NSF Announces CREATIV Initiative: Merit Review by Program Officers

The National Science Foundation (NSF) has announced a new initiative to support "bold interdisciplinary projects in all NSF-supported areas of science, engineering, and education research." The acronym experts have devised for the new program is CREATIV: Creative Research Awards for Transformative Interdisciplinary Ventures.

CREATIV will feature a pilot grant mechanism under the Integrated NSF Support Promoting Interdisciplinary Research and Education (INSPIRE) initiative, which was announced in the FY 2012 budget request. NSF will accept proposals for the CREATIV program between December 1, 2011, and June 15, 2012.

CREATIV's distinguishing characteristics are: only internal merit review is required; proposals must be interdisciplinary and potentially transformative; requests may be up to $1,000,000 and up to five years duration.   NSF expects to spend up to $24 million in FY 2012 for these awards.

The CREATIV grant mechanism would support proposals on any NSF-supported topic. The award must have substantial co-funding from at least two intellectually distinctNSF divisions or programs. According to NSF, this means "that the project be interdisciplinary, in a manner that attracts support from multiple programs that extend beyond the scope of one field. The NSF organizational structure is not the primary determining factor, because some divisions cover multiple disciplines, and some disciplines are supported by more than one division." This is particularly true in the Social, Behavioral, and Economic Sciences (SBE) directorate, where geography and social psychology are in the same division, as are economics and sociology.

NSF strongly advises that principal investigators should discuss this issue with NSF staff early in the process, before committing significant effort to writing a proposal. This is important because before writing and submitting a CREATIV proposal, it is the principal investigator's responsibility to obtain written authorization to submit a CREATIV proposal by NSF program directors from at least two intellectually distinct divisions or programs. NSF also suggests that if two co-funding programs are from the same NSF division, it would be useful for the proposal to argue that the programs represent distinct disciplinary communities. NSF staff will judge whether a proposal meets the "intellectually distinct" criterion.

The proposal must integrate across multiple disciplines, as opposed to incorporating disciplinary contributions additively. It also must identify and justify how the project is interdisciplinary, for example by:

• Combining concepts/methods from multiple fields in new, surprising ways;
• Forming a new community from a union of communities that rarely interact;
• Proposing problem-driven research that requires a comprehensive and integrative approach to a grand challenge issue;
• Raising new fundamental questions or interesting new directions for research at the interface of disciplines; or
• Making major changes in understanding or use of existing concepts or methods to address complex phenomena.

Furthermore, the proposal must also demonstrate how the research is potentially transformative. This is done, according to NSF, by showing specifically how it fulfills at least one of the following characteristics:

• Challenges conventional wisdom;
• Leads to insights that enable new techniques or methodologies; or
• Redefines the boundaries among disciplines of science, engineering, or education.

Finally, the CREATIV proposal has to indicate its promise for societal benefit and how the project is better suited for CREATIV than for a regular NSF review process. For example, if the project is of such a high-risk nature that it could meet resistance from conventional reviewers, the researcher should explain and justify this assertion.

NSF expects to use multiple program directors from intellectually distinct programs to independently determine that the review criteria are met. Furthermore, an NSF-wide CREATIV management group must also agree that the recommending programs are committing substantial funds and are sufficiently distinct intellectually to make the proposal appropriate for the new program.

The Dear Colleague letter from NSF describing CREATIV is available at:

http://www.nsf.gov/pubs/2012/nsf12011/nsf12011.jsp?WT.mc_id=USNSF_25&WT.mc_ev=click.

Lipinski Ensures Social Sciences' Inclusion in Natural Hazards Risk Reduction Act of 2011

On November 15, the Subcommittee on Technology and Innovation of the House Science, Space, and Technology (SST) Committee, marked up and reported to the full committee, the Natural Hazards Risk Reduction Act of 2011. The bill provides reauthorization for the national earthquake hazards reduction program and the national windstorm impact reduction program.

