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National Rural Electric Cooperative Association

Community development grants from rural electric cooperatives

National Rural Health Association

Telehealth infrastructure and program development for rural providers

NINR - National Institute of Nursing Research

PROJECT SUMMARY/ABSTRACT The increasing ubiquity of digital technology, including artificial intelligence (AI) presents a transformative opportunity for health promotion and disease prevention, particularly in rural and other medically under- resourced populations. and individuals predisposed to chronic conditions. However, the gap between technological innovation and its implementation to address health outcomes remains significant. Nurse scientists, with their unique combination of clinical expertise and holistic understanding of patient care, are ideally positioned to bridge this gap. This T32 training program, based at Florida State University (FSU) College of Nursing and implemented through its Institute on Digital Health and Innovation (IDHI), and with support from College of Medicine’s interdisciplinary Center for Translational Behavioral Science (CTBS), aims to prepare nurse-trained postdoctoral fellows to lead interdisciplinary research that leverages technology to improve prevention and health management outcomes in a variety of populations. Bridging the domains of digital health technology, nursing science, and compassionate care requires advanced training that encompasses technical skills, implementation science, and community engagement. This T32 program will equip nurse-trained postdoctoral fellows with the skills and knowledge to: (1) Design, test, and scale up digital health and AI interventions tailored to the needs of a variety of populations (e.g., emerging adults, rural residents, etc.); (2) Translate technological innovations into scalable, sustainable practices that address health outcomes; and (3) Collaborate across disciplines and multisectoral partners to lead research that bridges the divide between clinical and community practice, technological development, and health policy. FSU is uniquely positioned to lead this effort, providing an ideal environment for fostering interdisciplinary research to support postdoctoral nurse scientists toward research independence. The collaborative leadership of MPIs Dr. Lisa Hightow-Weidman, Dr. Jing Wang, and Dr. Sylvie Naar ensures a breadth of expertise spanning nursing, technology, health promotion, community engagement, translational behavioral science and implementation science. The T32 program, NURTURe: Nurse Scientists Using Research and Technology and AI to Uplift Resilient eHealth Outcomes, directly aligns with the National Institute of Nursing Research’s (NINR) priorities by addressing optimizing health for all through innovative research. By focusing on training the next generation of nurse scientists to develop and test digital health technology solutions, this program will advance the field of nursing science and contribute to a more responsive healthcare system. Trainees of this program will emerge as leaders capable of driving transformative change in health promotion, disease prevention, and disease self- management. By addressing these critical areas through cutting-edge research and training, this program supports NINR’s mission to advance nursing science and improve health outcomes across all communities with a solutions orientation, employing innovative and rigorous science.

Ohio Department of Development

Ohio's CDBG Program funds housing, infrastructure, community facilities, and economic development activities in Ohio's smaller cities and rural communities, primarily benefiting low- and moderate-income residents.

Oklahoma Department of Commerce

The REAP program provides grants to rural Oklahoma communities for critical infrastructure and economic development projects, supporting water and sewer improvements, fire protection, community centers, and other essential public facilities.

Ontario Ministry of Agriculture, Food and Rural Affairs

OMAFRA provides grants for agricultural innovation, rural economic development, food processing, and environmental stewardship in Ontario's agri-food sector.

NIH

Background: Chronic obstructive pulmonary disease (COPD), the sixth leading cause of death in the U.S., disproportionately affects Veterans, who are twice as likely to suffer from COPD as the general US population. Compared with urban counties, rural counties have higher rates of COPD-related hospitalizations and deaths. Challenges in accessing evidence-based care are likely contributing factors to worse rural COPD outcomes. Implementation of evidence-based COPD care through a pharmacist-led COPD program can improve access to and delivery of high-value care for rural Veterans. However, it is unclear if this type of implementation strategy for COPD is feasible, acceptable, appropriate, and effective for Veterans in resource-constrained rural clinics where pulmonary subspecialty care is not readily accessible. Significance/Impact: Rural Veterans are disproportionately affected by COPD. Additionally, they are less likely to receive evidence-based COPD care. This proposal will improve Veteran health by providing better quality and more equitable access to evidence-based COPD care. This work will advance delivery of high- value care to Veterans who face challenges in accessing care and will reduce health disparities by leveraging effective implementation strategies. Innovation: Innovations include: 1) extending the use of pharmacist-led CDM programs to include COPD tailored for rural Veterans; 2) testing a “proactive” (without prompting from patients or clinicians) program in which rural patients with frequent COPD exacerbations will be systematically identified outside of a routine clinic visit; and 3) targeting prevention of COPD exacerbations and hospitalizations. Specific Aims: The proposed research and training plan will increase my skills in implementation research, specifically focusing on rapid qualitative and mixed methods research, intervention development, and implementation evaluation through the following aims: Aim 1. Identify patient and institutional barriers and facilitators to implementation of a proactive pharmacist-led COPD program for rural Veterans; Aim 2. Pilot a proactive pharmacist-led COPD program to optimize COPD care for rural Veterans. Pharmacists will optimize COPD care for Veterans in rural clinics who are at high risk for hospitalization (n=40 patients). Program core components will include: 1) COPD education, 2) medication optimization, 3) inhaler technique review, and 4) smoking cessation; Aim 3. Development of an implementation toolkit to support implementation of a pharmacist-led COPD program for rural clinics. Methodology: The first research aims will be conducting qualitative assessments of patient and institutional (Aim 1) barriers to and facilitators for implementation of a proactive pharmacist-led COPD program by performing semi-structured interviews of rural COPD patients (n=30), rural clinic staff (n=20), and leadership (n=10) in VISN 23. Aim 2 will be to pilot a proactive pharmacist-led COPD program to optimize COPD care in rural clinics targeting Veterans (n=40) at highest risk for COPD hospitalizations. The study pharmacists will optimize COPD management based on established COPD guidelines. Aim 3 will use existing COPD programs to develop a prototype of an implementation toolkit support implementation of the proactive, pharmacist-led COPD program for rural clinics. Survey and focus groups will evaluate the toolkit. Next Steps/Implementation: After generating key pilot data, we will perform a large-scale hybrid effectiveness-implementation study of pharmacist-led COPD management.

