Measures and Methods to Advance Research on Minority Health and Health Disparities-Related Constructs (R01 Clinical Trial Not Allowed)

The purpose of this Funding Opportunity Announcement (FOA) is to support research that will advance the measurement and assessment of complex constructs relevant to minority health and health disparities.Research Objectives This initiative will support research to improve the measures and methods for complex social constructs that capture the lived experience of populations that experience health disparities. The NIH-designated U.S. populations with health disparities are racial and ethnic minority groups, sexual and gender minority groups, underserved rural populations, and socioeconomically disadvantaged populations of any race or ethnicity (https://www.nimhd.nih.gov/about/overview/). The objective of this initiative is to produce knowledge that can inform the field about the types of measurement approaches that may be most suitable for different health disparities-related research questions or specific populations, settings, or contexts. Projects are expected to examine the performance and utility of specific measurement and/or methodological approaches. Projects that simply use new or existing measures or methods to answer health disparities-related research questions, without examining their performance or utility, are not responsive to this FOA. Projects are encouraged to use multiple data sources across different levels and across multiple sectors when appropriate. However, because this initiative emphasizes capturing the lived experiences of individuals and populations, all projects are expected to include self-report measures or data in some way. Projects should also include relevant diversity (e.g., with respect to age, gender, race/ethnicity, socioeconomic status, sexual or gender minority status, and/or geographic region) in sampling, enrollment, and data analysis needed to advance health disparities and health equity research and interventions development. Examples of potential study designs include but are not limited to the following: Testing the validity and reliability of one or more new or existing measures within a single project. Developing and validating new measures of complex social constructs (e.g., structural racism) that are associated with health disparities and health inequities. Examination of psychometric properties and/or patterns of findings with different measures of the same construct across existing studies or datasets. Mixed-methods approaches including the integration of qualitative and quantitative data (e.g., research in which qualitative interviews or focus groups inform the development of quantitative measures) in which participants complete quantitative measures and provide their perspectives on the measures via cognitive interviews, or other qualitative strategies. Examination of measurement of cultural or construct equivalence or invariance across populations with health disparities and subpopulations within these groups such as recent immigrants or persons with disabilities. Examination of utility and feasibility of incorporating novel data sources to assess higher-level determinants of health and health disparities such as structural racism. Examination of ethical issues related to different measurement or analytic strategies, including understanding and mitigating potential risk from individual or group harm from data collection, analysis or dissemination. Examination of alternative methods for collecting data for these measures. Examination of novel analytic methods for exploring the interacting influences of factors associated with health disparities that are measured at different levels, across time, and/or across settings. Areas of Research Interest NATIONAL EYE INSTITUTE The mission of the National Eye Institute (www.nei.nih.gov) is to eliminate vision loss and improve quality of life through vision research. The NEI supports basic and clinical research into diseases and disorders of the visual system and the special needs of people with impaired vision or who are blind. The NEI encourages innovative applications that will advance innovative development of new measures and methods, or testing and adaptation of existing measures and approaches, to address health disparities and health inequities in the prevention, diagnosis, treatment and management of eye and vision conditions. NIMHD’s interests include, but are not limited to, the following: The lived experience of intersectionality, including self-identification, group affiliation, and multidimensional aspects of race and ethnicity as well as intersectional bias, stigma, and discrimination. Composite and cumulative exposure to adversity, including measures that encompass critical developmental periods, magnitude/frequency of exposure over time, and exposure and resilience across multiple levels and life stages. Measurement of protective and resilience factors, at both the individual (e.g., personality traits, psychological resources, behavioral skills) and sociocultureal levels (e.g., interpersonal, community, societal). The relationship between individual and higher-level determinants, including how neighborhood, community, and societal level determinants are associated with individual-level experiences, and in what circumstances higher-level social determinants can and cannot serve as proxies for individual-level determinants and vice versa. Advancing place-based indexes, composite measures and geocoded analysis, including best practices for clustering community and social level factors, level of granularity/area for specific purposes, ability to predict and explain health or health care disparities. Of interest are the extent to which these measures are predictive, and their usefulness in determining how structural racism and discrimination within regional or location specific conditions limit opportunities, resources, and power. Measurement of structural racism and discrimination, such as the facets, magnitude and cumulative effects