NARCH Research Areas

• National Heart, Lung, and Blood Institute (NHLBI)
• National Institute on Alcohol Abuse and Alcoholism (NIAAA)
• National Institute of Allergy and Infectious Diseases (NIAID)
• National Institute of Dental and Craniofacial Research (NIDCR)
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
• National Institute of Mental Health (NIMH)

National Heart, Lung, and Blood Institute (NHLBI)

Cardiovascular and Respiratory Research

NHLBI has a strong history of supporting research to document and intervene on health disparities among American Indians and Alaska Natives (AI/AN), including the Strong Heart Study, Pathways, Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN), the Stop Atherosclerosis in Native Diabetics Study (SANDS) and Community-Responsive Interventions to Reduce Cardiovascular Risk in AI/ANs.

The Strong Heart Study showed that many AI/AN communities bear a heavy burden of cardiovascular disease (CVD) and cardiovascular risk factors (e.g., obesity, diabetes) that could be reduced through effective interventions on modifiable risk factors. The high burden of disease will worsen unless behaviors and lifestyles affecting CVD risk can be changed. Prevalence of obesity in AI/AN communities is about 50 percent higher than in the U.S. general population, in which obesity is often described as being of epidemic proportions. AI/ANs are particularly vulnerable to Type 2 diabetes, a problem exacerbated by high rates of obesity. Diabetes prevalence is 3-20 fold higher among AI/ANs than in the general U.S. population. It is an important cause of coronary heart disease, cardiomyopathy, stroke, end-stage renal disease, non-traumatic amputation and vision impairment. Lipid abnormalities also are common in Type 2 diabetics, particularly high triglycerides and low HDL-cholesterol levels. Dyslipidemia and blood pressure can be improved by appropriate changes in diet and by increased exercise. CVD risk is also substantially improved by smoking cessation.

Attention to high stress levels, untreated sleep disordered breathing, short sleep duration and depression may be warranted, because of evidence that they may influence the health behaviors of interest. For example, poorer diet, higher smoking rates and physical inactivity are more prominent in those with high stress, sleep disorders or depression. These psychosocial factors also are associated with CVD progression in observational epidemiologic studies, and there is evidence from smaller clinical studies that they may affect mechanisms leading to CVD. NHLBI is interested in supporting research in AI/AN communities that promotes the adoption of healthy lifestyles and/or improves behaviors related to cardiovascular risk, such as weight reduction, regular physical activity and smoking cessation. These behaviors and lifestyles are known to affect biological cardiovascular risk factors, such as hypertension, dyslipidemia, obesity, glucose intolerance and diabetes. In addition, control of these risk factors by guideline-based use of antihypertensive, lipid lowering and hypoglycemic drugs can reduce their adverse consequences. However, these pharmacological interventions are often suboptimally utilized in AI/AN communities. NHLBI is interested in reducing cardiovascular disease mortality and morbidity in AI/AN, whether by lifestyle changes, drug interventions or combinations thereof.

Lifestyles characterized by sleeping less than 7 hours per night are associated with increased risk of CVD, obesity, diabetes and all-cause mortality. Insufficient sleep and poor sleep quality are associated with abnormalities in hypothalamic-pituitary axis function and behavioral stress. Sleep deprivation compromises vigilance, judgment, mood, emotional expression and other aspects of cognition increasing the risk of unstable patterns of behavior. The ability of sleep deprivation to enhance the encoding and recall of emotional (relative to neutral) memories may profoundly influence social interactions and stress. Insufficient sleep is associated with an increased risk of new onset substance abuse and relapse, and new onset depression and relapse. Intervention studies to assess the efficacy of improving sleep as part of a healthy lifestyle or assessing how improving sleep disorders could improve CVD outcomes would be of interest to NHLBI. Sleep disordered breathing appears to be 30-60 percent more common among American Indians than other racial and ethnic groups. Sudden infant death syndrome occurs 2.5 times more frequently in AI/AN children than in white children, and 2.0 times more frequently than in the U.S. population as a whole.