Natural Resources Conservation Service

May 12, 2022, UPDATE: This funding opportunity is open for second funding pool applications (from $250,000 to $4,999,999), which are due by June 10, 2022, by 11:59pm. Applications for the first funding pool (from $5 million to $100 million) were due May 06, 2022, by 11:59pm Eastern Time and are no longer being accepted. May 06, 2022 UPDATE: Applications for the first funding pool are due May 06, 2022 by 11:59pm Eastern Time, and the opportunity will be temporarily closed from May 07, 2022 through May 11, 2022. The opportunity will open again on May 12, 2022 for the second funding pool applications, which are due by June 10, 2022 by 11:59pm. Modifications on 03/11/2022 extended application due dates and added clarifying edits, including those related to eligibility and quantification. Modifications appear in red text in the Full Announcement document located in the Related Documents tab of this opportunity. Notice of Funding Opportunity (NFO) Summary Up to approximately $1 billion will be made available for the Partnerships for Climate-Smart Commodities projects through this funding opportunity, which will build markets and invest in America s climate-smart farmers, ranchers, and forest owners to strengthen U.S. rural and agricultural communities. Through the Partnerships for Climate-Smart Commodities, USDA will support the production and marketing of climate-smart commodities through a set of pilot projects that provide voluntary incentives through partners to producers and land owners, including early adopters, to: a. implement climate-smart production practices, activities, and systems on working lands, b. measure/quantify, monitor and verify the carbon and greenhouse gas (GHG) benefits associated with those practices, and c. develop markets and promote the resulting climate-smart commodities. Grant agreements under this funding opportunity will be with a single entity, i.e., partner ; however, USDA encourages multiple partners to coordinate on projects. A range of public and private entities are eligible to apply, as described in Section C of the Full Announcement which can be found in the Related Documents tab of this opportunity. Proposals must provide a plan to pilot implementation of climate-smart agriculture and/or forestry practices on a large-scale, including meaningful involvement of small or historically underserved producers, consistent with spirit of the Justice40 initiative; a quantification, monitoring, reporting, and verification plan; and a plan to develop markets and promote climate-smart commodities generated as a result of project activities. Funding will be provided through two funding pools. Proposals in the first funding pool (requests for amounts from $5 million to $100 million per proposal) will be large-scale pilot projects that emphasize the greenhouse gas benefits of climate-smart commodity production and include direct, meaningful benefits to a representative cross-section of production agriculture, including small and/or historically underserved producers. Proposals in the second funding pool (requests for amounts from $250,000 to $4,999,999 per proposal) are limited to particularly innovative pilot projects with an emphasis on enrollment of small and/or underserved producers and/or monitoring, reporting, and verification activities developed at minority-serving institutions. All projects must be tied to the development of markets and promotion of climate-smart commodities. For the purposes of this funding opportunity, a climate-smart commodity is an agricultural commodity that is produced using agricultural (farming, ranching, or forestry) practices that reduce greenhouse gas emissions or sequester carbon. Markets for climate-smart commodities may include companies or processors sourcing climate-smart commodities to meet internal targets or other supply chain goals, biofuel and renewable energy markets, companies seeking to sell branded consumer products, or other opportunities that could provide a premium or additional revenue for participating producers and land owners. Sufficient incentives to encourage producer participation, as well as, generation of verifiable greenhouse gas reductions and carbon sequestration are critical to project success and will be considered in the evaluation criteria. For new users of Grants.gov, see the Full Announcement located in the Related Documents tab of this opportunity for information about steps required before submitting an application via Grants.gov. Key Dates Applicants must submit their applications via Grants.gov by 11:59 pm Eastern Time on: May 06, 2022 for the first funding pool (proposals from $5 million to $100 million) June 10, 2022 for the second funding pool (proposals from $250,000 to $4,999,999). For technical issues with Grants.gov, contact Grants.gov Applicant Support at 1-800-518-4726 or support@grants.gov. Awarding agency staff cannot support applicants regarding Grants.gov accounts. For inquiries specific to the content of the NFO requirements, contact the federal awarding agency contact (found in section G of the Full Announcement located in the Related Documents tab of this opportunity.). Please limit questions to those regarding specific information contained in this NFO (such as dates, page numbers, clarification of discrepancies, etc.). Questions related to eligibility or the merits of a specific proposal will not be addressed. Information on available webinars and other supporting information for this funding opportunity will be posted at: https://www.usda.gov/climate-solutions/climate-smart-commodities The agency anticipates making selections by Summer 2022 and expects to execute awards by September 30, 2022. These dates are estimates and are subject to change. Federal Financial Assistance Training The funding available through this NFO is Federal financial assistance. Grants 101 Training is highly recommended for those seeking knowledge about Federal financial assistance. The training is free and available to the public via https://www.cfo.gov/grants-training/. It consists of five modules covering each of the following topics: 1) laws, regulations, and guidance; 2) financial assistance mechanisms; 3) uniform guidance on administrative requirements; 4) cost principles; and 5) risk management and single audit. USDA s Farm Production and Conservation (FPAC) agencies also apply Federal financial assistance regulations to certain non-assistance awards (e.g., non-assistance cooperative agreements).

