Opportunity Information: Apply for RFA AG 13 003
Apply for RFA AG 13 003
- The National Institutes of Health in the health sector is offering a public funding opportunity titled "Secondary Analyses of Comparative Effectiveness, Health Outcomes and Costs in Persons with Multiple Chronic Conditions (R21)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.213 Research and Training in Complementary and Integrative Health 93.866 Aging Research.
- This funding opportunity was created on Aug 29, 2012 and posted on Jul 17, 2012.
- Applicants must submit their applications by Oct 11, 2012. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- The funding agency has allocated a total of $1,000,000.00 to eligible and selected applicants.
- Each selected applicant is eligible to receive up to $200,000.00 in funding.
- Eligible applicants include: For profit organizations other than small businesses Nonprofits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education Independent school districts City or township governments County governments Special district governments State governments Small businesses Private institutions of higher education Public and State controlled institutions of higher education Public housing authorities/Indian housing authorities Others (see text field entitled Additional Information on Eligibility for clarification) Native American tribal governments (Federally recognized) 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.
- 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 Non domestic (non U.S.) Entities (Foreign Institutions) are eligible to apply. Non domestic (non U.S.) components of U.S. Organizations are eligible to apply. Foreign components, as defined in the NIH Grants Policy Statement, are allowed.
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Opportunity Summary:
The grant opportunity titled "Secondary Analyses of Comparative Effectiveness, Health Outcomes and Costs in Persons with Multiple Chronic Conditions (R21)" (Funding Opportunity Number RFA-AG-13-003) is a discretionary NIH research grant administered by the National Institute on Aging (NIA). It is designed to support short-term projects that rely on secondary data analysis rather than new, primary data collection. In practical terms, applicants are expected to use existing datasets (for example, administrative claims, electronic health record extracts, cohort studies, registries, or prior trial data) to answer important real-world questions about how older adults fare when they live with multiple chronic conditions at the same time. The central theme is comparative effectiveness, meaning the work should help clarify which treatments or care strategies work best, for whom, and under what combinations of coexisting illnesses, while also considering safety outcomes and costs.
The scientific goals emphasize the complexity of treating older populations who often have two or more chronic diseases simultaneously. One major aim is to quantify the public health impact and economic burden associated with specific combinations of conditions within defined older populations. Rather than treating multimorbidity as a single broad category, the opportunity pushes investigators to focus on particular disease pairings or clusters (such as diabetes plus heart failure, COPD plus depression, or dementia plus chronic kidney disease) and then estimate how those combinations influence outcomes like hospitalization, disability, mortality, quality of life, health care utilization, and total costs. This includes highlighting which combinations drive disproportionate spending or poor outcomes and may therefore represent high-value targets for care redesign or policy interventions.
A second major aim is to identify differences in the effectiveness and safety of different treatment regimens for patients who share specific constellations of chronic conditions. Many clinical guidelines and trials are built around a single disease, but older adults with multiple conditions are frequently excluded from trials or underrepresented. This funding opportunity encourages analyses that compare treatment approaches in the messy reality of multimorbidity, such as comparing medication classes, combinations, intensities, or care pathways, and then evaluating whether outcomes differ depending on the presence of other conditions. The intent is to produce evidence that is more directly usable in real clinical decision-making where tradeoffs are common and the "best" treatment for one disease may not be best overall for a person managing several at once.
A third aim focuses on interaction effects: how the presence of one or more coexisting conditions may alter the safety or effectiveness of a treatment intended for a different condition. This goes beyond simply stratifying results; it is about understanding whether a comorbidity changes the risk-benefit profile of a therapy. For example, a treatment may be effective for the target condition but pose higher adverse-event risks or reduced benefit in patients with certain other illnesses, functional limitations, or frailty-related factors. The opportunity encourages applicants to examine these kinds of modifications so clinicians and patients can make more individualized choices, particularly when polypharmacy and competing risks are common.
A fourth aim is methodological and is explicitly called out as a priority: identifying and addressing analytic challenges that arise when studying multiple chronic conditions using existing data. This includes dealing with validity and limitations of datasets, outcome misclassification, incomplete capture of functional status, and the especially important problem of confounding by indication, where sicker patients are more likely to receive certain treatments and therefore appear to have worse outcomes even if the treatment is beneficial. Projects that tackle these issues might involve robust observational methods, sensitivity analyses, novel approaches to defining multimorbidity clusters, improved measurement of disease severity, approaches to handle time-varying exposures, or strategies to reduce bias when comparing treatments in non-randomized data. The overall expectation is that funded work will not only provide findings about outcomes and costs, but also contribute to stronger, more credible methods for doing comparative effectiveness research in complex older populations.