AI/ANs also have been documented to exhibit high rates of chronic respiratory disease. AI/AN adults have the highest asthma rate among single-race groups. Recent evidence suggests that 11.6 percent of AI/AN suffer from asthma. This is significantly higher than the national average of 7.5 percent, and much higher than every other single racial or ethnic group. Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, is the sixth leading cause of death from chronic disease for AI/AN men and the seventh leading cause of death for women. AI/AN have the second highest rates of cystic fibrosis following whites. One in 10,500 AI/AN has cystic fibrosis compared with one in 3,200 whites. Pueblo Indians and Zuni Indians have higher incidence than among other AI/AN tribes. NHLBI is interested in supporting research in AI/AN communities that includes studies of approaches to prevent chronic respiratory diseases in adults and children, to improve clinical delivery of efficacious treatments of chronic lung disease and their risk factors, improved methods of chronic lung disease self-management, studies to promote or maintain respiratory health or improved methods of rehabilitation for diseases of the lungs and airways, such as asthma, COPD, cystic fibrosis; sleep disordered breathing, occupational lung diseases and pulmonary vascular disease. NHLBI also supports research on cardiovascular, pulmonary and hematologic complications of HIV/AIDS.

In addition to these areas of research, NHLBI recognizes a unique and compelling need to promote diversity in the biomedical, behavioral, clinical and social sciences research workforce. NHLBI supports science education and the use of diversity supplements and other training mechanisms in all of its research studies to increase the interest in, and commitment to, biomedical research by underrepresented groups across the career spectrum. NHLBI expects efforts to diversify the workforce to lead to:

• The recruitment of the most talented researchers from all groups.
• An improvement in the quality of the educational and training environment.
• A more balanced perspective in the determination of research priorities.
• An improved capacity to recruit subjects from diverse backgrounds into clinical research protocols.
• An improved capacity to address and eliminate health disparities.

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

NIAAA has a history of excellence in supporting research on the impact of alcohol use on human health and well being. NIAAA aims to better understand the health risks and benefits of consuming alcohol, discover why it can cause addiction and increase the understanding of how alcohol use impacts normal and abnormal biological functions and behavior across the lifespan. NIAAA supports research in the biological and socio-cultural origins of why people respond to alcohol differently as well as effective prevention and treatment strategies that address the physical, behavioral and social risks that result from both excessive drinking, and underage alcohol consumption. NIAAA leads the national efforts to reduce alcohol-related problems by conducting and supporting alcohol-related research in a wide range of scientific areas including genetics, neuroscience, epidemiology, prevention and treatment. NIAAA seeks to advance the public health by translating and disseminating research findings to health care providers, researchers, policymakers and the general public.

NIAAA’s programs to address minority health and health disparities are intended to increase our understanding of the factors that contribute to ethnic differences in alcohol-related problems and to encourage and support research on minority health and health disparities.

NIAAA’s areas of research emphasis include:

• Epidemiology: Studies that examine detailed epidemiologic information on the patterns of alcohol use and alcohol-related problems; genetic and clinical epidemiology.
• Genetics: Research that explores population differences in genetics and alcohol metabolism in responses to alcohol.
• Prevention intervention research: Alcohol prevention research aimed at reducing the causes and consequences of high-risk drinking; multi level prevention strategies.
• Treatment and health services research: Treatment and recovery research; research on factors influencing the availability of alcohol treatment across different populations.
• Fetal Alcohol Spectrum Disorders (FASD): Studies that develop prevention approaches and assess the effectiveness of these approaches; understanding of the biological consequences of alcohol use on birth outcomes.
• Underage/College/Young Adult Drinking, including prevention and treatment interventions.
• Screening and Brief Intervention; especially translation of SBI to diverse populations.
• Psychosocial influences on drinking initiation, escalation, maintenance, dependence (e.g., social norms/networks, peer/family, violence, health equity, economics/policy).
• Comorbidity of alcohol use disorders with other substance use and mental health disorders.
• New methodologies (mobile health, sensors, ecological/mathematical modeling of multiple level processes).
• Chronic Disease/Nutrition.

For additional information please contact:

Judith A. Arroyo, Ph.D.
Minority Health and Health Disparities Coordinator
National Institute on Alcohol Abuse and Alcoholism
National Institutes of Health
5635 Fishers Lane
Bethesda, MD 20892-9304
Tel: 301-402-0717
E-mail: jarroyo@mail.nih.gov

National Institute of Allergy and Infectious Diseases (NIAID)

NIAID conducts and supports basic and applied research to better understand, treat and ultimately prevent infectious, immunologic and allergic diseases that threaten millions of human lives globally.

NIAID has long recognized that racial and ethnic differences affect susceptibility to infection and disease. For example, Native Americans experience higher rates of meningitis and invasive bacterial disease from Haemophilus influenzae type B (Hib) than do other groups. Year after year, asthma has a disproportionate affect on inner-city populations, particularly among African American and Hispanic/Latino children.
NIAID is committed to research that helps reduce these and other health disparities. Its efforts have led to the development of better drugs for HIV/AIDS, vaccines that have almost eliminated Hib-related disease, and educational programs and other interventions to improve asthma control among inner-city children.