According to Subcommittee Chairman Rep. Ben Quayle (R-AZ), "Both programs are targeted federal research and development efforts to mitigate the loss of life and property due to wind and earthquake related hazards." Rep. Donna Edwards (D-MD), Ranking Subcommittee member, also noted: "The best way to minimize the loss of lives and property caused by natural disasters, as well as reduce disruptions to our economy, is to create communities that are disaster resilient."

Social scientists have conducted much of the research in community resiliency. Recently at an NSF-sponsored event on Capitol Hill, former COSSA President and University of South Carolina geographer Susan Cutter (see Update, September 12, 2011), discussed her work on this topic.

In order to ensure that social science research is considered part of the legislation Rep. Dan Lipinski (D-IL), a Ph.D. political scientist, offered an amendment at the markup, which was accepted on a voice vote. Lipinski argued that "the social sciences are essential" and that "the results of social science research are used in the development of outreach and implementation efforts and in mitigation, response, and recovery activities."

The bill now moves to the full SST Committee for consideration.

DBASSE Holds Meeting on Teaching SBE Sciences in K-12 Education

In recent times, the role of the Social, Behavioral and Economic Sciences (SBE) in K-12 education has generated lots of discussion, reports that include and omit these sciences, and a concern that the "seamless integration of the sciences" articulated by NSF Director Subra Suresh at the COSSA 30^th Anniversary meeting (see Update, November 10, 2011), does not extend to pre-college Science, Technology, Engineering and Math Education (STEM).

On November 17-18 the National Academies' Division of Behavioral and Social Sciences and Education (DBASSE), directed by Robert Hauser, brought together about 85 people from the SBE community as well as folks from the other sciences and engineering to figure out what steps are necessary to advance the inclusionary goal for the SBE sciences in STEM pre-college education. Lorraine McDonnell, Political Scientist from the University of California, Santa Barbara and former President of the American Educational Research Association (AERA), and Christine Massey of the Institute of Cognitive Science at the University of Pennsylvania, co-facilitated the meeting.

After hearing from representatives of geography, psychology, economics, and sociology describe the efforts these disciplines have made in the K-12 curriculum, which mostly involved trying to get courses at the high school level, generating Advanced Placement exams, and attempting to convince State Education officials, who control curricula in K-12, that their subjects deserved more time in the school day, AERA Executive Director Felice Levine argued that the key is to integrate the SBE sciences into the teaching of science from pre-K through high school. She indicated that the SBE community in its sharp reaction to the exclusion of these sciences from the draft of the National Academies' Board on Science Education (BOSE), A Framework for K-12 Science Education (see Update, July 26, 2010), had developed ways to achieve that integration as well as providing a preliminary group of core standards for these disciplines.

One of the difficulties of trying to advocate for more inclusion of the SBE sciences in K-12 classrooms is the lack of knowledge of how much is actually occurring now. As Diane Massell of the University of Michigan pointed out, based on a paper she did with Carol Barnes, also of Michigan, the amount of state data is inadequate to draw many conclusions and that most of what passes for social science gets included in the social studies curriculum. From a limited data base of states, they suggested that most disciplinary attention within that curriculum is given to Political Science, but this is mostly civics and government; Economics, mostly how markets work and personal finance; and Geography.

The meeting heard how other disciplines - environmental education, engineering education, statistics, and earth science - had made their cases through long and systematic efforts to include them in the K-12 curriculum.   These efforts included state level alliances with key actors and other partners, including business and industry. It also called for nimbleness and adaptation to possible roadblocks from the educational establishment. Another difficulty cited is the emphasis, exacerbated by the No Child Left Behind law, on basic skills and assessments.

In moving forward, the SBE community acknowledged that there are difficulties ahead.   The BOSE document and the report from the President's Council of Advisers on Science and Technology that excluded the SBE sciences (see Update, September 27, 2010) as well as the continued influence of the Rising Above the Gathering Storm report, with its emphasis on the physical sciences and engineering, provide enough challenges. The domination of state K-12 education by the emphasis on social studies is another obstacle. Yet, representatives of the National Science Foundation and the National Institutes of Health indicated that their agencies are interested in this topic. The big questions are: are the states interested and can support come from those interested in improving the nation's education system like the Gates Foundation?

