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NCI Funding Opportunities in NCI Funding Opportunities in Health Services and Outcomes Health Services and Outcomes ResearchResearch
Steven B. Clauser, Ph.D.Steven B. Clauser, Ph.D.
Chief, Outcomes Research Branch Chief, Outcomes Research Branch Applied Research ProgramApplied Research Program
Division of Cancer Control and Population Sciences Division of Cancer Control and Population Sciences http://appliedresearch.cancer.gov/http://appliedresearch.cancer.gov/
Academy Health Annual MeetingAcademy Health Annual MeetingWashington, DC June 9, 2008Washington, DC June 9, 2008
Session OutlineSession Outline Who We Are and What We Do Who We Are and What We Do
Organizational contacts and expertise Organizational contacts and expertise HSR priority areas related to key branch missionsHSR priority areas related to key branch missions
NCI Research Resources for Health NCI Research Resources for Health Services and Outcomes Research Services and Outcomes Research Investigators Investigators NCI Funding for HSR-related research NCI Funding for HSR-related research Potential research resources and consortia Potential research resources and consortia
connections for extramural investigators connections for extramural investigators
Funding Opportunities for Junior and Funding Opportunities for Junior and Mid-level InvestigatorsMid-level Investigators
Office ofCancer Survivorship
Dr. Julia H. Rowland
Office ofCancer Survivorship
Dr. Julia H. Rowland
Applied CancerScreening ResearchDr. Steve Taplin (Acting)
Applied CancerScreening ResearchDr. Steve Taplin (Acting)
Basic and Biobehavioral
ResearchDr. Paige McDonald
Basic and Biobehavioral
ResearchDr. Paige McDonald
Health Communicationand
Informatics ResearchDr. Bradford Hesse
Health Communicationand
Informatics ResearchDr. Bradford Hesse
Health PromotionResearch
Dr. Linda Nebeling
Health PromotionResearch
Dr. Linda Nebeling
Tobacco ControlResearch
Dr. Cathy Backinger
Tobacco ControlResearch
Dr. Cathy Backinger
Health Services andHealth Services andEconomicsEconomics
Dr. Martin BrownDr. Martin Brown
Health Services andHealth Services andEconomicsEconomics
Dr. Martin BrownDr. Martin Brown
OutcomesOutcomesResearchResearch
Dr. Steven ClauserDr. Steven Clauser
OutcomesOutcomesResearchResearch
Dr. Steven ClauserDr. Steven Clauser
Risk Factor Monitoringand Methods
Dr. Susan Krebs-Smith
Risk Factor Monitoringand Methods
Dr. Susan Krebs-Smith
Surveillance ResearchProgram
Dr. Brenda K. Edwards
Surveillance ResearchProgram
Dr. Brenda K. Edwards
Cancer StatisticsMr. David Stinchcomb
Cancer StatisticsMr. David Stinchcomb
Statistical Researchand Applications
Dr. Eric Feuer
Statistical Researchand Applications
Dr. Eric Feuer
Epidemiology andGenetics Research
ProgramDr. Deborah Winn
(Acting)
Epidemiology andGenetics Research
ProgramDr. Deborah Winn
(Acting)
Methods andTechnologies Branch
Dr. Mukesh Verma
Methods andTechnologies Branch
Dr. Mukesh Verma
Modifiable Risk FactorsDr. Britt Reid
Modifiable Risk FactorsDr. Britt Reid
Behavioral ResearchProgram
Dr. Robert T. Croyle(Acting)
Behavioral ResearchProgram
Dr. Robert T. Croyle(Acting)
Applied ResearchApplied ResearchProgramProgram
Dr. Rachel Ballard-BarbashDr. Rachel Ballard-Barbash
Applied ResearchApplied ResearchProgramProgram
Dr. Rachel Ballard-BarbashDr. Rachel Ballard-Barbash
DCCPS ORGANIZATION CHART
Office of the DirectorOffice of the DirectorDr. Robert T. Croyle, DirectorDr. Robert T. Croyle, Director
Office of the DirectorOffice of the DirectorDr. Robert T. Croyle, DirectorDr. Robert T. Croyle, Director
Host SusceptibilityDr. Mukesh Verma (Acting)
Host SusceptibilityDr. Mukesh Verma (Acting)
Clinical and Translational Epidemiology
Dr. Deborah Winn (Acting)
Clinical and Translational Epidemiology
Dr. Deborah Winn (Acting)
Revised 5/08
ARP STAFF EXPERTISE
Health Services Research
Cancer Screening
Outcomes Measurement
Cost-EffectivenessAnalysis
Health Disparities
Quality/Patterns of Care
Diet, Physical Activity, Tobacco
Energy Balance and Cancer
Risk Modeling
Genetics and Family History
http://appliedresearch.cancer.gov/about/staff/
Health Services and Health Services and Economics BranchEconomics Branch
The Branch’s mission: The Branch’s mission: Support, conduct, and coordinate research on Support, conduct, and coordinate research on
the dissemination of effective cancer-related the dissemination of effective cancer-related health services into community practice. health services into community practice.
