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Department of Health Care Access and Information

The Alfred E. Alquist Hospital Facilities Seismic Safety Act (Health and Safety Code (HSC) Section 129675) requires that hospitals be constructed to remain open and safely provide services to the public after an earthquake. The Small and Rural Hospital Relief Program will administer this new grant program to eligible small, rural, or Critical Access hospitals that have limited funds for seismic safety retrofit requirements. Ten percent of the funds from the California Electronic Cigarette Excise Tax will be allocated to HCAI to fund the new program (HSC Section 130075). The SRHRP supports qualified small, rural and Critical Access hospitals by providing state grant funding and technical assistance to help meet seismic safety standards and preserve access to general acute care for the communities they serve. The program is being developed to assist qualified facilities with technical assistance for development of seismic improvement program planning, project planning and development, and financial grants to apply towards implementing each facility’s unique compliance program. The first step in qualifying for the program will be the application process, which will be used to determine if facilities meet the qualifications as either a small, rural or Critical Access hospital at risk of closure for financial reasons. Program applicants will be required to have current seismic compliance plans and agreed-upon project delivery plans on file with HCAI’s Seismic Compliance Unit prior to acceptance of funding package applications. A process will be employed to optimize use of available funds across all program participants based on need and adherence to approved project schedules.

Department of Health Care Access and Information

The Alfred E. Alquist Hospital Facilities Seismic Safety Act (Health and Safety Code (HSC) Section 129675) requires that hospitals be constructed to remain open and safely provide services to the public after an earthquake. The Small and Rural Hospital Relief Program will administer this new grant program to eligible small, rural, or Critical Access hospitals that have limited funds for seismic safety retrofit requirements. Ten percent of the funds from the California Electronic Cigarette Excise Tax will be allocated to HCAI to fund the new program (HSC Section 130075). The SRHRP supports qualified small, rural and Critical Access hospitals by providing state grant funding and technical assistance to help meet seismic safety standards and preserve access to general acute care for the communities they serve. The program is being developed to assist qualified facilities with technical assistance for development of seismic improvement program planning, project planning and development, and financial grants to apply towards implementing each facility’s unique compliance program. The first step in qualifying for the program will be the application process, which will be used to determine if facilities meet the qualifications as either a small, rural or Critical Access hospital at risk of closure for financial reasons. Program applicants will be required to have current seismic compliance plans and agreed-upon project delivery plans on file with HCAI’s Seismic Compliance Unit prior to acceptance of funding package applications. A process will be employed to optimize use of available funds across all program participants based on need and adherence to approved project schedules.

Denali Commission

The Denali Commission is inviting statements of interest for rural Alaska transportation projects in need of local match or gap funding assistance. Many Alaskan communities lack the tax base or resources necessary to meet cost share requirements. This opportunity seeks to provide funding to cover local match needs or address funding gaps, facilitating the completion of transportation projects and supporting infrastructure development in rural communities across the state.OverviewThe Commission announces the availability of match and gap assistance funds for construction-ready rural transportation improvement projects. This announcement commits up to $7,500,000 for the purpose of this program from funds appropriated under Public Law 117-328 and allows for non-federal match via Section 309(h) Non-Federal Share of the Denali Commission Act of 1998 (42 U.S.C. 3121; Public Law 105-277), stating, funds made available to carry out this section may be used to meet the non-Federal share of the cost of projects under title 23, United States Code .Eligible projects must benefit the public in Alaska. Eligible applicants include municipal, borough, and tribal governments; Indian Tribes as defined by Title 25 US Code 5304; regional tribal non-profit organizations; and other non-profit organizations.Entities which do not have an active or pending award with the Denali Commission transportation program will be given priority consideration.The Commission will evaluate statements of interest forms shortly after the application window closes. A review committee of Commission staff and subject matter experts will conduct a conformance review and evaluate statements according to the priorities listed above, beginning to invite successful respondents by early September to submit proposals. Invitations for proposal will give interested parties approximately 30 days to respond with a full proposal. The Transportation Advisory Committee, Commission staff and subject matter experts will evaluate full proposals. The Commission anticipates making awards in spring 2027. The Commission reserves the right to partially fund projects, subject to the quality of funding assistance requests received and other relevant considerations.Download the full announcement and fillable form in Related Documents: Statement of Interest - Rural Transportation Match and Gap Funding Assistance Program Please email your completed Statement of Interest form to the Commission at projects@denali.gov. DO NOT UPLOAD TO Grants.gov.

NINR - National Institute of Nursing Research

Abstract National health authorities point to collecting sexual orientation and gender identity (SOGI) data as essential to systematically addressing the health and healthcare needs of sexual- and gender-diverse (SGD) people across all domains of life. The State of New Mexico answered this call by directing all its government agencies, including those overseeing or financing health and human service delivery, to collect voluntary self-reported SOGI data. These vital (a) illuminate the nature and extent of disparities and adverse health outcomes for a minoritized population, (b) encourage patient-centered care, and (c) develop equity-focused evidence-based interventions (EFEBIs) to eliminate long-standing disparities. New Mexico is a bellwether for other states wanting to routinize processes for robust demographic analyses of SGD people, enhance coordination of health services, guide policy and funding decisions, advance EFEBIs for their varied citizenries and monitor progress toward health equity for SGD people. New Mexico's health department (NMHealth) operates 53 public health offices (PHOs)— ideal settings for analyzing the uptake and sustainment of SOGI data collection. Staffed in large part by nurses, PHOs are a critical safety net for racially, ethnically, and geographically diverse communities in New Mexico, offering a wide range of health services, from immunizations, family planning, nutritional programming, substance use harm reduction, testing and treatment for sexually transmitted infections, cancer prevention and control, and other medical care across the lifespan. This multilevel, mixed-method R01 study will test the acceptability, appropriateness, and feasibility of implementation strategies in PHOs to enable SOGI data collection with different populations and in urban, rural, and frontier contexts. Guided by the Interactive Systems Framework, our interdisciplinary team will (1) assess gaps in implementation readiness to engage in accurate, reliable, and usable SOGI measurement in PHOs; and apply implementation mapping to systematically select and tailor implementation strategies to address barriers; (2) deploy and evaluate identified implementation strategies to enable SOGI data collection in PHOs in a sequential multiple assignment randomized trial (SMART); and (3) use the Discover, Design, Build, and Test framework to develop an online toolkit integrating manualized implementation strategy resources to disseminate SOGI data collection in service delivery settings. Our team of researchers, healthcare providers, and patient advocates are poised to foster use of implementation strategies for inclusive SOGI data collection, so the state and nation are prepared to identify, analyze, and advance EFEBIs to intervene in the alarming disparities negatively shaping SGD health and well-being. Through the innovative use of models and methods from dissemination and implementation science, our team's overall goal is to tackle a long-running, perplexing problem—the rampant deficiencies in state-sponsored data collection systems that abet the invisibility of SGD people in public health, medical, and human service records, thwart the development of EFEBIs, and buttress poor health outcomes.

NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases

PROJECT SUMMARY/ ABSTRACT Rural individuals with type-2 diabetes mellitus (T2D) face higher rates of complications including amputation, renal failure, and blindness compared to their urban counterparts, which is particularly concerning in Missouri where 99 of 101 rural counties are health professional shortage areas. Our pilot study in the Missouri Bootheel, which has the state’s highest diabetes prevalence rate, revealed that participants experiencing higher stress levels had suboptimal health self-management practices, underscoring the need to integrate stress management into diabetes self-management education programs (DSMEP). This project aims to address this gap by systematically adapting the Stress Process Model (SPM) into the evidence-based Dining with Diabetes (DWD) program for rural Missourians living with T2D. Therefore, in response to PAS-25-102 (Small R01 for Clinical Trials Targeting Disease within the Mission of NIDDK), this research project addresses these intersecting challenges through three specific aims: 1) to systematically adapt SPM into the DWD program for rural populations; to assess the feasibility and preliminary efficacy of the adapted DWD+SPM intervention in rural Missouri by implementing a pilot cluster randomized trial and 3) to evaluate implementation outcomes of the DWD+SPM adapted intervention to inform future scale-up efforts. Using the ADAPT-ITT framework, we will engage Extension Specialists and community partners from six Bootheel Missouri counties to incorporate SPM into the DWD program (DWD+SPM). We will identify rural-specific challenges to diabetes self-management, document necessary adaptations to program content and delivery methods, and develop stress resilience components based on the Stress Process Model. We will assess the acceptability, feasibility, and preliminary efficacy of the adapted DWD+SPM intervention through a pilot hybrid type 1 effectiveness-implementation trial comparing the adapted and traditional DWD programs. Finally, using mixed methods, we will evaluate implementation outcomes to inform future scale-up efforts, measuring implementation outcomes, documenting adaptations, identifying challenges and enablers, and examining how community-specific resources influence program implementation across rural contexts. The expected outcomes will significantly contribute to improving T2D management among rural individuals in Missouri, with underserved rural residents receiving additional stress management services through county extension. Findings will inform the development of a larger-scale R01 randomized controlled trial testing the efficacy and cost-effectiveness of the DWD+SPM intervention across various rural DSMEP delivering settings. This project directly addresses rural health disparities by incorporating stress management into an evidence-based education program to improve T2D outcomes in rural Missouri and responds to the need for interventions specifically effective for rural populations.

NIDA - National Institute on Drug Abuse

PROJECT SUMMARY/ABSTRACT The Central Appalachian region is a rural area that has some of the highest rates of opioid related mortality in the U.S. It is essential to fully understand factors contributing to these challenges and identify solutions as the region is heavily burdened with this major public health crisis. The East Tennessee State University (ETSU) Mentored Substance Use Research (EMSUR) program is a collaborative, transdisciplinary program that aims to mentor and train the next generation of researchers and practitioners focused on substance use in Central Appalachia. The EMSUR summer program will train 10 undergraduate students each year over five years through experiential faculty-mentored substance use research, engagement with the proven digital Substance Use Research Education and Training (SARET) curriculum that will include regionally-focused ETSU-developed modules, and participation in dynamic real-world presentations from guests speakers and experts in rural health, treatment and recovery research, and those with lived experience of substance use disorder (SUD). Every attempt will be made to recruit highly qualified students with an interest in living and working in the Central Appalachia region. The goal of the EMSUR program is to increase undergraduate student interest in SUD-related research and practice, thereby increasing the number of trained SUD researchers and practitioners living and working in the Central Appalachian region, that will ultimately be able to find solutions for these SUD related challenges. The EMSUR summer program will be accomplished through three specific aims: 1) Build a robust recruitment pipeline for undergraduate students through collaborations across ETSU and partnering institutions, leveraging faculty, staff, and direct student outreach to promote program awareness and engagement. 2) Train a cohort of 10 undergraduate students per year in a mentored, transdisciplinary summer research experience, fostering critical thinking skills, scientific rigor in addiction research, and practiced-based experiences. 3) Equip trainees for dissemination of their research through both conventional (e.g. poster, oral presentation) and innovative methods (e.g. infographics, data visualization). Program success will be evaluated across recruitment, program completion, and trainees continued engagement in SUD research in the short and long term.

NLM - National Library of Medicine

PROJECT SUMMARY / ABSTRACT Temporal changes in clinical practice, patient populations, and information systems degrade performance of artificial intelligence (AI) and machine learning (ML) models. Lack of model generalizability across patient contexts—be they clinical, geographic, or sociodemographic—creates performance gaps that can lead to differences in access to care and unevenly distribute algorithmic benefits. Failing to proactively address performance drift and differences in performance across patient subgroups risks patient safety, undermines user trust, and fails to deliver on the promise of predictive analytics based either traditional ML or novel large language models (LLMs) to improve patient and population health. Learning prediction systems (LPS), an extension of the learning health system paradigm of data-driven continuous improvement, would conduct post- deployment surveillance to collect evidence of model success or deterioration and recommend changes that sustain prospective model performance, both overall and within patient subgroups. Existing model maintenance methods focus on population-level performance and have yet to explore how model updates may generalize across variable patient contexts and impact subgroup performance. Our central objective is to design LPS that promote sustainable AI/ML decision support tools (AI-DST) to ensure all patients benefit from the AI-enabled transformation of healthcare. Using data from the Department of Veterans Affairs (VA) and Vanderbilt University Medical Center (VUMC), we will apply complex simulation studies and real-world evaluations across 3 clinical domains to advance novel LPS metrics and methods that sustain generalizable and effective delivery of clinical AI/ML. In Aim 1, we characterize the complex spectrum of temporal changes in performance gaps between patient contexts and whether/how model updating practices and learning algorithms (ML and LLMs) impact performance gap drift. In Aim 2, we develop and benchmark novel methods to characterize and detect exacerbation of performance gaps between patient subgroups, as well as updating strategies that foster restoration of overall and subgroup performance. In Aim 3, we extend LPS methods in support of small patient subgroups, such as those served by rural healthcare centers, where limited sample sizes present unique challenges to effectively monitoring performance, detecting deterioration, and training updates. In Aim 4, we disentangle changes in outcomes associated with effective AI-DST from dataset shift, establishing LPS methods to monitor and update models while accounting for feedback interference, including monitoring of decision consistency across patient contexts. We will evaluate these methods prospectively in a deployed AI-DST preventing postpartum hemorrhage at VUMC. With expertise in informatics, AI, data science, ethics, and clinical care, our team is well-positioned to have a major impact on the development and implementation of LPS that sustain AI-DST for all patients, propelling the adoption of responsible AI/ML.