of inequities in power, access, opportunities, treatment, and policy embedded in structures, institutions, and communities that contribute to inequities in health outcomes. Analytic methods to enable better understanding of the causes of health disparities, including identification of the causal pathways that connect the etiology (i.e., health determinants) with the effect (i.e., health disparities), especially with limited longitudinal data available. Advance analytic methods of small populations and population subgroups, including methods to analyze and interpret studies with large differences in population sample sizes (e.g., 100 vs 10,000). Methods are also needed to identify unique characteristics of population subgroups and within group heterogeneity. Development of culturally appropriate, unbiased health risk factors and outcome measures that are predictive across populations or tailored for populations. Testing and evaluation of accepted behavioral constructs in diverse populations to understand the science of behavior change in these groups. For example, measurement of behavioral intent is generally accepted as having a higher likelihood of actually doing this behavior although evidence in diverse communities is limited. National Cancer Institute The National Cancer Institute seeks applications that advance innovative development of new measures and methods, or testing and adaptation of existing measures and approaches, to address health disparities and health inequities in cancer prevention and control and survivorship. Applications of interest may include: Development, testing or adaptation of organizational, health system, and policy measures of structural racism, discrimination and SDOH. Advancement of measures and methods that facilitate development and testing of theories, models and frameworks that identify mechanisms by which Structural Racism influences cancer prevention and control outcomes at individual, interpersonal, healthcare, organizational and community levels. Advancement of methods and measures that facilitate development and testing of theories, models, and frameworks to identify when SDOH operate as moderators to multilevel or policy interventions and when a SDOH are/should be a target for interventions to reduce cancer health disparities. Approaches may consider the reinforcing and multi-sectoral influences of SDOH that may reinforce inequalities. Research to advance real-time/rapid assessment of SDOH measures and social risks that influence health behavior (e.g., diet, physical activity, sleep & alcohol) in multilevel interventions to reduce cancer health disparities and improve health equity. Research to develop, test, and validate measures to assess social determinants of health and other social factors (e.g., culture, power, trust, stigma, discrimination, intersectional identity) associated with cancer prevention and control outcomes using robust statistical approaches, such as exploratory factor analysis, confirmatory factor analysis, structural equation modeling, and analyses to assess within-group effects. Research to develop and validate pragmatic and actionable measures to identify or influence modifiable individual, social, community, or system factors that can reduce health inequities. Projects may include research to define and measure geographic units for area-based SDOH in diverse populations to improve cancer prevention and control. Research to validate new or existing measures of constructs associated with cancer health disparities (such as SDOH, social risk, community assets, culture, wealth, literacy). Approaches should include (but are not limited to) content, construct, convergent and discriminant reliability across and within populations experiencing disparities. Research to support the development of methods and measures that examine intersecting influences of healthcare access such as treatment costs, insurance coverage and out of pocket costs, geographic proximity to clinics, value of care, access to telehealth (e.g., technology and broadband access), and social topics such as clinician implicit bias. Integration of qualitative and quantitative research methods, in which qualitative methods are used to identify novel and emerging social and structural constructs contributing to health/ health disparities, and such knowledge is used to inform the development and validation of quantitative instruments to assess those constructs Apply stakeholder engaged approaches to identify and develop measures that are based on the interests and primary concerns identified by multiple groups, such as patients, providers, organizations, and communities, particularly for communities that are under resourced and small populations that have historically not been included in research or with whom measures have not been developed or validated in cancer prevention and control. Development of methods to examine individual and co-occurring factors associated with health inequities, such as demographic characteristics of patients and providers, geography, socioeconomic factors, and social constructs including implicit bias, overt and covert racism. Applications that advance the understanding of sleep disparities and how they affect cancer risk and/or cancer survivorship in underserved and marginalized populations, by developing or validating multidimensional sleep metrics, developing measures of cumulative sleep exposure , and integrating individual-level sleep metrics into a multilevel approach incorporating measurements of light, noise, and other personal, neighborhood or environmental intrapersonal and interpersonal influences on sleep behavior. National Institute of Environmental Health Sciences The mission of the National Institute of Environmental Health Sciences (NIEHS) is to discover how the environment affects people to promote healthier lives. The NIEHS seeks applications that advance innovative development of new measures and methods, or validation and adaptation of existing measures and approaches, to address the complex interplay of