Study demographic, social, economic, and Study demographic, social, economic, and health system factors as they relate to health system factors as they relate to providing preventive, screening, diagnostic, providing preventive, screening, diagnostic, and treatment services for cancer. and treatment services for cancer.
Improve cancer outcomes, reduce cancer-Improve cancer outcomes, reduce cancer-related health disparities, and reduce the related health disparities, and reduce the burden of cancer to patients, their families, burden of cancer to patients, their families, and society.and society.
HSEB carries out its mission HSEB carries out its mission by….by….
Monitoring cancer-related health services Monitoring cancer-related health services utilization and outcomes among individuals utilization and outcomes among individuals in the general population and among in the general population and among selected population subgroups; selected population subgroups;
Monitoring the dissemination and effective Monitoring the dissemination and effective delivery of cancer-related health services by delivery of cancer-related health services by community-based health care providers and community-based health care providers and health care delivery organizations; health care delivery organizations;
Assessing the role of economic factors Assessing the role of economic factors related to the equitable, efficient, and related to the equitable, efficient, and effective provision of cancer-related health effective provision of cancer-related health services; services;
developing and disseminating data resources developing and disseminating data resources to support policy-relevant researchto support policy-relevant research
http://healthservices.cancer.gov/about/http://healthservices.cancer.gov/about/
Outcomes Research Outcomes Research BranchBranch
The Branch mission: The Branch mission: Coordinate and sponsor research to Coordinate and sponsor research to
measure, evaluate, and improve measure, evaluate, and improve patient-centered outcomes of cancer patient-centered outcomes of cancer care delivery across the cancer care care delivery across the cancer care continuum. continuum.
ORB is particularly interested in ORB is particularly interested in morbidity and mortality outcomes, morbidity and mortality outcomes, patient symptoms and health-related patient symptoms and health-related quality of life, and patient experience quality of life, and patient experience of and satisfaction with health care.of and satisfaction with health care.
ORB carries out it’s mission ORB carries out it’s mission by….by….
Enhancing the state of the science of outcomes Enhancing the state of the science of outcomes measurement, especially patient-reported outcomes; measurement, especially patient-reported outcomes;
Assessing, monitoring, and enhancing patient-Assessing, monitoring, and enhancing patient-centered cancer care at all levels -- the provider-centered cancer care at all levels -- the provider-patient interaction, the health care organization, patient interaction, the health care organization, and the health care system;and the health care system;
Translating research findings into care delivery Translating research findings into care delivery products and strategies for use by public and private products and strategies for use by public and private decision makers, who provide, pay for, regulate, set decision makers, who provide, pay for, regulate, set standards for, and make personal decisions about standards for, and make personal decisions about cancer care; and cancer care; and
Evaluating innovative programs designed to improve Evaluating innovative programs designed to improve the effectiveness and efficiency of providing the effectiveness and efficiency of providing evidence-based practice throughout the cancer care evidence-based practice throughout the cancer care continuum. continuum.