Hauser concluded the meeting by noting that DBASSE is willing to continue to explore further steps in reinforcing Director Suresh's notion of seamless science even at the K-12 level.

AAMC: Behavioral and Social Science Foundations for Future Physicians

"Many of the pressing health conundrums of contemporary society are particularly amendable to research inquiry based on the behavioral and social science model, ranging from seemingly intractable behavioral determinants of morbidity and mortality to patient safety and medical error reduction," notes the newly released Association of American Medical Colleges (AAMC) report, The Behavioral and Social Science Foundations for Future Physicians. The report "argues the case for how the perspectives and findings that flow from the behavioral and social sciences serve to prepare medical school graduates for comprehensive, patient-centered practice and provide the conceptual framework needed to address complex societal problems that have direct bearing on health and health care disparities." It is a companion report to the Scientific Foundations for Future Physicians.

The report is the result of a panel, convened by the AAMC, of physicians, scientists, and educators with expertise in the behavior and social sciences from U.S. medical schools. The panel identified key competencies in these areas for medical school graduates and prepared the report to help medical educators decide what to teach from the behavioral and social sciences in their curricula and how best to teach it.

Behavioral and Social Science Foundations for Future Physicians emphasizes that "A complete medical education must include, alongside physical and biological science, the perspectives and findings that flow from the behavioral and social sciences." Accordingly, the report 'recommends explicit tools and strategies for the medical education community to use in developing meaningful student learning experience and comprehension of human behavior to improve patient care and the health of the public."

It cites the "prominent" examples of reduced tobacco use and diet modification as the "significant improvements in the health of the public" generated by behavioral and social science research and practice. It also recognizes that that "more and more disease states cannot be addressed without attention to the behavioral or social factors that cause them, erect barriers against treating them, or can ameliorate or even cure them."

Echoing Norman Anderson's talk at the COSSA 30^th Anniversary meeting (see Update, November 10, 2011), the report also highlights the role of social and behavioral science in addressing health care challenges. It points to the fact that more than "50 percent of premature morbidity and mortality is caused by behavioral and social determinants of health: smoking, diet, exercise, and socio economic status." It is recognized in the report that "behavioral and social science knowledge and skills can support health and wellness, explain disease etiology, improve adherence rates to existing treatments, and develop new interventions." The report acknowledges the contributions of these sciences to basic and applied research, including: interactions of physiology and behavior; interventions informed by accurate knowledge of motivation; facilitating behavior change; understanding social forces influencing health behavior; policy interventions to promote healthful behaviors; health care system factors; and effective relationships with all health care providers.

Social and behavioral science contributions are "apparent in individual physician-patient relationships, as well as in complex systems of health care, social policies, and population health practices," the report notes. With regard to medical education, the report points out that these sciences are "also very important to understand the medical education process and professional context of medicine." Accordingly, the report presents a Behavioral and Social Science Matrix arraying applicable physician roles and behavioral and social science domains that can be used in the undergraduate medical education program to guide student learning.

Behavioral and Social Science Foundations for Future Physicians adopts the findings of two other reports it deems "credible and authoritative:" the Institute of Medicine's Enhancing the Social and Behavioral Science Content of Medical School Curricula (2004), and the Royal College of Physicians and Surgeons of Canada's The CanMEDS 2005 Physician Competency Framework.

IPCC Report on Managing Climate Change Adaptation Includes Human and Behavioral Factors

The Intergovernmental Panel on Climate Change (IPCC) has released a summary for policy makers of its Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation. The report assesses the scientific literature on issues that range from the relationship between climate change and extreme weather and climate events ("climate extremes") to the implications of these events for society and sustainable development. It notes: "The assessment concerns the interaction of climatic, environmental, and human factors that can lead to impacts and disasters, options for managing the risks posed by impacts and disasters, and the important role that non-climatic factors play in determining impacts."

The report is full of references to human activity and its role in creating climate change, human impacts of possible climate change disasters, and human needs for recovery and adaptation. The IPCC declares that: "Climate extremes, exposure, and vulnerability are influenced by a wide range of factors, including anthropogenic climate change, natural climate variability, and socioeconomic development. Disaster risk management and adaptation to climate change focus on reducing exposure and vulnerability and increasing resilience to the potential adverse impacts of climate extremes, even though risks cannot fully be eliminated."

