NCI Funding Opportunities in Health Services and Outcomes Research Steven B. Clauser, Ph.D. Chief, Outcomes Research Branch Applied Research Program Division of Cancer Control and Population Sciences Academy Health Annual Meeting Washington, DC June 9, 2008

Session Outline Who We Are and What We Do Who We Are and What We Do Organizational contacts and expertise Organizational contacts and expertise HSR priority areas related to key branch missions HSR priority areas related to key branch missions NCI Research Resources for Health Services and Outcomes Research Investigators NCI Research Resources for Health Services and Outcomes Research Investigators NCI Funding for HSR-related research NCI Funding for HSR-related research Potential research resources and consortia connections for extramural investigators Potential research resources and consortia connections for extramural investigators Funding Opportunities for Junior and Mid- level Investigators Funding Opportunities for Junior and Mid- level Investigators

Office of Cancer Survivorship Dr. Julia H. Rowland Office of Cancer Survivorship Dr. Julia H. Rowland Applied Cancer Screening Research Dr. Steve Taplin (Acting) Applied Cancer Screening Research Dr. Steve Taplin (Acting) Basic and Biobehavioral Research Dr. Paige McDonald Basic and Biobehavioral Research Dr. Paige McDonald Health Communication and Informatics Research Dr. Bradford Hesse Health Communication and Informatics Research Dr. Bradford Hesse Health Promotion Research Dr. Linda Nebeling Health Promotion Research Dr. Linda Nebeling Tobacco Control Research Dr. Cathy Backinger Tobacco Control Research Dr. Cathy Backinger Health Services and Economics Dr. Martin Brown Health Services and Economics Dr. Martin Brown Outcomes Research Dr. Steven Clauser Outcomes Research Dr. Steven Clauser Risk Factor Monitoring and Methods Dr. Susan Krebs-Smith Risk Factor Monitoring and Methods Dr. Susan Krebs-Smith Surveillance Research Program Dr. Brenda K. Edwards Surveillance Research Program Dr. Brenda K. Edwards Cancer Statistics Mr. David Stinchcomb Cancer Statistics Mr. David Stinchcomb Statistical Research and Applications Dr. Eric Feuer Statistical Research and Applications Dr. Eric Feuer Epidemiology and Genetics Research Program Dr. Deborah Winn (Acting) Epidemiology and Genetics Research Program Dr. Deborah Winn (Acting) Methods and Technologies Branch Dr. Mukesh Verma Methods and Technologies Branch Dr. Mukesh Verma Modifiable Risk Factors Dr. Britt Reid Modifiable Risk Factors Dr. Britt Reid Behavioral Research Program Dr. Robert T. Croyle (Acting) Behavioral Research Program Dr. Robert T. Croyle (Acting) Applied Research Program Dr. Rachel Ballard-Barbash Applied Research Program Dr. Rachel Ballard-Barbash DCCPS ORGANIZATION CHART Office of the Director Dr. Robert T. Croyle, Director Office of the Director Dr. Robert T. Croyle, Director Host Susceptibility Dr. Mukesh Verma (Acting) Host Susceptibility Dr. Mukesh Verma (Acting) Clinical and Translational Epidemiology Dr. Deborah Winn (Acting) Clinical and Translational Epidemiology Dr. Deborah Winn (Acting) Revised 5/08

ARP STAFF EXPERTISE Health Services Research Cancer Screening Outcomes Measurement Cost-Effectiveness Analysis Health Disparities Quality/Patterns of Care Diet, Physical Activity, Tobacco Energy Balance and Cancer Risk Modeling Genetics and Family History

Health Services and Economics Branch The Branch’s mission: Support, conduct, and coordinate research on the dissemination of effective cancer-related health services into community practice. Support, conduct, and coordinate research on the dissemination of effective cancer-related health services into community practice. Study demographic, social, economic, and health system factors as they relate to providing preventive, screening, diagnostic, and treatment services for cancer. Study demographic, social, economic, and health system factors as they relate to providing preventive, screening, diagnostic, and treatment services for cancer. Improve cancer outcomes, reduce cancer-related health disparities, and reduce the burden of cancer to patients, their families, and society. Improve cancer outcomes, reduce cancer-related health disparities, and reduce the burden of cancer to patients, their families, and society.