NIAID - National Institute of Allergy and Infectious Diseases

PROJECT SUMMARY/ABSTRACT This project will assess whether digital crowdsourced messaging can increase syphilis/HIV/STI testing among women in two sites in the US (urban New York City and rural Alabama, including among Native American women). Syphilis rates in the US are the highest in 40 years, and rates are increasing more rapidly among women than men. Syphilis rates are up to ten times higher among women of color than among non-Hispanic White women. Women of color underutilize testing services, and stigma and medical mistrust remain significant barriers to syphilis/HIV/STI testing uptake. Different cultures require tailored dissemination messaging that speaks to and is relevant for their local context. Citizen science approaches, such as crowdsourcing (i.e., engaging groups of individuals online to address public health challenges and share solutions), are scalable, cost-effective implementation strategies that can increase syphilis/HIV/STI testing services and reduce stigma in resource-constrained settings. Crowdsourcing can be used to engage communities in developing culturally-relevant, locally-tailored messaging to promote syphilis/HIV/STI testing. Complementing crowdsourcing, specimen self-collection with remote syphilis/HIV/STI testing is another strategy that may also reduce stigma and increase access to testing, especially for women in rural or other resource-constrained areas. Study aims are: 1) to develop crowdsourced digital messages to promote syphilis/HIV/STI testing among women ages 18-45 in the United States and compare community preferences for digital content; 2) in a parallel, Hybrid Type 3 randomized controlled trial, to compare the crowdsourced dissemination messaging to existing public health messaging in increasing syphilis/HIV/STI testing among women (n=1,176) in rural AL and urban NYC, including among Native American women; and 3) using an integrated implementation science framework and a mixed methods approach, we will examine the contribution of multi-level factors on implementation outcomes, particularly effectiveness and broader community reach. This work will result in digital crowdsourced messaging to increase syphilis/HIV/STI testing uptake among demographically and geographically disparate women in the US. This project will also result in a crowdsourcing and messaging toolkit that can be broadly distributed to public health agencies across the country for their use in leveraging community voices to design culturally appropriate and relevant messaging campaigns to address the syphilis/HIV/STI epidemics and other public health issues in their communities. Findings from this project will lay the groundwork for community-developed dissemination messaging for women across the US to reduce syphilis rates among women and newborns nationally.

TX Dept of Agriculture

Grants for rural economic development, farm-to-market programs, and agricultural diversification.

Health Resources and Services Administration

The purpose of the THCGME Program is to provide maintenance funding to support the training of residents in existing HRSA-supported primary care residency training programs in community-based ambulatory patient care centers. These programs will prepare residents to provide high-quality care, particularly in rural and medically vulnerable communities, and develop competencies to serve a wide range of populations and communities.

Health Resources and Services Administration

<p>The purpose of the THCGME Program is to prepare residents to provide high-quality care,&nbsp;particularly in rural and medically underserved communities, while developing the competencies they need to serve a wide range of populations and communities. The THCGME does this by providing funding to support the training of residents in HRSA-supported primary care residency training programs in community-based ambulatory patient care centers.&nbsp;</p>

NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development

1 PROJECT SUMMARY 2 Children living in rural and underserved communities face persistent disparities in access 3 to early rehabilitation services due to geographic isolation, provider shortages, and 4 socioeconomic barriers. These challenges are especially detrimental during the first three years 5 of life, when early intervention has the greatest potential to improve developmental outcomes. 6 Physical therapy (PT) is a key component of early intervention for infants and toddlers with or at 7 risk for motor delays, yet many families face long waitlists or lack access to qualified providers. 8 ELEVATE (Early Learning & Engagement Via Access to Tele-coaching) is an innovative, 9 caregiver-delivered PT intervention delivered via telerehabilitation. This project will evaluate the 10 efficacy, acceptability, and caregiver engagement of ELEVATE for children aged 0–3 years with 11 or at risk for motor delays in rural communities. Forty-five children and caregivers will be recruited 12 from two rural sites in Ohio and Montana and randomized to immediate intervention or a waitlist 13 control group. The intervention includes twice-weekly telehealth PT sessions, and a structured 14 home program, delivered for 8 weeks. Primary outcomes include child motor function and 15 caregiver self-efficacy. Outcomes will be assessed at baseline, post-intervention, and at a 1- 16 month post-intervention follow-up. We will also assess acceptability through caregiver satisfaction 17 surveys and focus groups with both caregivers and community stakeholders. Finally, we will 18 explore caregiver and child engagement as a potential mechanism of motor and self-efficacy 19 change. Findings will provide critical outcome data to inform a future multi-site comparative 20 effectiveness trial evaluating ELEVATE versus usual care in underserved settings.

Tennessee Department of Economic and Community Development (ECD)

The Rural Economic Opportunity Fund supports economic development in Tennessee's rural communities through grants for infrastructure, site preparation, and community projects that attract investment and create jobs in distressed areas.

