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Agriculture Department

The Rural Housing Service (RHS or Agency), an agency within the United States Department of Agriculture, Rural Development (RD), is amending two program funding opportunities to remove references to the prior Administration's key priorities and DEI (diversity, equity, and inclusion)-related scoring criteria to bring them into compliance with the Executive Order, "Ending Radical and Wasteful Government DEI Programs and Preferencing", issued on January 20, 2025. The following funding notices are covered by this amendment: Notice of Funds Availability for the Multifamily Housing Preservation and Revitalization Demonstration Program and for Section 515 Subsequent Loans for Preservation Activities for the Fiscal Year 2024, and Consolidated Multifamily Housing Technical Assistance Grant Program Notice of Funding Availability Fiscal Year 2024. This notice also confirms that previous Administration key priorities will not be considered during application scoring and makes clear that applicants who already have applied need not reapply.

Agriculture Department

The United States Department of Agriculture, Rural Development (RD), which is comprised of the Rural Business-Cooperative Service (RBCS), Rural Utilities Service (RUS), and Rural Housing Service (RHS), announces that it is amending 14 program funding opportunities to remove references to the prior Administration's key priorities and DEI (diversity, equity, and inclusion)-related scoring criteria to bring them into compliance with the Executive Order, "Ending Radical And Wasteful Government DEI Programs And Preferencing", issued on January 20, 2025. This notice also confirms that previous Administration key priorities and discretionary points will not be considered during application scoring and makes clear that applicants who already have applied need not reapply. This notice also corrects the Rural Energy for America funding notice to include an omitted funding source.

NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases

PROJECT SUMMARY A new generation of anti-obesity medications (AOMs) have recently revolutionized the treatment of obesity. Critically, and in line with existing clinical guidelines for AOM use, clinical trials have evaluated these medications as an “adjunct to lifestyle intervention”; that is, all participants (whether randomized to placebo or study medication) received lifestyle intervention. There exists discordance, however, between the way that AOMs have been implemented in clinical trials (with lifestyle intervention) versus how they are implemented in clinical settings (with minimal follow-up focused on management of dosage and side effects). Furthermore, there is lack of clarity regarding whether patients prescribed second-generation AOMs benefit from behavioral lifestyle intervention and, if so, how much and what kind of lifestyle intervention is optimally beneficial. To address these critical questions, we propose to conduct a factorial experiment to optimize an individual-level lifestyle intervention for patients prescribed second-generation AOMs. We propose to recruit 608 adults with obesity (or overweight with a weight-related comorbidity) who are prescribed second-generation AOMs by their healthcare providers and, using an efficient 2x2x2x2x2 factorial trial design, randomize participants to receive (or not receive) each of 5 intervention components delivered over 12 months: 1) an individual Weight Loss 101 session including core weight loss education and behavioral skills training; 2) 3 individual coaching sessions delivered via telephone; 3) digital dietary self-monitoring and weekly automated feedback on calorie goal achievement; 4) digital physical activity self-monitoring and weekly automated feedback on activity goal achievement; and 5) digital weight self-monitoring and weekly automated feedback on weight trajectory. We propose to evaluate the efficacy of each intervention component for weight loss and identify an optimized program in which each component (or combination of components) contributes meaningfully to Month 12 weight loss outcomes (Aim 1). Importantly, we will also examine costs for each intervention component to inform future implementation. Under a precision medicine approach, we also propose to explore possible moderators (e.g., sex, race/ethnicity, age, income, nutrition literacy, rurality, level of social support, previous experience with lifestyle intervention, AOM type/dose and number of AOMs used) that might suggest different intervention protocols for specific subgroups. In addition, given the challenge of long-term weight loss maintenance, we also propose to examine weight loss maintenance at Month 24 (Aim 2). Other exploratory aims will investigate changes in body composition, health-related quality of life, hypothesized mediators such as treatment adherence, and additional health outcomes extracted from electronic health records; finally, we will explore AOM persistence and weight regain in participants who discontinue AOMs. This trial will result in an optimized behavioral intervention protocol for second-generation AOMs, supporting ideal implementation of these medications and development of new guidelines for the treatment of obesity.

