Opportunity Information: Apply for PA 18 005
The National Institutes of Health (NIH) funding opportunity titled "Reducing Overscreening for Breast, Cervical, and Colorectal Cancers among Older Adults (R01 Clinical Trial Optional)" (Funding Opportunity Number PA 18-005) supports research aimed at curbing the unnecessary use of cancer screening tests in average-risk older adults. The FOA is grounded in the idea that, although cancer screening campaigns have improved early detection and outcomes in many populations, screening can become harmful when it continues past the point where benefits outweigh risks. In older adults especially, repeated screening for breast, cervical, or colorectal cancer may expose people to avoidable downsides such as false positives, anxiety, follow-up procedures, complications from invasive diagnostic tests, overdiagnosis, and treatments that do not improve longevity or quality of life. The overall goal is to generate evidence that helps healthcare systems reduce this kind of low-value care while protecting older adults health, independence, and day-to-day well-being.
This announcement is specifically focused on interventions that are based in healthcare settings and are designed to reduce overscreening. NIH is signaling that overscreening is not simply an individual choice problem; it is often driven by multiple, interacting influences that can occur at several levels at once. These levels include the individual patient (beliefs, preferences, fear of cancer, misunderstanding of benefits and harms, prior screening habits), the healthcare team (clinician knowledge of guidelines, communication style, incentives, workflow pressures, defensive medicine), the healthcare system (electronic health record reminders, quality metrics that reward more screening, institutional policies, referral pathways), and the surrounding community or community organizations (norms, messaging, local advocacy, access patterns). Because of that complexity, the FOA emphasizes research that both explains why overscreening happens and tests practical strategies to reduce it in real-world delivery systems.
A central requirement of the research approach is that proposed projects should intervene at two or more levels and measure outcomes at two or more levels, while also accounting for the interactions between those levels. In practice, this means NIH is looking for multi-level intervention designs rather than single-component solutions. For example, an application might combine patient-facing decision support with clinician communication training, or pair changes to EHR prompts and performance metrics with patient education and shared decision-making tools. Outcomes could similarly span multiple levels, such as changes in patient knowledge and decisional conflict, clinician ordering behavior, clinic-level screening rates among older adults, rates of follow-up diagnostic procedures, complications, patient-reported outcomes, or system-level measures of low-value care. The explicit expectation is that investigators will analyze how changes at one level affect other levels (for instance, how altering automated reminders influences clinician behavior and patient expectations, or how clinician messaging affects patient acceptance of stopping screening).
The mechanism is an R01 research project grant, with clinical trials listed as optional, meaning applicants may propose either clinical trial or non-trial research as appropriate for the intervention and evaluation plan. The opportunity falls under the discretionary grant category and is associated with CFDA numbers 93.394 and 93.866, reflecting NIH program areas relevant to cancer prevention, healthcare delivery, and aging-related outcomes. While the listing includes an original closing date of January 7, 2020, the scientific scope summarized here reflects what the FOA is seeking: rigorous healthcare-setting research that reduces overscreening and clarifies its consequences for older adults.
Eligibility is broad and includes many types of domestic applicants such as state, county, and local governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; nonprofit organizations (with or without 501(c)(3) status); for-profit organizations (other than small businesses) as well as small businesses; public housing authorities/Indian housing authorities; and federally recognized Native American tribal governments. The FOA also highlights additional eligible applicants, including Alaska Native and Native Hawaiian Serving Institutions; Asian American Native American Pacific Islander Serving Institutions (AANAPISIs); Hispanic-serving Institutions; Historically Black Colleges and Universities (HBCUs); Tribally Controlled Colleges and Universities (TCCUs); faith-based or community-based organizations; eligible federal agencies; regional organizations; U.S. territories or possessions; tribal governments that are not federally recognized; and non-U.S. entities (foreign organizations). Overall, NIH is encouraging proposals from a wide range of institutions that can study overscreening in diverse healthcare environments and populations, especially where older adults may experience different risks, expectations, and system pressures that lead to continued screening even when it is unlikely to help.Apply for PA 18 005
- The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Reducing Overscreening for Breast, Cervical, and Colorectal Cancers among Older Adults (R01 Clinical Trial Optional)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.394, 93.866.
- This funding opportunity was created on 2017-11-03.
- Applicants must submit their applications by 2020-01-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.
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Frequently Asked Questions (FAQs)
What is the title and funding opportunity number for this NIH grant?
The opportunity is titled "Reducing Overscreening for Breast, Cervical, and Colorectal Cancers among Older Adults (R01 Clinical Trial Optional)" and the Funding Opportunity Number is PA 18-005.
What problem is this funding opportunity trying to address?
This FOA supports research to reduce unnecessary (low-value) cancer screening among average-risk older adults. It is based on the idea that screening can become harmful when it continues beyond the point where the potential benefits outweigh the risks, particularly for older adults.
Which cancer screenings are the focus of this announcement?
The FOA focuses on screening related to breast cancer, cervical cancer, and colorectal cancer.
