Improving Children's Health Through Health Services Research
Grantsmanship and Mock Study Review
Grantsmanship and Mock Study Review
Linda Blankenbaker, M.D., Carolyn Clancy, M.D.,
Jose Julio Escarce, M.D., Ph.D., Anne Gadomski, M.D., M.P.H.
Improving Children's Health Through Health Services Research was a special 1-day meeting held June 26, 1999, in Chicago. The state of the science in children's health services research was explored, including public and private funding opportunities, networks for conducting research, and uses of research in policy and practice. The meeting was co-sponsored by the National Association of Children's Hospitals and Related Institutions (NACHRI), with the Agency for Health Care Policy and Research (AHCPR), the American Academy of Pediatrics (AAP), the David and Lucille Packard Foundation, the Association for Health Services Research (AHSR), the Robert Wood Johnson Foundation, and Data Harbor, Inc.
In general, the Federal grant process takes approximately 9 months from receipt of the grant application/proposal to the award notice. New researchers need to be aware of the fact that the actual grant process timeline is substantially longer, as developing a competitive grant application will usually take a number of months. In addition, many applications will receive a score that is good, but not in the range of scores for funding. In this case, the applicant will be encouraged to revise the application in response to the reviewers' critiques and then resubmit the application. This will add 4 to 8 months to the process.
At the Agency for Healthcare Research and Quality (AHRQ), letters of intent are requested for informational purposes only. The Agency uses these letters to determine who should be asked to review grants and to anticipate the grant review workload. This differs from the letters of intent used by some private foundations and government agencies that may use letters of intent as the first phase of the grant review process.
The phases of the grant process include:
- The grant application.
- Review for scientific and technical merit by a peer review group.
- Award of the grant.
- Completion of the grant and a "close-out" process.
Each grant proposal/application has information and detailed instructions for completing the grant application. Grant seekers are encouraged to carefully review and adhere to the procedures in preparing their grant application.
Successful grant applications have a number of characteristics:
- A good idea. Successful applications include hypotheses that are well defined, creative/new, and address a significant issue. The specific aims of the study should be achievable during the proposed grant time frame. The study's purpose and research questions should be well supported and linked to the hypotheses and methodology. The research should also contribute to advancing the science and knowledge in child health services research. The research plan must also address issues related to human subjects protection and the representation of women, minorities, and children.
- Articulated theoretical or conceptual framework. The hypotheses, aims, purpose, research questions, and methodology should be well thought out, and described in relation to the theoretical or conceptual framework that guides the research.
- Good science. A clear rationale for selection of the methods should be provided. The research plan and methods must also be clearly tied to the specific aims of the study. Reviewers will also be assessing the assumptions associated with the proposed research and the limitations of the study; both should be explicitly discussed in the application. The data analysis and statistical approach should be described with attention to how research questions will be answered. Many researchers will need statisticians and methodologists to assist them and thus, should identify their roles and the expertise they will provide for the proposed research.
- Technically clear and accurate application. Adhere to the requirements of the application (for example, PHS Form 398). All components of the application should have a clear and concise rationale that justifies the approach being used. The application should be presented clearly, using graphs, charts, timelines, etc. to present information. It is also necessary to use the correct font size to avoid rejection of the application for this reason. The timeline and budget should be realistic and appropriate to the proposed design. An amended application may be limited to no more than two resubmissions. Also, if a research project is judged by reviewers to be valuable but the methodology needs further attention, this component of the project may be revised in light of the reviewer's comments.
In addition to funding investigator-initiated grants, the Agency also supports targeted research initiatives. These are published as Requests for Applications (RFAs). RFAs have earmarked funds and explicit timelines separate from the rolling submission dates for investigator-initiated grants. These opportunities are publicized in the NIH Guide and on AHRQ's Web site under .
Some examples of the general areas of interest to AHRQ include:
Methods and Measures:
- Research that validates performance measures.
- Development and testing of outcome measures and risk adjustment methodologies.
- New and enhanced measures of health and functional status, and quality of life.
- Timeliness of care and the importance of communication in quality of care (frequently neglected areas).
Organizational Change and Quality Measurement:
- Research to understand how different approaches to designing and implementing quality function in different health care delivery settings.
- Research that examines the impact of changes in the organization, delivery, and financing of health care services on quality and outcomes.
- Research that looks at the continuum and coordination of care issues, such as home care.
Using and Applying Quality Information:
Research that examines how information affects decision making of:
- Health plans, etc.
General review criteria used by the agencies and reviewers include:
- Significance and originality from a scientific or technical viewpoint.
- Adequacy of method(s).
- Availability of data or adequacy of the proposed plan to collect data required for the project.
- Adequacy and appropriateness of the plan for organizing and carrying out the project.
- Qualifications and experience of the principal investigator and proposed staff.
- Reasonableness of the proposed budget and time frame in relation to the work proposed.
- Adequacy of the facilities and resources available to the applicant.
- The extent to which women, minorities and, if applicable, children, are adequately represented in the study populations.
- As applicable, the adequacy of the proposed means for protecting human subjects.
Approvals of awards are based on the substantive and scientific merit of proposals, their fit with the program, and the availability of funds. Some of the common problems in applications include:
- Lack of new or original ideas.
- Diffuse, superficial, or unfocused research plan.
- Lack of knowledge of published, relevant work in the area.
- Lack of investigator experience with the proposed methodology.
- Poorly defined reasoning for research approach/methods.
- Absence of a scientific rationale.
- Unrealistic scope of work.
- Lack of sufficient detail about the methods/experiment.
- Lack of a critical approach.
Grantsmanship and Mock Study Review. Presentation Summary, Improving Children's Health Through Health Services Research, Chicago, June 26, 1999. http://www.ahrq.gov/research/chsrgrnt.htm