U.S. Mission to Tajikistan

Purpose of Public Diplomacy Grants: PDS Embassy Dushanbe invites proposals for programs that strengthen ties between the United States and Tajikistan in priority program areas (see below) in order to highlight shared values and promote bilateral cooperation. All proposed programs must include an American element, either through a connection with American expert/s, organization/s, or institutions/s, usage of American educational/informational resources, or any other activities that promote or contribute to increased mutual understanding between the people of the United States and people of Tajikistan. Competitive proposals will promote continued and sustainable cooperation between the people of the United States and Tajikistan even after the project concludes. Competitive proposals will include partnership with Tajik governmental bodies, and to organizations that have a demonstrated track record of implementing such programs. Examples of programs could include, but are not limited to: Academic or professional exchanges, lectures, seminars, trainings, speaker programs, or workshops; and Artistic, cultural, or sports workshops, masterclasses, joint performances, and/or exhibitions. PDS welcomes proposals that support one of the following priority program areas: TOPIC 1: Counter Gender-based Violence (GBV) Domestic violence (DV) and gender-based violence (GBV) remains a serious issue in Tajikistan and much of the world. In a USAID-funded survey in Tajikistan, 97% of men and 60% of women believed spousal abuse was justified. Cases of GBV and DV are underreported because victims wish to avoid humiliation, reprisal, or social stigmatization, or believe it may have been warranted. Further, authorities wishing to promote traditional gender roles frequently dismiss domestic violence as a family matter or only gave a warning or fine. Government resources for survivors are also limited. Project Audience(s) may include: Religiously or socially conservative communities, especially Tajik men (18-50 years old) High school students (14-18 years old.) Youth and emerging leaders (18-35 years old.) University teachers and students. Labor migrants and spouses of labor migrants. Tajik advocacy groups. Government bodies. Independent media including bloggers and vloggers Countering Gender-Based Violence Project Goal: Empower civil society and communities in Tajikistan to prevent and prosecute cases of Domestic Violence (DV) or Gender-Based Violence (GBV) through community-led initiatives. Project Objectives (may address one or more of the following): Messaging campaigns or awareness raising activities, such as sports diplomacy, should engage and target both men and women. Having men as the face of campaigns, or having men speak to men standing against GBV, demonstrates solidarity and emphasizes that eradicating gender-based violence is the collective responsibility of everyone, regardless of gender. Improve collaboration between civil society, independent media, and the government to identify and address gaps in existing laws and policies that criminalize GBV/DV, provide protections for victims, and establish legal frameworks for persecution. Raise awareness among vulnerable populations about laws, rights, and support services concerning early marriage, domestic abuse, harassment, divorce, alimony, and other civil rights. TOPIC 2: Promoting Women s Economic Empowerment and Entrepreneurship Due to the high rate of male labor migration and unemployment, more Tajik women are exploring ways to financially support their households and communities. However, women entrepreneurs' activities are highly dependent on the effectiveness of the business environment in the country. Moreover, the mountainous regions throughout the country challenge the development of entrepreneurship, as does lack of information, limited access to financing for starting a business, and other socio-economic conditions. Nevertheless, successful small business development creates new employment opportunities in Tajikistan and helps women support themselves and their families. Small businesses are fast becoming the main source of income for women in Tajikistan. Proposed projects should enhance women s participation, promotion, and longevity in the Tajik economy and ability to assume leadership positions. Projects should clearly support the protection of economic rights for women and increase respect for women s rights in society to improve their independence and proactive role in Tajik society. Project Audience(s) may include: Women from rural areas (including the spouses of labor migrants) and women entrepreneurs. Small businesses in rural areas. Business associations. Financial and government institutions. Tourism agencies (including guesthouse and small hotels). Community leaders and youth demonstrating leadership potential in these areas. Women s Economic Empowerment Project Goal: Increase the capacity of women from underserved, rural communities, including the spouses of labor migrants, to participate or increase their participation in the Tajik economy. Improve women's economic opportunities in Tajikistan by increasing the capacity of women to start, establish, or expand their own companies. Project Objectives (may address one or more of the following): Develop the business and technical skills of women in rural communities to increase employability, launch and/or improve their own businesses. Establish and conduct activities with a professional network for women from under-represented communities, including the spouses of labor migrants, to support mentorship relationships and collaborative initiatives among network members that go beyond the conclusion of project activities. o Projects could connect women s entrepreneurship in the development of tourism around newly recognized UNESCO heritage sites. o Increase awareness of tourism initiatives and employment opportunities centered around newly designated UNESCO heritage sites. o Projects could seek to increase participation of women from underserved and target communities in the fields of Science, Technology, Engineering, and Mathematics (STEM). Increase women s knowledge and understanding about their legal rights in society and how to advocate for the respect of those rights. o Increase women s knowledge and understanding about their legal rights in the workplace, including rights related to employment, equal pay, job security, and access to economic opportunities. o Equip Tajik women with the ability to advocate for the recognition and enforcement of these rights. Promote women s economic empowerment and entrepreneurship through support from start-up hubs, corporate social responsibility, and/or access to finance. Emphasis should be placed on strengthening chambers of commerce, entrepreneurs, and core private sector industries through interactions or linkages with U.S. counterparts. o Facilitate access to funding resources and financing opportunities for women entrepreneurs to launch and grow their businesses. o Strengthen organizational capacities of chambers of commerce to support business development of aspiring female entrepreneurs. o Facilitate interactions and linkages between women entrepreneurs, chambers of commerce, startup hubs, and private sector industries in Tajikistan and their U.S. counterparts. TOPIC 3: Sharing America with Tajikistan The United States values innovation, creativity, critical thinking, freedom of expression, democratic principles, economic growth, and security. The United States supports a sovereign and independent Tajikistan, which includes support for a well-informed, discerning public who can inoculate itself against disinformation. Both the United States and Tajikistan have rich cultural traditions as shown in literature and storytelling, theater and performing arts, film, music, dance, sport, and education. Educational, cultural, and other exchange activities are a great way to engage the public, especially at-risk youth and those with neutral views or misconceptions about the United States, in order to bridge our cultures, deepen understanding, and discuss topics of mutual importance. Proposed projects should strengthen understanding between the United States and Tajikistan and advance areas of mutual interest by leveraging the experiences and lessons learned from the United States, while respecting cultural differences. Project Audience(s) may include: Tajik audiences who have not had exposure to the United States before. Youth 16-35. Academia, professors, and teachers. Civil society, non-government organizations, and associations/organizations promoting shared values or areas of mutual interest. Information professionals (media outlets, managers, editors, journalists, influencers). Religious and community leaders. Entrepreneurs and business community advocacy organizations. National and subnational government officials. Project Goal: To share American values, such as freedom of expression, respect for human rights, and celebrate/promote respect for diversity and social inclusion, while also improving access to objective information and increase media literacy and critical thinking skills to analyze mis and disinformation aimed at the United States. Project Objectives (may address one or more of the following): Raise awareness about shared U.S.-Tajik values and partnerships through trainings, workshops, masterclasses, joint performances, or other projects by U.S. and/or Tajik experts. Increase access to American content by Tajik audiences (such as book translations) that promote U.S. democratic and rights-based values. Increase collaboration between local, state, and civil society actors/stakeholders on well-defined social issues affecting both the United States and Tajikistan by sharing U.S. models of government-community engagement, or by working with U.S. experts/peers. Increase the effectiveness of individuals, organizations, and coalitions working to advance and/or advocate for respect and the promotion of human rights. Strengthen the ability of Tajik media professionals to develop accurate and fact-based informational media campaigns through digital skills building and training initiatives based on U.S.-best practices. Increase production and publication of objective, fact-based and editorially diverse media content by Tajik media professionals. Increase critical thinking skills, especially for youth and publics with a neutral or view or misconceptions about the United States, to identify and critically analyze sources of misinformation and disinformation. In addition to the specific requirements listed above by program area, all proposals must: 1. Clearly indicate the primary activity area to which it is being submitted for consideration. 2. Focus on the key public diplomacy audiences and activities specified in the areas, provide programs for underserved geographic regions of Tajikistan, as well as non-elite schools (if applicable); 3. Clearly delineate how elements of their program will have a multiplier effect and be sustainable beyond the life of the grant; 4. Provide a traditional and/or social media plan for marketing program activities and outcome, if applicable 5. Identify the cities/districts in which activities will take place. 6. Identify specific outcomes to be achieved by the end of the grant period. 7. Identify any tools (surveys, beneficiary interviews, focus groups, etc.) that will be developed for Monitoring and Evaluation purposes. Applicants must also demonstrate competency to manage all financial aspects of the project, including participant costs and transparent arrangements of sub-grant relationships with partner organizations, if applicable.

