RFA-HD-23-035 Maternal Health Research Centers of Excellence (U54 Clinical Trial Optional)

This Funding Opportunity Announcement (FOA) invites applications to participate as a Research Center as part of the Maternal Health Research Centers of Excellence initiative. The purpose of this initiative is to generate innovative approaches to address preventable maternal mortality (MM), decrease severe maternal morbidity (SMM), and promote maternal health equity in partnership with communities that are most affected (i.e., Blacks/African Americans, American Indians/Alaska Natives, Hispanics/Latinos, Asian Americans, Native Hawaiians and other Pacific Islanders, sexual and gender minorities, socioeconomically disadvantaged populations, and underserved rural populations). Persons with disabilities are also a priority population. This initiative will use an integrated multi-level approach encompassing structural, social, and biobehavioral research strategies to address the multiple contributing factors that lead to adverse maternal health outcomes and health disparities. Significant contributing factors include comorbid conditions (e.g., hypertension, diabetes, cerebrovascular disease, chronic stress, immune-mediated diseases, sleep disorders, organ-specific diseases, mental illness, and substance use disorders) and structural and social determinants of health, which include structural racism and health care system factors.

The goal of this initiative is for trans-disciplinary research teams to conduct multi-layered novel research projects that will have the potential to drastically reduce pregnancy-related and pregnancy-associated maternal deaths and decrease SMM. Proposed research can address maternal health in the pre-pregnancy, pregnancy, or postpartum period, provided that the research outcomes directly address severe maternal morbidity and/or maternal mortality and equitable healthcare. Studies may be interventional (including testing novel interventions, effectiveness, comparative effectiveness, optimization, or dissemination and implementation studies), or observational (including health services studies, natural experiments, or policy analyses) and assess maternal health outcomes. To stimulate novel approaches, it is anticipated that key personnel in complementary disciplines (e.g., biology, medicine, nursing, environmental science, public health, behavioral and social science, biostatistics/statistics, mathematics; computer science, engineering) and community partners will jointly develop and test multi-level strategies to address overall maternal well-being and preventable contributors to SMM and MM. In addition to demonstrating disciplinary diversity of the team, applications submitted in response to this FOA will be expected to submit a Plan for Enhancing Diverse Perspectives (PEDP). The PEDP will demonstrate how diverse perspectives will be obtained throughout the course of the project and will be assessed as part of the scientific and technical peer review evaluation, as well as considered among programmatic matters with respect to funding decisions.

The Maternal Health Research Centers of Excellence will be uniquely poised to collaborate on studies and projects with other networks and initiatives – such as the NICHD Neonatal Research Network, the Maternal Fetal Medicine Units Network, the NICHD Maternal and Pediatric Precision in Therapeutics (MPRINT) initiative, the NIH Helping to End Addiction Long-term (HEAL) Initiative, the NIH Researching COVID to Enhance Recovery (RECOVER) Initiative, the Foundation for the NIH, and other NIH institutes, and maternal health activities ongoing at partner Federal health agencies, such as the Centers for Disease Control and Prevention, the Health and Research Services Administration, and the Office of the Assistant Secretary on Women's Health.

This FOA runs in parallel with companion FOAs that seek applications for an Implementation Science Hub/Resource Center (RFA-HD-23-037) and a Data Innovation and Coordinating Hub/Resource Center (RFA-HD-23-036). It is expected that all components of the Centers of Excellence, Research Centers and Hubs, work collaboratively to design and implement research projects, including data collection and data sharing. It is expected that funded investigators will work jointly with NIH scientific staff to assist, guide, coordinate, or participate in project activities. Annual Centers of Excellence meetings will be held. The annual meeting will foster the initiation and maintenance of collaborative efforts and resource sharing among the Centers. Centers of Excellence PD/PIs should budget funds for the PD/PI and one to -two designees to attend an annual meeting in the Bethesda, Maryland / Washington DC area or virtually, if necessary.