Under a section called Human Impacts and Disaster Losses, the report suggests a number of probable effects. First, changes in climate "have the potential to seriously affect water management systems." Second, there will be socioeconomic differences in future economic losses projected from climate change, but the IPCC indicates that more research is necessary to examine this phenomenon further. Third, the group is confident that tropical cyclones will increase and this will result in higher direct economic losses. Finally, climate change will likely "influence population mobility and relocation" with important effects on both host and origin communities"

The report also examines various scenarios across geographic regions. In looking at the probability of increasing heat waves in urban Europe, it notes that "factors affecting exposure and vulnerability include age; preexisting health status; level of outdoor activity; socioeconomic factors including poverty and social isolation; access to and use of cooling; physiological and behavioral adaptation of the population; and urban infrastructure." While risk management and adaptation strategies include public information on what to do during heat waves, including behavioral advice and the use of social care networks to reach vulnerable groups.

In any strategy for risk management, the report points out, that "a portfolio of actions to reduce and transfer risk and to respond to events and disasters, as opposed to a singular focus on any one action or type of action," produces a more effective response. Yet, the report suggests that creating international finance synergies to fund those responses has not been fully realized.

Conservation Options for Farm Policy Explored at Forum

On November 9, the Farm Foundation held a forum titled "Conservation Options for Future Farm Policy." Speaking were James Andrews, Iowa farmer; David DeGennaro, Environmental Working Group; Bruce Knight, Strategic Conservation Solutions; Ronnie Lee, Georgia farmer; and Patrick O'Toole, Wyoming rancher.

 Andrews began the forum by pointing out that farmers with limited incomes can still work towards conservation if they understand that it will increase productivity. He noted that the problem of absentee landlords and aggressive hired managers, which leads to abuse of resources, is actually down due to peer pressure. The majority of farmers are attempting to do the right thing these days, according to Andrews. He noted that dealing with government bureaucracy and repetitive forms can often make it difficult even for farmers who are trying to comply with conservation requirements; this bureaucracy has only gotten more difficult since the National Resources Conservation Service (NRCS) has been forced to reduce staffing. Andrews closed by noting that incentives work very well to encourage most farmers towards conservation, but there are some people that only respond to fines and other punishments. The government should create policies accordingly, he suggested.

DeGennaro called for conservation as a top priority. He also noted that with 25 different conservation programs, there is room for reducing costs by increasing efficiency. DeGennaro also voiced a concern many in the broad agriculture community have held in recent weeks: the so called "secret Farm Bill" currently being worked on by the House and Senate Agriculture Committees in an attempt to submit it to the Super Committee before its January deadline. He called this inappropriate and declared that the Farm Bill must be created though a transparent process with ample input from stakeholders.

O'Toole focused his attention on the loss of young farmers- a trend that has been dramatic and is clearly unsustainable. We need to send a clear message, according to O'Toole, to farmers through legislation or otherwise that we expect ample food to be produced, but we expect it done in a sustainable manner.

For more on this forum and the Farm Foundation, please visit their website here.

NIDDK Mentored Research Scientist Development Award

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Mentored Scientist Development Award (K01) (PAR-12-020) is designed to provide support and protected time (three, four, or five years) for an intensive, supervised career development experience in the biomedical, behavioral, or clinical sciences leading to research independence. The NIH Research Career Development program is designed to help ensure that a diverse pool of highly trained scientists is available in appropriate scientific disciplines to address the Nation's biomedical, behavioral, and clinical research needs.

NIDDK is seeking applications from advanced postdoctoral and/or recently appointed junior faculty (usually with a Ph.D.) in biomedical or behavioral sciences who are pursuing careers in research areas supported by the Institute. NIDDK will contribute $90,000 per year toward the salary of the recipient. The total salary requested, however, must be based on a full-time faculty or staff appointment. NIDDK will also contribute $25,000 per year toward the research development costs of the recipient. Indirect costs are reimbursed at eight percent of modified total direct costs.