NIDA - National Institute on Drug Abuse

PROJECT SUMMARY Partly due to inaccurate beliefs about substance use disorder and inadequate public policies, the substance use epidemic has increased associated risks of infection with the Human Immunodeficiency Virus (HIV) and viral hepatitis (e.g., Hepatitis C Virus [HCV]) in rural regions of the United States. Identifying efficacious programs that are effective and scalable remains imperative. The proposed project, submitted in response to RFA-DA-25024, High Priority HIV and Substance Use Research, will examine the effectiveness of a virtual social intervention to increase HIV/HCV testing and prevention in rural areas of the US. The intervention convenes people with recent substance use and members of the community at large via Zoom to increase social integration, decrease negative beliefs, and improve pro-health norms in all involved. In addition to increasing social capital, the intervention provides remote access to testing and Naloxone (Narcan) and adapts to participants’ needs by promoting individual goal achievement within a group format and through an ad-hoc social platform. The research plan is supported by meticulously collected preliminary data establishing a large effect of the intervention on HIV testing, HCV testing, HIV prevention, and social integration as a composite primary outcome. The approach is also supported by impressive AI (Artificial Intelligence) data on the feasibility of developing an AI Co-Pilot to scale up this intervention by training and providing realtime assistance to community facilitators at a low cost. This five-year project will begin by preparing the infrastructure to conduct an implementation Cluster-Randomized Controlled Trial (C-RCT), including convening our Community Advisory Board (CAB) to cover at-risk rural counties and fine-tuning the AI Co-Pilot (Aim 1). We will enroll 700 participants from high-risk rural locations in the US, half using substances and the other half from the community at large, randomizing them to the AI-assisted intervention or a virtual supportgroup attention control, both with booster sessions (Aim 2). Over the next 6 months, we will measure the outcome of the intervention on a composite index of HIV and HCV testing, HIV prevention, and social integration, as well as each of those outcomes and mental health, substance use treatment seeking, substance use behaviors, and idiosyncratic goal achievement as supplementary outcomes. We will assess theoretical processes that mediate the intervention effects based on measures of norms, social support, goal session and implementation, and testing- and Narcan-kit requests. The project, which will document implementation outcomes, will be conducted by an interdisciplinary team with expertise in psychology, medicine, communication, public health, implementation science, computer science, and biostatistics, from the University of Pennsylvania and the University of North Carolina.

Texas Department of Agriculture

Supports rural Texas communities and agricultural enterprises through grants for infrastructure, market development, and rural economic development.

OD - NIH Office of the Director

Trauma is a leading cause of mortality and disability in the United States, particularly among civilians and military members aged 5–45 years. Although injuries are largely preventable and treatable, access to timely, high quality trauma care remains limited in austere settings such as rural “trauma deserts” and disaster response environments in the US. These challenges mirror conditions in sub Saharan Africa (SSA), where injuries and surgically treated diseases represent a substantial disease burden, yet research infrastructure and funding opportunities are limited. Settings such as Cameroon, therefore, provide scientifically informative and cost efficient environments to study trauma and surgical care questions directly relevant to U.S. civilian and military populations facing low resource conditions. The Data Science Center for the Study of Surgery and Injury in Africa (D SINE Africa) is an NIH funded research hub based at the University of Buea in Cameroon. It is a strategic partnership between the University of Buea, the University of California (Los Angeles and Berkeley), the Cameroonian Ministry of Public Health, and the University of Cape Town. This collaboration enables trauma research that is often infeasible in the U.S. due to prohibitive cost or lack of clinical equipoise. Similar to how U.S. military experience has advanced civilian trauma care, research conducted in austere African settings can generate evidence benefiting U.S. populations. D SINE Africa leverages data science to reduce the burden of trauma, surgical disease, and health disparities in Cameroon and SSA through three Center Cores (Administrative, Capacity Building, and Data Management and Analysis) and two Research Projects. Project 1 develops socioeconomic status surveillance tools, and Project 2 applies machine learning to enhance post discharge trauma follow up. Both projects rely on the Cameroon Trauma Registry (CTR), a centralised nine hospital database that has enrolled over 18,000 patients and includes longitudinal mHealth follow up at 2 weeks, 1, 3, and 6 months post discharge, capturing rare data on disability and economic impact. This administrative supplement addresses two critical needs centred on CTR sustainability and institutionalization to achieve D-SINE Africa’s overall mission and complete the integration of Project 2’s Aim 1 to “scale-up an mHealth, phone-based screening tool to identify trauma patients in Cameroon who would benefit from further formal medical care”. Specifically, it aims to 1) Streamline the CTR and mHealth program through “de-implementation” and data harmonisation to improve efficiency and sustainability, and 2) Engage Cameroon’s National Health Information System to incorporate priorities for CTR data collection and explore integration of core CTR elements into the District Health Information System 2 (DHIS2) platform. This supplement will ensure completion of these critical projects, sustain high impact trauma research, and continue to provide U.S. trainees with valuable opportunities for secondary data analysis and hypothesis driven research with direct relevance to U.S. trauma care.

NIAID - National Institute of Allergy and Infectious Diseases

Project summary: With the growing prevalence of pediatric atopic dermatitis (AD) and subsequent food allergy, asthma and allergic rhinitis, there is an unmet need to identify early biomarkers to allow early disease-preventative interventions. Recent studies emphasize the heritable and environmental components of early-onset AD. DNA methylation (DNAm), a regulator of gene expression highly reactive to environmental exposures, is one potential mechanistic biomarker that that may work along the causal pathway. In our population birth cohort, the Wayne County, Health, Environment, Allergy and Asthma Longitudinal Study (WHEALS), we identified differential cord-blood DNAm in children with early-onset AD compared to those without. Furthermore, we created a cord-blood poly-CpG score that differentiates those with early-onset AD, with a cross-validated AUC of 0.937. We aim to further investigate the connection between cord-blood DNAm and newborn blood spot DNAm, and early-onset AD in the context of established germline genetic and environmental AD risk factors. Using a rigorous framework, we will achieve this objective through the following Specific Aims: Aim 1: To identify and validate cord blood DNAm associated with early-onset AD in the context of in- utero environmental factors. We will use WGBS to identify and validate cord blood DNAm variation associated with early-onset AD in five birth cohorts spanning urban, suburban, and rural environments for early-onset AD and whether known AD-associated prenatal factors lie upstream in the causal pathway. We will also investigate whether methylation-based gestational age is associated with early-onset AD risk and the impact of the prenatal environment on this relationship. Leveraging our Henry Ford Health Eczema and Primary Care Clinics, we will also determine whether the cord-blood signatures for early-onset AD translate to newborn blood spot DNAm. Aim 2: To determine whether cord blood DNAm causally impacts risk of early-onset AD using Mendelian randomization. First, we will determine which of the 101 multi-ethnic GWAS established risk variants are cord blood methylation quantitative trait loci (mQTL) using an epigenome-wide analysis approach. Second, for those risk variants that are also mQTL, we will use these variants as instrumental variables to assess the causal relationship of the CpG sites with early-onset AD using one-sample Mendelian randomization methods. Aim 3: To determine the individual and joint contributions of DNAm, genetic, and prenatal environment scores to the prediction of early-onset AD. We will develop and validate poly-prenatal environmental risk scores (PERS) and poly-CpG risk scores (PCRS) for early-onset AD, and along with an existing polygenic risk score (PGRS) for AD, evaluate their separate and joint impact on early-onset AD prediction.