NEI - National Eye Institute

Non-infectious uveitis (NIU) is a leading cause of visual impairment, responsible for 15% of blindness cases in the United States. It primarily affects young, working-age individuals, carrying a significant lifetime risk of visual disability and an economic burden comparable to that of diabetic retinopathy. Despite advancements in systemic immunomodulatory therapies (IMTs), the management of NIU remains suboptimal due to the heterogeneity of the disease and the lack of personalized treatment strategies. Approximately 40% of patients do not respond to first-line therapies, resulting in delays in controlling inflammation and an increased risk of complications. Additionally, access to uveitis care is limited, especially for rural and socioeconomically disadvantaged populations. These challenges highlight the need for predictive models that can guide personalized interventions and optimize patient outcomes. This K23 proposal aims to develop and validate machine learning (ML) models that predict treatment response, disease activity, and the risk of complications in patients with NIU. We will extract detailed ocular exam data from Electronic Health Records (EHRs, Aim 1) and build predictive tools that can be integrated into clinical workflows, providing clinicians with real-time, evidence-based decision- making support (Aim 2). Career Development Plan: Dr. Emami-Naeini’s career development plan includes advanced training in bioinformatics, ML, and clinical informatics, which will be essential to achieving independence as a clinician-scientist. She will complete coursework in ML and data science, attend health informatics workshops, and receive mentorship from a multidisciplinary team with expertise in uveitis, ML, and health informatics. The mentorship and training will allow her to acquire the necessary skills to develop and validate predictive models for uveitis care. Environment: UC Davis offers an exceptional environment for achieving candidate’s career goals, with access to the Clinical and Translational Science Center (CTSC), the Biomedical Informatics Program, and the Sight Outcomes Research Collaborative (SOURCE) consortium. The institutional support, infrastructure, and protected research time provided by the Department of Ophthalmology will ensure the successful execution of this project. The data generated from this K23 proposal, along with the training received during the award period, will provide the foundation for the PI’s independent career as a clinician-scientist. This work will also form the basis for future R01 applications, with the goal of integrating predictive models into the EHR systems for widespread use and personalized care for NIU patients.

NIMH - National Institute of Mental Health

PROJECT SUMMARY / ABSTRACT Despite availability of HIV pre-exposure prophylaxis (PrEP) for over a decade, many persons who could benefit from PrEP have not yet accessed PrEP services. Implementation of pharmacy-based PrEP is a promising strategy that presents opportunity to overcome barriers related to clinic distance and stigma and to increase PrEP access, uptake, and continuity of treatment among individuals who would benefit most. Despite the fact that team member and pharmacist Dr. Elyse Tung started the first pharmacy-based PrEP clinic nearly ten years ago, PrEP still is not widely available through pharmacies without a prescription from a doctor or other licensed clinician. As of 2024, not all states allow pharmacists to prescribe medications independently, and many insurance companies erect barriers to providing compensation to pharmacists for this role. Implementation science projects are needed to develop, refine, and evaluate the training and educational support required by pharmacists to expand their scope of practice. Health economics work is also needed to determine whether there are incremental financial benefits for pharmacies to provide injectable PrEP in addition to oral medications and to evaluate the cost-effectiveness of providing PrEP through telehealth. In response to RFA MH-25-185, we propose three specific aims. Aim 1 will build on a current supplement through the Ending the HIV Epidemic (EHE) initiative that is funding a pilot project to evaluate an online virtual community of practice (VCoP) for pharmacists and pharmacy staff to increase their knowledge, capabilities, and comfort in prescribing PrEP. Aims 2 and 3 will conduct financial analyses to provide information for new pharmacy implementation and use time and motion data to compare the costs and benefits of providing injectable PrEP versus oral PrEP and in-pharmacy visits versus telePrEP. This project addresses the Prevent pillar of the EHE plan with a secondary impact on the Diagnose pillar. This project also addresses the NIH HIV/AIDS Research Priorities (NOT-OD-20-018) to reduce HIV incidence by testing new prevention strategies and training the workforce. It is in synergy with the local EHE plan, the Washington State Department of Health, and the National HIV/AIDS Strategy. The national strategy specifically calls out to leverage pharmacists’ knowledge and accessibility in nearly every urban and rural community as part of a comprehensive HIV prevention and care strategy. Ultimately our goal is to provide more PrEP options and motivate pharmacists and pharmacy owners to expand access points for PrEP care in locations and to populations disproportionately impacted by HIV infection in order to end the HIV epidemic.