The NIAID research portfolio to help improve minority health and reduce health disparities has grown in recent years in response to new and continuing challenges related to infectious and immune-mediated diseases that disproportionately affect certain populations. NIAID’s strategic plan for fiscal years 2009 to 2013 identifies scientific priorities and areas of emphasis in research capacity, training and outreach to target populations, including racial and ethnic minorities, those of low socioeconomic status (SES) and rural communities that are more likely to suffer higher rates of disease incidence, prevalence, morbidity and mortality.

Current and Prior Research Areas Focusing on Native American and Alaskan Native Populations:

• HCV
• Systemic lupus erythematosus
• Pneumococcal infections
• HIV/AIDS
• Helicobacter pylori

Researchers are encouraged to submit projects within the NIAID scientific mission and priority areas listed below. For further guidance on proposed projects for consideration by NIAID, please contact: Diane Adger-Johnson at the NIAID Training Help Desk AITrainingHelpDesk@niaid.nih.gov:  Please label subject line NARCH.

Scientific Priorities:

• Advance understanding of the development and progression of diseases and conditions within NIAID’s research purview for which health disparities often are an issue. Read more about health disparities.
• Promote research to inform screening, diagnosis and interventions for target populations to determine how to triage various groups (e.g., persons who are immune-compromised, chronic carriers or more highly susceptible) for appropriate prevention, treatment and education strategies. Read about NIAID’s collaborative efforts to research immune tolerance disorders.
• Strengthen basic research and product development efforts to advance prevention, diagnostic and treatment strategies, including those aimed at developing new and more broadly protective vaccines. Read more about NIAID vaccine research.
• Identify innovative and practical approaches to access, enroll and study diverse populations in clinical and epidemiological research. Read more about clinical research at NIAID.
• Attract and develop the next generation of talented researchers to engage in basic, preclinical and clinical research with emphasis on scientists and clinicians who understand health disparities. Read more about NIAID-funded training programs.
• Enable the study of diseases that contribute to health disparities in the United States and take a tremendous toll on global health. Read about NIAID’s role in global research.
• Support and encourage collaborations among scientists and participation in the extensive network of international and domestic partnerships of scientists, governments, industry and non-government organizations to further develop and advance research capacity in the United States and in resource-poor nations. Read more about partnering with NIAID.
• Develop evidence-based health-related information that addresses risk factors as well as prevention, diagnosis and treatment strategies to reduce or eliminate immune-mediated and infectious diseases, and tailor the messages and the dissemination of materials to the communities and populations at highest risk for the adverse consequences of these diseases and conditions.

National Institute of Dental and Craniofacial Research (NIDCR)

Oral Health Research

NIDCR is committed to reducing the disproportionate burden of oral diseases experienced by AI/ANs. The focus of NIDCR's health disparities research is on improving oral health status and quality of life by understanding and addressing oral diseases that are prevalent in AI/AN communities, specifically caries (including early childhood caries), oral and pharyngeal cancer and periodontal disease. Interdisciplinary research teams and the full participation of communities are viewed by NIDCR as essential components of any health disparities research.

The paucity of quality data and conceptual models concerning the broad array of potential determinants and risk-factors inhibits progress toward preventing disease, and improving oral health status and quality of life. Little information is available for age groups other than children and even for children insight is needed into the etiology or determinants of oral disease and oral health particularly related to “upstream factors.” NIDCR invites applications that, in preparation for intervention research, explore the complex array of social, behavioral, psychological, contextual, environmental, systems and biological factors and their interactions that may contribute to oral health disparities within AI/AN community. Mixed methods research is encouraged. Applications that are limited to the assessment of disease prevalence and that explore a limited range of potential determinants will be considered non-responsive.

NIDCR has particular interest in intervention research that would provide essential information needed to inform clinical practice, public health policy, health care provision, community and/or individual action. Intervention studies that are grounded in theory are needed as well as research that tests new paradigms for prevention and care. Studies may need to intervene at multiple levels of influence such as policy, community, family and individual levels. NIDCR encourages the use of the strongest research design possible and recognizes that not all intervention research is amenable to randomized clinical trials.