NCI - National Cancer Institute

PROJECT SUMMARY/ABSTRACT No changes are being made in this proposed supplement to the stated project summary. With the evolution of the Experimental Therapeutics Clinical Trials Network (ETCTN), the Johns Hopkins Translational Science Team (JHTST) supports 8 Affiliate Organizations (AO) under our Lead Academic Organization (LAO) with the goal to enhance and accelerate our collective contribution to the drug development efforts of the NCI. We have organized a comprehensive and cohesive infrastructure that can conduct high-quality clinical trials evaluating novel anticancer agents, in combinations, in molecularly selected patient populations, or rare tumor sites. Our infrastructure stems from the need to be clinically efficient, regulatory compliant and scientifically rigorous in our approach as we collaborate as network members within the ETCTN. Our infrastructure consists of seven experienced NCI-designated Cancer Centers: Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Emory Winship Cancer Institute, Georgetown Lombardi Comprehensive Cancer Center, Sidney Kimmel Cancer Center at Thomas Jefferson University (withdrawn), Memorial Sloan Kettering Cancer Center, University of Virginia Cancer Center, University of Wisconsin Carbone Cancer Center, University of Colorado Denver, University of Maryland Greenbaum Cancer Center, and most recently Wake Forest University. This collection of Centers brings together many unique discovery strengths, diverse patient volumes, and locations both urban and rural. We will focus on 4 specific aims: Aim 1- To lead and maintain a clinical trial consortium that will support cancer clinical trials from Phase 1 initiation through proof-of-activity and foster seamless Phase 2 clinical development of NCI CTEP IND agents; Aim 2- To actively participate and engage disease-focused clinical investigators in the ETCTN by promoting accrual to a range of ETCTN studies led by other LAO/AO members; Aim 3- To incorporate and implement innovative correlative and biological laboratory studies in the context of or as eligibility for participation in early phase clinical studies that enhance our understanding of determinants of toxicity and response that will be used for further definitive practice-changing clinical trial evaluation; and Aim 4- To train the next generation of investigators in drug development. With 9 centers within our consortium, we anticipate no problem in meeting the grant metrics of 100 accruals per year, submitting enough LOI concepts to have 6 new studies approved each year, functioning as a network by having Disease-Focused Clinical Investigators champion ETCTN studies at each site across disease sites, and to provide opportunities to engage and train early career investigators in drug development. We anticipate that our contributions within the ETCTN will impact the clinical care of cancer patients.

NCI - National Cancer Institute

In 2025, an estimated 80,350 people in the US will be diagnosed with non-Hodgkin lymphoma (NHL), and 19,390 will die from this cancer. NHL survival rates began improving in the 1990s with the advent of improved treatment strategies, leading to the current 5-year survival rate of 74%. These trends led to a growth in the number of NHL survivors, estimated at 808,413 as of January 1, 2024. To address the unmet health needs of this patient population, in 2002 we established the Molecular Epidemiology Resource, which was expanded nationally in 2015 as Lymphoma Epidemiology of Outcomes (LEO) cohort study. LEO enrollment is currently over 17,000 NHL participants (and >19,000 at the start of this grant), with <1% loss to follow-up and 73% alive and in follow-up. LEO abstracts pathology, demographic, address (to derive neighborhood variables), clinical, treatment and outcome data, and collects patient reported epidemiologic risk factors and quality of life (QoL) outcomes. Importantly, LEO enrollment (2015-2020) had similar distributions of participants by demographic and NHL subtype as the national Surveillance, Epidemiology, and End Results (SEER) registry, making LEO the largest and most representative prospective cohort of lymphoma outcomes reflecting NHL patients in the US. Cumulatively, LEO has supported numerous publications, prior and ongoing grants (NIH, foundation, industry), NCI Supplements, and career development awards. Under this funding mechanism, we propose to use the LEO cohort to drive the next generation of NHL prognosis and survivorship studies, define patient subgroups with poor outcomes in need of clinical trials, and identify unmet needs for long-term survivors. We will develop and validate novel clinical risk prediction models across NHL subtypes utilizing both the extensive existing LEO data and proposed ongoing follow-up. Our aims are: 1) To develop, validate, and disseminate new clinical models for early treatment failure (ETF) across the major NHL subtypes; 2) To define the intermediate and long-term outcomes and longitudinal QoL in NHL patients who achieve a functional cure with standard of care (SOC) management; and 3) To evaluate the impact of rurality and social determinants of health (SDOH) using individual and area-level measures on NHL outcomes in the context of clinical and lifestyle factors, comorbidities, frailty and QoL. To achieve these aims, we will leverage existing data from the LEO cohort and further annotate the cohort with new data on outcomes, longitudinal and pulse surveys, and external data sources. Maintenance of the cohort also will provide outcomes for ongoing and new studies utilizing the LEO biorepository, and completion of our proposed aims will provide validated clinical models to integrate with biologic studies. This proposal addresses key research questions in outcomes and survivorship for patients with NHL (an understudied cancer) and in understudied populations, including rural and adolescent and young adults. Our results will directly inform clinical guidelines and risk assessment, and support development of novel studies and interventions to improve the outcomes of NHL patients.