http://outcomes.cancer.gov/http://outcomes.cancer.gov/
Health Services/Outcomes Research is Relevant Health Services/Outcomes Research is Relevant Across the Cancer ContinuumAcross the Cancer Continuum
• Obesity diagnosis and management
• Risk Assessment Communication/
Counseling • Cancer chemo- prevention
• Cancer Screening Recommenda-tions and Practices
• End-of-Life Care
• Use of Evidence-
Based Therapies• Pain Management
• Follow-up of cancer survivors
Prevention Detection Treatment SurvivorshipDiagnosis
• Risk Assessment (Cancer genetics)
• Timely Diagnosis and Referral
Cross Cutting Topics• Access to Care • Health Disparities • Economics of Cancer Care• Quality of Care • Quality of Life/Patient Centered Care
DCCPS Source of DCCPS Source of Funding and Expenditures Funding and Expenditures
(FY07)(FY07)
DCCPS
Cancer Control RPG Collaborations
In-house
6% IAA/MOUContracts
13%
RFA/PA32%
Investigator Initiated49%
Fu
nd
ing
So
urc
esE
xpen
dit
ure
s
Distribution of ARP Funding Distribution of ARP Funding Related to Health Related to Health Services/Outcomes Research in Services/Outcomes Research in 20072007 Total Funding (Control+RPG) =$32.6M
Total grants - 91
OAD $5.4M 16%
HSEB $18.2M
55%
ORB $4.7M 16%
RFMB $4.1M
13%
12
ARP Health Services/Outcomes ARP Health Services/Outcomes Related Grant Funding, 1998-Related Grant Funding, 1998-
20072007 Growth in Funded Grants
1931
41
66
8292
0
20
40
60
80
100
1999 2000 2002 2004 2006 200705
101520253035
1998 2002 2006
Growth in Grant Dollars(in millions)
Building Infrastructure for Building Infrastructure for
Extramural InvestigatorsExtramural Investigators
NCI Health Service Research ResourcesNCI Health Service Research Resources
Data Resources for Data Resources for InvestigatorsInvestigators Cancer Registry Based ResourcesCancer Registry Based Resources
SEERSEER Patterns of Care/Quality of Care StudiesPatterns of Care/Quality of Care Studies SEER-Medicare Linked DatabasesSEER-Medicare Linked Databases
Consumer and Healthcare Provider Consumer and Healthcare Provider SurveysSurveys National Health Interview Survey Cancer National Health Interview Survey Cancer
Control ModuleControl Module California Health Interview SurveyCalifornia Health Interview Survey National Survey of Colorectal Cancer National Survey of Colorectal Cancer
Screening Practices – 2000, 2006Screening Practices – 2000, 2006 Public Health Research ResourcesPublic Health Research Resources
Cancer Planet Cancer Planet Outcomes Research ResourcesOutcomes Research Resources
PROMIS Quality of Life Measures and CAT PROMIS Quality of Life Measures and CAT applicationsapplications
Example:Example: SEER-Medicare Data SEER-Medicare Data Are Useful for Research Across the Are Useful for Research Across the Cancer ContinuumCancer ContinuumScreening/ Diagnosis/ Survivorship Secondary Terminal Care Detection & Treatment Occurrence
Use of PSA testing, mammography, sigmoidoscopy/colonoscopy
Patterns of care
Peri-operative complications
Volume outcomes studies
Comorbidities
Health disparities
Late effects of treatment
Post-diagnostic surveillance
Treatment of prevalent cancers
Survival
Rates of recurrence/second primaries
Relationship of second events to initial treatment and ongoing surveillance
Use of hospice
End-of-life patterns of care
Over 150 SEER-Medicare articles in print
What would youlike to measure in your study?
