Effectiveness of School-Based Health Centers to Advance Health Equity (R01 Clinical Trial Optional) | PAR 21 287

FAQs: NIH PAR-21-287 - Effectiveness of School-Based Health Centers to Advance Health Equity (R01 Clinical Trial Optional)

What is this funding opportunity?

This is a National Institutes of Health (NIH) funding opportunity titled "Effectiveness of School-Based Health Centers to Advance Health Equity (R01 Clinical Trial Optional)" (Funding Opportunity Number PAR-21-287). It supports research that tests how well school-based health centers (SBHCs) work as a health care delivery model for school-aged children and adolescents who experience health disparities, with an explicit focus on advancing health equity.

What is the main goal of the research NIH is seeking?

The central goal is to generate strong evidence about whether, how, and under what conditions SBHCs improve access to care, quality of services, and health outcomes for underserved youth. The emphasis is on real-world effectiveness in school settings and on results that can inform broader practice and policy.

What does "R01" mean for the scope of proposed projects?

Because this is an R01 mechanism, NIH expects rigorous, well-designed research capable of producing generalizable findings. It is positioned for substantive studies rather than small pilot or preliminary efforts.

What does "Clinical Trial Optional" mean?

"Clinical Trial Optional" means applicants may propose either clinical trial designs (when appropriate) or non-trial evaluation approaches. The key expectation is that the study design should match the research question and credibly test effectiveness in real-world settings.

What settings and populations are the focus of this FOA?

The focus is on school-based health centers operating in real-world school settings and serving school-aged children and adolescents who experience health disparities. The intent is to understand SBHC effectiveness for underserved youth and how SBHCs can advance health equity.

What kinds of barriers to care is this opportunity concerned with?

The announcement highlights barriers that often show up in school-aged populations, such as transportation challenges, limited primary care availability, cost and insurance issues, stigma around seeking behavioral health services, and gaps in preventive care. SBHCs are viewed as a model that may reduce these barriers by offering services where students already are.

What kinds of outcomes could an SBHC effectiveness study measure?

Depending on the project, outcomes may include measures related to health care utilization and access (for example, receipt of recommended preventive services, timely management of chronic conditions, continuity of care, or reduced unmet need), physical health indicators (such as asthma control, obesity-related measures, sexual and reproductive health outcomes, immunizations, or oral health), and behavioral health outcomes (including screening, treatment initiation, symptom improvement, crisis response, or substance use prevention).

Is the FOA limited to physical health outcomes, or can behavioral health be included?

Behavioral health is explicitly included as a potential focus. Examples listed include screening, treatment initiation, symptom improvement, crisis response, and substance use prevention outcomes.

Does NIH encourage applicants to study implementation factors that influence effectiveness?

Yes. Strong applications typically examine implementation realities that affect effectiveness, such as staffing models, service integration, referral and follow-up processes, telehealth use, confidentiality and consent practices, cultural and linguistic responsiveness, and coordination with families and community providers.

Are telehealth models within SBHCs relevant to this opportunity?

Yes. Telehealth use is specifically mentioned as one of the implementation realities that may affect effectiveness and can be examined as part of an effectiveness study.

What types of organizations are eligible to apply?

Eligibility is broad. Eligible applicants include state, county, and city/township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; Native American tribal governments (federally recognized); tribal organizations that are not federally recognized; public housing authorities/Indian housing authorities; nonprofits (both 501(c)(3) and non-501(c)(3)); for-profit organizations (other than small businesses); and small businesses.

Are schools and school districts eligible applicants?

Yes. Independent school districts are listed as eligible applicants, and the opportunity is designed to encourage participation from organizations that commonly partner with schools and deliver services.

Are nonprofits eligible, and do they need to be 501(c)(3) organizations?

Nonprofits are eligible, including both 501(c)(3) and non-501(c)(3) nonprofit organizations.

Are for-profit organizations eligible?

Yes. For-profit organizations (other than small businesses) are listed as eligible applicants, and small businesses are also listed as eligible applicants.

Are tribal governments and tribal organizations eligible?

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

Are U.S. territories eligible to apply?

Yes. The announcement explicitly highlights U.S. territories or possessions among eligible applicant types.

Does the FOA highlight any specific institution types related to underserved communities?

Yes. It explicitly highlights additional eligible applicant types including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), and Tribally Controlled Colleges and Universities (TCCUs), as well as faith-based or community-based organizations and regional organizations.

Are foreign institutions or non-U.S. entities allowed to apply?

No. Non-U.S. entities and foreign institutions are not eligible to apply under this opportunity.

Can a U.S. organization include a non-U.S. component in the proposed work?

No. Non-U.S. components of U.S. organizations are not eligible, and foreign components (as NIH defines them in its Grants Policy Statement) are not allowed.

What is the application deadline listed in the summary provided?

The original closing date listed is January 7, 2025.

Does the provided summary state an award ceiling or the expected number of awards?

No. The provided summary notes that it does not specify an award ceiling or the expected number of awards, indicating that applicants typically need to consult the full FOA text and NIH guidance for budget expectations, project period norms, and any institute- or center-specific priorities.

Is this a discretionary grant, and what activity categories is it associated with?

Yes. It is described as a discretionary NIH grant opportunity and is associated with the education and health activity categories.

What CFDA numbers are associated with this opportunity?

The opportunity is associated with CFDA numbers 93.242, 93.279, and 93.307.

What kinds of research questions fit this FOA best?

Research questions that fit best are those that test the real-world effectiveness of SBHCs in improving access, quality, and health outcomes for underserved children and adolescents, and that identify how context and implementation conditions shape results (for example, which SBHC models work best, for whom, and under what circumstances).

What is the broader purpose of NIH funding this research area?

The overall purpose is to build the evidence base for SBHCs as a strategy to reduce inequities in child and adolescent health by testing real-world models of school-linked care and identifying what works best for underserved student populations.