Re-Issue of NIDDK Translation R18 and R34

NIDDK has recently re-issued their translation research calls for the R18 and R34 mechanisms. It is strongly advised that you thoroughly read the new call and note that there have been some changes including the addition of a translation component to the review criteria:

Translation

Is the approach to be tested novel and/or significant in relation to its potential to meaningfully improve healthcare or public health?  Does the approach to be tested have the potential to reach and/or be generalized to a reasonably large segment of at risk individuals?  If the translation is to a new population, is the adaptation or modification to the evidence based approach directed toward meaningful differences between the target population and the population addressed in the clinical efficacy research? For example, does the proposed intervention address unique barriers or differences in lifestyle and beliefs?  Does the approach to be tested have the potential for wide dissemination and implementation at the conclusion of the research? Have the researchers justified the sustainability of the approach beyond the research period, including appropriate partnerships and consideration of cost and resources such as personnel and infrastructure? Is there a sufficient evaluation of the implementation costs in relation to sustainability and the health benefit achieved?

Translational Research to Improve Obesity and Diabetes Outcomes

(R18) PAR-12-172
http://grants.nih.gov/grants/guide/pa-files/PAR-12-172.html




Planning Grants for Translational Research to Improve Obesity and Diabetes 


Outcomes (R34) PAR-12-173
http://grants.nih.gov/grants/guide/pa-files/PAR-12-173.html

Benefits of approaches proven efficacious in clinical trials for diabetes and obesity are often not fully realized because the therapies are not implemented in many healthcare settings or communities. For example, it is well established that behavioral lifestyle interventions, with modest (5-7%) weight loss, can prevent or delay development of type 2 diabetes in individuals at high risk for the disorder.  Further, large clinical trials have demonstrated that glycemic control and cardiovascular risk factor modification can reduce the risk of diabetes complications.  Large controlled trials have also consistently demonstrated success in achieving weight loss though lifestyle approaches, although maintenance of weight loss remains a challenge.  Despite these advances, the efficacious interventions from these trials are rarely translated into widespread practice.  Often this is because they lack adaptation and testing to be feasible, acceptable, cost effective and sustainable outside of tightly controlled research settings and populations. Closing the gap between clinical efficacy research and adoption and application of these approaches in community and healthcare settings is a complex challenge but an important focus of necessary research to improve the health of the nation.

Research in response to this announcement must test sustainable, acceptable, and cost efficient adaptations of efficacious strategies or approaches prevent and treat diabetes and/or obesity.  Areas of research included in this FOA include:

• Testing innovative strategies to promote the implementation of evidence-based health practices within applied practice or community settings.  Examples include testing approaches designed to achieve more rapid medication intensification in patients with diabetes, improve adherence to diabetes medications and blood glucose monitoring, or increase adherence to screening guidelines such as screening for gestational diabetes, assessing body mass index in healthcare practice, or screening high risk individuals for type 2 diabetes.
• Testing novel adaptation, or translation, of evidence based interventions to evaluate effectiveness within applied practice or community settings.  Such evidence based interventions could include behavioral lifestyle counseling for weight management in both children and adults or diabetes self management approaches to improve adherence and tighten glucose control.
• Adaptations should retain core strategies from the evidence based intervention (e.g.        inclusion of both dietary and physical activity changes as well as core behavioral strategies for weight loss). Innovations in delivery frequency, intensity and/or modality are encouraged, particularly if they are aimed at overcoming barriers to wide implementation or unique barriers in high risk communities.  Amount of adaptation should be balanced with maintaining core elements of an evidence based approach.  A less expensive and more adoptable approach only benefits public health if it also achieves meaningful health outcomes.

All grant applications must specifically include a description of the tested approach’s capacity to address the following questions: 

a) Could it be applied to a significant number of at risk individuals? 

b) Could it be widely disseminated (widely adopted) and implemented (put into practice)? 

c) Would the approach be sustainable once the research is concluded?

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