NIA - National Institute on Aging

The Rural Family Dementia Caregivers (RFD Caregivers) Program: Developing Caregiving Knowledge and Skills for a Disproportionately Burdened Caregiver Population Abstract. Americans living in rural areas, compared to their urban and suburban counterparts, are disproportionately affected by shortages of health care resources, resulting in poorer health status and health outcomes. The prevalence and impact of dementia and other chronic illnesses is and will continue to be higher in rural America. Rural-dwelling persons living with dementia illnesses (PLWD) and the friends and family (caregivers) who support them are adversely affected by the scarcity of primary care health providers and competent diagnostic and coordinated dementia-sensitive care and support services, the distance to and unavailability of specialty care and effective education, and the ongoing closure of rural hospitals. This project seeks to ameliorate the challenges faced by rural dementia families by embedding an evidence-based online dementia caregiver psychoeducation program (Tele-Savvy) into a statewide dementia diagnostic and care planning entity (Georgia Memory Net (GMN)). GMN, established by the State of Georgia in 2018 to expand dementia diagnostic capacity statewide, supports seven Memory Assessment Clinics (MACs) that provide in-person and virtual comprehensive dementia and dementia caregiver assessments and care management recommendations (but not care coordination), especially to residents in rural counties. Tele- Savvy, a 43-day synchronous/asynchronous program, employs a Social Cognitive Theory-based mechanism to strengthen dementia family caregivers’ competence and confidence (mastery) for enacting solution-focused coping behaviors in their day-to-day caregiving. Tele-Savvy has been shown to be efficacious in improving caregivers’ emotional well-being and improving PLWD quality of life, improvements mediated by demonstrated enhancements in caregiving mastery. Tele-Savvy will be augmented to incorporate curriculum elements aimed at developing rural caregivers’ competence and confidence for identifying, accessing, and coordinating the formal and informal healthcare and support services needed to help maintain community living for PLWD. Employing a cohort-based wait-list design, we will recruit 10 groups of 24 families (N=240) to participate in a 12-month study to evaluate Tele-Savvy’s impact on caregiver and PLWD well-being. The study will pursue two principal aims and an exploratory aim: Aim 1. Evaluate the efficacy of RFD Tele-Savvy to enhance the sense of mastery and emotional well-being of GMN family caregivers and document ways RFD Tele-Savvy enhanced caregivers’ capacities to carry out care plans and master the particular challenges of rural caregiving. Aim 2. Establish the efficacy of RFD Tele-Savvy in promoting improvements in the quality of life of PLWD whose caregivers are trained in the RFD Tele-Savvy program. Exploratory Aim: Gather information to assess the feasibility of and to estimate power needs for a future examination of the effect of GMN caregiver participation in RFD Tele-Savvy on PLWD healthcare utilization (ED visits and preventable hospitalizations).

FIC - John E. Fogarty International Center for Advanced Study in the Health Sciences

This project addresses persistent gaps in access to expert diagnosis and management of skin diseases by integrating thermography and artificial intelligence (AI) into scalable, field-adapted solutions. Skin diseases affect more than 1.8 billion people globally, and in the United States, 1 in 5 individuals seek treatment annually. Despite this burden, access to dermatologic expertise remains limited in many rural, medically underserved, and underserved urban communities, where specialist shortages, prolonged wait times, and long travel distances delay care and contribute to preventable disease progression and chronic morbidity. To address these challenges, this project will develop and implement a multi-sensor remote diagnostic platform designed to improve early triage, diagnostic accuracy, and assessment of disease progression, with direct relevance to expanding timely dermatologic care in underserved U.S. communities. This study will be conducted in rural Côte d’Ivoire due to the high endemicity and co-endemicity of clinically distinct skin diseases not available at comparable scale in the United States. This epidemiologic setting provides a scientifically and ethically compelling environment to develop, train, and validate AI-enabled diagnostic tools across diverse skin disease presentations directly relevant to U.S. conditions, including inflammatory diseases, infections, and chronic wounds. The concentration and diversity of cases will enable robust algorithm development and validation within a shorter timeframe and with greater clinical variability than feasible in a single U.S. population. In addition, conducting this work in Côte d’Ivoire allows rigorous testing of diagnostic performance and implementation strategies under challenging conditions—including limited connectivity, workforce shortages, and resource constraints—that increasingly characterize healthcare delivery in medically underserved regions of the United States. During the R21 phase, to be conducted at Tulane University, we will collect multi-sensor data, develop and validate algorithms drawing upon existing collaborations and datasets, and employ a two-level masking approach to generate AI algorithms capable of improved diagnostic performance. In the subsequent R33 phase, we will develop a user-friendly, smartphone-based multi-sensor data platform and field-test our approach in more challenging settings in Côte d'Ivoire. We will gather large-scale image datasets, evaluate performance and user acceptability, and iteratively refine on-device AI algorithms. By integrating thermography and AI technology into an accessible mobile platform, this project aims to bridge diagnostic access gaps in low-resource environments while informing scalable solutions with direct relevance to improving dermatologic care in rural and underserved regions of the United States and broader global application. Rigorous evaluation and validation will position this technology for wide adoption and sustained impact.

