Partnering Research and Community Organizations for Novel Health Equity Research: Addressing Health Systems Factors and Social Determinants of Maternal Health -- Cycle 1 2023

Significant disparities in maternal mortality and severe maternal morbidity persist among Black or African American people, American Indian/Alaska Native people, Hispanic people, people with disabilities, residents of rural areas, and people of lower socioeconomic status. Because social determinants of health are recognized as important drivers of disparities in health outcomes, addressing these disparities requires evidence-based solutions that comprehensively address both the clinical and social needs of communities impacted by these disparities.

The Partnering Research and Community Organizations for Novel Health Equity Research: Addressing Social and Clinical Determinants of Maternal Health Targeted PCORI Funding Announcement (Partner Targeted PFA) is seeking to fund high-quality, comparative clinical effectiveness research (CER) studies that focus on multicomponent, multilevel interventions simultaneously addressing health conditions and social determinants of health to improve maternal health outcomes.

The Partner Targeted PFA, which supports PCORI’s National Priorities for Health, including Achieve Health Equity, will fund CER studies in which community organizations are full partners in the work, are in leadership roles, and are partners in critical decision making alongside research organizations.

For questions about this announcement, please consult the Partner PFA FAQs, or email [email protected].

Research Question

PCORI is seeking to fund rigorous high-quality studies that address the following research question: What is the comparative effectiveness of multicomponent, multilevel interventions to improve maternal outcomes for individuals from populations highly impacted by maternal health disparities?

Proposed CER studies may focus on pre-and/or postnatal care and should include at least one of each of the following types of interventions:

• Health systems strategies to address disparities in maternal health outcomes (e.g., data accountability measures; bias awareness training; trauma-informed care; team-based care; community-informed models of care; telehealth; standardized protocols for monitoring/treatment of hypertension, substance use, depression, and diabetes)
• Strategies to address social determinants of health (e.g., active assistance with resources; medically tailored meals; vouchers for food, housing, or other needs; medical-legal partnerships; integrated social services in clinical settings)

Guidance for Applicants

This announcement solicits proposals from applicants that have established researcher-community partnerships. Partnerships will consist of at least one research organization and at least one community organization but may include more than two organizations to ensure the appropriate range of expertise and knowledge of the population of interest needed to carry out the award successfully. PCORI welcomes a broad range of community organizations to participate in partnerships to provide critical insights into populations of interest to the proposed studies, understand the context and root causes of health issues in the community, and facilitate robust and meaningful engagement of a range of stakeholders.

Types of community organizations of particular relevance to the Partner Targeted PFA are those that provide social services or address specific social needs of affected individuals or their households, including, but not limited to, housing, food, transportation, and home health; maternal health organizations; faith-based organizations; patient-/condition-specific advocacy organizations; organizations that represent communities experiencing disparate health outcomes; organizations that can provide historical context to studies; and organizations with relevant community data. Partnerships should comprise an appropriate set of organizations with expertise to successfully complete the awardee’s scope of work. Because the awards fund CER, PCORI expects the applicant organization to have significant experience in conducting and overseeing complex intervention research and must demonstrate the ability to comply with conditions for funding contracts entered with PCORI.

What does it mean to be an established researcher-community partnership?

This announcement seeks organizations with a previous or existing working relationship because applications will be written collaboratively by the partners, who should share a similar understanding of the community's needs regarding drivers of maternal health disparities. Experienced partners are more likely to initiate conduct of the research quickly and facilitate timely dissemination and uptake of study findings. Examples of established partnerships among research and community organizations include, but are not limited to, an organization participating on a community advisory board for a study, organizational representatives collaborating as investigators on a study, collaboration on an implementation project addressing a health issue, or co-participation in a health coalition. In the application, partners must describe their history of collaboration and demonstrate their ability to work together in meaningful partnership.

Shared Leadership within the Researcher-Community Partnership

This announcement seeks innovative and novel approaches to sharing leadership across multiple organizational partners to facilitate equity in leadership. Applications will include a leadership plan that details team member leadership roles and responsibilities, decision-making processes for the award, and approaches to resolving disagreements. PCORI requires that a principal investigator (PI) from a research organization and a PI from a community organization be named and serve as dual PIs to promote parity. If other arrangements are proposed, applicants must seek prior approval from PCORI to ensure the coequal and independent voices of partnered organizations in the award.

Community Engagement

Due to the requirement of shared leadership across research and community organizations within each award, applicants should have the resources and staffing to conduct sustained community engagement over the duration of the award. As awards evolve, engagement of the community may evolve through collaborations with different types of expertise, sectors, and knowledge.

Award Structure and Budget Information

PCORI acknowledges that the Partner Targeted PFA seeks more innovative approaches to answering highly complex research questions and is therefore allotting time to study teams for planning purposes. The award will have two phases: a planning phase of up to one year and a research phase of up to five years in which CER will be conducted.

Multiple applications are likely to be awarded. To provide applicants flexibility in addressing their communities’ maternal health priorities, they may propose to conduct, within the five-year research phase, only one or more than one CER study. If multiple studies are proposed, they may vary by population of interest, interventions tested, outcomes, duration of study, settings, etc. PCORI has no preference for single-study or multiple-study applications, but we expect each proposed CER study to be distinct from each other and written with a high level of rigor.

For each award, a maximum budget of $1 million in total costs is allowed for the planning phase and a maximum budget of $20 million in total costs is allowed for the research phase (regardless of the number of studies). During the planning phase, funds may cover the refinement of roles, responsibilities, leadership processes, research, engagement, and mentorship plans. Adaptations of interventions to specific communities may be conducted during the planning phase.

During the research phase, funds will cover the conduct of CER studies, community engagement, participation in a learning network across awardees, participation in a process evaluation of the entire initiative, and the conduct of a researcher mentorship program focusing on investigators underrepresented in science (including, but not limited to people who are Black/African American, Hispanic/Latinx, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander; LGBTQ+ individuals; people with disabilities; or women). Competitive applications will appropriately allocate funds to all organizations within the partnership, consistent with their level of effort and using equitable compensation practices.

For questions about this announcement, please consult the Partner PFA FAQs or email [email protected].