NCI - National Cancer Institute

PROJECT SUMMARY/ABSTRACT Cancer patient participation in therapeutic clinical trials is essential to the development and evaluation of new cancer treatments to improve patient survival, outcomes, and quality of life. However, investigators and institutions often fail to recruit the number of patients required to answer the study’s question or provide generalizable results, limiting the advancement of cancer care. Trial enrollment rates among U.S. cancer patients remain persistently low. It is estimated that 77% of US cancer patients are not enrolled to trials due to being treated at sites with no trial options for them. Of the remaining 23% of all patients treated at facilities with available trials, only 8%, or just over 1 in 3, are enrolled. Rural areas are characterized by uneven and insufficient accrual of patients onto therapeutic clinical trials. Current solutions to supporting clinical trial enrollment include big data initiatives, such as precision oncology protocols, designed to reduce structural barriers by matching patients to trial opportunities within large clinical trial networks. Patient decision aids administered at the time of invitation to a specific trial are designed to help patient better understand and make informed decisions about joining trials . Despite the proliferation of these efforts, their efficacy in increasing trial enrollment is inconsistent and trial enrollment rates remain stagnant. Research from our group and others has shown that patients’ trial enrollment decisions are not just based on their views of a specific trial opportunity but also factors such as misunderstanding, mistrust, negative attitudes, and poor communication skills which can limit patients’ participation in clinical trial conversations and decision making. Our premise is that interventions are needed to extend beyond prevailing strategies of offering decision aids or education at the time of trial invitation to also proactively preparing patients to have meaningful conversations and make informed decisions if presented with a trial opportunity. We have developed and experimentally tested a set of evidence-based message strategies, grounded in health communication principles and behavior change theories, which can be effective at improving patient understanding and communication skills, even among those with mistrust or negative attitudes toward research. We propose to assemble these evidence-based components into an interactive, game-based educational intervention to prepare patients to engage in clinical trial conversations and informed decision-making if an opportunity to join a trial emerges during their treatment. The planning studies in this R34 application are designed to support a future trial by completing these Specific Aims: 1) to apply user-centered design and iterative development methods to produce an intervention that integrates evidence-based messaging strategies into a game package ; 2) to conduct a pilot study of the intervention in the field; and 3) to collect prospective data from medical records and self-report patient survey related to clinical trials.

NIA - National Institute on Aging

The goal of the PRAISE: Promoting Rural Aging Innovations, Science, and Education T32 application is to fund an innovative research training program at Dartmouth to prepare scholars for careers dedicated to advancing whole person care for rural older adults with multiple chronic conditions using multi-level policy evaluation and clinical intervention research. Whole person health for aging adults is about treating patients as individuals with unique needs, goals, and circumstances, rather than focusing on isolated health issues. It’s a comprehensive, holistic approach that seeks to optimize well-being in all areas of life. This training program will focus on the intersection between aging and rural health and innovative solutions to the distinct challenges it poses to the provision of whole person health, using the social ecological model as the framework for multi-level policy evaluation and clinical intervention research. We will select 2 predoctoral scholars per year in Y1-4 from two doctoral programs: health policy and clinical practice and quantitative biomedical sciences and 1 postdoctoral scholar in Y2-4 from geriatrics or palliative care. Scholars will receive comprehensive multidisciplinary training that integrates relevant theories, methodological strategies, and evidence from clinical medicine (i.e., geriatrics, palliative care), social science (i.e., behavioral decision science, social psychology, economics, public health policy), and clinical research (i.e., epidemiology, biostatistics, implementation science). Scholars will learn methods for rigorous design and testing of interventions intended to align care plans with individual patient’s goals and care preferences, promote age-friendly practices in all care settings, and integrate social services and caregiver support into healthcare delivery. They will receive in-depth training in clinical trial methods, ranging from early-phase formative and feasibility trials through pragmatic efficacy studies, including effectiveness-implementation hybrid designs and quasi-experimental policy analysis. To build this program we will focus on recruiting and retaining outstanding trainees, supporting their training through rigorous coursework and mentored research guided by an interdisciplinary mentoring team and individualized research career development plans. The training program will be housed in the Dartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine and will leverage the expertise of faculty associated with The Dartmouth Institute and/or one or more of the ten centers across Dartmouth and Dartmouth Health with resources for promoting rural aging innovations, science and education (C. Everett Koop Institute, Center for Advancing Rural Health, Geriatric Center of Excellence, Center for Rural Health Care Delivery Science, Center for Precision Health and Artificial Intelligence, Center for Technology and Behavioral Health, Center for Implementation Science, Northern New England System Transformation for Primary Care, Promise Partnership and Learning Health System Embedded Scientist Training and Research Center, and the SYNERGY Clinical and Translational Science Award).

