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

Frequently Asked Questions (FAQs)

What is the name and identifier of this NIH funding opportunity?

The opportunity is titled "Intervention Research to Improve Native American Health (R21 Clinical Trials Optional)" and the FOA number is PAR-23-299.

What is the main purpose of PAR-23-299?

This FOA supports early-stage, developmental, and exploratory research intended to lay the groundwork for future, larger intervention studies that improve health outcomes in Native American populations. The focus is on generating foundational evidence, practical implementation insights, or key knowledge needed to move an intervention forward.

What NIH grant mechanism does this FOA use?

It uses the NIH R21 mechanism, which is designed for projects that are still in a formative stage but can produce preliminary evidence and other essential groundwork for later, larger studies.

What health areas and outcomes does the FOA emphasize?

The FOA emphasizes health promotion, disease prevention, treatment, and treatment services research that can reduce morbidity and mortality and address persistent health inequities affecting Native communities.

Which populations are included under "Native American" in this FOA?

For 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.

How does the FOA define "Native Hawaiian"?

The FOA includes a specific definition of Native Hawaiian tied to ancestry in the Hawaiian Islands prior to 1778, reflecting federal usage in related policy contexts.

What kinds of research projects does the FOA encourage?

The FOA encourages multiple study types depending on what is already known in the topic area, including: etiologic research to fill key gaps that directly inform intervention development or adaptation; intervention design/adaptation and pilot testing focused on feasibility, acceptability, and scalability; short-term efficacy testing to look for early signals of benefit; and research on adoption, integration, scale-up, and sustainability when an intervention already has a solid evidence base.

What is meant by "etiologic research" in this FOA?

Etiologic research is supported when there is a meaningful gap in knowledge and filling that gap would directly inform developing a new intervention or adapting an existing one for Native American contexts.

What is meant by feasibility, acceptability, and scalability in this context?

Feasibility asks whether the intervention can be carried out in real-world settings. Acceptability focuses on whether the intervention is meaningful, usable, and appropriate for participants and communities. Scalability considers whether the intervention can be expanded beyond a small pilot without losing effectiveness or cultural fit.

Does the FOA allow short-term efficacy testing?

Yes. The FOA welcomes short-term efficacy testing, meaning studies designed to detect early signals that an intervention improves outcomes over the near term.

If an intervention is already evidence-based, what type of work is encouraged?

When an intervention already has a strong evidence base, the FOA encourages research that addresses real-world barriers to adoption and long-term success, including integration into local systems, scaling across sites, and sustainability after initial funding ends.

Why does the FOA emphasize culturally informed and community-grounded research?

The FOA recognizes that Native American health inequities are shaped by unique sociopolitical, historical, and environmental stressors that can worsen health conditions and influence how well standard interventions work in Native contexts. NIH is seeking research that is grounded in community knowledge, resources, strengths, and resiliencies rather than simply transplanting approaches developed for other populations.

Does the FOA mention protective factors and resiliencies in Native communities?

Yes. The FOA highlights community strengths, protective factors, and resiliencies that can buffer stressors and can be leveraged to build stronger, more culturally appropriate interventions.

Is this FOA limited to treatment research, or does it also include prevention and health promotion?

It includes health promotion and disease prevention as well as treatment and treatment services research, with the overall goal of improving health outcomes and reducing inequities.

Are clinical trials required under this FOA?

No. The FOA is labeled "Clinical Trials Optional," meaning applicants may propose clinical trial or non-clinical trial research, as long as the project aligns with NIH definitions and fits the FOA scope.

Who is eligible to apply?

Eligibility is broad and includes many organization types, such as state, county, city/township, and special district governments; independent school districts; public and private higher education institutions; federally recognized Native American tribal governments; Native American tribal organizations other than federally recognized tribal governments; public housing authorities/Indian housing authorities; nonprofits (with or without 501(c)(3) status); for-profit organizations (other than small businesses) and small businesses; and other eligible entities described in the FOA.

Are tribal governments and tribal organizations eligible?

Yes. Federally recognized Native American tribal governments are eligible, and Native American tribal organizations that are not federally recognized tribal governments are also listed as eligible applicants.

Are U.S. colleges and universities eligible, including specialized serving institutions?

Yes. The FOA includes eligibility for public and private institutions of higher education and specifically calls out Alaska Native and Native Hawaiian Serving Institutions, AANAPISIs, tribally controlled colleges and universities (TCCUs), HBCUs, and Hispanic-serving institutions.

Are faith-based or community-based organizations eligible?

Yes. The FOA explicitly lists faith-based or community-based organizations among eligible groups.

Are U.S. territories or possessions eligible?

Yes. U.S. territories or possessions are listed among eligible applicants.

Are foreign institutions eligible to apply?

No. Foreign (non-U.S.) institutions are not eligible to apply. In addition, non-U.S. components of U.S. organizations are not eligible.

Are any foreign components allowed at all?

Yes. The FOA states that foreign components, as defined by NIH policy, are allowed. This can be relevant when a project uses certain kinds of external expertise or resources.

What is the overall funding category and type of award?

The opportunity is categorized as a discretionary grant under NIH and uses the R21 activity code.

Does the FOA connect to specific subject categories?

Yes. The funding activity focus includes health and is also listed under education and environment categories.

Does this FOA involve multiple NIH programs?

The listing notes that it spans multiple CFDA numbers, which reflects participation or relevance across multiple NIH institutes and programs.

What is the closing date listed for this opportunity?

The listing shows an original closing date of January 7, 2027, indicating a multi-year window during which standard NIH receipt dates and cycles may apply under this announcement.

What kinds of projects are likely to be competitive under this FOA?

Competitive projects are likely to clearly link proposed research activities to a pathway for improving Native health outcomes and demonstrate that the intervention approach is culturally grounded, community-engaged, and realistic for the settings where it would be implemented. Projects that address feasibility, trust, local infrastructure, workforce needs, data considerations, and long-term sustainability are aligned with the R21 exploratory intent, especially when positioned as a stepping stone toward larger-scale efficacy/effectiveness trials and broader implementation.

What does it mean that this FOA is meant to "lay the groundwork" for future studies?

It means the FOA is intended to support early and exploratory work that produces the preliminary evidence, implementation learnings, or foundational knowledge needed to justify and design later, larger intervention studies.

Does the FOA encourage adapting interventions rather than creating entirely new ones?

Yes. The FOA supports studies that develop new interventions and studies that adapt existing interventions, particularly when adaptation is informed by community context and cultural fit.

What is the relationship between health inequities and intervention effectiveness in this FOA?

The FOA explicitly recognizes that unique sociopolitical, historical, and environmental stressors shaping inequities can also influence whether standard or previously tested interventions work well in Native contexts, which is why culturally informed research is emphasized.