Behavioral Interventions to Address Multiple Chronic Health Conditions in Primary Care

Recognizing that primary care providers (PCPs) face the ongoing challenge of engaging patients in decisions and behaviors that influence their daily well-being and long-term health outcomes, the National Institutes of Health Office of Behavioral and Social Science Research (OBSSR) along with the Institutes: Cancer (NCI); Heart, Lung and Blood Institute (NHLBI); Aging (NIA); Alcohol Abuse and Alcoholism (NIAAA); Drug Abuse (NIDA); Mental Health (NIMH); Nursing (NINR); are seeking research applications that propose to use a common conceptual model to develop behavioral interventions to modify health behaviors and improve health outcomes in patients with comorbid chronic diseases and health conditions.

The funding opportunity announcement (FOA), Behavioral Interventions to Address Multiple Chronic Health Conditions in Primary Care (PA-12-024), will support research in primary care that uses a multi-disease care management approach to behavioral interventions with high potential impact to improve patient-level health outcomes for individuals with three or more chronic health conditions. The need for this research was identified by a workshop organized by the Trans-NIH Integrated Health Strategies Working Groups designed to identify research priorities and gaps. The meeting highlighted the need for research on more effective methods for conceptualizing, triaging, and assessing health behaviors (e.g., adherence, mental health problems/disorders, diet and exercise, alcohol and substance abuse/dependence disorders and pain) in patients with multiple chronic health conditions.)

Applications are encouraged to include the following:

• Interventions should be practical and have potential, if successful, for implementation in primary care (e.g., in terms of cost of training, staff, office space and patient burden);
• Test a behavioral intervention in a primary care setting that targets health behaviors in three or more related chronic diseases or health conditions;
• The most rigorous design and methodology possible, given the populations and settings in which the study is taking place.  In some cases, randomization (by patient, clinic, or community) is possible and feasible; in others, randomization may not be possible, and other rigorous, but non-randomized designs (e.g., quasi-experimental) that are both internally and externally valid, may be necessary;
• Describe and justify the components of the intervention to be used;
• Researchers will elicit input from key stakeholders, including providers and consumers, to maximize implementation feasibility and sustainability potential;
• Specify eligibility criteria for the patients to be enrolled in the study;
• Specify the primary outcomes and how they will be measured;
• Assessment of health outcomes (e.g., blood pressure, cholesterol levels, BMI, viral load in HIV, or HbA1c) that should be affected by behavior changes;
• The design may include care management decision support tools to optimize medication management and disease care management activities;
• Applicants are encouraged to include measurement of the intervention characteristics and contextual factors that affect implementation (e.g., necessary personnel, training, feasibility, staff and/or leadership acceptance) and adoption.  

Applications may be submitted on January 5, 2012. For more information and/or to apply see the announcement at: http://grants.nih.gov/grants/guide/pa-files/PA-12-024.html.

Practical Interventions to Improve Medication Adherence in Primary Care

The National Institutes of Health (NIH) Adherence Network through the Office of Behavioral and Social Sciences Research (OBSSR), with participation from Cancer (NCI), Eye (NEI), Heart, Lung, and Blood (NHLBI), Aging (NIA), Deafness and other Communications Disorders (NIDCD), Diabetes and Digestive and Kidney Diseases (NIDDK), Mental Health (NIMH), Nursing (NINR), and the National Center for Complementary and Alternative Medicine (NCCAM) are seeking applications that propose practical interventions to improve adherence to medication. The Funding Opportunity Announcement (FOA) recognizes that adherence is inextricably connected to the efficacy of medical treatment regimens and therefore to health outcomes.

According to the FOA, Practical Interventions to Improve Medication Adherence in Primary Care (PA-12-022), adherence to a medication treatment regimen is a complex, multi-factorial behavior. It reflects individual behavioral factors such as cognitive functioning, health literacy, self-efficacy and motivation for self-care in addition to the nature of the condition and complexity of the treatment regimen and social factors such as the individual's relationships and access to social support. Additionally, whether a person adheres to medication recommendations also depends on successively larger spheres of influence, such as the patient-provider relationship and/or systemic and organizational factors associated with the health care system.

