Innovations for Healthy Living - Improving Population Health and Eliminating Health Disparities (R43/R44)

The purpose of this funding opportunity is to engage small business concerns (SBC) in developing technologies and products that engage, empower, and motivate individuals and communities, including providers and healthcare institutions, in sustainable health promoting activities and interventions that lead to improved health, healthcare delivery, and the elimination of health disparities in one or more NIH-defined health disparity population group(s). Healthy People 2020 defines a health disparity as a particular type of health difference in the incidence, prevalence, morbidity, and burden of diseases and other adverse health outcomes that is closely linked with social, economic, and/or environmental disadvantage. NIH-defined health disparity population groups include racial/ethnic minorities (African Americans, American Indians, Alaska Natives, Asian Americans, Hispanic Americans, Native Hawaiians, and other U.S. Pacific Islanders), socioeconomically disadvantaged individuals, and individuals residing in rural areas.  Appropriate technologies should be effective, affordable, culturally acceptable, and easily accessible to those who need them.  This announcement is expected to reduce health disparities within and across the priority areas of cardiovascular disease, stroke, cancer, diabetes, HIV/AIDS, infant mortality, mental health, and obesity, as well as lung, liver, and kidney diseases, psoriasis, scleroderma, and other diseases, illnesses, and conditions of public health importance.

Over the years, there has been continued improvement of health for Americans with the introduction of medical and scientific advances. Despite notable improvements gained as a result of the technological advancement, there continues to be an alarming disproportionate burden of illness among minority and other health disparity populations. Overcoming persistent disparities in healthcare access and health outcomes remains a foremost challenge. To meet this challenge, the NIMHD is committed to supporting a wide range of research, aimed at the development of innovative diagnostics, treatments, and preventative strategies to reduce, and eventually eliminate health disparities.

NIMHD seeks research projects aimed at the development of innovative diagnostics, treatments, and preventative strategies and making these products available and accessible to those individuals and communities bearing disproportionate burdens of illness. Technologies to address the unique challenges encountered in rural areas are of particular interest, including technologies to support healthy eating and active living, access and utilization of important government services and new scientific information and technologies that can help improve their quality of life; decrease food insecurity and decrease childhood obesity rates. Technologies to be developed may be new and innovative, or they may arise from existing technologies that by redesign create increased and more attractive opportunities for health disparity populations to experience better health, improve their current health, prevent and treat disease, and maintain a long and healthy lifestyle. Nutrition related technologies should not duplicate existing information and should use science-based nutrition content from the Dietary Guidelines for Americans, 2015 or from sources of federal nutrition communications for the public, such as http://www.choosemyplate.gov

or http://www.fns.usda.gov/tn/team-nutrition. Empowering technologies are appealing, attractive, accessible, easy to use, adoptable, affordable and sustainable. To be effective, a technology should provide users with improvements in access, affordability, health status and well-being relative to their current health status and well-being. The technology should be reliable, robust, and have reproducible outcomes. Ideally, the proposed technology should improve health through increased opportunities for enhanced access to: 

• Healthcare institutions and providers, including those in geographically remote or physically difficult to access locations;
• New or increased patient populations especially, those located in geographically remote or physically difficult to access locations;
• Medical and health knowledge through increased opportunities for individuals with limited English proficiency or low health, food or media literacy;
• Diverse medical and non-medical providers and organizations, including medical specialists, appropriately resourced small or large centers with access to advanced medical technologies, and organizations dedicated to health promotion through access to nutritious food, such as farmer's markets, etc.;  
• Publicly available resources including free and/or affordable and sustainable insurance coverage, enrollment in social safety net programs, such as the women, infants, and children special supplemental nutrition program (WIC), Medicaid, social security, school meals, etc.;
• Healthcare delivered in culturally acceptable and respectful manners and in safe environments; and
• Quality healthcare appropriately priced for diverse providers, hospitals, community-health care centers, primary care physicians, etc., and patients. 

Technologies that might achieve the objectives of this initiative include but are not limited to:                

• Innovative products or services that facilitate or enhance multi-sectorial or multigenerational interventions, such as coordinated enrollment or delivery of benefits and services, or care coordination between primary care providers, hospital emergency department staff, specialty physicians, nurse practitioners, providers of mental health and behavioral health services, patient navigators, nutrition counselors, etc., in medically underserved communities and regions;
• Culturally attuned behavioral interventions or low-cost tools and technologies (e.g. software apps for mobile devices) that empower and promote opportunities for individuals and communities to  engage in health-seeking behaviors (healthy eating and cooking, diet choice, grocery shopping, meal planning and budgeting,  nutrition counseling, exercise/physical activity, oral hygiene, medication adherence, child immunizations, breast feeding, etc.) and to avoid risky behaviors (smoking, alcohol/drug misuse, unsafe sex, etc.);
• Tools, technologies, and methods for detecting, measuring, and assessing a broad array of unhealthy social and environmental exposures (stress, pollutants, allergens, noise, crime, etc.), and for characterizing cumulative exposures to these environments (exposomes) for individuals and communities and linking this information to physiological responses and health indicators at the individual and population levels. These technologies may include efforts to improve data collection and data integration across disparate data sources, including clinical patient data, public health data, census data, housing data, employment data, crime statistics, etc., and overcome data/information barriers and thus increase opportunities and ease of use electronic and digitized data;
• Technologies increasing ease of learning about and applying for supplemental nutrition benefits, enrolling children for school meals and meeting eligibility requirements for Medicaid, are of priority interest;     
• Products or services that expand opportunities to access and utilize high-quality pre or postnatal care, including nutrition promotion and breastfeeding support, and thereby reduce the frequency of high-risk pregnancies in health disparities populations;
• Products or services that engage, empower, and motivate individuals and communities to enhance the quality of life and reduce health disparities;
• Culturally appropriate survey instruments, tools, modules and databases to promote community-based research engaging racial/ethnic minorities, rural and other medically underserved communities;
• Culturally appropriate, evidence-based health empowering promotion and disease prevention educational media such as software, informational videos, printed materials for health disparities populations and disadvantaged communities;
• Innovative software, tools and technology for promoting healthy food selection, preparation, and consumption, community gardening, nutrition, cooking, and science and health education, such as curriculum materials, interactive teaching aids, models for classroom instruction for early childhood, K-12,  undergraduate students, and the general public;
• Mobile health (mHealth), mobile nutrition, and telehealth/telemedicine technologies and apps for communication, diagnosis, monitoring, evaluation, medical management, tracking and treatment in underserved community settings and rural and remote locations;
• Groundbreaking products or technology to promote big data science or enhance data scientist training to address health inequities and/or minority health research, for example software or tools developed to easily link social determinants of health (e.g., years of education, race/ethnicity, etc.) with massive datasets such as electronic medical record (EMR), genomic information, census data, national surveys, and other state or community-level data sources. Such technology will be instrumental in understanding fundamental causes of health disparities and developing meaningful interventions; and
• Technologies for the rapid identification in human specimens (e.g., blood, buccal swabs, etc.) of genes and/or genomic variants of known importance to minority health.

See Section VIII. Other Information for award authorities and regulations.