Improving Patient Adherence to Treatment and Prevention Regimens to Promote Health (R21 Clinical Trial Optional) | PA 18 723

Opportunity Information: Apply for PA 18 723

The NIH funding opportunity titled "Improving Patient Adherence to Treatment and Prevention Regimens to Promote Health (R21 Clinical Trial Optional)" (PA-18-723) supports early-stage, exploratory research aimed at understanding and improving how well patients follow recommended treatment and prevention plans. It is issued through the NIH Adherence Network led by the Office of Behavioral and Social Sciences Research (OBSSR), with multiple NIH Institutes and Centers participating. The central focus is patient adherence as a driver of better health outcomes, recognizing that even highly effective therapies and prevention strategies fail to deliver their full benefit when people cannot or do not start them, carry them out as intended, or stay with them over time.

The FOA invites applications that study adherence across the full course of regimen use, including initiation (whether a person starts a prescribed medication, behavior change, screening schedule, or other regimen), implementation (how accurately and consistently the regimen is followed in day-to-day life), and persistence (how long the regimen is maintained before it is discontinued). Proposed projects can be descriptive (for example, identifying barriers, predictors, and patterns of adherence) or intervention-focused (designing and testing strategies to improve adherence). A key theme is that adherence is shaped by multiple layers of influence, so applicants may address determinants at one or more ecological levels, such as the patient (knowledge, motivation, cognition, symptoms, side effects, health literacy), caregiver or family context (support, competing demands, shared decision-making), provider and healthcare system factors (communication, access, workflow, continuity of care, cost and coverage issues), and community-level conditions (transportation, culture, social norms, resource availability).

Scientific rigor is emphasized throughout. The announcement highlights the importance of well-justified study designs, appropriate sample sizes for the questions being asked, and the use of valid and meaningful outcome measures. It also stresses testing mechanisms of action, meaning applications should go beyond asking whether an adherence approach works and instead examine why and how it works (or does not), such as through behavioral, social, or system-level pathways. Because this is an R21 mechanism, projects are generally expected to be developmental and hypothesis-generating, supporting innovative ideas, early proof-of-concept testing, refinement of measures, and foundational work that can lead to larger follow-on studies.

Clinical trials are optional under this FOA, so applicants may propose studies that include a clinical trial component or studies that do not involve a clinical trial. This flexibility allows a broad range of adherence research, from observational studies and methodological development to pilot intervention testing. The specific research interests of the participating NIH Institutes and Centers are referenced as being detailed in the full announcement, which typically means applicants should align their topic area and population of interest with the missions of the participating NIH components.

Eligibility is broad and includes many types of organizations. Eligible applicants include state, county, city, township, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; Native American tribal organizations that are not federally recognized; public housing authorities and Indian housing authorities; nonprofit organizations with or without 501(c)(3) status; for-profit organizations (other than small businesses) and small businesses; and other eligible entities. The FOA also explicitly notes additional eligible applicants such as 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, and non-U.S. (foreign) organizations.

Key administrative details provided include that the sponsoring agency is the National Institutes of Health, the funding instrument is a grant, and the opportunity falls under education and health-related activity categories. The opportunity lists an award ceiling of $200,000 (as provided in the source information) and cites an original closing date of 2021-05-07, with a creation date of 2018-03-28. The FOA is associated with multiple CFDA numbers (93.242, 93.273, 93.279, 93.307, 93.361, 93.393, 93.855, 93.866), reflecting the multi-Institute participation and the wide range of health areas where adherence research is relevant.

Overall, this grant opportunity is designed for investigators and organizations seeking to develop and test innovative, rigorous approaches to improving adherence to medical and preventive regimens. It supports work that treats adherence as a complex, multi-level problem and encourages studies that measure adherence well, explain the mechanisms behind successful interventions, and ultimately contribute to improved health outcomes across diseases, populations, and care settings.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Improving Patient Adherence to Treatment and Prevention Regimens to Promote Health (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.242, 93.273, 93.279, 93.307, 93.361, 93.393, 93.855, 93.866.
• This funding opportunity was created on 2018-03-28.
• Applicants must submit their applications by 2021-05-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• 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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