RFA: Cancer Health Equity Research Centers at Minority-Serving Institutions

Purpose  

The American Cancer Society (ACS) believes that everyone should have a fair and just opportunity to prevent, find, treat, and survive cancer (Alcaraz et al, 2020). Societal conditions where people are born, grow up, live, worship, and age, have a profound effect on their health status and their ability to access cancer care and to carry-out care recommendations (Alfano et al, 2020; Braveman 2017). This funding is intended to support the formation of Cancer Health Equity Research Centers (CHERCs) designed to target cancer health disparities that are unique to a local or regional community. We anticipate this funding will stimulate novel collaborations and approaches to mitigate societal risk factors and contribute to our goals for achieving health equity and reducing cancer mortality.

Background

Mark Your Calendar

Interactive Webinar to Learn More: 
May 20, 2021, at 2 pm EST; Webinar will be recorded and available upon request.

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Phone Conference ID: 609 872 047#

LOI Due Date: 
June 15, 2021, at 11:59 pm
See “RFA LOI Instructions

Addressing the root causes of cancer health disparities in the context of the social determinants of health is needed to accelerate progress in health equity research. This requires addressing obstacles to health caused by poverty and discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care (Alcaraz et al, 2020).

Cancer health disparities largely result from inequities in wealth leading to differences in exposures to risk factors and barriers to high‐quality cancer care (Siegel et al, 2021). Societal factors, such as structural racism, have downstream effects on the ability for some population groups to thrive. Discriminatory practices such as redlining impede access to home ownership and to a quality education, which impacts a person's level of educational attainment and employment, and thus, the degree of wealth. Interrelated factors of racism, discrimination, education, employment, wages, neighborhood, health insurance coverage, and access to care all intersect to impact health outcomes.

Ideally, everyone diagnosed with cancer should be able to receive high-quality cancer care (Yabroff et al, 2020). New cancer technologies and treatments can cause or exacerbate health disparities due to access or affordability barriers (Elmore et al, 2021). For example, being able to access a clinical trial offers the opportunity for people living with cancer to receive new therapies. However, even with access to protocol-directed care in clinical trials, high area-level socioeconomic deprivation is associated with worse survival (Unger et al, 2021). There is a critical need for research addressing tangible, impactful solutions for equitable access to high-quality cancer care and ways in which optimal outcomes can be achieved. 

Scientific Scope 

Due to the complexities associated with social determinants of health and cancer, multi-level and multi-sector research that addresses the interactions of factors responsible for cancer inequalities is required. This RFA is a call for minority-serving institutions (MSIs) to propose solution-based research addressing cancer health disparities that will contribute to achieving health equity. Thirty percent (30%) of the planned research participants must be racial and ethnic minorities or live in rural or medically underserved areas. Teams may propose collaborations with consortia of community hospitals and/or oncology practices, public hospitals, or other academic institutions or medical centers to accrue study participants. We encourage teams to collaborate with non-MSI institutions to increase their awareness of the specific needs and opportunities for solving cancer disparities that are unique to MSIs.

Areas of interest:  

Research topics could include:

  • Integration of social-determinants-of-health screening tools and interventions into practice, to ensure that the revealed needs are addressed and monitored;
  • Strategies to prevent diagnostic or treatment delays regardless of health insurance or socioeconomic status, geographic location, age, race, ethnicity, gender, gender identity, or sexual orientation; 
  • Strategies to increase participation of medically underserved populations in clinical trials;
  • Strategies to overcome barriers or promote facilitators of treatment adherence, and interventions to target care planning and coordination between teams of health care  professionals caring for people being treated for cancer. 

Who Should Apply

Investigators at an accredited college, university, or medical school, within the United States (in accordance with ACS grant policies) that is a Minority-Serving Institution (MSI). MSIs are institution of higher learning that serve minority populations, such as Historically Black Colleges and Universities (HBCUs), Hispanic-Serving Institutions (HSIs), Tribal Universities (TCUs), and Asian-American-and-Pacific-Islander-Serving Institutions (AAPISIs), and Alaska Native and Native Hawaiian Serving Institutions (ANNH). For more information see U.S.C. Title 20.

The Principal Investigator (PI): 

  • Must be full-time faculty at a federally designated MSI;
  • Must have attained the rank of Associate Professor or Full Professor; 
  • Must have a track record of: Extramural cancer research funding, mentoring junior investigators, publications in peer-reviewed journals, and administrative/leadership experience, i.e., deputy director or director of a program, center, or department.

Project Budget and Sub-Award Mechanism(s) 

A total budget of $4.08 M ($3.4 M direct cost plus 20% indirect cost) for a 4-year project period will support research, collaboration among researchers, training, and community  engagement. Subawards from this institutional block grant will then be awarded through the following ACS research grant mechanisms: Clinician Scientist Development Grant (CSDG), Postdoctoral Fellowship (PF), and Research Scholar Grant (RSG). This format will provide flexibility based on the research and workforce needs at the MSI. For example, a PI may propose 2 RSGs, 1 CSDG, and 1 PF or 2 RSGs, 1 CSDG, and 2 PFs or any other combination of subawards that collectively does not exceed the maximum budget allowed. Collectively, the CHERCs funding will facilitate new collaborations and support innovative research centered on a common goal of achieving sustainable health equity in your community.

  1. Clinician Scientist Development Grants (CSDGs) provide support for protected time to allow junior faculty who are involved with patient care to be mentored and participate in research training to aid their development as independent clinician scientists. Applicants are typically within the first 6 years of their initial faculty appointment and can request from 3 to 5 years, for a maximum $135,000 direct costs, plus 8% allowable indirect costs per year. See CSDG policies and instructions.
     