If investigators plan to conduct randomized clinical trials, NIDCR requires that specific mechanisms must be used (not the NARCH mechanism). For information about the mechanisms to be used for randomized clinical trials please consult the information at   http://www.nidcr.nih.gov/ClinicalTrials/ToolkitClinicalResearchers/PoliciesGuidance.

Examples of health disparities intervention research that could use the NARCH mechanism that would be of interest to NIDCR includes, but are not limited to:

• Studies that intervene on common risk factors or that take a systems approach;
• Research that explores making the healthy choices the easiest choices;
• Studies that explore multifaceted strategies to intervene at several levels within society;
• Studies that tailor/target preventive approaches to communities/individuals;
• Research that explores alternative approaches to delivering preventive, restorative or therapeutic oral health care;
• Research that intervenes in novel ways on macro- or intermediate level determinants of oral health status;
• Dissemination and implementation research at multiple organizational levels;
• Studies that use new technology for translation, implementation, adoption, adherence and acceptance of oral disease prevention programs in defined populations, clinics and communities;
• Telehealth approaches to increase access to care and interventions or improve health literacy;
• Nesting oral health outcome measures in studies that address common risk factors with other diseases are welcomed.

Pilot research projects that are designed to lead to larger research projects funded as part of a center or as free-standing NIH grants may be proposed.

For additional information about oral health research please contact:

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

The NIDDK mission is to conduct and support medical research and research training and to disseminate science-based information on diabetes and other endocrine and metabolic diseases; digestive diseases, nutritional disorders and obesity; and kidney, urologic and hematologic diseases, to improve people’s health and quality of life. Many of the diseases in the NIDDK mission area disproportionately afflict AI/AN communities, and NIDDK has programs specifically directed at reducing and ultimately eliminating the disparities.

The Institute’s research interests are many and broad. The Division of Diabetes, Endocrinology, and Metabolic Diseases supports research, research training and career development related to a vast and diverse range of diseases and conditions, including diabetes mellitus, obesity, osteoporosis, cystic fibrosis, thyroid and other endocrine disorders, and metabolic diseases.

The diabetes program encompasses 25 diabetes research programs, including: Adipocyte Biology, Autoimmunity/Viral Etiology of Type 1 Diabetes, Behavioral/Prevention, Beta Cell Therapy, Clinical Islet Transplantation Consortium, Clinical Research in Type 2 Diabetes, Complications of Diabetes,Developmental Biology, Diabetes Centers, Drug Discovery, Endocrine Pancreas, Environmental Determinants of Diabetes in the Young , Genetics of Type 1 Diabetes, Genetics of Type 2 Diabetes, Glucose Sensors, Hypoglycemia in Diabetes, Insulin Receptor/Structure/Function/Action, Islet Transplantation, Molecular and Functional Imaging, Mouse Metabolic Phenotyping, Pharmacogenetics and Personalized Medicine in the Treatment of Diabetes, Prevention of Type 1 Diabetes, Type 1 Diabetes Clinical Trials, Type 2 Diabetes Clinical Trials, Type 2 Diabetes in the Pediatric Population.

The endocrinology research program includes Bone and Mineral Metabolism, G-Protein Coupled Receptors, Integrative Biology of Obesity, Intracellular Signal Transduction, Neuroendocrinology, Nuclear Receptor Superfamily, and Regulation of Energy Balance and Body Composition Research.

The metabolic diseases research program includes Cystic Fibrosis, Functional Metabolomics, Gene Therapy, Genomic Resource and Technology Development, Inborn Errors of Metabolism, Integrative Metabolism and Insulin Resistance, Intrauterine Environment, Key Regulators of Intermediary Metabolism, Metabolic Imprinting, Metabolomics, Technology Development Roadmap, Protein Trafficking/Secretion/Processing, Proteomics and Metabolic Diseases Research.

The Division of Digestive Diseases and Nutrition (DDN) supports research related to digestive diseases, including the alimentary tract, liver and pancreas, nutrition and obesity. The programs include basic, translational and clinical research. DDN also promotes public awareness and education about digestive diseases and related conditions, and oversees several national public awareness campaigns. Alimentary tract research programs include: Basic Neurogastroenterology, Clinical Trials in Digestive Diseases, Gastrointestinal and Nutrition AIDS, Gastrointestinal Development,Gastrointestinal Epithelial Biology, Gastrointestinal Host-Microbial Interactions, Gastrointestinal Inflammation, Gastrointestinal Motility, Gastrointestinal Mucosal Inflammation and Immunology, Gastrointestinal Transport and Absorption, Gastroparesis Consortium, and Genetics and Genomics of the Gastrointestinal Tract and its Diseases.