HSEB carries out its mission by…. Monitoring cancer-related health services utilization and outcomes among individuals in the general population and among selected population subgroups; Monitoring cancer-related health services utilization and outcomes among individuals in the general population and among selected population subgroups; Monitoring the dissemination and effective delivery of cancer-related health services by community-based health care providers and health care delivery organizations; Monitoring the dissemination and effective delivery of cancer-related health services by community-based health care providers and health care delivery organizations; Assessing the role of economic factors related to the equitable, efficient, and effective provision of cancer- related health services; Assessing the role of economic factors related to the equitable, efficient, and effective provision of cancer- related health services; developing and disseminating data resources to support policy-relevant research developing and disseminating data resources to support policy-relevant researchhttp://healthservices.cancer.gov/about/

Outcomes Research Branch The Branch mission: Coordinate and sponsor research to measure, evaluate, and improve patient-centered outcomes of cancer care delivery across the cancer care continuum. Coordinate and sponsor research to measure, evaluate, and improve patient-centered outcomes of cancer care delivery across the cancer care continuum. ORB is particularly interested in morbidity and mortality outcomes, patient symptoms and health- related quality of life, and patient experience of and satisfaction with health care. ORB is particularly interested in morbidity and mortality outcomes, patient symptoms and health- related quality of life, and patient experience of and satisfaction with health care.

ORB carries out it’s mission by…. Enhancing the state of the science of outcomes measurement, especially patient-reported outcomes; Enhancing the state of the science of outcomes measurement, especially patient-reported outcomes; Assessing, monitoring, and enhancing patient-centered cancer care at all levels -- the provider-patient interaction, the health care organization, and the health care system; Assessing, monitoring, and enhancing patient-centered cancer care at all levels -- the provider-patient interaction, the health care organization, and the health care system; Translating research findings into care delivery products and strategies for use by public and private decision makers, who provide, pay for, regulate, set standards for, and make personal decisions about cancer care; and Translating research findings into care delivery products and strategies for use by public and private decision makers, who provide, pay for, regulate, set standards for, and make personal decisions about cancer care; and Evaluating innovative programs designed to improve the effectiveness and efficiency of providing evidence-based practice throughout the cancer care continuum. Evaluating innovative programs designed to improve the effectiveness and efficiency of providing evidence-based practice throughout the cancer care continuum.

Health Services/Outcomes Research is Relevant Across the Cancer Continuum Obesity diagnosis and management Risk Assessment Communication/ Counseling Cancer chemo- prevention Cancer Screening Recommenda- tions and Practices End-of-Life Care Use of Evidence- Based Therapies Pain Management Follow-up of cancer survivors Prevention Detection Treatment Survivorship Diagnosis Risk Assessment (Cancer genetics) Timely Diagnosis and Referral Cross Cutting Topics Access to Care Health Disparities Economics of Cancer Care Quality of Care Quality of Life/Patient Centered Care

DCCPS Source of Funding and Expenditures (FY07) DCCPS Source of Funding and Expenditures (FY07) DCCPS Cancer ControlRPGCollaborations In-house 6% IAA/MOU Contracts 13% RFA/PA 32% Investigator Initiated 49% Funding Sources Expenditures

Distribution of ARP Funding Related to Health Services/Outcomes Research in 2007 Distribution of ARP Funding Related to Health Services/Outcomes Research in 2007

12 ARP Health Services/Outcomes Related Grant Funding,

Building Infrastructure for Extramural Investigators NCI Health Service Research Resources

