Technologies for Improving Minority Health and Eliminating Health Disparities (R41/R42- Clinical Trial Optional)

Background Over the years, there has been continued improvement of health for Americans with the introduction of medical and scientific advances. Despite notable health improvements for the population as a whole through technological advancements, there continues to be an alarming disproportionate burden of illness among persons from racial and ethnic minority and other populations who experience health disparities. To meet this challenge, the NIMHD is committed to supporting a wide range of research, aimed at the development of innovative diagnostics, treatments, and prevention strategies that improve the health of racial and ethnic minority populations so as to reduce, and eventually eliminate health disparities. The purpose of this funding opportunity is to stimulate a partnership of ideas and technologies between small business concerns (SBCs) and non-profit research institutions resulting in improving minority health and the reduction of health disparities by commercializing innovative technologies for one or more NIH-defined health disparity population group(s). NIH-defined population groups who experience health disparities include racial and ethnic minorities (African Americans/Blacks, Hispanics/Latinos, American Indians/Alaska Natives, Asians, Native Hawaiians and Other Pacific Islanders), socioeconomically disadvantaged individuals, individuals residing in underserved rural areas, and sexual/gender minorities. Appropriate technologies must be effective (for example, does it provide an improvement over current quality of care for racial and ethnic and health disparity population?), affordable (Can the technology be used with existing community resources or an organizations' existing infrastructure?), acceptable (Is the technology suitable for the population in terms of culture, language, literacy level, and content; and for organizations: Does it assist in advancing the mission of the organization; is it compatible with the organizational culture where it will be used? Can it be combined with or embedded within other current services or programs within the organization?), and easily accessible by or deliverable to the desired populations. Applicants that do not explicitly address technologies for minority or other NIH-designated populations experiencing health disparities will be considered non-responsive. Research Objectives Technologies may be new or innovative. Innovations designed to reduce or eliminate health disparity outcomes or improve health in racial and ethnic populations are of special interest, as are technologies informed by the NIMHD Research Framework, https://nimhd.nih.gov/about/overview/research-framework.html. The NIMHD Research Framework identifies diverse factors within socioecological domains and levels that individually and synergistically are known to influence the distribution of disparate health outcomes among racial/ethnic populations compared to the majority U.S. population. Within the context of the SBIR/STTR programs, this framework can be leveraged by small business to inform product conceptualization, and design. It can be also incorporated into design thinking and outcome-driven innovation methods. In addition to the factors listed in the Research Framework, technologies are also needed to assist in overcoming the social determinants of health (SDOH) and various barriers including but not limited to: Physical Barriers – factors such as proximity to healthcare facilities and transportation may limit access to healthcare Knowledge Barriers - health literacy and language barriers can inhibit healthcare delivery, as well as a lack of patient information for the healthcare provider Infrastructure Barriers - rural hospitals and community health centers may not have the same resources and expertise of large hospitals, and may not be able to afford advanced medical technologies Economic Barriers - lack of insurance coverage or financial resources may also contribute to disparities in healthcare access Cultural Barriers - culture, i.e., beliefs and practices shared among the members of social groups, including racial/ethnic populations, communities, healthcare organizations, institutions, and facilities. Cultural practices, procedures, and policies may impede access to healthcare, health promoting activities, or health promoting technologies. For racial/ethnic minorities, the proposed product may provide increased and more attractive opportunities for improved and better health, preventing and treating disease, and maintaining 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, 2015-2020 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. Applicants should make explicit how: 1) the proposed product will lead or is expected to lead to improvements in racial/ethnic minority population health and well-being; or, 2) the proposed technology will reduce or eliminate one or more disparities. Applicants should identify the disparity and the processes or mechanisms expected to be involved in realizing reductions. Specific Areas of Research Interest Technologies that might achieve the objectives of this initiative include, but are not limited to: Innovative products or services that facilitate or enhance disease self-management or family centered-care, patient-healthcare provider or system communication, and/or care coordination between primary care providers, hospital emergency department staff, specialty physicians, dental health professionals, nurse practitioners, providers of mental health and behavioral health services, patient navigators, 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, families, social networks, and communities to engage in health-seeking behaviors and health promoting activities (diet choice, exercise/physical activity, oral hygiene, medication adherence, child immunizations, etc.) and to avoid risky behaviors (smoking, vaping, 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 across multiple levels, individual, interpersonal, and communities and linking this information to physiological responses and health indicators at the individual and higher population levels. These technologies may include efforts to improve and standardize data collection and the integration of social determinants of health (SDOH) and other data across disparate data sources, including clinical patient data, electronic medical records, public health data, census data, housing data, employment data, crime statistics, etc.; Products or services that engage, empower, and motivate individuals, families, and communities to enhance the quality of life and to sustain health gains; 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, serious and applied games; printed materials for populations experiencing health disparities and disadvantaged communities; Innovative software, tools and technology for Science and Health Education such as curriculum materials, interactive teaching aids, serious and applied games, models for classroom instruction for K-12 and undergraduate students, and the general public; Mobile health (mHealth) and telehealth/telemedicine technologies and apps for improving communication among health care providers and between patients, families, and physicians and healthcare providers, medication adherence, diagnosis, monitoring, evaluation, medical management, screening, 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; Technology for linking family medical histories and family ancestries; 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; Technologies for promoting precision medicine and other precision-based strategies; Technology for leveraging electronic information and communication technologies to deliver and evaluate interventions that have the greatest potential to reduce health disparities by removing accessibility and health literacy barriers, facilitating population tailoring and personalization, and decreasing cost; Technologies for preventing one or more health disparities; Technologies using systems modeling, artificial intelligence, or other techniques to predict relationships between health disparities and health determinants and to assess health disparities interventions outcomes; and Technologies for creating and testing algorithms that identify interventions tailored and optimized for implementation in specific communities and that target reducing or eliminating disparities associated with one or more specific health condition, disease, or health outcome; Technologies for leveraging robotic and autonomous systems for improving minority health, and preventing, reducing, and eliminating health disparities. Technologies for preventing and minimizing adverse exposures and health risks (post-traumatic stress) or for promoting health, well-being, resilience, and recovery resulting from disasters or the threat of a disaster. Such technologies may include new tools, apps, education, curricula, or other technologies to detect, screen, treat, or prevent or otherwise mitigate adverse health outcomes or to leverage community and or population resilience and prevention efforts. Technologies and tools for educating prospective social entrepreneurs, and minority and health disparity communities on how to transition technologies from the bench to the bedside. Applications Not Responsive to the Funding Opportunity: Applications that do not explicitly address minority health or health disparities will be considered non-responsive to the RFA and not reviewed. Potential applicants are encouraged to discuss responsiveness with the Scientific Contact.