NINDS - National Institute of Neurological Disorders and Stroke

Project Abstract Motor impairments are one of the first signs of atypical development in infants who go on to have autism spectrum disorder (ASD) and are more closely tied to abnormal neurobiological processes in ASD. Motor behavior has high potential to serve as a measurable early behavioral difference to advance early detection of ASD—a necessary step for access to earlier and more effective interventions. However, standardized assessments of infant motor function have not been able to capture motor behaviors that are specific to ASD due to their focus on categorical ratings of milestone-attainment that are present across many neurodevelopmental conditions. There is a critical need for methods that objectively capture deeper aspects of underlying infant movements that are more sensitive and specific to ASD outcomes. The current study aims to use wearable sensor technology and advanced computational techniques to develop and validate objective, specific, reliable, and scalable measures of infant motor function that serve as predictive biomarkers of ASD, with the ultimate goal of advancing earlier detection and intervention that can improve long-term outcomes in ASD. The proposed study will use wearable sensors to measure motor development in the first year of life in infants at increased likelihood for ASD (ILA, defined as having an older sibling with ASD). Our team’s preliminary data strongly supports a theoretical model that lower sensor-based quantitative measures of infant movement symmetry and variability are specifically associated with later ASD outcomes, and that lower infant movement variability in the first year of life is associated with later forming repetitive motor behaviors (RMB) seen in ASD. We will enroll 120 ILA infants and examine an external validation cohort of infants. Infants will be assessed at 3, 6, 9, and 12 months of age with wearable sensors worn on bilateral upper and lower extremities and with standardized motor and behavioral assessments. Behavioral measures of ASD symptoms and developmental level will occur at 12 and 24 months. The assessments from 3-12 months will occur in the infant’s home, capture ecologically valid movement data, and remove barriers for participation for rural and underserved populations that cannot easily access major academic areas. We will apply sophisticated signal processing and machine learning techniques on the multidimensional quantitative infant movement data collected to: (1) validate our existing quantitative measures of infant movement variability (complexity and curvature) and symmetry; (2) create and validate new quantitative measures that improve detection of atypical movement characteristics across different developmental stages; and (3) advance early detection of ASD by creating prediction models that include the quantitative measures of infant movements and measures of other atypical behaviors associated with ASD. We will further examine the performance of our prediction models in briefer time subsets that mirror pediatric well child visits. This study has great potential to advance our understanding of motor impairments in ASD and drive a paradigm shift in scalable ASD identification in the first year of life.

NIMH - National Institute of Mental Health

Modified Project Summary/Abstract Section More than 50% of people receiving HIV pre-exposure prophylaxis (PrEP) discontinue PrEP within 6 -12 months of initiation partly due to social and structural barriers, resulting in an unacceptable rate of new infections disproportionately affecting communities with less access to PrEP. While some may appropriately discontinue based on lifestyle changes, HIV seroconversion among those who discontinue is high, indicating premature discontinuation or lack of timely re-engagement in PrEP care. Despite identified barriers to PrEP persistence (encompassing retention and adherence), effective implementation strategies to support persistence are lacking compared to other steps of the HIV prevention continuum such as linkage and uptake. A greater understanding of patient preferences about PrEP persistence and re-engagement, with a focus on the factors most relevant to urban vs. rural clinics, is critical to creating innovative strategies to end the HIV epidemic. This research applies multidisciplinary methods to design and pilot-test preference-informed implementation strategies to improve PrEP persistence in urban and rural settings in Missouri, an Ending the HIV Epidemic priority state due to the burden of both urban and rural epidemics. This career development award will provide Dr. Aditi Ramakrishnan with the mentored training and research expertise to launch her career as an independent clinician-investigator leading the 1) design of preference-informed and community-engaged implementation strategies and 2) rigorous testing through implementation trials in urban and rural contexts. To achieve this goal, Dr. Ramakrishnan has assembled an expert mentoring team and proposed an impactful training plan to develop her skills in 1) stated preference methods for implementation science, 2) human-centered design and community-engaged research methods, and 3) implementation trial design. These training objectives complement a research study with the following Specific Aims: 1) Identify patient and provider preferences for HIV prevention strategies supporting persistence and re-engagement through a discrete choice experiment, 2) Design a multicomponent strategy, PREFER-PrEP, to improve persistence and re-engagement among individuals with ongoing indications for PrEP using human-centered design principles, and 3) Assess implementation outcomes (e.g., acceptability) and persistence (e.g., retention, adherence) of the PREFER-PrEP prototype. This study will leverage robust community-academic partnerships across urban and rural Missouri and provide preliminary data for an R01 application to test the PREFER-PrEP strategy through a Type 3 hybrid effectiveness-implementation cluster randomized controlled trial to optimize HIV prevention services. This career development award training, mentorship, and research, within the rich environment of Washington University in St. Louis School of Medicine, will position Dr. Ramakrishnan to independently lead the design and testing of preference-informed, community-engaged implementation strategies and interventions to improve HIV prevention in priority regions.

