themes are encouraged under this announcement?
The announcement encourages research that links three broad areas: (1) prediction (identifying predictors and early warning signals for adverse progression), (2) trajectory mapping (understanding patterns of decline, recovery, relapse, and transitions over time), and (3) intervention development and testing (creating and evaluating palliative and end-of-life care interventions suited to acute-on-chronic or high-risk scenarios).
What does the grant mean by "predictors" and "early warning signals"?
Predictors and early warning signals refer to patient factors, clinical features, comorbidities, or adverse risk variables that are associated with rapid deterioration, life-limiting outcomes, end-of-life concerns, or death. The program encourages studies that identify which factors are linked to these outcomes and how they can be recognized earlier in real-world care.
Are applicants encouraged to develop predictive tools or algorithms?
Yes. The announcement specifically encourages the development of algorithms or other predictive approaches to detect or estimate risk of adverse progression. Examples mentioned include clinical decision support models, risk stratification tools, or analytic methods that help clinicians recognize when an acute episode is shifting from treatable to life-threatening and when palliative or end-of-life care planning should be introduced.
What does "disease trajectories" mean in this funding opportunity?
Disease trajectories refer to the patterns patients experience over time, such as decline, partial recovery, relapse, and transitions across care settings or phases of illness. The opportunity encourages research that maps these trajectories and examines how they relate to covariates like comorbidities, socioeconomic conditions, or access to services.
Does the opportunity include outcomes beyond survival and medical endpoints?
Yes. It explicitly calls for capturing the full burden of illness in acute-on-chronic scenarios, including quality of life and day-to-day functioning, as well as symptom distress, functional capacity, psychosocial well-being, and spiritual or existential concerns.
How does the opportunity address multifactorial or co-occurring conditions?
The announcement highlights complexity arising from multifactorial causes and interacting conditions or adverse variables. It encourages research that identifies palliative and end-of-life issues that emerge specifically because two or more conditions interact, creating care needs that may not fit neatly within one disease specialty.
What types of interrelationships does the program want researchers to study?
It encourages studying medical, physical, and psychosocial interrelationships among disease status, symptom patterns, functional capacity, psychosocial well-being, and spiritual concerns, and how these domains influence both length of life and quality of life.
Does this opportunity support intervention development and testing?
Yes. A key action-oriented component is developing and testing palliative and end-of-life care interventions tailored to people who become severely ill due to an acute condition layered onto chronic disease or major risk factors.
What areas can palliative and end-of-life interventions address under this grant?
Interventions may address symptom burden, communication and decision-making, care coordination, psychosocial support, spiritual support, and planning for transitions across settings such as hospitals, intensive care, nursing facilities, home care, or hospice.
Does the grant encourage comparisons between sudden and gradual end-of-life progression?
Yes. The announcement specifically calls for research comparing patients whose progression to end-of-life is sudden with those whose decline is gradual, recognizing that sudden deterioration can leave little time for goals-of-care discussions, advance planning, or caregiver preparation and may require different support strategies.
Are caregivers included as a research focus?
Yes. Caregivers are a defined focus throughout. The opportunity invites studies that examine the impact of acute life-threatening events and complex end-of-life trajectories on caregivers, identify caregiver needs, and test caregiver-focused interventions.
What caregiver outcomes or needs are mentioned?
Examples include caregiver burden, stress, preparedness, mental health outcomes, and the effectiveness of supports that improve caregiver coping, knowledge, and capacity to provide care during high-acuity episodes and end-of-life phases.
What funding mechanism is used for this opportunity?
This is an NIH discretionary grant using the R01 research project grant mechanism.
What is the CFDA number associated with this announcement?
The opportunity is listed under CFDA 93.361 (Nursing Research).
Is cost sharing or matching required?
No. The announcement states that cost sharing or matching was not required.
How much total funding was estimated for this opportunity?
The total estimated funding amount listed was 2,000,000.
What was the award ceiling?
The award ceiling listed was 300,000.
When was the opportunity posted and when did it close?
The posted and creation date was January 11, 2011. The original and current closing date was April 14, 2011. The archive date was May 15, 2011.
Who was eligible to apply based on the announcement?
Eligibility was broad and included many organization types, such as state and local governments; tribal governments and tribal organizations; public and private institutions of higher education; nonprofits (with and without 501(c)(3) status); for-profit organizations (including small businesses); independent school districts; public housing authorities; and special district or regional organizations.
Does the eligibility language include specific institution categories and community organizations?
Yes. The eligibility text explicitly referenced faith-based and community-based organizations, eligible federal agencies, U.S. territories or possessions, and institutions serving specific populations, including HBCUs, Hispanic-serving institutions, Alaska Native and Native Hawaiian serving institutions, and tribally controlled colleges and universities.
What is the overall research goal of the program in plain terms?
The overall goal is to support research that helps clinicians and researchers recognize when an acute episode is likely to become life threatening (especially in high-risk or chronic disease contexts), understand how patient and caregiver needs evolve across complex trajectories, and develop interventions that improve palliative and end-of-life care and caregiver support during medically and emotionally difficult periods.
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