Domain definitions
item content review
item characteristics
Click below for:
or select a box on the right and proceed
http://www.nihpromis.org
pain
emotional distress
physicalfunction
fatigue
social roleparticipation
Example:Example: PROMIS Measure PROMIS Measure
WebsiteWebsite
NCI Health Services Research NCI Health Services Research NetworksNetworks
National, multi-site research networks National, multi-site research networks thatthat Can enroll large cohorts of individualsCan enroll large cohorts of individuals Track receipt of cancer control services Track receipt of cancer control services
longitudinally at the patient, provider, and longitudinally at the patient, provider, and health system levels health system levels
Investigate impact of interventions on patient-Investigate impact of interventions on patient-centered outcomescentered outcomes
Current ExamplesCurrent Examples Breast Cancer Surveillance Consortium (BCSC)Breast Cancer Surveillance Consortium (BCSC) Cancer Research Network (CRN)Cancer Research Network (CRN) Cancer Care Outcomes Research and Cancer Care Outcomes Research and
Surveillance Consortium (CanCORS)Surveillance Consortium (CanCORS)
NCI Consortium-based NCI Consortium-based Research PlatformsResearch Platforms
P r e p a r e d f o r D r . [ N a m e ]
F r o m [ B e g i n Q t r ] t o [ E n d Q t r ] B a s e d o n [ n u m b e r ] s m o k e r s s e e n
9 0 t h P e r c e n t i l e = T o p 1 0 % p a r t i c i p a t i n g p r i m a r y c a r e p r o v i d e r s a t y o u r h e a l t h p l a n .
S p e c i f i c E v i d e n c e - B a s e d W a y s t o A s s i s t Y o u r P a t i e n t s W h o S m o k e
1 . E n c o u r a g e N i c o t i n e R e p l a c e m e n t T h e r a p y o r B u p r o p r i o n p r e s c r i p t i o n i f p a t i e n t i s i n t e r e s t e d
2 . W r i t e a r e f e r r a l t o S m o k i n g C e s s a t i o n C l a s s e s o r t h e Q u i t L i n e a t [ p h o n e ]
3 . H e l p p a t i e n t d e v e l o p a s p e c i f i c a c t i o n p l a n f o r q u i t t i n g b y s e t t i n g a q u i t d a t e a n d l i s t i n g p o s s i b l e c o p i n g s t r a t e g i e s ( e . g . t e l l o t h e r s a b o u t q u i t d a t e , t h r o w i n g c i g a r e t t e s a w a y )
T h e 5 A ’ s S t r a t e g i e s R e c o m m e n d e d b y t h e N a t i o n a l C a n c e r I n s t i t u t e a n d t h e U S T o b a c c o P r e v e n t i o n T a s k F o r c e
A S K : U p d a t e s m o k i n g s t a t u s e v e r y v i s i t
A D V I S E : P a t i e n t t o q u i t i n a p e r s o n a l l y r e l e v a n t w a y
A S S E S S : P a t i e n t r e a d i n e s s t o m a k e q u i t a t t e m p t w i t h i n t h e n e x t 8 0 d a y s
A S S I S T : P a t i e n t t o s e t q u i t d a t e a n d m a k e a c o p i n g p l a n f o r q u i t t i n g a n d / o r r e l a p s e p r e v e n t i o n
A R R A N G E : F o l l o w - u p s u p p o r t b y p h o n e , v i s i t , o r e m a i l w i t h i n a f e w w e e k s o f q u i t d a t e
Y o u r F i r s t Q u a r t e r R e s u l t sB a s e d o n I n f o r m a t i o n R e c o r d e d i n H e a l t h C o n n e c t
9 2 %
5 2 %
2 2 %2 7 %
1 . 8 %0
1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
1 0 0
A s k A d v i s e A s s e s s A s s i s t A r r a n g e
Perc
ent S
mok
ers
Y o u 9 0 t h P e r c e n t i l e
5 0 4 0 3 a 9 / 0 4 C H R
U s i n g E l e c t r o n i c M e d i c a l R e c o r d s t o H e l p Y o u r P a t i e n t s Q u i t S m o k i n g
Breast Cancer Surveillance Consortium Cancer Research Network
$$$$$$$$$$$$$$$$$$$$$$