Department of Transportation

The synopsis for this grant opportunity is detailed below, following this paragraph. This grant opportunity is being funded by the American Recovery and Reinvestment Act of 2009, Pub. L. 111-5, 123 Stat.115 (Feb. 17, 2009) ( Recovery Act ). This synopsis contains all updates to this document that have been posted as of April 30, 2009. If updates have been made to the opportunity synopsis, update information is provided below the synopsis. All individuals and organizations potentially interested in this grant opportunity are responsible for frequently MONITORING this website AND the Department s TIGER Grants website for any AMENDMENTS to this notice. Such Amendments could contain crucial information. The Department s TIGER Grants website is http://www.dot.gov/recovery/ost/. Document Type: Grants Notice Funding Opportunity Number: DTOS59-09-RA-TIGER Opportunity Category: Discretionary Posted Date: May 1, 2009 Creation Date: May 1, 2009 Original Closing Date for Applications: To be determined. The Department is in the process of developing criteria and requirements for this program. Additional information will be available when the Department publishes a full announcement. Current Closing Date for Applications: To be determined. The Department is in the process of developing criteria and requirements for this program. Additional information will be available when the Department publishes a full announcement. Archive Date: November 30, 2010 Funding Instrument Type: Grant Category of Funding Activity: Surface Transportation Expected Number of Awards: To be determined. The number of awards will be determined after evaluating all Applications. Estimated Total Program Funding: $1,500,000,000. Of this amount, the Department may use an amount not to exceed $200,000,000 for the purpose of paying the subsidy and administrative costs of projects eligible for federal credit assistance under chapter 6 of title 23, United States Code, if the Department finds that such use of the funds would advance the purposes of this program. In addition, the Department may retain up to $1,500,000, and may transfer portions of those funds to the Administrators of the Federal Highway Administration, the Federal Transit Administration, the Federal Railroad Administration, and the Maritime Administration, to fund the award and oversight of grants made under this program. Award Ceiling: $300,000,000 per project. Award Floor: $20,000,000 per project. The Department may waive the $20,000,000 minimum grant size for the purpose of funding significant projects in smaller cities, regions, or States. CFDA Number(s): 20.932 Cost Sharing or Matching Requirement: The Federal share of the costs for which an expenditure is made under this program may be up to 100 percent, however, the Department will give priority to projects that require a contribution of Federal funds in order to complete an overall financing package. Eligible Applicants The funds provided under this program will be awarded to State or local governments or transit agencies on a competitive basis. Recipients of Recovery Act funds and their first tier sub-awardees will be required to have a DUNS number (www.dnb.com) and a current registration in the Central Contractor Registration (www.ccr.gov). Recipients of Recovery Act funds must have systems and internal controls that allow them to separately track and report Recovery Act funds even if the funds are being used to fund an existing project/activity. Additional Information on Eligibility: The Department is in the process of developing criteria and requirements for this program. Additional information will be available when the Department publishes a full announcement. Agency Name Office of the Assistant Secretary for Transportation Policy, Office of the Secretary, U.S. Department of Transportation. Description The Office of the Secretary, through the Office of the Assistant Secretary for Transportation Policy (OST-P), announces a Request for Applications under a competitive discretionary grant program that provides capital investments for surface transportation infrastructure. The program is funded by the American Recovery and Reinvestment Act of 2009, Pub. L. 111-5,123 Stat.115 (Feb.17, 2009) ( Recovery Act ). Under this program, $1,500,000,000 is available through September 30, 2011, for the Department to make grants on a competitive basis for projects that will have a significant impact on the Nation, a metropolitan area, or a region. Projects eligible for funding provided under this program include, but are not limited to, highway or bridge projects eligible under title 23, United States Code, including interstate rehabilitation, improvements to the rural collector road system, the reconstruction of overpasses and interchanges, bridge replacements, seismic retrofit projects for bridges, and road realignments; public transportation projects eligible under chapter 53 of title 49, United States Code, including investments in projects participating in the New Starts or Small Starts programs that will expedite the completion of those projects and their entry into revenue service; passenger and freight rail transportation projects; and port infrastructure investments, including projects that connect ports to other modes of transportation and improve the efficiency of freight movement. The Department may also use an amount not to exceed $200,000,000 for the purpose of paying the subsidy and administrative costs of projects eligible for federal credit assistance under chapter 6 of title 23, United States Code, if the Department finds that such use of the funds would advance the purposes of this program. In distributing funds available under this program, the Department must take measures to ensure an equitable geographic distribution of funds and an appropriate balance in addressing the needs of urban and rural communities. Grants provided under this program shall generally be not less than $20,000,000 and not greater than $300,000,000; however, the Department may waive the $20,000,000 minimum grant size for the purpose of funding significant projects in smaller cities, regions, or States. Not more than 20 percent of the funds made available under this program will be awarded to projects in a single State. The Federal share of the costs for which an expenditure is made under this program may be up to 100 percent, however, the Department will give priority to projects that require a contribution of Federal funds in order to complete an overall financing package, and to projects that are expected to be completed by February 17, 2012. Projects conducted using funds provided under this program must comply with the requirements of subchapter IV of chapter 31 of title 40, United States Code. Recipients will be required to comply with all of the applicable reporting requirements under the Recovery Act. The Department is in the process of developing criteria and requirements for this program. Additional information about criteria and requirements will be available when the Department publishes a full announcement. Link to Full Announcement The Department is in the process of developing criteria and requirements for this program. The criteria and requirements will be included in the full announcement. The full announcement will be available on the Department s TIGER Grants website at http://www.dot.gov/recovery/ost/. Additional Department information related to the Recovery Act is available at http://www.dot.gov/recovery/. If you have difficulty accessing the full announcement electronically, please contact: Jim Mowery at james.mowery@dot.gov [_____] Synopsis Modification History There are currently no modifications for this opportunity.

