Exploratory/Developmental Surgical Disparities Research (R21) | PAR 16 392

FAQs: Exploratory/Developmental Surgical Disparities Research (R21) (PAR-16-392)

What is the Exploratory/Developmental Surgical Disparities Research (R21) opportunity (PAR-16-392)?

This is a National Institutes of Health (NIH) discretionary grant opportunity using the R21 mechanism. It is intended to spark early-stage, developmental, or exploratory research that improves understanding of disparities in surgical care and surgical outcomes, with a focus on generating foundational evidence and proof-of-concept findings.

What is the main purpose of this R21 funding opportunity?

The central purpose is to support research that explains why inequities occur across the surgical care continuum and that tests or refines intervention ideas that could reduce those inequities, especially for minority and other health disparity populations.

Who is the primary population focus of the FOA?

The FOA emphasizes minority and other health disparity populations. Projects are expected to center on understanding and addressing inequities affecting these groups in surgical care and outcomes.

What types of research does the FOA encourage?

The FOA encourages early-stage, developmental, or exploratory studies that move beyond simply documenting disparities and toward actionable solutions. This includes piloting new approaches, generating foundational evidence, and producing proof-of-concept results that could support larger, more definitive studies later.

Does the FOA want projects that only describe disparities?

No. A key theme is moving beyond describing disparities and toward actionable, multi-level solutions, including testing or refining interventions that could reduce disparities.

What does the FOA mean by the "surgical care continuum"?

Based on the description provided, the surgical care continuum includes phases such as timely surgical evaluation, treatment, and follow-up, and it also relates to differences in who receives surgery, when they receive it, the quality of care provided, and recovery outcomes.

What levels of factors should projects consider when studying surgical disparities?

The FOA encourages research that examines patient-level factors (for example: access barriers, comorbidities, language, trust, and adherence challenges) as well as institutional and health system factors (for example: policies, referral patterns, workforce composition, clinical workflows, resource availability, and quality improvement infrastructure).

What kinds of interventions are expected under this FOA?

Projects are expected to explore the effectiveness of clinical intervention approaches to address surgical disparities, while explicitly considering real-world delivery settings such as hospitals, surgical practices, and larger care networks. The FOA particularly values interventions that can be embedded within institutions and systems rather than relying only on individual-level behavior change.

What settings are considered "real-world" for this opportunity?

The FOA explicitly references real-world surgical delivery settings including hospitals, surgical practices, and larger care networks where referral patterns, workflows, resources, and quality improvement capacity can shape outcomes.

Why does the FOA emphasize multi-level solutions?

The FOA points out that disparities are shaped not only by individual patient circumstances but also by institutional and system conditions. Multi-level approaches are encouraged because policies, workflows, staffing, and resources can strongly influence whether patients receive timely, appropriate surgical care and follow-up.

What grant mechanism is used, and what does that imply for project scope?

This opportunity uses the NIH R21 mechanism. As described, it is geared toward generating foundational evidence, piloting new approaches, and producing proof-of-concept findings that could lead to larger studies later, rather than funding large, definitive trials.

What is the award ceiling for this opportunity?

The award ceiling listed is $200,000, which aligns with the relatively modest budget expectations for an exploratory R21 project.

Who is eligible to apply?

Eligibility is broad and includes many U.S.-based organizations and government entities. Eligible applicants include state, county, and city or township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations other than federally recognized tribal governments; public housing authorities and Indian housing authorities; nonprofit organizations with or without 501(c)(3) status (excluding institutions of higher education in those nonprofit categories); for-profit organizations other than small businesses; small businesses; and other unspecified eligible entities.

Are organizations focused on health disparities specifically highlighted as eligible?

Yes. The FOA explicitly highlights applicant types aligned with its disparities focus, including Historically Black Colleges and Universities (HBCUs), Hispanic-serving Institutions, Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, regional organizations, eligible federal agencies, Indian/Native American tribal governments other than federally recognized entities, and U.S. territories or possessions.

Can non-U.S. (foreign) institutions apply as the applicant organization?

No. Non-domestic (non-U.S.) entities (foreign institutions) are not eligible to apply as the applicant organization for this opportunity.

Can a U.S. organization include a non-U.S. component as part of its application?

Non-domestic components of U.S. organizations are not eligible to apply as components. However, the FOA indicates that foreign components are allowed as defined under the NIH Grants Policy Statement, meaning a U.S. applicant may include certain foreign elements if they are justified and compliant with NIH policy.

What is the difference between a "foreign institution" and a "foreign component" in this posting?

Based on the description provided, a foreign institution (a non-U.S. entity) cannot be the applicant. A foreign component may be included by a U.S. applicant when justified and compliant with NIH policy, even though the foreign institution itself cannot apply as the main applicant organization.

What category is this opportunity associated with?

From an administrative standpoint, this opportunity is categorized under Education and Health.

Which CFDA numbers are associated with this funding opportunity?

The opportunity is associated with multiple CFDA numbers: 93.307, 93.313, 93.395, 93.399, and 93.846.

What is the original closing date listed for this opportunity record?

The opportunity record shows an original closing date of January 24, 2018.

What is the creation date listed for this opportunity record?

The opportunity record shows a creation date of August 5, 2016.

What kinds of teams are this FOA trying to attract?

The FOA is aimed at teams that can bring together surgical expertise, disparities research methods, implementation or health services research perspectives, and partnerships with affected communities and care delivery organizations.

What kinds of outcomes or impacts is the FOA ultimately trying to improve?

The intent is to reduce inequities in who gets surgery, when they get it, the quality of surgical care they receive, and how well they recover. The FOA places particular attention on strategies that can be embedded within institutions and systems.