Who is the primary population of interest?
The focus is on average-risk older adults, especially in situations where screening is continued even when it is unlikely to improve longevity or quality of life.
Why can continued screening be harmful for older adults?
The FOA notes several potential downsides of overscreening in older adults, including false positives, anxiety, follow-up procedures, complications from invasive diagnostic tests, overdiagnosis, and treatments that do not improve longevity or day-to-day well-being.
What is the overall goal of the research supported by this FOA?
The goal is to generate evidence that helps healthcare systems reduce overscreening (a form of low-value care) while protecting older adults' health, independence, and everyday well-being.
Does NIH want interventions outside the healthcare system (for example, purely community campaigns)?
This announcement is specifically focused on interventions that are based in healthcare settings and designed to reduce overscreening. Community and community-organization influences are recognized as part of what drives overscreening, but the intervention focus is healthcare-setting based.
How does the FOA describe the causes of overscreening?
NIH emphasizes that overscreening is often driven by multiple, interacting influences at several levels at once, including the patient, the healthcare team, the healthcare system, and the surrounding community or community organizations.
What patient-level influences does the FOA mention?
Examples include patient beliefs and preferences, fear of cancer, misunderstanding of benefits and harms, and prior screening habits.
What healthcare team (clinician/team) influences does the FOA mention?
Examples include clinician knowledge of guidelines, communication style, incentives, workflow pressures, and defensive medicine.
What healthcare system-level influences does the FOA mention?
Examples include electronic health record (EHR) reminders, quality metrics that reward more screening, institutional policies, and referral pathways.
What community or community-organization influences does the FOA mention?
Examples include community norms, messaging, local advocacy, and access patterns.
What type of intervention approach is NIH emphasizing?
The FOA emphasizes multi-level interventions rather than single-component solutions. NIH is looking for research that both explains why overscreening happens and tests practical, real-world strategies to reduce it in healthcare delivery systems.
Is there a requirement to intervene at more than one level?
Yes. A central requirement is that proposed projects should intervene at two or more levels and measure outcomes at two or more levels, while accounting for interactions between levels.
What does it mean to "intervene at two or more levels"?
It means the project should include intervention components aimed at multiple parts of the overscreening system (for example, combining patient-facing decision support with clinician communication training, or pairing EHR reminder changes with patient education and shared decision-making tools).
What does it mean to "measure outcomes at two or more levels"?
It means the evaluation should include outcomes spanning multiple levels such as patient outcomes (for example, knowledge or decisional conflict), clinician outcomes (for example, ordering behavior), clinic outcomes (for example, screening rates among older adults), and/or system outcomes (for example, measures of low-value care).
Does the FOA expect applicants to study how levels interact?
Yes. The FOA explicitly expects investigators to analyze how changes at one level affect other levels (for example, how changes to automated reminders influence clinician behavior and patient expectations, or how clinician messaging affects patient acceptance of stopping screening).
What are examples of multi-level strategies mentioned in the FOA?
Examples include combining patient-facing decision support with clinician communication training, and pairing changes to EHR prompts and performance metrics with patient education and shared decision-making tools.
What kinds of outcomes are mentioned as relevant?
The FOA mentions outcomes such as changes in patient knowledge and decisional conflict, clinician ordering behavior, clinic-level screening rates among older adults, rates of follow-up diagnostic procedures, complications, patient-reported outcomes, and system-level measures of low-value care.
What grant mechanism is being used?
The mechanism is an NIH R01 research project grant.
Are clinical trials allowed under this funding opportunity?
Yes. Clinical trials are optional, meaning applicants may propose either clinical trial or non-trial research, depending on what fits the intervention and evaluation plan.
What type of funding category is this opportunity?
It is listed as a discretionary grant.
What CFDA numbers are associated with this opportunity?
The opportunity is associated with CFDA numbers 93.394 and 93.866.
What is the original closing date listed for this FOA?
The listing includes an original closing date of January 7, 2020.
Who is eligible to apply?
Eligibility is broad and includes many types of applicants, including state, county, and local governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; nonprofit organizations (with or without 501(c)(3) status); for-profit organizations (other than small businesses) as well as small businesses; public housing authorities/Indian housing authorities; federally recognized Native American tribal governments; and non-U.S. entities (foreign organizations).
Are U.S. territories and possessions eligible?
Yes. The FOA highlights U.S. territories or possessions as eligible applicants.
Are tribal governments eligible even if they are not federally recognized?
Yes. The FOA highlights tribal governments that are not federally recognized as eligible applicants.
Are federal agencies eligible to apply?
Yes. The FOA includes eligible federal agencies among additional eligible applicants.
Are faith-based and community-based organizations eligible?
Yes. The FOA explicitly includes faith-based or community-based organizations among eligible applicants.
Are minority-serving institutions specifically encouraged or included?