Arkansas Development Finance Authority (ADFA)

ADFA provides financing and grants for small businesses in Arkansas, supporting capital investment, job creation, and business expansion in both urban and rural areas of the state.

Arkansas Rural Development Commission

The Rural Development Commission supports projects that improve quality of life in rural Arkansas communities, funding healthcare access, broadband expansion, workforce development, and essential services for underserved areas.

NHLBI - National Heart Lung and Blood Institute

Interactive, evidence-based conversations can improve cardiovascular health, especially for people with low health literacy, rural residence, and limited access to care. Coronary heart disease (CHD), including angina and myocardial infarction, accounts for 40% of cardiovascular deaths. The “Beat-to-Beat” project addresses these challenges by developing an innovative, AI- powered, community-informed digital health intervention that delivers accurate, locally relevant guidance through trusted, conversational video chatbots. The broad, long-term objective of Beat- to-Beat is to improve CVD health by empowering individuals—especially those in rural communities with limited access to healthcare—with accessible, trustworthy, and engaging health information. The specific aims are: 1) Develop and test the Cardiovascular Information Engine (CIE), an AI tool trained on validated scientific literature, distorted information, and local resource data. The CIE is designed to correct distorted information and provide evidence-based responses to CHD-related questions; 2) Develop and test locally relevant Trusted Health Companions (TrHCs), three AI-driven video personas (a doctor, nurse, and friend) representing different conversational styles and vocabulary. These characters will be evaluated for relatability, engagement, and trustworthiness by community advisory panels; 3) Integrate CIE and TrHCs to create “Beat-to-Beat”, a fully functional prototype that will be tested against traditional AI- generated recorded health videos for accuracy, trust, and user engagement. Research will be conducted on Hawai‘i Island, which has a high burden of CHD and significant rural health access challenges. A mixed-methods approach will be used, including true/false knowledge assessments, focus groups, and validated surveys. The project is guided by the Personalized Patient Activation and Empowerment (P-PAE) framework and includes real-time updates and community feedback throughout development. This Phase I study will establish feasibility, usability, and foundational data for a future Phase II trial evaluating health outcomes and cost- effectiveness.

Birla Foundation

Funds education, healthcare, and rural development across India through Aditya Birla Group philanthropy.

Blandin Foundation

Community leadership and broadband development in rural Minnesota

NIA - National Institute on Aging

Overall Abstract The Boston University-Quantitative Population Science and Healthy Cognitive Aging Research Program (BU-SHARP) will serve as a hub for interdisciplinary research on Alzheimer’s Disease (AD) and Alzheimer’s Disease-Related Dementias (ADRD). BU-SHARP will concentrate on three research themes: (A) between and within-group patterning of AD/ADRD onset, progression, and consequences across persons with disabilities, underserved rural populations, and other populations disproportionately affected by AD/ADRD, (B) life course individual and interpersonal resources and mechanisms contributing to this patterning, and (C) modifiable influences on AD/ADRD onset, progression, and consequences in these populations. BU-SHARP will collaborate with initiatives across Boston University (BU), drawing on campus-wide strengths in demography, sociology, economics, epidemiology, data science, and related fields to stimulate interdisciplinary research. BU-SHARP will contribute to the future pipeline of AD/ADRD researchers via pilot funding and mentorship to early-stage investigators, enhancing access to data, methodological resources, and technical assistance. Bridging disciplinary divides to share quantitative methods will accelerate AD/ADRD research and generate new insights. BU-SHARP will provide an infrastructure and structured programs focused on enhancing research rigor and innovation (e.g., bi-weekly research accelerator meetings, technical assistance to pilot awardees and collaborators, curated speaker series on innovations in research methods relevant to AD/ADRD), effective research translation (e.g., expert guidance in translating research findings, fostering multiple dissemination channels for scientific findings), and mentorship and support of early-stage researchers (an emerging scholars pilot grant program, structured and individualized mentorship, curated professional development workshops), among other activities. The BU-SHARP Administrative Core will provide leadership and oversee all activities. The Program Development (Pilot) Core will fund 2 early career pilot projects annually (12 total across the 6-year grant), and provide structured mentorship and technical assistance. The Communications & Dissemination Core will collect, curate, and disseminate research findings, ensure cross-disciplinary sharing of research advances, and train a cohort of students to develop expertise in writing and reporting on AD/ADRD via a social science writing fellowship program and a public health journalism program at BU. Through these efforts, BU-SHARP will generate new insights into the behavioral and contextual risk and protective factors that influence cognitive aging and its consequences, contribute to the development of effective prevention strategies, and increase the pipeline of population science AD/ADRD researchers.