  2. Postdoctoral Fellowships (PFs) provide 2 or 3 years of support for investigators within 3 years of receiving a doctoral degree to receive mentored research and training experiences with the goal of becoming an independent investigator. The award covers annual stipend support of $52,000, $54,000, and $56,000 for the first, second, and third years, respectively. Fellows eligible for only 2 years may request progressive stipends of $54,000 and $56,000, respectively. See Post-doctoral fellowship policies and instructions.

    Note to PIs:
     Budget $4,000/year as a fellowship allowance and $1,500 for domestic travel in the last year for the PFs to present at a scientific conference. 
     
  3. Research Scholar Grants (RSGs) fund full-time faculty member (with a doctoral degree) for 4 years at $200,000/year (direct costs), plus 20% allowable indirect costs. For this RFA, faculty may be at any rank. The research must be multi-level and involve 2 or more social determinants of health. See RSG policies and instructions.

Letter-of-Intent Process  

A letter-of-intent (LOI) process will be used for selecting investigators to submit a full application. 

LOIs are required and must include the following: 

  • Name of proposed Cancer Health Equity Research Center (CHERC) 
  • Center PI Information (3 pages maximum): Full name, degree(s), title, department, institution name, mailing address, email address, telephone number, administrative assistant’s full name and email address 
  • Subaward PI Information: Names, titles, and institution affiliations
  • Overview of the Center and Research Subawards (2 pages maximum for each subawardee overview): Provide an overview of how the planned CHERC will address the unique, identified need(s) of your community. For each subawardee, provide the following: 
  • Research project title 
  • Brief overview of the research plan including specific aims and hypothesis, study design, inclusion/exclusion criteria for participation in the study, general data analysis plan, and the expected significance and impact 
  • Brief description about how the proposed research is aligned with the overall goals of the CHERC
  • Attachments (not included in page limit): NIH Biosketches are required for PIs of the center and subawards. 

Expectations for Full Application 

Those invited to submit a full application, will be provided details about the required components for the CHERCs to be developed and described in the proposal. This includes but is not limited to:

  • Establishing a mentor advisory board;
  • Establishing a community/stakeholder advisory board;
  • Developing strategies for translating research findings to the community;
  • An action plan for practical, clinical, and public health benefit and community engagement (i.e., implementation guide for equity).

Application Review

An independent and competitive peer review of grant applications will be conducted in October 2021. Reviewers will evaluate proposals based on:  

  • Importance of the scientific or clinical problem and clarity of the hypothesis
  • Strength of the experimental design, scientific rationale (could include preliminary data), investigators, scientific environment, and where applicable collaborations with a consortia of community hospitals, oncology practices, public hospitals, community partners, etc. Innovation and creativity 
  • Potential for the work, if successful, to positively influence the care of people being treated for cancer
  • Inclusion of at least 30% of study participants who are medically underserved or part of a population group with known health disparities, such as those characterized by age, race or ethnicity, religion, literacy, socioeconomic-status, mental health, disability, gender, sexual orientation, or gender identity, geographic location, or other characteristics historically linked to discrimination or exclusion.

key announcements and due dates

Invitation-to-Apply Date: July 12, 2021
Invitation-to-apply decisions will be communicated to applicants via ProposalCentral. That correspondance will include a link to the grant application and instruction materials posted on ProposalCentral. 

Full Application Due Date: September 7, 2021

Award Notification: October 27, 2021

Additional Questions: Please contact grants@cancer.org

References 

Alcaraz, KI, Wiedt T, Daniels ED, Yabroff KR, Guerra C, Wender RC. Understanding and Addressing Social Determinants to Advance Cancer Health Equity in the United States: A Blueprint for Practice, Research, and Policy. CA Cancer J Clin. 2020;70(1):31-46. 

Alfano CM, Leach CR, Smith TG, Miller KD, Alcaraz KI; Cannady RS, Wender RC, Brawley OW. Equitably Improving Outcomes for Cancer Survivors and Supporting Caregivers: A Blueprint for Care Delivery, Research, Education, and Policy. CA Cancer J Clin. 2019;69:35–49. 

Braveman P. A new definition of health equity to guide future efforts and measure progress. Health Affairs Blog Health Equity. 2017. 

Edwards H, Monroe DY, Mullins CD. Six ways to foster community-engaged research during times of societal crises. J Comp Eff Res. 2020;9(16):1101-1104. 

Elmore LW, Greer SF, Daniels ECD, Saxe CC, Melner MH, Krawiec GM, Phelps WC. Blueprint for Cancer Research: Critical Gaps and Opportunities. CA Cancer J Clin. 2021 Mar;71(2):107-139. 

Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33.

Unger J, Moseley AB, Cheung CK, Osarogiagbon RU, Symington B, Ramsey, SD, Hershman, DL. Persistent Disparity: Socioeconomic Deprivation and Cancer Outcomes in Patients Treated in Clinical Trials.  J Clin Oncol. 2021

Yabroff KR, PhD, Gansler T, Wender RC, Cullen KJ, Brawley OW. Minimizing the Burden of Cancer in the United States: Goals for a High-Performing Health Care System. CA Cancer J Clin. 2019; 69(3):166-183. 

Other Resources on Minority-Serving Institutions  

United States Department of Education Lists of Postsecondary Institutions Enrolling Populations with Significant Percentages of Undergraduate Minority Students

Minority Serving Institutions Program 

College Student Guide to Minority Serving Institutions

2020 NASA List of Minority Serving Institutions