Department of Fish and Wildlife

The California Drought, Water, Parks, Climate, Coastal Protection, and Outdoor Access for All Act of 2018 (Proposition 68) provides funding to award grants to projects that improve a community’s ability to adapt to the unavoidable impacts of climate change; improve and protect coastal and rural economies, agricultural viability, wildlife corridors, or habitat; develop future recreational opportunities; or enhance drought tolerance, landscape resilience, and water retention. Project priorities include, but are not limited to, reconnection of rivers with their floodplains, riparian and side-channel habitat restoration, and restoration and protection of upper watershed forests and meadow systems that are important for fish and wildlife resources. Proposition 68 requires that at least 15 percent of the funds available pursuant Chapter 10 shall be allocated for projects serving severely disadvantaged communities. A severely disadvantaged community is defined as a community with a median household income less than 60 percent of the statewide average (PRC § 80002[n]).

Department of Fish and Wildlife

The California Drought, Water, Parks, Climate, Coastal Protection, and Outdoor Access for All Act of 2018 (Proposition 68) provides funding to award grants to projects that improve a community’s ability to adapt to the unavoidable impacts of climate change; improve and protect coastal and rural economies, agricultural viability, wildlife corridors, or habitat; develop future recreational opportunities; or enhance drought tolerance, landscape resilience, and water retention. Eligible projects include acquisition of water from willing sellers, acquisition of land that includes water rights or contractual rights to water, short- or long-term water transfers or leases, provision of water for fish and wildlife, or improvement of aquatic or riparian habitat conditions.

Department of Fish and Wildlife

The California Drought, Water, Parks, Climate, Coastal Protection, and Outdoor Access for All Act of 2018 (Proposition 68) provides funding to award grants to projects that improve a community’s ability to adapt to the unavoidable impacts of climate change; improve and protect coastal and rural economies, agricultural viability, wildlife corridors, or habitat; develop future recreational opportunities; or enhance drought tolerance, landscape resilience, and water retention. Project priorities include, but are not limited to, reconnection of rivers with their floodplains, riparian and side-channel habitat restoration, and restoration and protection of upper watershed forests and meadow systems that are important for fish and wildlife resources.

Department of Fish and Wildlife

The California Drought, Water, Parks, Climate, Coastal Protection, and Outdoor Access for All Act of 2018 (Proposition 68) provides funding to award grants to projects that improve a community’s ability to adapt to the unavoidable impacts of climate change; improve and protect coastal and rural economies, agricultural viability, wildlife corridors, or habitat; develop future recreational opportunities; or enhance drought tolerance, landscape resilience, and water retention. Project priorities include, but are not limited to, reconnection of rivers with their floodplains, riparian and side-channel habitat restoration, and restoration and protection of upper watershed forests and meadow systems that are important for fish and wildlife resources.

Department of Fish and Wildlife

The California Drought, Water, Parks, Climate, Coastal Protection, and Outdoor Access for All Act of 2018 (Proposition 68) provides funding to award grants to projects that improve a community’s ability to adapt to the unavoidable impacts of climate change; improve and protect coastal and rural economies, agricultural viability, wildlife corridors, or habitat; develop future recreational opportunities; or enhance drought tolerance, landscape resilience, and water retention. Projects that remove significant barriers to steelhead migration and include other habitat restoration and associated infrastructure improvements will be the highest priority.