NCATS - National Center for Advancing Translational Sciences

Modified Project Summary/Abstract Section Although health disparities between rural and urban communities have been known for decades2–5, there is evidence individuals from rural areas are less likely to participate in translational research and clinical trials6. Rural communities face higher mortality than urban communities for the six leading causes of death in the US–heart disease, cancer, unintentional injuries, COVID-19, stroke, and chronic lower respiratory disease.20–23 This has been referred to as the ‘rural mortality penalty’ as rural areas show slower declines in mortality compared to urban areas.14,24 Barriers to research participation among rural populations include participation costs (e.g., travel time, monetary), limited Internet connectivity, and socio-cultural barriers (e.g., perceived lack of anonymity)6. NCATS’s More Treatments for All People More Quickly initiative outlines the need to develop effective treatments that can reach underserved populations, which highlights the need for a research tool that can collect data and administer interventions in the privacy of participants homes regardless of Internet connectivity. Given the ubiquity of smartphones (~90% ownership in rural areas), the planned research will test the Wear-IT app,7 a smartphone research platform that can reduce barriers for rural populations by 1) ensuring a fast and responsive experience even when Internet is limited; and 2) delivering automatic, personalized interventions. Wear-IT is unique in the mHealth space due to its on-device processing model which allows for real-time responsiveness when Internet is unavailable7 with data uploaded to the cloud for more computationally intense processing when a participant passively encounters better connectivity (e.g., travel to town, WiFi). Wear-IT can flexibly assess complex clinical targets through multi-modal ecological momentary assessments (EMA) including video, photo, geolocation, and survey responses. On-device processing of multi-modal EMA or sensor data (e.g., step count) also enables delivery of just-in-time adaptative interventions (JITAI)7, which aim to provide personalized information or support at the exact moment it is needed.8 The proposed study will demonstrate the translational and clinical utility of Wear-IT by assessing diet-related health behaviors in 100 rural families with children from the Appalachian region. Using Federal Communications Commission fixed and mobile Broadband coverage data, targeted recruitment will ensure half the families (n = 50) have at-home Broadband and half (n = 50) have poor/no at-home Internet. Parents will use the Wear-IT app for three weeks. During the 3-week period, parents will receive EMA prompts and JITAI messages related to the three diet-related health behaviors: 1) home food environment; 2) home meals; and 3) food shopping (Figure 1). Assessing the acceptability and feasibility of Wear-It in rural communities will help to increase rural representation in health research and clinical trials, which is the first step in addressing persistent health disparities in rural communities.

NINR - National Institute of Nursing Research

BLOOM Project Summary Birth is the leading reason for hospital admission in the United States. There are three possible birth outcomes: spontaneous vaginal birth (SVB), which is a birth without forceps or vacuum, operative vaginal birth which is a birth with forceps or vacuum, and cesarean. SVB is the best birth outcome for most women and babies' short- and long-term health, the least expensive birth outcome, and the birth outcome most women want. This makes it an excellent example of high-value healthcare. SVB rates vary significantly across hospitals and this variation is not explained by hospital structural characteristics. There are high-performing hospitals where women have appropriately excellent SVB rates and these hospitals exist across all structural characteristics (bed size, teaching status, technology status, rurality, and state). Nurses provide most direct patient care to women in labor and this care is critical for supporting SVB. Preliminary research suggests that a hospital's nursing organizational resources, including the work environment and staffing, differentiate high-performers from low-performers. In this research we look to optimize the health of our current and future generations by learning from our high- performing hospitals for birth outcomes to inform practice and policy. The purpose of this study is to examine high-performing hospitals with excellent SVB outcomes overall and for women from racial/ethnic minorities, who typically experience lower SVB rates, compared with low-performers regarding the organizational resources that differentiate them and to understand what the high- performers do, especially regarding those differentiating organizational resources, that sets them apart. Accordingly, we propose to conduct an explanatory sequential mixed methods study. In Aim 1, we will examine the relationship between hospital nursing organizational resources and SVB, for women overall and from racial and ethnic minority groups in high-performing hospitals (compared to low), by leveraging a novel benchmarking/ranking approach42 that uses propensity score weighting and machine learning methods. Sub-Aim 1: We will explore the relationship of varying state midwifery and staffing legislation with the presence of high- and low-performers. In Aim 2, we will explore the pathways by which high- and low-performing hospital's nursing organizational factors prevent or contribute to SVB outcomes and disparities, as well as high-performer's actions, interventions or culture to realize these organizational factors, their recommendations for improvement and implementation. We will do this via a semi- structured qualitative interview with hospital maternity leaders. In Aim 3, we will develop a joint display map, integrating the aspects of the hospital organizational resources identified in Aim 1 with the pathways and recommendations from Aim 2 to understand the relationship between the organizational resources and performance status to illumine actions for improvement.

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

This IRSDA K-award will provide me with mentored research and career development training to build expertise in translating global health findings to benefit U.S. populations and underserved healthcare systems. I will learn to validate neurocognitive impairment (NI) screening tools and analyze inflammatory biomarkers that predict NI in meningitis patients with or without HIV in rural, northern Uganda, an area of high meningitis burden within Africa’s meningitis belt. Meningitis affects over 2.5 million people globally each year, and causes significant disability, with 20-32% of survivors experiencing long-term morbidity and 14-38% developing prolonged NI, yet data on NI burden in meningitis patients remain scarce. Despite evidence that inflammation in central nervous system infections is associated with NI, limited information is available about the biomarkers involved in NI development. This study seeks to fill the gaps in our understanding of the burden and pathogenesis of NI by identifying which brain injury biomarkers are expressed in patients with NI and can be used to predict NI development among meningitis patients with and without HIV. This study will be embedded within my primary mentor’s existing Meningitis Diagnosis and Treatment Program (MEN-DTP) at Lira Regional Referral Hospital in northern Uganda, which focuses on understanding mortality due to various meningitis etiologies in an area with high meningitis and HIV burden. Aim 1 is to validate neurocognitive assessment tools to determine the burden of NI among meningitis patients living with and without HIV, including follow-up for two years to assess long- and short-term NI burden. Aim 2 is to identify clinical parameters and immune/inflammatory biomarkers predictive of NI. Serum and CSF samples will be collected from meningitis patients who do or do not develop NI to identify biomarkers specifically associated with NI. Investigating immunologic and brain injury biomarkers will provide insights into inflammatory pathways activated by meningitis that lead to NI in those with or without HIV. Our neurocognitive assessments will help determine the true burden of NI and enable timely diagnoses and interventions. Our findings from this high-burden setting will inform neurocognitive assessment and early intervention strategies to improve care for meningitis patients that could be implemented in underserved U.S. populations and globally.