The Liver Disease Research Programs include: Acute Liver Failure, Autoimmune Liver Disease, Bile, Bilirubin and Cholestasis, Bioengineering and Biotechnology, Cell and Molecular Biology of the Liver, Childhood Liver Disease Network , Clinical Trials in Liver Disease, Childhood Liver Disease Network , Complications of Chronic Liver Disease, Developmental Biology and Regeneration, Drug-Induced Liver Disease, Fatty Liver Disease, Gallbladder Disease and Biliary Diseases, Genetic Liver Disease, Genetics and Genomics of Liver/Pancreas Diseases, Hepatitis B, HIV and Liver, Liver Cancer, Liver Cell Injury, Repair, Fibrosis and Inflammation, Liver Transplantation, Nonacoholic Steatohepatitis Network, Pediatric Acute Liver Failure, Pediatric Liver Disease and Viral Hepatitis and Infectious Diseases.

The Pancreas Research Programs include Gastrointestinal Neuroendocrinology, Pancreas Research and Study of Nutrition in Acute Pancreatitis .

The Obesity Research Programs include Bariatric Surgery Clinical Research Consortium, Clinical Obesity and Nutrition, Genetics and Genomics of Obesity, Lifestyle Interventions in Obese Pregnant Women, Lifestyle Interventions in Pregnancy Consortium, Obesity and Eating Disorders, Obesity Prevention and Treatment, Pediatric Clinical Obesity and Study of Health Outcomes of Weight-Loss.

The Nutrition Sciences Research Programs include Clinical Obesity and Nutrition, Clinical Trials in Nutrition, Genetics and Genomics of Nutrition, Nutritional Epidemiology and Data Systems and Nutrient Metabolism.

The Division of Kidney, Urologic, and Hematologic Diseases provides research funding and support for basic, translational and clinical research studies of the kidney, urinary tract and disorders of the blood and blood-forming organs. The division also provides funding for training and career development of people committed to academic and clinical research in these areas: Kidney Diseases Research Programs include Acute Kidney Injury, Basic Kidney Biology, Chronic Kidney Disease, Developmental Biology of the Kidney, Diabetic Kidney Disease, End-Stage Renal Disease, Genetics and Genomics, Inflammatory Kidney Disease, Kidney HIV/AIDS, Pediatric Kidney Disease, Polycystic Kidney Disease, Renal Diseases Epidemiology and research using data from the U.S. Renal Data System .

The Urological Diseases Research Programs include Basic Cell Biology of the Bladder and Prostate, Developmental Biology of the Urogenital Tract, Genetics and Genomics of Urology, Pediatric Urology, Urologic Diseases Epidemiology, Urology Basic Science, Urology Clinical Science, Urology HIV/AIDS, Urology Technology Development, Urology Women’s Health Studies and Urologic Diseases in America Epidemiology.

The Hematology Research Programs include Basic and Translational Hematology Research, Erythropoiesis and Hemoglobin, Genetic and Genomic Hematology Research, Hematology HIV/AIDS, Hematopoiesis and Hematopoietic Stem Cell Biology, Heme-Net program, Iron and Heme Metabolism, Iron Chelation and Stimulating Hematology Investigation: New Endeavors Program.

All of the disease areas listed above significantly impact the AI/AN communities. Through these research programs, NIDDK hopes to reduce the clinical impact they have on the communities.

National Institute of Mental Health (NIMH)

Burden of Mental Disorders and HIV/AIDS in Native American Communities

Mental Disorders: The CDC Health Disparities and Inequalities Report—United States, 2011, indicates that, when compared to the white population, Native Americans (NA), experience disproportionately higher rates of psychological distress, death by suicide and unmet mental health need (i.e., a greater  percentage of adults who did not receive mental health counseling or medication treatments). In 2006, suicide was the second leading cause of death for AI/ANs between the ages of 10 and 34. Violent deaths, unintentional injuries, homicide and suicide accounted for 75 percent of all mortality in the second decade of life for AI/ANs. Multiple factors contribute to the high rates of suicide among AI/AN populations, including individual-level factors (e.g., alcohol and substance misuse and mental illness), family or peer-level factors (e.g., family disruption or suicidal behavior of others) and societal-level factors (e.g., poverty, unemployment, discrimination and historical trauma—defined as the cumulative emotional and psychological wounding across generations). There is a paucity of empirical data on the incidence and prevalence of mental disorders, tools to pre-empt or prevent disorder, barriers to and facilitators of receipt of and retention in treatment and effective treatments for mental disorders among the various NA populations, nationwide.

