Dr. Bush, whose research focuses on health equity and disparities, shared an example from his own R01 grant, the CHHIRP study. “We’re conducting a pragmatic clinical trial in state-funded public health centers in the commonwealth of Kentucky to see if a patient navigation program can improve diagnosis and treatment for kids who fail a newborn hearing screening,” he said. Additional components include implementation factors through qualitative and quantitative methods, assessing methods for success or failure while implementing in a community-based setting, and cost-effectiveness of the program.
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September 2024“A patient navigator is a layperson who has personal experience with this type of healthcare scenario and wants to be involved in helping others,” he said. This comes out of the cancer world, where cancer survivors have been trained and are paid to support patients in acquiring care.
In Dr. Bush’s study, these patient navigators are often the parents of children who have gone through a pediatric hearing diagnostic pathway. The grant, which was for about $3.3 million, covers hiring and training navigators, participant payments, and staff. “The biggest cost for a pragmatic clinical trial like this is human resources: the staff collaborators, co-investigators, collaborators, interventionists,” Dr. Bush said.
One thing aspiring researchers may not consider is that grant program officers can provide a wealth of information if you just reach out to them. Dr. Bush says having a healthy dialogue with program officers can be immensely helpful in sharing some of the priorities of institutes or foundations. “They can often direct you to the best home for a particular grant,” Dr. Bush said, adding that while a program officer can’t review your science, they can really help to navigate the system of the grant review.
“This is public information for the NIH in that each grant mechanism and each institute has very clearly delineated individuals who serve as program officers,” he said. “You can request a meeting, and they are often more than happy to meet with investigators.”
If you do request a meeting, Dr. Bush advised sending a one-page aims document stating what you plan to do and why, along with a biographical sketch to help the program officer understand your background and your project. He also warned against proposing aims that are dependent on each other. For example, if you write two or three aims, and the second and third are dependent on aim one, the feasibility of the later aims are affected if that first experiment doesn’t pan out. “Make the aims clear, succinct, and independent,” Dr. Bush said.
Common Pitfalls
One thing to avoid in writing an R01 grant is what Dr. Nelson calls “fishing experiments.” These are experiments where you are essentially proposing casting a line and hoping for the best. These proposals are not usually viewed very well. “Do your fishing in preliminary experiments,” Dr. Nelson said. “Grant reviewers don’t want to hear that you’re going to screen 1,000 different things and hope you find something. They want you to come in with a candidate target that helps to increase the feasibility of the project.”
Grant reviewers don’t want to hear that you’re going to screen 1,000 different things and hope you find something. They want you to come in with a candidate target that helps to increase the feasibility of the project.” — Rick Nelson, MD, PhD