Bush Foundation

Leadership development for rural community leaders in the upper Midwest

NIGMS - National Institute of General Medical Sciences

This Phase I Centers of Biomedical Research Excellence (COBRE) proposal establishes the Center for Aging with Serious Illness (CASI) at Dartmouth Health (DH). The growing number of older adults living with chronic, serious illness represents one of the most pressing public health challenges in the United States. However, research addressing the unique needs of this population has not kept pace with its rapid expansion. Building a robust evidence base to improve the quality of life for this group is critical to advancing healthcare. To address this gap, it is essential that research be designed to navigate the complexities of providing care for older adults facing serious illness. The primary goal of this COBRE is to create the foundational infrastructure required to develop a multidisciplinary research program focused on aging with serious illness al DH, one of the most rural academic medical centers in the country. This program will provide expert mentorship, protected research time, and institutional support to recruit and nurture a critical mass of early-career clinician-scientists, facilitating their transition into independent researchers dedicated to improving care for older adults with serious illness. To achieve this overarching goal, CASI will pursue three specific aims: (1) Establish a robust framework that integrates research expertise and mentorship to formalize CASI and strengthen DH's research infrastructure, in collaboration with affiliate institutions; (2) Develop a structured pathway to support early-career clinicianscientists as Research Project Leaders (RPLs) and enhance their transition to independent investigators through tailored, milestone-driven research plans; and, (3) Ensure the success of RPLs and Pilot Project Leaders by providing comprehensive technical assistance through the Biostatistics, Ethics, Data Management, Research Design, and Community Engagement (BEDRoC) Core, which will serve the broader DH research community focused on improving care for older adults with serious illness. CASI will concentrate on building a network of experts who will conduct clinical, behavioral, and health services research to address the challenges faced by older adults with serious illness. Our investigators will focus on solving key issues in aging with serious illness and use their findings to inform healthcare policy and stakeholder decision-making. The initial three RPLs will focus on shared decision-making for surgery in older adults, palliative care for older patients with cancer, and management of osteoarthritis in older adults with multimorbidity. The BEDRoC Core will support CASI by: (1) Providing the three RPLs specialized expertise in statistical analysis, research ethics, and community engagement to aid in the planning and execution of their projects, and (2) Creating an innovative learning collaborative that provides workshops, tutorials, resources, and services to promote continuous researcher development. COBRE funding, combined with substantial institutional investment and plans to hire additional faculty, will lay a strong foundation for creating a self-sustaining, vibrant Center. This Center will foster independent investigators whose work will ultimately improve the care and quality of life for older adults.

Washington State Community Economic Revitalization Board (CERB)

This funding program provides loans and grants to rural communities for public infrastructure to enable future business development. Jurisdictions in rural counties and rural communities may apply for the Prospective Development program if an economic feasibility study demonstrates that private business development is likely to occur as a result of the public improvements. Additional requirements include: Evidence from an economic feasibility study that the project will lead to the creation of a significant number of permanent jobs or generate significant private capital investment; and Applicants must also demonstrate the need for CERB assistance and that no other timely source of funds is available at a reasonably similar rate to the current CERB rate.