Health Services/Outcomes Health Services/Outcomes Research Funding Research Funding
Opportunities at NClOpportunities at NCl
NCI Funding NCI Funding Mechanisms Mechanisms for for Junior and Mid-level Junior and Mid-level
InvestigatorsInvestigators K-Awards – NCI Training Awards K-Awards – NCI Training Awards
R03 – Small Research Grants in R03 – Small Research Grants in Behavioral and Social Sciences Behavioral and Social Sciences
R21 – Exploratory/Developmental GrantsR21 – Exploratory/Developmental Grants
R01 – Research ProjectsR01 – Research Projects http://deainfo.nci.nih.gov/flash/awardshttp://deainfo.nci.nih.gov/flash/awards
.htm.htm
General Grant Applications General Grant Applications InstructionsInstructions http://deainfo.nci.nih.gov/flash/awards.htmhttp://deainfo.nci.nih.gov/flash/awards.htm
Current Health Services Current Health Services Research Program Research Program AnnouncementsAnnouncements
PA-02-005: Economic Studies in Cancer Prevention, PA-02-005: Economic Studies in Cancer Prevention,
Screening and Care(R01, R21) Screening and Care(R01, R21) http://grants.nih.gov/grants/guide/pa-files/PA-02-005.htmlhttp://grants.nih.gov/grants/guide/pa-files/PA-02-005.html
PA-02-006: Cancer Surveillance Using Health Claims-Based PA-02-006: Cancer Surveillance Using Health Claims-Based Data System(R01, R21) Data System(R01, R21) http://grants.nih.gov/grants/guide/pa-files/PA-02-006.htmlhttp://grants.nih.gov/grants/guide/pa-files/PA-02-006.html
PA-02-015: Enhanced Understanding of ColorectalPA-02-015: Enhanced Understanding of ColorectalCancer Screening(R21) Cancer Screening(R21)
http://grants.nih.gov/grants/guide/pa-files/PA-02-015.htmlhttp://grants.nih.gov/grants/guide/pa-files/PA-02-015.html
PA-05-090: Methodology and Measurement in the PA-05-090: Methodology and Measurement in the Behavioral Behavioral
and Social Sciences(R01, R21) and Social Sciences(R01, R21)
http://grants1.nih.gov/grants/guide/pa-files/PA-05-090.htmlhttp://grants1.nih.gov/grants/guide/pa-files/PA-05-090.html
NCI Funding Mechanisms for NCI Funding Mechanisms for Dissemination and Implementation Dissemination and Implementation ResearchResearch
R03 – Small Research GrantsR03 – Small Research Grants Dissemination and Implementation Dissemination and Implementation
Research in HealthResearch in Health http://grants2.nih.gov/grants/guide/pa-fhttp://grants2.nih.gov/grants/guide/pa-f
iles/PAR-06-071.htmliles/PAR-06-071.html
R21 – Exploratory/Developmental GrantsR21 – Exploratory/Developmental Grants Dissemination and Implementation Dissemination and Implementation
Research in Health Research in Health http://grants2.nih.gov/grants/guide/pa-fhttp://grants2.nih.gov/grants/guide/pa-f
iles/PAR-06-072.htmliles/PAR-06-072.html
R01 – Research ProjectsR01 – Research Projects Dissemination and Implementation Dissemination and Implementation
Research in HealthResearch in Health http://grants1.nih.gov/grants/guide/pa-fhttp://grants1.nih.gov/grants/guide/pa-f
iles/PAR-06-039.htmliles/PAR-06-039.html
For further information on For further information on anything presented today -- anything presented today -- including most appropriate including most appropriate
NCI contacts, email ….NCI contacts, email ….Steven Clauser, Ph.D. Steven Clauser, Ph.D.
Chief, Outcomes Research Chief, Outcomes Research BranchBranch
Clausers@mail.nih.govClausers@mail.nih.govMartin Brown, Ph.D.Martin Brown, Ph.D.
Chief, Health Services & Chief, Health Services & Economics BranchEconomics Branch
Brownm@mail.nih.govBrownm@mail.nih.gov
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