Finally, the FOA acknowledges that despite the last couple of decades, there is increased need for transformative research in this area. Accordingly, the announcement will support applications that propose to test interventions with the potential to significantly improve medication adherence behaviors in patients with chronic health conditions. 

Successful applications should:

• Justify that the approach to improve adherence behavior is feasible (e.g. practical and acceptable) and a potentially sustainable; that is, interventions, which if successful, have the potential to be widely implemented within the current health care system;
• Demonstrate an ability to identify and enroll representative participants with sub-optimal adherence;
• Be the most rigorous design and methodology possible, given the populations and settings in which the study is taking place.  In some cases, randomization (by patient, clinic, or community) is possible and feasible; in others, randomization may not be possible, and other rigorous but non-randomized designs (e.g., quasi-experimental) that are both internally and externally valid may be necessary;
• Assess and measure self-reported participant adherence outcomes as a function of the proposed intervention (i.e., did the program alter adherence behaviors?);
• Include a non-self-report measure of adherence, such as MEMS caps, pharmacy refill records, or pill counts;
• Include health outcomes or biomarkers (e.g., blood pressure, cholesterol levels, and viral load in HIV or HbA1c) that are expected to be affected by adherence changes. For diseases without identified biomarkers, such as, mental health disorders, inclusion of a clinical assessment (e.g., a medicine blood level, diagnostic interview or an independent clinician rating of the symptoms and behaviors), should be included. 

Additionally, to increase the potential for sustainability, applicants are encouraged to measure costs of the intervention as well as a characteristics and contextual factors that affect implementation and adoption (e.g., necessary personnel, training, feasibility, staff and/or leadership acceptance).

Applications may also include:

• Appropriate contextual factors in the patient's life - e.g., family, community, neighborhood, school, worksite, pharmacy, or other setting(s);
• The intervention may be population-based or  a more tailored approach (i.e., individualization based on patient characteristics, and/or directing intensive intervention to those either demonstrating or at-risk for worse adherence based on psychosocial, sociocultural or biological vulnerabilities such as depression, ethnic minorities or those living in poverty, genotype, or physical disability);
• Use technologies (e.g., cellular phone applications, wireless medication monitors) that might enhance adherence.

Potential study topics include, but are not limited to:

• Research testing innovative approaches for maintaining patient adherence to medication regimens through social or peer support, lay health worker delivered approaches (e.g., peer-led, patient navigator, or community health worker), and/or the integration of adherence monitoring/support within routine health care.
• Testing the efficacy of institutional-level interventions that target clinic or provider practice (i.e., health care policy, electronic medical record practices, or  physician, nursing and other health care and support staff) in order to promote patient adherence.
• Developing screening tools that will help identify individuals who are non-adherent and test targeted interventions to improve adherence, particularly in groups at high risk for non-adherence such individuals with cognitive impairment, complex medical conditions or regimens, psychiatric comorbidity, and/or substance abuse.  
• Studies which test the effectiveness and potency of adherence-promoting interventions that incorporate technological tools to target clinician behavior, patient behavior, both, and/or provider-patient interaction and feedback. For example, how can providers use specific technologies to monitor patient adherence when adding new medication or changing treatment regimens? What "real time" data (e.g., graphical feedback on medication use and any periodic tests that are needed) would providers want to collect in order to monitor adherence and intervene concomitant to the nonadherent behaviors of populations?
• Research to test developmentally and/or culturally appropriate medication adherence interventions among specific risk groups. For example, interventions to address racial and ethnic disparities in treatment adherence and outcomes or to target high risk age groups such as adolescents/young adults and the elderly.
• Studies of brief counseling or peer-led approaches to improving adherence in settings that deliver primary care.
• Research to test interventions that enhance health literacy and/or health numeracy to improve medication adherence in settings that deliver primary care.
• Research testing complementary and alternative medicine approaches to improving medication adherence.

Applications may be submitted after January 5, 2012. More information is available at: http://grants.nih.gov/grants/guide/pa-files/PA-12-022.html.