Center for Rural Affairs

Training and resources for beginning farmers and ranchers

Center for Rural Affairs

Micro-enterprise development and small business support in rural areas

NIH

Significance to VA: Each year, hundreds of thousands of Veterans are hospitalized for new presentations and acute exacerbations of complex chronic conditions, such as cardiovascular, pulmonary, neurologic, and substance use disorders. For each of these conditions, there are medications with strong evidence for improving clinical outcomes when taken long-term. Use of evidence-based, long-term medications following hospitalization is often deficient, with disparities observed in prescribing by race, ethnicity, rurality, and socioeconomic status. To date, no studies have systematically assessed the quality and equity of evidence-based prescribing at hospital discharge, a critical time to initiate guideline-recommended care. The objectives of this proposal are to detect and understand determinants of quality and equity of prescribing for hospitalized Veterans and to identify evidence-based strategies to improve prescribing. This research has been developed in partnership with the National Hospital Medicine Program, Office of Health Equity, and Center for Medication Safety and aligns with HSR priorities to apply Learning Health Systems foundational methods to achieve the VA Quintuple Aims of improving outcomes and ensuring equity. Innovation and Impact: The proposal is innovative in three ways. First, this research moves beyond disease- specific silos to examine evidence-based prescribing as a cross-cutting concept for hospitalized Veterans. Second, this research evaluates prescribing quality with an explicit health equity lens and employing a novel pharmacoequity framework. Third, it will use a complementary set of rigorous health services research methods to understand the underlying mechanisms for gaps in the quality and equity of prescribing and develop strategies with stakeholders to close gaps. This proposal will provide hospital-specific metrics to frontline clinicians and administrators to guide quality improvement efforts to advance inpatient prescribing quality and equity. Specific Aims: Aim 1: To examine the association of sociodemographic factors with receipt of evidence-based medications at hospital discharge. Aim 2: To determine mechanisms by which Veterans do not receive evidence- based medications at hospital discharge. Aim 3: To identify stakeholder perceptions of hospital prescribing performance and barriers to and facilitators of discharge prescribing quality and equity. Methodology: Aim 1 will be a retrospective cohort study using electronic health record data from the VA Corporate Data Warehouse to assess national and hospital-level rates of evidence-based medication use for Veterans hospitalized from 2022 and 2024 for five common complex chronic conditions: alcohol use disorder, atrial fibrillation, cerebrovascular disease, chronic obstructive pulmonary disease, and heart failure. Aim 2 will be a chart review study of a sample of 1,000 Veterans identified in Aim 1 as not receiving evidence-based medications at hospital discharge, oversampling for sociodemographic groups with the largest disparities in care. Aim 3 will be a qualitative study of 75 semi-structured interviews with inpatient clinicians and VA hospital leaders to identify barriers to and facilitators of equitable, high-quality discharge prescribing, recruiting from VA hospitals that are high and low performing (by quality and equity metrics) based upon Aim 1 results. Path to Translation/Implementation: This project will yield critical evidence to guide research and quality improvement efforts to equitably improve care delivery for hospitalized Veterans. The sum impact of this proposal will be the foundational data needed to initiate a Learning Health System Translation-to-Policy Learning Cycle to urgently transform current prescribing practices and test the implementation of data-informed strategies to improve hospital discharge prescribing quality and equity. Findings from all aims will be synthesized and reviewed with Operations partners, Veterans, and a longitudinal Expert Stakeholder Panel of frontline hospital- based clinicians to inform the co-design of implementation strategies to increase prescribing of evidence-based therapies for hospitalized Veterans that will be studied in future QUERI and Merit proposals.

NIA - National Institute on Aging

The growing number of older Americans who seek care in emergency departments (EDs) has increased awareness of the need for specialized geriatric emergency care. Since 2018, the Geriatric ED Accreditation (GEDA) program has promoted such care, and there now are >500 GEDA EDs, across the 3 levels: Gold (~6%), Silver (~11%), and Bronze (~83%). GEDA is particularly attentive to the care of vulnerable older adults, such as persons living with dementia (PLWD). PLWD are a large and growing population that has been shown to visit the ED more often than their cognitively intact counterparts. Alzheimer’s Disease and Related Dementias (ADRD) are often under-recognized during these ED visits, and PLWD have been shown to experience prolonged ED length-of-stay and avoidable hospitalizations. Over the past two years, members of the study team have performed foundational research on GEDA and now seek to investigate, among PLWD, if ED participation in GEDA leads to better emergency care processes and better clinical outcomes. We propose a mixed methods project that combines three population-based datasets from 2022-2024 (NEDI-USA for ED characteristics, including GEDA level; and HCUP SEDD/SID and Medicare for clinical outcomes), and performs qualitative research on ADRD-related ED care practices. The Aims investigate: (1) GEDA level and documentation of ADRD among PLWD. Clinician recognition of ADRD is a critical first step for improving the care of PLWD, yet our Preliminary Work shows that ~1/3 of ED visits by PLWD lack this coding. Hypothesis 1: Compared to non-GEDA EDs, GEDA Gold/Silver EDs are more likely to code ADRD among PLWD. (2) GEDA level and clinical outcomes among PLWD. Hypothesis 2: Compared to PLWD in non-GEDA EDs, those in GEDA Gold/Silver EDs are less likely to have prolonged ED LOS (8+ hours) and to be hospitalized. (3) Adoption and long-term implementation of GEDA practices that improve emergency care for PLWD. Guided by the Consolidated Framework for Implementation Research, we will conduct in-depth qualitative interviews with a purposive sample of ED physician and nurse leaders, based on GEDA level and key ED characteristics (e.g., annual ED visit volume, urban vs rural). Hypothesis 3a: GEDA EDs that successfully integrate ADRD-related care practices into their workflows demonstrate common organizational, cultural, and leadership characteristics. Hypothesis 3b: Specific factors affect the adoption and long-term implementation of ADRD-related care. This R01 project addresses major knowledge gaps and will advance interventional work, including future trials of ADRD-related ED care practices. The investigators have complementary expertise (e.g., emergency medicine, geriatrics, epidemiology, health services research, mixed methods) and a track record of successful collaboration in an exceptional research environment. Preliminary work confirms feasibility, with >90% power for clinically important associations. This 4-year R01 project advances the scientific priorities of NIA/NIH by developing strategies to improve the emergency care of older adults, especially those with ADRD.