Data Resources for Investigators Cancer Registry Based Resources Cancer Registry Based Resources SEER SEER Patterns of Care/Quality of Care Studies Patterns of Care/Quality of Care Studies SEER-Medicare Linked Databases SEER-Medicare Linked Databases Consumer and Healthcare Provider Surveys Consumer and Healthcare Provider Surveys National Health Interview Survey Cancer Control Module National Health Interview Survey Cancer Control Module California Health Interview Survey California Health Interview Survey National Survey of Colorectal Cancer Screening Practices – 2000, 2006 National Survey of Colorectal Cancer Screening Practices – 2000, 2006 Public Health Research Resources Public Health Research Resources Cancer Planet Cancer Planet Outcomes Research Resources Outcomes Research Resources PROMIS Quality of Life Measures and CAT applications PROMIS Quality of Life Measures and CAT applications

Example: SEER-Medicare Data Are Useful for Research Across the Cancer Continuum Screening/  Diagnosis/  Survivorship  Secondary  Terminal Care Detection & Treatment Occurrence Use of PSA testing, mammography, sigmoidoscopy/ colonoscopy Patterns of care Peri-operative complications Volume outcomes studies Comorbidities Health disparities Late effects of treatment Post- diagnostic surveillance Treatment of prevalent cancers Survival Rates of recurrence/ second primaries Relationship of second events to initial treatment and ongoing surveillance Use of hospice End-of-life patterns of care Over 150 SEER-Medicare articles in print

What would you like to measure in your study? Domain definitions item content review item characteristics Click below for: or select a box on the right and proceed pain emotional distress physical function fatigue social role participation Example: PROMIS Measure Website

NCI Health Services Research Networks National, multi-site research networks that National, multi-site research networks that Can enroll large cohorts of individuals Can enroll large cohorts of individuals Track receipt of cancer control services longitudinally at the patient, provider, and health system levels Track receipt of cancer control services longitudinally at the patient, provider, and health system levels Investigate impact of interventions on patient-centered outcomes Investigate impact of interventions on patient-centered outcomes Current Examples Current Examples Breast Cancer Surveillance Consortium (BCSC) Breast Cancer Surveillance Consortium (BCSC) Cancer Research Network (CRN) Cancer Research Network (CRN) Cancer Care Outcomes Research and Surveillance Consortium (CanCORS) Cancer Care Outcomes Research and Surveillance Consortium (CanCORS)

NCI Consortium-based Research Platforms Breast Cancer Surveillance Consortium Cancer Research Network

$$$$$$$$$$$ Health Services/Outcomes Research Funding Opportunities at NCl

NCI Funding Mechanisms for Junior and Mid-level Investigators K-Awards – NCI Training Awards K-Awards – NCI Training Awards R03 – Small Research Grants in Behavioral and Social Sciences R03 – Small Research Grants in Behavioral and Social Sciences R21 – Exploratory/Developmental Grants R21 – Exploratory/Developmental Grants R01 – Research Projects R01 – Research Projects General Grant Applications Instructions General Grant Applications Instructions

Current Health Services Research Program Announcements PA : Economic Studies in Cancer Prevention, PA : Economic Studies in Cancer Prevention, Screening and Care(R01, R21) Screening and Care(R01, R21) PA : Cancer Surveillance Using Health Claims-Based Data System(R01, R21) PA : Cancer Surveillance Using Health Claims-Based Data System(R01, R21) PA : Enhanced Understanding of Colorectal PA : Enhanced Understanding of Colorectal Cancer Screening(R21) PA : Methodology and Measurement in the Behavioral PA : Methodology and Measurement in the Behavioral and Social Sciences(R01, R21) and Social Sciences(R01, R21)

NCI Funding Mechanisms for Dissemination and Implementation Research R03 – Small Research Grants R03 – Small Research Grants Dissemination and Implementation Research in Health Dissemination and Implementation Research in Health html html html html R21 – Exploratory/Developmental Grants R21 – Exploratory/Developmental Grants Dissemination and Implementation Research in Health Dissemination and Implementation Research in Health html html html html R01 – Research Projects R01 – Research Projects Dissemination and Implementation Research in Health Dissemination and Implementation Research in Health html html html html

For further information on anything presented today -- including most appropriate NCI contacts, …. Steven Clauser, Ph.D. Chief, Outcomes Research Branch Martin Brown, Ph.D. Chief, Health Services & Economics Branch