1. Agency for Healthcare Research and Quality Advancing Excellence in Health Care www.ahrq.gov Research Centers for Excellence in Clinical Preventive Services (P01) RFA-HS-11-005 Agency for Healthcare Research and Quality Technical Assistance Call April 14, 2011

2. Advancing Excellence in Health Care Conference Call Agenda Overview of the FOA Overview of the FOA Frequently asked questions Frequently asked questions Open forum Open forum

3. Advancing Excellence in Health Care Summary: Research Center for Excellence in Clinical Preventive Services This FOA solicits Research Program Project Grant (P01) applications with a focus on one of three programmatic areas: This FOA solicits Research Program Project Grant (P01) applications with a focus on one of three programmatic areas: – (1) Patient safety; – (2) Health equity; or – (3) Health care system implementation

4. Advancing Excellence in Health Care Centers will complement the efforts of other Federal investments in prevention and public health by focusing on the role of the formal health care system, and primary care in particular, in improving the health of all Americans, and in improving patient experience, through the implementation of evidence-based clinical preventive services. Centers will complement the efforts of other Federal investments in prevention and public health by focusing on the role of the formal health care system, and primary care in particular, in improving the health of all Americans, and in improving patient experience, through the implementation of evidence-based clinical preventive services. The goal is to support high quality, multidisciplinary programs of innovative research that will move forward the nation’s emerging National Prevention and Quality Strategies. The goal is to support high quality, multidisciplinary programs of innovative research that will move forward the nation’s emerging National Prevention and Quality Strategies. Summary: Research Center for Excellence in Clinical Preventive Services

5. Advancing Excellence in Health Care Summary: Research Center for Excellence in Clinical Preventive Services This FOA is intended to support both necessary This FOA is intended to support both necessary – core Center infrastructure and – two to four integrated research projects. – two to four integrated research projects. The projects should contribute to the overarching Center goal such that the whole is greater than the individual parts. The projects will thus not simply be unitary investigations that would better be supported by individual R01 or R18 awards. The projects should contribute to the overarching Center goal such that the whole is greater than the individual parts. The projects will thus not simply be unitary investigations that would better be supported by individual R01 or R18 awards.

6. Advancing Excellence in Health Care Programmatic areas of interest Patient Safety There are many potential harms associated with clinical preventive services such as false positive tests, anxiety, labeling, physical harms, and opportunity costs such as time off from work. These harms can result from the clinical preventive service but also from additional follow-up tests or from treatments. There are many potential harms associated with clinical preventive services such as false positive tests, anxiety, labeling, physical harms, and opportunity costs such as time off from work. These harms can result from the clinical preventive service but also from additional follow-up tests or from treatments. In order to improve patient safety, we must learn as much as possible about the tradeoff of potential benefits and harms of clinical preventive services. In order to improve patient safety, we must learn as much as possible about the tradeoff of potential benefits and harms of clinical preventive services. It is also important to understand how patients perceive these harms and how to communicate about the harms of clinical preventive services. It is also important to understand how patients perceive these harms and how to communicate about the harms of clinical preventive services.

7. Advancing Excellence in Health Care Programmatic areas of interest Health Equity This Center’s purpose is to study how to improve access, delivery and outcomes of clinical preventive services in priority populations such as children, women, the elderly, racial and ethnic minorities, and rural residents (see list of AHRQ priority populations at: http://www.ahrq.gov/populations). The aim is to generate evidence to help increase health equity in access to and use of clinical preventive services. This Center’s purpose is to study how to improve access, delivery and outcomes of clinical preventive services in priority populations such as children, women, the elderly, racial and ethnic minorities, and rural residents (see list of AHRQ priority populations at: http://www.ahrq.gov/populations). The aim is to generate evidence to help increase health equity in access to and use of clinical preventive services. http://www.ahrq.gov/populations – This Center may focus on constructing new data sets and/or cataloging existing datasets to study causes of disproportional mortality in priority populations. – It may develop new methods or enhance existing methods to study priority populations. – It may conduct original research on the provision of clinical preventive services in groups of people with different risk factors – It also may conduct research on strategies to decrease disparities in priority populations. Strategies may include community-wide approaches as well as interventions in the clinical setting.

8. Advancing Excellence in Health Care Programmatic areas of interest Implementing Clinical Preventive Services This Center will support basic or applied implementation research to address how primary care practices and the larger health care system can improve the delivery of evidence-based clinical preventive services based on USPSTF and the CDC’s Advisory Committee on Immunization Practices recommendations. This Center will support basic or applied implementation research to address how primary care practices and the larger health care system can improve the delivery of evidence-based clinical preventive services based on USPSTF and the CDC’s Advisory Committee on Immunization Practices recommendations. This may include research into how to redesign primary care to improve the delivery of clinical preventive services. The Center may study how primary care practices can partner with community-based organizations and the public health system to enhance the delivery and quality of clinical preventive services. This may include research into how to redesign primary care to improve the delivery of clinical preventive services. The Center may study how primary care practices can partner with community-based organizations and the public health system to enhance the delivery and quality of clinical preventive services.