NIGMS - National Institute of General Medical Sciences

The Clinician Research Education and Scientific Training (CREST) MSTP will rigorously train MD/PhD students in laboratory, clinical, translational, and community research to ensure their development into successful, independent clinician-scientists. This new MSTP will build on the strong foundation established by the current institutionally-supported MD/PhD program at the University of Arkansas for Medical Sciences (UAMS) and its affiliated Arkansas Children’s Research Institute (ACRI) to uniquely address the need for clinician-scientists in Arkansas and the neighboring IDeA states of Mississippi, Louisiana and Oklahoma. This would be the only MSTP in a geographically isolated desert of 4 contiguous rural IDeA states, all of which have some of the worst health outcomes in the country. CREST will focus recruitment of top applicants from the mid-South region and also leverage a statewide pool of candidates from the University of Arkansas at Fayetteville (UAF) and 17 primarily undergraduate universities already linked with programs at UAMS/ACRI through the Arkansas IDeA Network of Biomedical Research Excellence (INBRE). Recognizing we are at a critical inflection point in training clinician- scientists in Arkansas and the surrounding states, UAMS recently established a new Office of Clinician-Scientist Development (OCSD). The OCSD will facilitate coordination between the CREST Program, existing T32 training programs, our Clinical and Translational Sciences Award (CTSA) and its affiliated Translational Research Institute (TRI), and other UAMS/ACRI IDeA programs, including multiple Centers of Biomedical Research Excellence (COBREs), and the strong population health research programs at UAMS/ACRI and UAF. This central coordination will promote synergies between programs to enhance opportunities for CREST students to pursue broad areas of biomedical research to address healthcare needs unique to the mid-South region. UAMS will provide critical institutional support to ensure full tuition, health insurance supplements, and stipend support for every MD/PhD student in every year of both the MD and PhD phases of training. We are requesting 4 MSTP slots per year in years 1-2, and 2 additional slots beginning in year 3 for a steady state of 10 funded slots, with matching institutional support for a total program size of 32 MSTP students. CREST leadership will utilize a multi- PI (MPI) approach that includes highly successful and complementary investigators well-versed in MD/PhD training. CREST mentoring will include an individualized Scholarship Oversight Committee and near-peer mentoring to support CREST students and ensure seamless integration of the MD and PhD phases of training. Mentoring will purposefully continue for 4 years after completion of the Program to ensure the development of CREST students as independent clinician-scientists. CREST will capitalize on established infrastructure to build a nationally recognized MSTP to train and promote retention of clinician-scientists in Arkansas and surrounding IDeA states, including incentivizing the return of graduates following residency and fellowship training. These clinician-scientists will change the paradigm in a region with particularly poor healthcare outcomes.

NIA - National Institute on Aging

Half of all persons who develop clinical dementia become symptomatic after age 85 years, whereas most studies of dementia have focused on younger patients in their 70s. Compared to dementia beginning at a younger age, dementia in the oldest-old has a more heterogeneous, multifactorial etiology. Although, Alzheimer disease remains important there are greater contributions from vascular brain injury, systemic disease and dysfunction that indirectly affects the brain, and recently described, poorly understood brain pathologies. Vascular and lifestyle risk factors may contribute differently to risk of dementia in the oldest-old. Conversely, it is also important to learn what resilience factors permit persons to remain alive and cognitively normal as nonagenerians. Studies that enroll persons aged 85+, often lack information from when these individuals were middle-aged. Longitudinal cohort studies that enrolled participants between ages 45 and 70 years and followed them past age 80 years, till they died or developed dementia, would be ideal study samples, but each such cohort usually has only a small number of participants surviving beyond age 80. One solution is to combine data across multiple longitudinal studies with harmonizable protocols. The Cross-Cohort Collaboration Consortium (CCC) was established in 2018, as an offshoot of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium. The Neurology working group within the CCC (led by MPIs Seshadri, Ikram, Dufouil, Debette, Satizabal) brought together 8 cohorts (RF1 AG059421) to study late life dementia. We now request a renewal of this grant to expand and continue the collaboration. We will add 5 new cohorts reaching 13 cohorts, to study 102,285 participants, 37,803 with brain MRI, and add a new MPI in Suchy-Dicey who will bring her experience working with AD in American Indians. We propose the following aims. Aim 1: To relate various risk factors, systemic illness and MRI markers in midlife (ages 45 to 70) to (a) the risk of late life dementia, and (b) the probability of reaching age 85 (+/- 5) years, alive and dementia free (‘wellderly’). Aim 2: To assess (a) the impact of multimorbidity examining how persons with two or more chronic conditions differ in life-expectancy and dementia risk and (b) to combine various risk and resilience factors, multimorbidity and MRI measures using artificial intelligence and machine learning to create parsimonious models that predict late-onset dementia and wellderly status. Aim 3: To examine the biological pathways underlying the observed associations using pathway analyses and structural equation modeling to explore the mediating role of plasma proteins. The proteins we study will include known biomarkers of amyloid, tau and neurodegeneration (Aβ40 Aβ42, p-tau181/217, NfL, GFAP) in 37,824 individuals, as well as an array of 3000+ plasma proteins in 38,067 persons (new assays on Olink Explore 3072 + available data) so we can identify previously unsuspected biology using Mendelian randomization methods to examine causality. Aim 4: We will investigate any effect modification by sex-, age-, race-, ethnicity-, urban or rural residence, menopause, APOE genotype on findings from Aims 1-3. We hope to uncover putative drug targets to reduce risk of late life dementia.

NIGMS - National Institute of General Medical Sciences

PROJECT SUMMARY/ABSTRACT Liquid-liquid phase separation (PS) is thought to be the process by which the cell organizes many of its complex structures. While PS is typically associated with intrinsically disordered regions, regions with well-defined structures are also known to contribute, particularly if they can support multivalent transient interactions. Recently, coiled-coil proteins, which can lack elements typically associated with phase separation, have been identified as forming liquid condensates in cells. Examples include structural elements in the centrosome, spindle and Golgi, as well as proteins that help to initiate endocytosis. Motivated by those observations, we recently developed coarse-grained models that demonstrate that the transient interactions between small coiled-coil regions are sufficient to drive phase separation in silico, results which have been supported experimentally by synthetic biology collaborators. Taken together, these observations indicate that coiled-coil regions act as drivers of the intermolecular interactions that organize cells. However, the molecular details of the phase separation of coiled-coil proteins is still unclear. Coiled-coil regions have long confounded structural biology techniques because of their inherent plasticity. We hypothesize that coiled-coil mediated phase separate can arise from exactly those transient interaction that have confounded structural work. We propose phase separation is driven by individual labile coils that interact through their multimeric interfaces, or by interactions between stable and well defined coiled-coil structures and other parts of the protein. We have designed three aims, combining computational (Aim 1), biochemical, and cell biology approaches (Aims 2 and 3) to dissect the molecular mechanisms driving the assembly of condensates by proteins that initiate endocytosis (Aim 2) and organize the Golgi cisternae (Aim 3). Our long term goal is to understand the functional and medical importance of CC domains. In addition, we propose a comprehensive plan to improve the accessibility and quality of the biomedical profes- sional development and research training opportunities for students from historically marginalized populations. We will collaborate with Ft. Lewis College, which serves a significant Native and rural population, and has a relative lack of biomedical research opportunities for students. In addition, strengthening the cultural fluency of CU Boulder researchers will help reduce barriers faced by students coming to a primarily white and well-resourced school. We will (Aim 1) use virtual workshops to bring exposure and access of biomedical research to this community, will (Aim 2) host students for research intensive visits to the Colorado Front Range, and (Aim 3) will work to improve the cultural fluency of CU Boulder researchers to improve the quality of those research experiences.