Yes. The FOA highlights Alaska Native and Native Hawaiian Serving Institutions; Asian American Native American Pacific Islander Serving Institutions (AANAPISIs); Hispanic-serving Institutions; Historically Black Colleges and Universities (HBCUs); and Tribally Controlled Colleges and Universities (TCCUs) as eligible applicants.
Are for-profit organizations eligible?
Yes. For-profit organizations (other than small businesses) and small businesses are both listed as eligible applicant types.
Can a non-U.S. (foreign) organization apply?
Yes. The FOA includes non-U.S. entities (foreign organizations) as eligible.
What kinds of settings and environments does NIH seem to be aiming for?
NIH is encouraging proposals that can study and reduce overscreening in diverse healthcare environments and populations, especially where older adults may face different risks, expectations, and healthcare system pressures that contribute to continued screening.
Is this FOA mainly about understanding overscreening, testing interventions, or both?
Both. The FOA emphasizes research that explains why overscreening happens and tests practical strategies to reduce it in real-world healthcare delivery systems.
Does the FOA treat overscreening as only an individual patient choice issue?
No. NIH explicitly signals that overscreening is not simply an individual choice problem and is often driven by interacting influences across patient, clinician/team, system, and community levels.
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| Oral Anticancer Agents: Utilization, Adherence, and Health Care Delivery (R21 Clinical Trial Optional) Apply for PA 18 014 Funding Number: PA 18 014 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Marijuana, Prescription Opioid, or Prescription Benzodiazepine Drug Use Among Older Adults (R03 Clinical Trial Optional) Apply for PA 18 080 Funding Number: PA 18 080 Agency: National Institutes of Health Category: Education, Health Funding Amount: $50,000 |
| Prevention Research in Mid-Life Adults (R01 Clinical Trial Optional) Apply for PA 18 134 Funding Number: PA 18 134 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Neuroscience Research on Drug Abuse (R21 Clinical Trial Optional) Apply for PA 18 078 Funding Number: PA 18 078 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Marijuana, Prescription Opioid, or Prescription Benzodiazepine Drug Use Among Older Adults (R21 Clinical Trial Optional) Apply for PA 18 079 Funding Number: PA 18 079 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Functional Wellness in HIV: Maximizing the Treatment Cascade (R01 Clinical Trial Optional) Apply for PA 18 136 Funding Number: PA 18 136 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Marijuana, Prescription Opioid, or Prescription Benzodiazepine Drug Use Among Older Adults (R01 Clinical Trial Optional) Apply for PA 18 061 Funding Number: PA 18 061 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Prevention Research in Mid-Life Adults (R21 Clinical Trial Optional) Apply for PA 18 153 Funding Number: PA 18 153 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Functional Wellness in HIV: Maximizing the Treatment Cascade (R21 Clinical Trial Optional) Apply for PA 18 154 Funding Number: PA 18 154 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Research on Informal and Formal Caregiving for Alzheimer's Disease (R01 Clinical Trial Optional) Apply for PAR 18 027 Funding Number: PAR 18 027 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Applying Metabolomics to Drive Biomarker Discovery in Symptom Science (R01 Clinical Trial Optional) Apply for PA 18 140 Funding Number: PA 18 140 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Early Phase Clinical Trials in Imaging and Image-Guided Interventions (R01 Clinical Trial Required) Apply for PAR 18 011 Funding Number: PAR 18 011 Agency: National Institutes of Health Category: Education, Health Funding Amount: $250,000 |
| Research on Informal and Formal Caregiving for Alzheimer's Disease (R21 Clinical Trial Optional) Apply for PAR 18 179 Funding Number: PAR 18 179 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Applying Metabolomics to Drive Biomarker Discovery in Symptom Science (R21 Clinical Trial Optional) Apply for PA 18 158 Funding Number: PA 18 158 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Addressing Unmet Needs in Persons with Dementia to Decrease Behavioral Symptoms and Improve Quality of Life (R01 Clinical Trial Optional) Apply for PA 18 147 Funding Number: PA 18 147 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Improving Individual and Family Outcomes through Continuity and Coordination of Care in Hospice (R01 Clinical Trial Optional) Apply for PA 18 148 Funding Number: PA 18 148 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Personalized Strategies to Manage Symptoms of Chronic Illness (R21 Clinical Trial Optional) Apply for PA 18 156 Funding Number: PA 18 156 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Innovative Questions in Symptom Science and Genomics (R01 Clinical Trial Optional) Apply for PA 18 139 Funding Number: PA 18 139 Agency: National Institutes of Health Category: Education, Health Funding Amount: Case Dependent |
| Use of Technology to Enhance Patient Outcomes and Prevent Illness (R21 Clinical Trial Optional) Apply for PA 18 163 Funding Number: PA 18 163 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
| Addressing Unmet Needs in Persons with Dementia to Decrease Behavioral Symptoms and Improve Quality of Life (R21 Clinical Trial Optional) Apply for PA 18 165 Funding Number: PA 18 165 Agency: National Institutes of Health Category: Education, Health Funding Amount: $200,000 |
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