Fish and Wildlife Service

Partners for Conservation (PFC) is a national network of private landowners led by ranchers, farmers, and silviculturists who are champions of public-private conservation efforts to sustain working landscapes for wildlife, agricultural production, and rural communities. PFC was born through the proven success of working with the U.S. Fish & Wildlife Service (Service) s Partners for Fish and Wildlife Program in the intermountain west to achieve positive wildlife benefits. PFC has grown into a powerful national conservation ally to the Service and its members have worked to conserve and restore hundreds of thousands of acres of wildlife habitat. PFC helps carry out the Service s model of strategic habitat conservation by acting as vital communicators and fostering a non-hostile environment for critical conversations to take place and productive relationships to develop to advance landscape-scale conservation. This project will involve three tasks: (1) hosting regional landowner engagement forums; (2) enhancing landowner-agency partnerships; and (3) work on an intra-Service "in-reach" education program targeted at partnerships with private landowners This funding opportunity is being awarded without competition to PFC due to their unique qualifications as a facilitator between the Service and private landowners, technical expertise, and landowner support capacity. Authorizing statues for this program include the Partners for Fish and Wildlife Act of 2006, 16 U.S.C. 3771-3774; the Fish and Wildlife Act of 1956; 16 U.S.C. 742a-c, 742e-j; and the Fish and Wildlife Coordination Act of 1958, 16 U.S.C. 661-667(e). The full text of this funding opportunity can be found under the "Related Documents" tab.

NIH

Significance to VA: The VA annually delivers cancer to care to more than 400,000 Veterans at substantial risk of death related to cardiovascular disease (CVD). Mortality risk can be mitigated by high-quality prevention and management of cancer therapy-related cardiovascular toxicity (CTR-CVT). Non-VA studies have demonstrated significant opportunities for improvement in the quality and quality across populations of CVD care, but the quality of cardio-oncologic care in the VA is unknown. In this context, the related performance of VAMCs according to both quality and quality across populations has not been elucidated, and factors influencing hospital performance are unknown. Investigators, Scientific Review and Management priorities addressed include Veteran well-being by evaluating quality of cardio-oncologic care in VA direct and community care; timely access to cardio-oncologic care; differences in care quality according to rural residence or homelessness; and putting VA data work for Veterans by leveraging data elements unique to the VA, including cancer anatomical site, stage, and treatment via the VA Central Cancer Registry and left ventricular function via the VA Corporate Data Warehouse (CDW). Innovation and Impact: The proposed studies will provide proof-of-concept whereby VAMCs are benchmarked according to not only quality but also quality across populations, addressing a need to improve quality across populations on a health care system level. They also answer a call issued in professional society guidelines to conduct large-scale, ‘big data’ studies in the cardio-oncology space. In addition, they account for multidisciplinary perspectives including cardiology, oncology, nursing, and pharmacy via qualitative interviews and blend quality across populations with quality measurement and intervention development, areas with significant opportunities for improvement. Specific Aims: 1. Quality: In a national cohort of Veterans receiving cardiotoxic cancer treatment, assess the quality of prevention and management of CTR-CVT 2. Populations: In a national cohort of Veterans with cancer receiving cardiotoxic cancer treatment, evaluate the quality of prevention and management of CTR-CVT according to rural residence and homelessness 3. Best Practices: Profile VAMC performance according to quality and differences in quality across populations and conduct key informant interviews to identify best practices associated with high-quality care and high-quality care across populations at high-performing centers and barriers to performance at low- performing facilities Methodology: We propose an observational, retrospective, national cohort study of Veterans with cancer receiving cardiotoxic cancer treatment in conjunction with an explanatory sequential mixed methods study. Quantitative data sources will consist of the VA CDW, the VA Central Cancer Registry, the Centers for Medicare & Medicaid Services, and VA community care data; qualitative data sources will consist of semi- structured interviews of VA staff. Analyses will include mixed effects regression modeling and augmented inverse probability weighting estimation (Aims 1-2), hospital profiling via regularized regression modeling (Aim 3a), and rapid, team based approach to qualitative content analysis (Aim 3b). Path to Translation/Implementation: A stakeholder advisory panel, led by the research team and joined by representatives from the VA National Oncology Program Office, the National Cardiology Program Office, the Office of Quality and Patient Safety, the Office of Rural Health, the Office of Health Equity, and the Cardio- Oncology Veteran Consultation Group, will be convened to develop comprehensive recommendations to optimize the quality and quality across populations of prevention and management of CTR-CVT delivered to Veterans receiving cardiotoxic cancer treatment.