National Park Service

This funding opportunity announcement is issued to provide public notice of the National Park Service, Alaska Region intent to fund a Cooperative Agreement without competition to the Alaska Nanuuq Commission - ANC. The intended Cooperative Agreement is a continuation of an existing project that was started in 2012. The project end date is May 30, 2014. The purpose is to conduct a habitat-use study for polar bears that builds on previous studies using traditional knowledge and local observers in several villages in Chukotka, Russia. In 2012, the ANC completed a polar bear habitat use study on the Alaska portion of the shared polar bear population. In order to get a more complete picture of the changing nature of these habitats, it is essential to include the Chukotka population. Scientists and Native leaders alike recognize that the most effective management of shared Bering/Chukchi polar bears and their habitat would require active cooperation among the governments and local Native people of the United States and Russia. The ANC will work with indigenous hunters organizations in Chukotka and gather reports on environmental changes in polar bear habitats in Russian. This project will cooperatively develop a report serving to update the report Traditional Knowledge of Chukotka Native Peoples Regarding Polar Bear Habitat Use, which was conducted by ANC and the National Park Service in 2003. Updating information gathered in the `90s. The ANC study in Chukotka will benefit a large number of Chukotka Natives, agencies, organizations, and governmental entities, including the NPS. This project is mutually beneficial and the knowledge exchange is a primary objective of the project. It contributes to the larger body of knowledge on the changing habitat of polar bears on both sides of the Bering Strait, and the long-term implications for this important species. The objectives of this cooperative agreement will be: To continue work and further develop the relationship between the ANC and Native organizations in Chukotka, with the NPS facilitating the exchange of information and the process of writing international agreements. -To gather information about polar bear habitat use through the observations of indigenous people in Chukotka. The NPS will act as a liaison when needed to facilitate exchanges, enhance communication, provide translation services when necessary, assist with organizing trainings and seminars, and provide logistical support. -To assist the Native organizations in their village outreach programs of conservation education and habitat protection of polar bear. -To update the habitat use study in Chukotka through the collection of interviews, data, and TEK in Chukotka villages -To provide a written report that will be shared by the SHBP with a vast network of interested parties through the SBHP website, Facebook page, and other distribution methods including participating communities and respondents. The National Park Service agrees to: 1. Using the network of contacts in Alaska and Russia (especially in Native communities), facilitate dissemination of project results to relevant communities and organizations in Alaska and Russia. Assist with the dissemination of information; working with local park units to post information, advertise presentations, and include in interpretive programs. 2. Use the network of contacts, the program website, and the program Facebook page to share information from the final and interim reports with the participating communities and participants, public, as well as targeted audiences through the development of distribution plan for final project materials and results. 3. Assist the ANC in strengthening their relationship with Native organizations in Chukotka, with the NPS facilitating the exchange of information and the process of writing international agreements. The SBHP has experience in writing successful agreements with Russian organizations, and will provide essential support to the ANC during the negotiation and finalization of an international agreement with a Russian Native organization. 4. The NPS will assist the ANC during their process of gathering information about polar bear habitat use through the observations of indigenous people in Chukotka. The SBHP will act as a liaison when needed to facilitate exchanges, enhance communication, provide translation services when necessary, assist with organizing trainings and seminars, and provide logistical support. 5. Provide technical assistance and expertise to the project including help with travel arrangements, and safety briefings related to project and geographic location. Also will provide translation and interpretation when necessary through our network of translators, as well as bilingual staff members. 6. The NPS will also support the ANC during meetings and conferences, including inter-Commission annual gathering. By attending relevant partner meetings, the NPS will support the mission and the objectives of the project by interacting and networking with other organizations in order to strengthen the liaison role. The NPS SBHP will also support the ANC by presenting information about the project to other interested parties, as well as at the annual gathering of ANC Commissioners. 7. Connect this project with the NPS network of projects aimed at indigenous and subsistence knowledge and share how this effort is structured and the final results, to inform other preservation efforts especially those working internationally. 8. Assign Elizabeth Shea, Program Specialist for the SBHP, NPS, as the Agreements Technical Representative (ATR) for the administration of this Cooperative Agreement; and as Liaison between the NPS and the ANC for the implementation of the program(s) identified within this agreement. The Alaska Nanuuq Commission agrees to: 1. Work directly with Native organizations on the Russian side to successfully accomplish the goals outlined under this project. 2. ANC will work directly with local organizations to coordinate all overall activities for the completion of the entire study within Chukotka. 3. Authors and editors for the Final report will be selected from the local Native organizations in Chukotka by the ANC. 4. ANC will work with chosen local organizations to incorporate the project s data and results in to the greater context of the Beringia Program to show the importance of subsistence aboriginal hunting and TEK in rural and urban communities within Chukotka. 5. The designated organizations in Chukotka will work with experts on the Russian side to provide the final draft of the overall report that includes the data, surveys and interviews conducted by the local surveyors. 6. Survey team will be headed by local Russian organizations that already have contacts with local surveyors, utilizing primarily team members from the original study, wherever possible. Technical Point of Contact: Elizabeth Shea 907-644-3606.