From an administrative and funding standpoint, this is an R21 mechanism, which is typically used for exploratory or developmental research projects that can be completed on a shorter timeline and with a more limited budget than larger R01 studies. The total estimated funding for the opportunity is listed as $1,000,000, with an award ceiling of $200,000. There is no cost-sharing or matching requirement. The program was posted July 17, 2012, with an original and current closing date of October 11, 2012, and an archive date of November 11, 2012, meaning it is a past opportunity but still useful as a reference for the kind of projects NIA has sought in this area.
Eligibility is broad and includes a wide range of organizations. Eligible applicants include for-profit organizations (other than small businesses), small businesses, nonprofits (including those with and without 501(c)(3) status), public and private institutions of higher education, independent school districts, local and state governments, special district governments, public housing authorities/Indian housing authorities, and tribal governments and organizations. The announcement also explicitly includes many institution types and community-serving organizations such as HBCUs, Hispanic-serving institutions, tribally controlled colleges and universities, Alaska Native and Native Hawaiian serving institutions, faith-based and community-based organizations, regional organizations, and U.S. territories or possessions. Foreign institutions are eligible to apply, and foreign components of U.S. organizations are allowed under NIH policy, signaling that the topic is considered globally relevant and that international datasets or collaborations could be appropriate if they address the program goals.
The opportunity is associated with CFDA numbers 93.866 (Aging Research) and 93.213 (Research and Training in Complementary and Integrative Health), indicating its alignment with aging research priorities while also allowing overlap with broader health research portfolios where relevant. The sponsor agency is NIH, with NIA as the inviting institute, and the official announcement link is hosted on the NIH grants site at http://grants.nih.gov/grants/guide/rfa-files/RFA-AG-13-003.html. For technical issues accessing or linking to the full announcement, the contact listed is the NIH Office of Extramural Research webmaster at FBOWebmaster@OD.NIH.GOV.
Taken together, the program is aimed at generating practical, decision-relevant evidence for older adults with multimorbidity by leveraging existing data sources. It is focused on understanding which combinations of conditions matter most, how those combinations shape treatment benefits and harms, what the cost implications are, and how to improve the rigor of observational and secondary-data methods so that findings are more trustworthy and applicable to real-world care.
Frequently Asked Questions (FAQs)
1) What is the title of this grant opportunity?
The opportunity is titled "Secondary Analyses of Comparative Effectiveness, Health Outcomes and Costs in Persons with Multiple Chronic Conditions (R21)."
2) What is the Funding Opportunity Number (FON)?
The Funding Opportunity Number is RFA-AG-13-003.
3) Which agency and institute administer this grant?
This is an NIH discretionary research grant administered by the National Institute on Aging (NIA).
4) What type of grant mechanism is this?
This uses the NIH R21 mechanism, which is typically intended for exploratory or developmental projects that can be completed on a shorter timeline and with a more limited budget than larger awards such as R01s.
5) What is the overall purpose of the funding opportunity?
The purpose is to support short-term research projects that use secondary analyses of existing data to answer real-world questions about comparative effectiveness, health outcomes, safety, and costs for older adults living with multiple chronic conditions.
6) Does this opportunity support primary data collection?
The opportunity is designed around secondary data analysis rather than new, primary data collection. Applicants are expected to rely on existing datasets.
7) What kinds of data sources are expected for projects under this opportunity?
Projects are expected to use existing datasets such as administrative claims, electronic health record extracts, cohort studies, registries, or prior clinical trial data.
8) What does "comparative effectiveness" mean in the context of this grant?
In this context, comparative effectiveness focuses on clarifying which treatments or care strategies work best, for whom, and under what combinations of coexisting illnesses, while also considering safety outcomes and costs.
9) Who is the population focus for this opportunity?
The focus is older adults, particularly those living with two or more chronic diseases simultaneously (multiple chronic conditions).
10) How does this opportunity treat "multiple chronic conditions" as a research topic?
Rather than treating multimorbidity as one broad category, the opportunity encourages researchers to study specific disease pairings or clusters and evaluate how those combinations relate to outcomes, utilization, and costs.
11) What are examples of condition pairings or clusters that could be studied?
Examples mentioned include diabetes plus heart failure, COPD plus depression, and dementia plus chronic kidney disease.
12) What kinds of outcomes are relevant to study under this opportunity?
Relevant outcomes include hospitalization, disability, mortality, quality of life, health care utilization, and total costs, among other real-world outcomes tied to living with multiple conditions.
13) Is cost and economic burden part of the program priorities?
Yes. A major aim is to quantify the public health impact and economic burden associated with specific combinations of conditions, including identifying combinations that drive disproportionate spending or poor outcomes.
14) What is the first major scientific aim described in the announcement summary?