9. Advancing Excellence in Health Care Definitions Clinical Preventive Services include: Clinical Preventive Services include: – Screening tests, such as colonoscopy, mammography, or blood pressure measurement. – Counseling, such as counseling to prevent tobacco use. – Preventive medications, such as aspirin to reduce the likelihood of heart attack or stroke. – Immunizations to prevent illnesses in infants, children, and adults, including pneumonia, flu, polio, and others.

10. Advancing Excellence in Health Care Definitions Some preventive services are meant to catch diseases early, and others are meant to prevent diseases entirely. Some preventive services are meant to catch diseases early, and others are meant to prevent diseases entirely. For the purposes of the FOA, clinical preventive services do NOT include screenings or services targeted to individuals with established medical conditions as part of the management and treatment of those conditions. For example, this FOA is not intended to address research gaps in the provision of screening for retinopathy in patients with diabetes For the purposes of the FOA, clinical preventive services do NOT include screenings or services targeted to individuals with established medical conditions as part of the management and treatment of those conditions. For example, this FOA is not intended to address research gaps in the provision of screening for retinopathy in patients with diabetes

11. Advancing Excellence in Health Care P01 Core Core personnel include the following administrative positions: Core personnel include the following administrative positions: – Principal Investigator – Collaborative Lead Core functions must address but are not limited to training, evaluation, administration, and dissemination Core functions must address but are not limited to training, evaluation, administration, and dissemination

12. Advancing Excellence in Health Care P01 core Other possible functions of the Core are shared research resources, such as statistics, communication or data programming expertise Other possible functions of the Core are shared research resources, such as statistics, communication or data programming expertise Another Core function is the coordination with the other Centers and with the Technical Assistance Center, and participating in regular teleconferences and once or twice a year in person meetings. These coordinated activities are expected to include support for common elements in evaluation and dissemination. Another Core function is the coordination with the other Centers and with the Technical Assistance Center, and participating in regular teleconferences and once or twice a year in person meetings. These coordinated activities are expected to include support for common elements in evaluation and dissemination.

13. Advancing Excellence in Health Care Research Projects The proposed projects may be independent, linked, sequential, or conducted in parallel as long as each one affords good independent feasibility and probability of success. All projects should relate to the chosen programmatic area of the Center. The proposed projects may be independent, linked, sequential, or conducted in parallel as long as each one affords good independent feasibility and probability of success. All projects should relate to the chosen programmatic area of the Center. Individual projects are not required to begin at the start of the grant and are not required to last the entire duration of the project period, but the proposed start and end of each project must be clearly stated, and must be budgeted appropriately. Overall the series of research projects must span the entire project period. Individual projects are not required to begin at the start of the grant and are not required to last the entire duration of the project period, but the proposed start and end of each project must be clearly stated, and must be budgeted appropriately. Overall the series of research projects must span the entire project period.

14. Advancing Excellence in Health Care Research Projects Applications must clearly describe each proposed research project including Applications must clearly describe each proposed research project including – a brief background – rationale and hypothesis, – specific aims, – research design, – analytic plan – analytic plan A separate detailed budget must be provided for each research project as part of the application budget section. Applications must also identify the specific research team that will conduct each study. Each specific research project must have an identified project leader. Individual project leaders must be listed as key grant personnel, but are not considered to be co-PIs for the Center. A separate detailed budget must be provided for each research project as part of the application budget section. Applications must also identify the specific research team that will conduct each study. Each specific research project must have an identified project leader. Individual project leaders must be listed as key grant personnel, but are not considered to be co-PIs for the Center.

15. Advancing Excellence in Health Care Budget, Project Period and Renewal Budget and Project Period: The total costs per grant awarded under this FOA will not exceed $1,500,000 annually for each year of the project period. An application with a budget that exceeds $1,500,000 total costs in any given year or a project period that exceeds 3 years will not be reviewed. Funding beyond the first year and in all subsequent years will be contingent upon a review and acceptance by Agency staff of an annual progress report (PHS 2590). Budget and Project Period: The total costs per grant awarded under this FOA will not exceed $1,500,000 annually for each year of the project period. An application with a budget that exceeds $1,500,000 total costs in any given year or a project period that exceeds 3 years will not be reviewed. Funding beyond the first year and in all subsequent years will be contingent upon a review and acceptance by Agency staff of an annual progress report (PHS 2590). Renewals: Centers established under this FOA will be eligible for one 2-year renewal. Renewals: Centers established under this FOA will be eligible for one 2-year renewal.

