Improving the Reach and Quality of Cancer Care in Rural Populations (R01 Clinical Trial Required) | RFA CA 18 026

Opportunity Information: Apply for RFA CA 18 026

The National Institutes of Health (NIH) released this discretionary grant opportunity, RFA-CA-18-026, titled "Improving the Reach and Quality of Cancer Care in Rural Populations (R01 Clinical Trial Required)," under CFDA 93.939. Its overall aim is to reduce the cancer burden and improve the quality of cancer care in rural communities, with a clear emphasis on rural populations that are low-income and/or otherwise underserved. The announcement recognizes that rural patients often face compounding challenges across the cancer continuum, from diagnosis through treatment and into survivorship, and it encourages research designed to produce practical, evidence-based improvements in care delivery and outcomes.

The FOA supports two broad categories of projects. First, it invites observational research that also includes pilot testing of an intervention. In this pathway, the goal is to better understand what predicts cancer care experiences and outcomes in rural, low-income, and underserved groups, while also taking early steps to test whether a potential solution is feasible, acceptable, and promising. These projects are expected to examine how factors such as social determinants of health (for example, transportation access, financial strain, education, employment conditions, housing stability, and social support), structural and logistical barriers to care, and treatment-related issues contribute to disparities. The intent is not purely descriptive work; applicants are expected to connect observational findings to action by pilot-testing an intervention that can address the identified predictors or mediators.

Second, the FOA encourages intervention research that targets known predictors of cancer care, treatment, and outcomes in these rural populations. Here, the focus shifts from identifying drivers of disparities to actively improving quality of care related to cancer diagnosis, treatment, and/or survivorship. Projects in this category should be built around testing strategies that can measurably improve care processes and patient outcomes in rural settings, such as better coordination and timeliness of diagnosis, improved adherence to evidence-based treatments, enhanced symptom management, more consistent follow-up, and survivorship care that is realistic for patients who may live far from specialty centers.

A key theme in the announcement is that many existing cancer control interventions were developed in urban or well-resourced systems and are not automatically ready for implementation in low-income rural areas. Because of that, proposals are encouraged to develop new interventions or adapt and tailor existing ones so they fit rural contexts. That includes designing around practical constraints like long travel distances, limited oncology workforce, fewer specialty services, broadband or technology gaps, and the realities of smaller clinics or critical access hospitals. The FOA is also explicit that projects should move beyond simply proposing dissemination of an intervention that has not been adequately adjusted for rural, resource-limited conditions; the expectation is to develop, adapt, implement, and test interventions in ways that are grounded in rural needs and feasible for rural health systems.

The funding mechanism is an R01 and is labeled "Clinical Trial Required," signaling that applicants should be prepared to include a clinical trial component consistent with NIH definitions when proposing intervention testing, and to meet NIH expectations for trial design, oversight, and reporting. While the notice does not list an award ceiling or the expected number of awards in the provided source data, it is structured as an NIH research project grant competition with the typical rigor and requirements associated with R01-level work.

Eligibility is broad across public, private, nonprofit, and certain for-profit entities. Eligible applicants include state, county, and local governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; Native American tribal organizations that are not federally recognized tribal governments; public housing authorities/Indian housing authorities; nonprofits with and without 501(c)(3) status (excluding institutions of higher education in those categories); for-profit organizations other than small businesses; and small businesses. The announcement also highlights additional eligible applicant types such as 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), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, tribal governments other than federally recognized, and U.S. territories or possessions. At the same time, it places firm limits on foreign involvement: non-U.S. entities and foreign institutions are not eligible to apply, non-U.S. components of U.S. organizations are not eligible, and foreign components as defined by the NIH Grants Policy Statement are not allowed.

The original closing date listed for this opportunity was September 19, 2018, with a creation date of April 27, 2018. Even though that date indicates the specific solicitation window has passed, the substance of the FOA reflects NIH priorities around rural cancer care improvement, especially where inequities are driven by social risk, access constraints, and system-level barriers.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Improving the Reach and Quality of Cancer Care in Rural Populations (R01 Clinical Trial Required)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.939.
• This funding opportunity was created on 2018-04-27.
• Applicants must submit their applications by 2018-09-19. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for RFA CA 18 026

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