the physical, chemical, cultural, social, and built environmental factors that contribute to or exacerbate environmental health disparities. Applications of interest may include, but are not limited to: The use of mixed methods approaches that integrate qualitative and quantitative data collection methods and measures of factors that contribute to environmental health disparities, including how qualitative methods can inform the development and validation of quantitative surveys and instruments that evaluate these factors. Application and testing of methods and measures of SDOH, and structural racism and discrimination, to the study of environmental health disparities. Establishment of novel interdisciplinary collaborations (including, but not limited to, methodologists, behavioral scientists, exposure scientists, epidemiologists, bioinformaticians, biostatisticians, data scientists, social scientists) to incorporate concomitant chemical and built environmental factors with existing or developed measures of structural and individual racism into a multilevel assessment of environmental health disparities. Development, testing and adaptation of methods and measures that capture the lived experience of intersectionality to identify structural factors contributing to disproportionate exposures to chemical and non-chemical stressors at the community and individual level. Application of community engaged approaches to identify or develop measures that are based on the interests and primary concerns identified by multiple community stakeholders, such as parents, schools, organizations, and fence-line residents, particularly for communities that are under resourced and populations that have historically been combating environmental injustices and disparate rates of adverse health outcomes. Examination of the ethical issues related to methods and measurement approaches in the study of environmental health disparities, including issues around data harmonization and the collection of common data elements. Enhancement of existing place-based indices, environmental exposures models and geocoded data to account for social level factors, to explain environmental health disparities at the regional or community level. Of interest are the extent to which these measures demonstrate how placed-based structural racism and discrimination exacerbate environmental risk factors and/or limit protective factors. Novel use of SDOH and structural racism and discrimination methods and measures to guide the development of multi-level, evidence-based prevention and intervention strategies to reduce environmental health disparities. National Institute of Dental and Craniofacial Research NIDCR is interested in funding research that will advance measurement, analysis, and monitoring of social determinants of health that contribute to dental, oral, and craniofacial (DOC) health disparities and inequities within the U.S. population over time and across settings. To this end, NIDCR will support research to examine the performance and utility of measures and methodologic approaches to improve the measurement and assessment of social determinants of DOC health. Specific areas of research interest include but are not limited to: Examining approaches to measure, analyze, and/or monitor social and structural determinants of health affecting DOC health disparities and inequities in a population or across populations Elucidating intersectionality of social determinants of DOC health and their independent and synergistic effect on DOC health disparities and inequities within- and between-groups Examining methodologic approaches to analyze protective and resilience factors relating to DOC health disparities and inequities across a population and/or between subpopulations Examining the performance of measures to identify structural racism and discrimination and the impact on DOC health disparities and inequities among racial and ethnic minorities during the life-course Assessing the utility of geographic and area indices and analytical methodologies that inform DOC health care needs and the performance of DOC health systems in rural communities Assessing the utility and feasibility of using electronic health record (EHR) data to monitor DOC health disparities and inequities over time and/or across settings National Institute of Mental Health NIMH encourages research that addresses Institute priorities and is aligned with these recommended areas for domestic and global mental health research. Applicants may consider using the Research Domain Criteria (RDoC; https://www.nimh.nih.gov/research/research-funded-by-nimh/rdoc) approach in their work. Areas of interest include, but are not limited to: Applications on advancing methods for analyzing complex and dynamic systems that impact mental health disparities, including research on methods for estimating non-linear, dynamic, and time-varying relationships between SDOH and disparities in mental health service use, delivery and outcomes. Research on advancing methods for multilevel models examining mutable factors associated with disparities in mental health service use, delivery, and outcomes. Applications developing and/or refining methods for adequately powered analyses of mental health disparities experienced by smaller groups or subpopulations (e.g., when addressing intersectionality, conducting subgroup analyses) and low base rate mental health events (e.g., suicide deaths). Research to develop and validate measures and methods for expanding data capacity to appropriately represent disparities populations, incorporate SDOH, and reduce algorithmic bias in artificial intelligence and machine learning approaches for understanding risk and optimizing mental health care for populations with mental health disparities. Research to develop and validate measures and methods for integration of SDOH in health care decision-making processes and examine the impact of such integration on reducing disparities and achieving equity in mental health services outcomes. Research to develop or