16. Advancing Excellence in Health Care One-time Program Project FOA Key Dates Release Date: March 11, 2011 Letters of Intent Receipt Date(s): April 29, 2011 Application Receipt Dates(s): May 23, 2011 Peer Review Date(s): Approximately two months after receipt date Earliest Anticipated Start Date: Approximately two months after peer review date Earliest Anticipated Start Date: Approximately two months after peer review date

17. Advancing Excellence in Health Care Some example Questions and Answers - Training - Dissemination - Project research topics

18. Advancing Excellence in Health Care Q and A: Training Can the P01 support a small grants research fund? Can the P01 support a small grants research fund? Can the P01 support post-doctoral positions? Can the P01 support post-doctoral positions? RESPONSE: The individual projects may include as named personnel persons doing post-doctoral research. The P01 is not meant to be used as a T32, and may not have funds for research not described in the application RESPONSE: The individual projects may include as named personnel persons doing post-doctoral research. The P01 is not meant to be used as a T32, and may not have funds for research not described in the application

19. Advancing Excellence in Health Care Q and A: Dissemination Are activities described as being undertaken by AHRQ’s Office of Communication and Knowledge Transfer meant to take the place of dissemination activities in the Center? Are activities described as being undertaken by AHRQ’s Office of Communication and Knowledge Transfer meant to take the place of dissemination activities in the Center? NO, the requirement to maintain contact with AHRQ’s OCKT committee is meant to supplement the plans of the Core described in the application NO, the requirement to maintain contact with AHRQ’s OCKT committee is meant to supplement the plans of the Core described in the application

20. Advancing Excellence in Health Care Q and A: Project Topics Should the projects be grouped onto a single clinical topic? Should the projects be grouped onto a single clinical topic? RESPONSE- In order to see the greatest benefit from these Centers, AHRQ wants to see advancing generalizable knowledge about Clinical Preventive Services- a clear way to do this would be to focus research on more than one clinical topic. It is possible that a proposal focusing multiple projects on one service could make clear the general applicability of their findings to other services. RESPONSE- In order to see the greatest benefit from these Centers, AHRQ wants to see advancing generalizable knowledge about Clinical Preventive Services- a clear way to do this would be to focus research on more than one clinical topic. It is possible that a proposal focusing multiple projects on one service could make clear the general applicability of their findings to other services.

21. Advancing Excellence in Health Care Other FAQ Does AHRQ accept modular budgets? NO Does AHRQ accept modular budgets? NO Does AHRQ recognize multiple PIs? NO Does AHRQ recognize multiple PIs? NO Must the P01 be prepared on paper forms? YES, the P01 application must be submitted on paper. Appendix material on CD. Must the P01 be prepared on paper forms? YES, the P01 application must be submitted on paper. Appendix material on CD. Does the application need a table of contents? YES Does the application need a table of contents? YES

22. Advancing Excellence in Health Care Application Research Strategy Length Program Project applications must set out the overall strategy for the program project and in addition include (two) distinct sections describing: Program Project applications must set out the overall strategy for the program project and in addition include (two) distinct sections describing: 1) Core Center functions and structure (e.g., training, evaluation, administration, and dissemination) and 1) Core Center functions and structure (e.g., training, evaluation, administration, and dissemination) and 2) A separate research strategy section for each proposed project. 2) A separate research strategy section for each proposed project. The overall P01 Research Strategy section may not exceed 30 pages, including tables, graphs, figures, diagrams, and charts. The overall P01 Research Strategy section may not exceed 30 pages, including tables, graphs, figures, diagrams, and charts.

23. Advancing Excellence in Health Care Funds Available and Anticipated Number of Awards AHRQ anticipates committing $4.5 million in FY2011 to fund three Centers. AHRQ anticipates awarding one application under each programmatic interest area assuming high quality, competitive applications are received for each area. AHRQ anticipates committing $4.5 million in FY2011 to fund three Centers. AHRQ anticipates awarding one application under each programmatic interest area assuming high quality, competitive applications are received for each area.

24. Advancing Excellence in Health Care Ground rules for Open Forum The conference call operator will put you in a queue based on call order The conference call operator will put you in a queue based on call order Please keep your questions brief Please keep your questions brief We will try to keep responses brief We will try to keep responses brief Questions that are very specific to a particular institution or situation will not be addressed – these can be discussed individually with a Project Officer from AHRQ at a later time Questions that are very specific to a particular institution or situation will not be addressed – these can be discussed individually with a Project Officer from AHRQ at a later time If you do not get an opportunity to ask a question, please e-mail your question to gloria.washington@ahrq.hhs.gov If you do not get an opportunity to ask a question, please e-mail your question to gloria.washington@ahrq.hhs.gov gloria.washington@ahrq.hhs.gov

25. Advancing Excellence in Health Care AHRQ Contacts For additional technical assistance, please contact an AHRQ staff person who will be glad to provide technical assistance: – – Scientific/Research Issues: Mary Barton: Mary.Barton@ahrq.hhs.govMary.Barton@ahrq.hhs.gov Therese Miller: Therese.Miller@ahrq.hhs.govTherese.Miller@ahrq.hhs.gov – – Peer Review Issues: Mitra Ahadpour: Mitra.Ahadpour@ahrq.hhs.gov Mitra Ahadpour: Mitra.Ahadpour@ahrq.hhs.govMitra.Ahadpour@ahrq.hhs.gov – – Financial/Grant Management Issues: Brian Campbell: gmi@ahrq.hhs.gov Brian Campbell: gmi@ahrq.hhs.govgmi@ahrq.hhs.gov