National Park Service

This announcement is to provide public notice of the National Park Services intention to fund the following project activities without full and open competition to Go North! Adventure Learning for the amount of $30,000 to cooperatively complete the project described below. STATUTORY AUTHORITY: National Historic Preservation Act 16 U.S.C.470. STATEMENT OF JOINT OBJECTIVES/PROJECT MANAGEMENT PLAN: Through this project, Traditional Beringian Sports and Games, the NPS and the Shared Beringian Heritage Program (SBHP) will support an adventure learning program designed to promote, preserve and encourage Beringia s rich tradition of sports and games. This project fits with the goals of the SBHP, as well as with the overall goals of the National Park Service. In conjunction with our partner GoNorth! Adventure Learning, the NPS will join forces with the Administration of Chukotka (the SBHP s counterpart across the Bering Strait) in an effort to protect and promote Beringia s traditional sports and games. Through the encouragement of adventure learning programming and website support, SBHP s contribution will augment funding from the Chukotka Administration. (For detailed information on the level of financial and logistical support provided by the Chukotka Administration, please see the attached original proposal.) With the support of the SBHP this programming will provide a unique opportunity for the people of Beringia, and around the world, to explore the region through the prism of traditional games and sports in a new and growing medium: adventure learning. Traditional sports and games are expressions indigenous cultures and ways of life, and are a vital part of human heritage. They advance cultural diversity and protect cultural identity at the local, national and international level. They can form the backbone of a community (UNESCO, 2012). They can also link communities and regions through participation in regional, national, and international events celebrating the importance of sports and games, especially within the communities of Beringa. Beringian Traditional Sports and Games will: Transmit knowledge, enhance understanding and disseminate and share information on the heritage of traditional sports and games Improve the role and opportunity for traditional sports and games activities in the formal education process and in the promotion of cultural heritage in both Alaska and Russia. Strengthen cooperation and exchanges between the United States and Russia Based on the concepts and methods of adventure learning, GoNorth provides learners of all ages across the US and worldwide with transformational learning experiences. These are experiences that advance healthy active living and build literacy in order to ensure sustainable development while enhancing cultural collaboration. A. The partner, in cooperation with the National Park Service will: Go North! Adventure Learning agrees to: 1. Work directly with the Administration of the Chukotka Autonomous Okrug and native organizations on the Russian side to successfully conduct the activities outlined under this project. 2. Go North will work directly with the Shared Beringian Heritage Program to incorporate the goals and results into the greater context of the Beringia Program to show the importance of traditional sports and games in rural and urban communities within Chukotka. 3. Go North will support and encourage the participation of community members from rural Alaska and rural Chukotka in the Beringia Games; this work will be accomplished with the input of the Shared Beringian Heritage Program. 4. Project partner and Go Mille Porsild will work with three designated entities of the Government of Chukotka: The Department for Natural Resources and Agriculture, Department for Education and Culture and Department for Sports and Tourism. Collaborating with these entities is an essential part of this project, and facilitates greater communication between the Shared Beringian Heritage Program and the Administration of Chukotka on an important element of our shared culture: traditional sports and games. 5. Go North will promote the Racing Beringia and Beringia Games curriculum in schools , but the primary vehicle for distribution will be the existing users of the Go North website PolarHusky.com . This adventure learning website has an audience in the millions. It is seen in 6000+ schools in 38 countries across the 50 US states and around the world. 6. Go North will continue to maintain and promote their website through mechanisms like the SBHP website and Facebook page. 7. Go North will share results and solicit feedback on project results and will develop project materials with input from the Shared Beringian Heritage Program. B. NATIONAL PARK SERVICE INVOLVEMENT -Substantial Involvement : The National Park Service agrees to: 1. Cooperate and collaborate with Go North Adventure Learning by linking this project to the Beringia Program s network of contacts in Alaska and Russia (especially in native communities). The Beringia Program s contacts differ from those already established by the cooperator due to their status and access. The SBHP will assist the cooperator in deepening the relationships between the various entities. 2. Use the network of contacts, the Beringia program s website, and the program Facebook page to share information from the final and interim reports with the public, as well as targeted audiences through the development of distribution plan for project materials and results. 3. Work cooperatively with Go North on developing formal relationships with entities in Chukotka, whether government or non-profit. The National Park Service will assist with the exchange of information and the process of writing international agreements. The NPS s Shared Beringian Heritage Program has experience in writing successful agreements with Russian organizations, and can also advise the cooperators on cultural matters. 4. The Beringia Program will act as a liaison when needed to facilitate exchanges, enhance communication, provide translation services, and provide logistical support. 5. The NPS SBHP will also support GoNorth by presenting information about the project to other interested parties, as well as sharing the goals of the project with others in the NPS/SBHP network, thereby facilitating collaboration and cooperation between past and current partners. 6. Assign Elizabeth Shea, Program Specialist for the Shared Beringian Heritage Program, National Park Service, as the Agreements Technical Representative (ATR) for the administration of this Cooperative Agreement; and as Liaison between the NPS and for the implementation of the program(s) identified within this agreement. 7. Provide $30,000 during FY 2013 to GoNorth Adventure to carry out the work stated in the preceding objectives. (See attached Detailed budget ). SINGLE-SOURCE JUSTIFICATION: Department of the Interior Policy (505 DM 2) requires a written justification which explains why competition is not practicable for each single-source award . The National Park Service did not solicit full and open competition for this award based the following criteria: Unique Qualifications. The field research that the cooperator specializes in is an essential component of the project. The partner has the necessary background in adventure learning, working with youth, dog-mushing, project management, and cultural exchanges. Technical contact information: Elizabeth Shea, Elizabeth_shea@nps.gov, 907-644-3606. National Park Service, Alaska Region, End of FOA

FIC - John E. Fogarty International Center for Advanced Study in the Health Sciences

Project Summary Timely and accessible viral load (VL) monitoring is essential for early detection, optimizing treatment decisions, and preventing new infections; however, significant gaps in diagnostic access remain in the U.S., particularly in decentralized care settings, contributing to delayed treatment adjustments and ongoing transmission. These challenges are further amplified in settings where limited healthcare infrastructure constrains access to routine VL testing, providing a critical context for evaluating scalable diagnostic solutions. To address these barriers, our project aims to develop TRI-CARE, a mobile health (mHealth) platform for rapid HIV-1 VL testing, with the future goal of expanding the platform to include hepatitis B virus (HBV) and hepatitis C virus (HCV) testing. TRI-CARE leverages cellphone-based, AI-powered diagnostics integrated with an innovative microfluidic cartridge system to enable decentralized, real-time VL monitoring. The development of TRI-CARE follows a phased approach. In the R21 phase, we will optimize the CamoChip microfluidic platform and functionalize color-encoded beads with target-specific antibodies to enable direct capture and detection of HIV-1 RNA from blood samples, coupled with a cellphone-based optical detection system. In the R33 phase, we will conduct clinical validation using 100–200 patient samples, including specimens from Nigeria, assessing sensitivity, specificity, accuracy, and usability relative to gold-standard qPCR-based testing. Samples from Nigeria provide a uniquely valuable validation set due to the high burden of HIV-1 and viral hepatitis and the variability inherent in real-world collection and handling conditions—factors that are not readily captured in U.S.-based sample sets. This rigorous evaluation supports assessment of robustness and usability across viral variants and sample conditions, with relevance to decentralized care settings in the U.S. The proposed work has direct relevance to American health by advancing a portable, rapid, and low-cost viral load testing platform that can expand access to timely diagnostic monitoring in U.S. settings with limited laboratory infrastructure, including rural communities, mobile and point-of-care environments, correctional facilities, and safety-net clinics. These settings often face delays due to centralized laboratory dependence, transportation barriers, and limited testing frequency. By enabling decentralized, real-time VL monitoring, TRI-CARE has the potential to improve treatment management, reduce transmission, and enhance continuity of care. In addition, validation across genetically diverse viral populations strengthens the generalizability of the platform to the heterogeneous U.S. patient population. The development of a scalable, field-deployable diagnostic platform also supports U.S. public health preparedness by enabling rapid and flexible responses to infectious disease outbreaks. TRI-CARE represents a transformative approach to viral load monitoring, offering a portable, affordable, and power-independent solution. Successful implementation will establish a scalable platform for multiplexed detection of HIV-1, HBV, and HCV, with broad applicability across both international and U.S. healthcare settings.