refine causal inference methods within quasi-experimental designs (e.g. General Causal Model, Directed Acyclic Graphs, Deterministic Structural Equation Models, Probabilistic Causal Models, Instrumental Variables), to address research questions addressing mental health equity for mental health disparity populations. Research to develop measures of quality of mental health care for mental health disparity populations. Development and validation of mental health measures that can be submitted to and endorsed by the National Quality Forum (https://www.qualityforum.org/map/) for use to advance equity and quality in mental health care as part of the Healthcare Effectiveness Data and Information Set (HEDIS; https://www.cms.gov/Medicare/Health-Plans/SpecialNeedsPlans/SNP-HEDIS) or as a quality indicator for the Centers for Medicare and Medicaid Services (https://www.cms.gov/). Metrics that elucidate mechanisms at the individual, community, and organizational levels that result in disparities in specific adverse mental health outcomes across the lifespan, especially those that can point towards therapeutic targets. Assessments of how structural racism and discrimination impact trajectories of mental health disorders across the lifespan, particularly focusing on sequential and integrative relationships across neural, behavioral, and environmental factors that lead to disparities in mental health outcomes. Measures that systematically and reliably quantify individual exposure to factors that drive mental health disparities, including rigorous, lifestage-appropriate, and repeatable measures of environmental and sociocultural factors like neighborhood effects, access to and quality of healthcare, food and resource security, intersectionality, and cultural beliefs. Research on measures and approaches to be used in basic studies in healthy populations of interest addressing mechanisms of complex social, cognitive, affective and behavioral functioning. National Institute on Aging (NIA) NIA supports research to understand health differences and health inequities associated with race, ethnicity, gender, environment, socioeconomic status (SES), geography, access, and sociocultural factors over the life course and their impact on aging processes, and aging-relevant outcomes including Alzheimer’s disease and Alzheimer’s disease related dementias (AD/ADRD). The goals of this initiative are to (1) identify the environmental, social, cultural, and behavioral factors that drive disparities in health, well-being, healthcare, and mortality; and (2) develop strategies to reduce or eliminate those disparities and promote active life expectancy and improve the health status of diverse midlife and older adults. NIA's Health Disparities Research Framework reflects levels of analysis researchers might consider across each of the four domains, refines the causal pathways, and further refines potentially adaptable targets for interventions. Additionally, the framework reflects priorities and investments made in this important aging research area. The framework could also facilitate researchers identifying relevant expertise needed to expand their team and ultimately accomplish the proposed study’s goals and objectives. NIA’s interests in PAR-22-072, “Measures and Methods to Advance Research on Minority Health and Health Disparities-Related Constructs” include, but are not limited to, development of, or enhancements to, measures or methods for assessing constructs related to minority health and health disparities, such as the following: Methods that capture composite and cumulative exposure to adversity, structural racism, and discrimination. Measurement of protective (and resilience) factors that contribute to (or buffer against) health disparities in AD/ADRD outcomes, at both the individual (e.g., personality traits, psychological resources, behavioral skills) and sociocultural levels (e.g., interpersonal, community, societal). Analytic methods to generate causal evidence from observational and non-clinical studies to inform the prevention and mitigation of health disparities in AD/ADRD and increase confidence in observational results as evidence of treatment efficacy or effectiveness in populations underrepresented in AD/ADRD research. Development of analytical tools to dynamically assess health and exposure to risk and protective factors across multiple timescales, including mobile technology-based measures that capture lived experiences in “real time,” without imposing undue burden, particularly for populations that experience health disparities. Development of analytical tools and methods to promote and support research on the impact of social factors on molecular, cellular, genetic, and physiological mechanisms underlying disparate outcomes in aging and age-related pathologies, particularly for populations that experience health disparities. Development of approaches that integrate qualitative and quantitative data collection methods and measures of diverse environmental factors (chemical, physical, built, etc.) with social and behavioral factors associated with aging and age-related neuro-pathologies, including AD/ADRD. Development and use of methods for integrating social and behavioral data with molecular, cellular, genomic, other -omic and biological data in epidemiological studies of aging and age-related neuro-pathologies, including AD/ADRD. Methods to harmonize measures and conduct analyses using longitudinal cohort studies with heterogenous representation of individuals across different health disparities populations using NIA's Health Disparities Research Framework (i.e., across levels of analysis). Applications Not responsive to the FOA: Projects not conducting measurement and methodologic research, Projects conducting primary data collection outside of the U.S., and Projects that are exclusively qualitative. Non-responsive applications will not be reviewed. Applicants are strongly encouraged to reach out to the relevant scientific contacts to discuss whether their applications are responsive.