The first major aim is to quantify public health impact and economic burden for specific combinations of chronic conditions within defined older populations, including identifying high-impact combinations that may be targets for care redesign or policy interventions.
15) What is the second major scientific aim?
The second major aim is to identify differences in the effectiveness and safety of different treatment regimens for patients who share specific constellations of chronic conditions.
16) Why does the opportunity emphasize studying treatment effectiveness in multimorbidity?
Many guidelines and trials are oriented around single diseases, and older adults with multiple conditions are often excluded or underrepresented. This opportunity encourages work that reflects the real-world complexity of treating multiple conditions at once, including tradeoffs and competing risks.
17) What kinds of treatment comparisons fit the intent of this opportunity?
Examples include comparing medication classes, combinations, intensities, or care pathways, and then evaluating whether outcomes differ depending on the presence of other conditions.
18) What is the third major scientific aim?
The third major aim focuses on interaction effects, meaning how one or more coexisting conditions may alter the safety or effectiveness of a treatment intended for a different condition.
19) What does it mean to study "interaction effects" here?
It means examining whether comorbidities change the risk-benefit profile of a therapy, including situations where a treatment may help the target condition but could have higher adverse-event risks or reduced benefit for people with certain other illnesses or frailty-related factors.
20) Does the opportunity encourage individualized, decision-relevant evidence?
Yes. A core intent is to produce evidence that can be used in real clinical decision-making for people managing multiple chronic conditions, where tradeoffs, polypharmacy, and competing risks are common.
21) What is the fourth major aim, and why is it called out as a priority?
The fourth aim is methodological: identifying and addressing analytic challenges that arise when studying multiple chronic conditions using existing data. It is explicitly highlighted as a priority to improve the rigor and credibility of comparative effectiveness findings in complex older populations.
22) What analytic challenges are specifically mentioned?
Challenges mentioned include dataset validity and limitations, outcome misclassification, incomplete capture of functional status, and confounding by indication (where sicker patients are more likely to receive certain treatments, which can bias comparisons).
23) What is "confounding by indication" in the context of secondary data analyses?
It refers to a common bias in observational or non-randomized data where the reasons a patient receives a treatment (for example, being sicker) are also related to the outcome, potentially making the treatment look harmful or less effective even if it is beneficial.
24) What kinds of methodological approaches does the opportunity encourage?
Examples mentioned include robust observational methods, sensitivity analyses, novel approaches to defining multimorbidity clusters, improved measurement of disease severity, methods to handle time-varying exposures, and strategies to reduce bias when comparing treatments in non-randomized data.
25) What is the total estimated funding amount for this opportunity?
The total estimated funding listed is $1,000,000.
26) What is the award ceiling?
The award ceiling is $200,000.
27) Is cost-sharing or matching required?
No. The opportunity states there is no cost-sharing or matching requirement.
28) When was this funding opportunity posted?
The opportunity was posted on July 17, 2012.
29) What was the closing date for applications?
The original and current closing date is October 11, 2012.
30) Is this an active funding opportunity?
Based on the provided information, it is a past opportunity. It has an archive date of November 11, 2012, and is described as still useful as a reference for the types of projects NIA has sought in this area.
31) Who is eligible to apply?
Eligibility is broad and includes for-profit organizations (other than small businesses), small businesses, nonprofits (with or without 501(c)(3) status), public and private institutions of higher education, independent school districts, local and state governments, special district governments, public housing authorities/Indian housing authorities, and tribal governments and organizations.
32) Are community-serving or minority-serving institutions included in the eligible categories?
Yes. The announcement explicitly includes institution types and community-serving organizations such as HBCUs, Hispanic-serving institutions, tribally controlled colleges and universities, Alaska Native and Native Hawaiian serving institutions, faith-based and community-based organizations, regional organizations, and U.S. territories or possessions.
33) Are foreign institutions eligible?
Yes. Foreign institutions are eligible to apply.
34) Are foreign components of U.S. organizations allowed?
Yes. Foreign components of U.S. organizations are allowed under NIH policy.
35) What CFDA numbers are associated with this opportunity?
The opportunity is associated with CFDA 93.866 (Aging Research) and 93.213 (Research and Training in Complementary and Integrative Health).
36) Where can applicants find the official announcement?
The official announcement link is hosted on the NIH grants site at: http://grants.nih.gov/grants/guide/rfa-files/RFA-AG-13-003.html
37) Who is listed as the contact for technical issues accessing or linking to the announcement?
The contact listed is the NIH Office of Extramural Research webmaster at FBOWebmaster@OD.NIH.GOV.
38) What kinds of results does the opportunity expect from funded projects?
The overall expectation is that funded work will generate findings about outcomes and costs for older adults with multiple chronic conditions and also strengthen methods for comparative effectiveness research using secondary or observational data.
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