Intervention Research to Improve Native American Health (R21 Clinical Trials Optional) | PAR 23 299

Opportunity Information: Apply for PAR 23 299

The National Institutes of Health (NIH) funding opportunity titled "Intervention Research to Improve Native American Health (R21 Clinical Trials Optional)" (PAR-23-299) supports early-stage, developmental, and exploratory research meant to lay the groundwork for future, larger intervention studies that improve health outcomes in Native American populations. It uses the NIH R21 mechanism, which is designed for projects that are still in a formative stage but can generate strong preliminary evidence, practical implementation insights, or key foundational knowledge needed to move an intervention forward. The overall focus is on health promotion, disease prevention, treatment, and treatment services research that can reduce morbidity and mortality and help address persistent health inequities affecting Native communities.

The FOA encourages several kinds of studies, depending on what is already known in a given topic area. One option is etiologic research when there is a meaningful gap in knowledge and filling that gap would directly inform the development of a new intervention or the adaptation of an existing one. Another strong fit is research that designs, adapts, and pilot tests interventions, with an emphasis on feasibility (can it be done in real settings), acceptability (is it meaningful, usable, and appropriate for participants and communities), and scalability (can it be expanded beyond a small pilot without losing effectiveness or cultural fit). The announcement also welcomes short-term efficacy testing, meaning studies that look for early signals that an intervention improves outcomes over the near term. Finally, when an intervention already has a solid evidence base, applicants can propose research that tackles real-world barriers to adoption and long-term success, such as integration into local systems, scale-up across sites, and sustainability after initial funding ends.

A central theme throughout the opportunity is that Native American populations experience substantial acute and chronic disease inequities, and that these inequities are shaped by unique sociopolitical, historical, and environmental stressors. The FOA explicitly recognizes that these stressors can worsen health conditions and can also change how well standard or previously tested interventions work in Native contexts. At the same time, the announcement highlights community strengths, protective factors, and resiliencies that can buffer stressors and can be used to build better interventions. NIH is looking for culturally informed research that is grounded in community knowledge and resources, rather than simply transplanting approaches developed for other populations. The intent is to produce foundational evidence that supports future science-based, culturally appropriate solutions, including identifying and addressing early precursors to disease and developing culturally informed treatment approaches.

For the purposes of this FOA, "Native American" includes Alaska Natives, American Indians (whose ancestral lands are at least partially within the U.S. mainland borders), and Native Hawaiians. The FOA also includes a specific definition of Native Hawaiian tied to ancestry in the Hawaiian Islands prior to 1778, reflecting federal usage in related policy contexts.

Eligibility is broad and includes many organization types that could reasonably partner with or serve Native communities. Eligible applicants listed include state, county, city/township, and special district governments; independent school districts; public and private institutions of higher education; federally recognized Native American tribal governments; Native American tribal organizations other than federally recognized tribal governments; public housing authorities/Indian housing authorities; nonprofits with and without 501(c)(3) status; for-profit organizations (other than small businesses) and small businesses; and additional entities categorized as "others." The FOA also calls out additional eligible groups such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), tribally controlled colleges and universities (TCCUs), historically Black colleges and universities (HBCUs), Hispanic-serving institutions, faith-based or community-based organizations, regional organizations, eligible federal agencies, and U.S. territories or possessions. Foreign institutions (non-U.S. entities) are not eligible to apply, and non-U.S. components of U.S. organizations are not eligible; however, foreign components as defined by NIH policy are allowed, which can matter for projects involving certain kinds of external expertise or resources.

The opportunity is categorized as a discretionary grant under NIH, with a funding activity focus that includes health (and is also listed under education and environment categories). It spans multiple CFDA numbers, reflecting participation or relevance across multiple NIH institutes and programs. The listing shows an original closing date of January 7, 2027, indicating a multi-year window in which standard NIH receipt dates and cycles may apply under this announcement. The FOA is labeled "Clinical Trials Optional," meaning applicants can propose either clinical trial or non-clinical trial research, as long as the work aligns with NIH definitions and the FOA scope.

In practical terms, competitive projects under this FOA are likely to be those that can show a clear link between the proposed research activities and a pathway to improving Native health outcomes, while also demonstrating that the intervention approach is culturally grounded, community-engaged, and realistic for the settings where it would eventually be implemented. Projects that thoughtfully address feasibility, trust, local infrastructure, workforce, data considerations, and long-term sustainability tend to fit the R21 exploratory purpose, especially when they position the work as a strong stepping stone toward larger-scale efficacy or effectiveness trials and broader implementation.

• The National Institutes of Health in the education, environment, health sector is offering a public funding opportunity titled "Intervention Research to Improve Native American Health (R21 Clinical Trials Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.113, 93.121, 93.213, 93.242, 93.273, 93.279, 93.307, 93.313, 93.361, 93.393, 93.399, 93.846, 93.879.
• This funding opportunity was created on 2023-09-11.
• Applicants must submit their applications by 2027-01-07.
• 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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