NIMH encourages research projects that:

• Develop and test empirically informed preventive and therapeutic strategies.
• Study the effectiveness of strategies to improve the utilization, quality, outcomes and financing of mental health services for AI/AN populations in the settings where they are most likely to be seen.
• Empirically determine the most effective strategies for the scale-up and implementation of evidenced-based interventions that treat, pre-empt or prevent mental disorders and prevent suicide.
• Determine the most effective interventions for increasing engagement in mental health services across Tribes and geographic regions, taking into consideration cultural, workforce and service system factors.
• Test the effectiveness of existing mobile or IT interventions in delivering evidence-based mental health care to AI/AN populations.
• Explore which factors prevent mental disorders in persons at extreme social disadvantage.
• Develop and test strategies for detecting and treating co-occurring medical conditions in AI/AN people with mental illness.
• Develop and test empirically informed, culturally appropriate interventions for increasing engagement in mental health services across tribes and geographic regions.
• Explore novel use of mobile or IT-based interventions to improve the efficiency and reach of mental health services.

NIMH strongly encourages the establishment of collaborative research partnerships which will provide the researchers of NA mental health, the capacity to investigate multiple units of analysis across domains/constructs that moderate intervention effects (e.g., stress, distress, cognition, social processes).

HIV/AIDS: Even though Native American HIV/AIDS cases comprise less than 1 percent of total cases in the United States, NA communities are disproportionately impacted by the disease. NAs have a 40 percent higher rate of AIDS than non-Hispanic white Americans, and the AIDS rate among Native women is 2.8 times that of non-Hispanic white women. NA communities experience significant health disparities and face high rates of substance abuse and sexually transmitted infections, which increase the risk of HIV transmission. Several dimensions of the AIDS epidemic for NA groups are especially concerning including rapid  progression from HIV infection to AIDS-defining illness and low survival rates after AIDS diagnosis is made. Additionally, many NAs, like other Americans, do not know that they are infected and are therefore more likely to spread the disease. Relevant factors that place these individuals at risk and present barriers to prevention include poverty, high rates of sexually transmitted diseases, substance abuse, violence, stigma, denial and concern about confidentiality in smaller reservation and rural communities.

Because HIV infection is a continuing health crisis in indigenous people, research on NAs has been identified as one of the overarching research priorities of the FY 2012 Trans-NIH Plan and Presidential By-Pass Budget, section on Reducing HIV-Related Disparities (http://www.oar.nih.gov/strategicplan/fy2012). To reduce the impact of the HIV/AIDS epidemic among indigenous communities in the United States, NIMH/DAR-supported HIV/AIDS research in NA communities should have the following objectives:

• Rapidly expand the HIV prevention intervention portfolio for gay men and other high-risk vulnerable individuals from indigenous communities. 
• Identify mechanisms to explain differences in HIV-related disparities (e.g., factors like social/sexual networks, access to and quality of health care, characteristics of health biology).
• Develop and advance multilevel preventive intervention programs; address consequences of HIV; and incorporate community-based participatory principles that ensure bidirectional benefit and investment of community and the research team.
• Examine utility of combination behavioral-biomedical interventions and treatment as prevention approaches.
• Explore operations research to focus on barriers, facilitating factors and outcomes of scaling-up HIV prevention interventions with known efficacy; improve uptake and effectiveness of efficacious interventions.  

For these research objectives to be realized, it will be necessary to strengthen the workforce of HIV investigators from NA backgrounds through programs that develop a cadre of  investigators in NIMH/DAR priorities, http://www.nimh.nih.gov/about/organization/dar/aids-research-centers-program/aids-research-centers-program.shtml.

NIMH recommends, for both nonAIDS and AIDS, that applications that propose an adaptation to existing interventions should provide an empirical rationale for the need for and focus of the adaptation, consistent with NAMHC Workgroup Report recommendations on intervention adaptation (http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/reports/fromdiscoverytocure.pdf) and consult with relevant Institute program staff.

Scientific/Research Contacts:

Robert A. Mays, Jr., Ph.D. (nonAIDS applications)
National Institute of Mental Health
Tel: 301-443-2847
E-mail: rmays@mail.nih.gov

David M. Stoff, Ph.D. (AIDS applications)
National Institute of Mental Health
Tel: 301-443-4625
E-mail: dstoff@nih.gov