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

PROJECT SUMMARY Food insecurity is a critical driver of maternal and infant health and nutrition, including poor birth outcomes, suboptimal breastfeeding, perinatal depression and stress, and poor child growth and development. Pregnant women living with HIV are particularly vulnerable to food insecurity and face an excess risk of poor birth and infant outcomes. In sub-Saharan Africa, where both food insecurity and HIV are highly prevalent and a third of children under five are stunted, interventions to reduce food insecurity and malnutrition that are relevant for both women with and without HIV are needed. In rural settings in this region, small-scale farming is the primary source of livelihood, yet unpredictable rainfall, severe climate events, and limited irrigation hamper crop yields. Agricultural livelihood interventions are a promising approach to raising income, bolstering food security, and ultimately improving maternal and infant health and nutrition. Yet studies of agricultural interventions initiated in pregnancy are lacking despite the fact that in utero exposures crucially predict pregnancy and infant outcomes. The objectives of this proposal are to determine the effectiveness of an agricultural livelihood intervention on improving maternal and infant health when initiated in early pregnancy, and to understand factors that influence implementation of an agricultural intervention in the perinatal period, including the need for farming support when pregnancy impacts women’s capacity to work in the fields. We propose a hybrid effectiveness- implementation trial among 410 pregnant women enrolled at ≤20 weeks gestation, half living with HIV in western Kenya. Women will be randomized 1:1 the intervention or routine care. Those randomized to the intervention will receive guidance on obtaining farming support. Our central hypothesis is that by empowering pregnant women with skills and tools for sustainable farming and perinatal nutrition, the intervention will lead to improved maternal and infant health compared to control participants. We propose an HIV status neutral approach to optimize the generalizability and potential reach of this intervention. Also, because HIV stigma and poor health present additional barriers to empowerment and healthy behaviors, this intervention, which may reduce these barriers, has the potential to alleviate infant health disparities associated with maternal HIV. We propose the following aims: Aim 1: Determine the impact of the intervention on maternal, pregnancy and infant health outcomes, among women living with and without HIV and their newborns. Aim 2: Determine the impact of the intervention on empowerment, socioeconomic, and behavioral factors that may influence maternal and infant health. Aim 3: Identify attitudes, norms, processes, and resources that influence implementation outcomes and effectiveness of the intervention initiated in early pregnancy. This research will significantly advance scientific understanding of whether, how, and under what circumstances an agricultural intervention for pregnant women affects health.

NIDA - National Institute on Drug Abuse

PROJECT SUMMARY/ABSTRACT Rural adolescents are more likely than their peers in urban areas to engage in high-risk substance use, including opioid misuse. Rural adolescents also face challenges accessing behavioral care because of limited clinics and providers in rural settings, including substance use care providers. External specialists may fill a critical gap in augmenting existing school-based services; however, challenges in cross-system coordination contribute to poor reach and retention in care. These challenges are particularly urgent given the need to treat opioid use disorder (OUD) and prevent escalation to OUD among high-risk adolescents with other substance use disorder (SUD) or behavioral health challenges. Research is needed to identify implementation strategies that support cross-system coordination without overburdening existing school staff. The proposed K23 will examine the implementation and effectiveness of an innovative community partnership—the Youth Substance Use Unit (YSU), a collaboration between schools and local substance use service providers that delivers services to adolescents with substance use problems at high schools on the rural Eastern Shore of Maryland. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, the study has three aims: (1) identify determinants and opportunities to improve implementation of the YSU by conducting semi-structured interviews with constituents (e.g., school personnel, peer recovery specialists); (2) develop and adapt initial implementation strategies to improve reach and implementation of the YSU into rural schools based on constituent feedback using Implementation Mapping, a participatory approach to co-develop and specify implementation strategies; and (3) test the effectiveness and implementation of the YSU in Type 2 hybrid effectiveness-implementation trial using an adaptive-iterative design. The candidate is a clinical psychologist with a strong record of community-partnered research focused on improving behavioral health access for underserved youth. The proposed K23 will enable him to pivot to conducting addiction-focused research in rural settings. To ensure successful execution of the study and to prepare the candidate for an independent research career, four training aims are proposed: (1) effectiveness-implementation research for substance use prevention and intervention, (2) school-based and community-partnered implementation research (3) implementation strategy co-development and adaptation, and (4) qualitative and mixed-method approaches. Mentorship will be provided by a multidisciplinary team with expertise in implementation science, adolescent behavioral health and substance use, and community- and school-based research. This project will generate practical strategies to improve cross-system coordination and successfully implement adolescent substance use services in rural schools, ultimately helping to address OUD and other SUD among high-risk youth.

National Institutes of Health

Purpose. This Funding Opportunity Announcement (FOA) issued by the National Institute of Nursing Research (NINR), National Institute of Child Health and Human Development (NICHD), National Heart, Lung, and Blood Institute (NHLBI), National Institute on Alcohol, Alcoholism, and Alcohol Abuse (NIAAA), National Cancer Institute (NCI), and National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health (NIH), solicits Research Project Grant (R01) applications from institutions/organizations that propose to conduct research to reduce health disparities among minority and underserved children. Specifically, this initiative focuses on ethnic and racial minority children and underserved populations of children such as: children from low literacy, rural and low-income populations, geographically isolated children, hearing and visually impaired children, physically or mentally disabled children, children of migrant workers, children from immigrant and refugee families, and language minority children. Specific targeted areas of research include biobehavioral studies that incorporate multiple factors that influence child health disparities such as biological (e.g., genetics, cellular, organ systems), lifestyle factors, environmental (physical and family environments), social (e.g., peer influences), economic, institutional, and cultural and family influences; studies that target the specific health promotion needs of children with a known illness and/or disability; and studies that test and evaluate the cost effectiveness of health promotion interventions conducted in nontraditional settings