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Under Review Whether a grant request is submitted to a federal agency or a private foundation, some process of review takes place to decide whether the proposal merits funding. At the U.S. Department of Defense, which funds numerous medical research programs, a two-step review process evaluates the proposals, explained Dr. Barbara Terry-Koroma, special populations program manager. A peer review committee begins the evaluation, weighing the level of innovation, the investigator’s experience, the scientific relevance of the proposal and other factors. Next, a programmatic review takes place, in which judges ask: How relevant are the goals of the proposal? What were the ratings of the peer review committee? What is the level of scientific innovation? Does the research target special populations? If these evaluations are favorable, award levels will be based on several factors, including the stage of the researcher’s career, the grant applied for and his or her university affiliation.

Infusion of Funding

Securing funds for cancer research was the topic of a recent meeting of minority nurses

By Paula Lipp

Minority nurse researchers—and would-be researchers—concerned with oncology met recently near the nation’s capital to discuss funding opportunities for their efforts, as well as the role that nurses play in advancing what is known about cancer in minorities.

Held in and around the National Cancer Institute in Bethesda, Md., the National Cancer Nursing Research Network’s NCI Grant Writing Program assembled 20 nursing faculty, students and others interested in advancing their efforts in clinical cancer study. The elite group was addressed by representatives of leading agencies and organizations that provide financial support for such efforts, including the National Institutes of Health, the Department of Defense, the American Cancer Society and the Susan G. Komen Breast Cancer Foundation.

Organized by Dr. Sandra Millon Underwood, American Cancer Society Oncology Nursing Professor at the University of Wisconsin-Milwaukee School of Nursing, and facilitated by Dr. Sherry Mills, director of the NCI Applied Sociocultural Research Branch, the three-day program introduced participants to the latest accomplishments in cancer prevention and control. The group also toured the National Library of Medicine and the nearby campus of the Howard University Cancer Center, along with the school’s Division of Nursing.

Participants in the grant-writing seminar added to their network of contacts and funding sources.

Among the program’s goals was to educate participants on the best way to present their intended research and its significance when applying for research funding. Underwood said, “Minority nurse researchers need to understand the mechanisms through which a research grant application is reviewed and how that review is conducted. With that information, they can better position themselves to secure funding and further advance our knowledge of cancer control and prevention” in minority populations.

The speakers who addressed the group reiterated that hope. Dianne McDonald, grants manager for the Susan G. Komen Breast Cancer Foundation in Dallas, encouraged the nurses in attendance to send her organization applications that may not be appropriate for other funding.

“Our mission is to eradicate breast cancer as a life-threatening disease through research, education, screening and treatment,” she said. “We focus on research projects with the potential for high impact that may not be considered by other agencies.”

Otis W. Brawley, M.D., director of the NCI’s Office of Special Populations Research, made a direct connection between improving the health of underrepresented populations and increasing the prevalence of minority researchers. “The number of minority people with doctoral degrees is paltry,” he noted. “What we desperately need are researchers who are focused and who understand all the problems” of minority health.

Closing the Cancer Gap

As the lead federal agency in medical research, the National Institutes of Health allocated $13 billion in fiscal year 1997 to medical research. Each year, NIH receives about 24,000 research project grant applications from investigators seeking a piece of that pie and, after a process of scientific and peer review, about 28% of them succeed in gaining funding. Review panels evaluate numerous factors, including the potential impact of the proposed research on human health, the projects’ cost and benefits, and the specific types of funding being sought.

On average, slightly over half of the budget of each of the 25 institutes and centers within NIH supports research proposals, most generated by investigators working in medical and nursing schools, research centers and the like. These research project grants (RPGs) cover a range of activities, from molecular investigations to applied research, and also support training for young scientists. In addition, the institutes’ scientists may identify areas of research that warrant investigation. To stimulate interest, an agency may release a program announcement or request for applications on a specific topic.

Among NIH institutes, the National Cancer Institute is the oldest and the largest, according to George A. Alexander, M.D., program director for the OSPR and project officer for the National Hispanic Leadership Initiative on Cancer. The OSPR’s role is to ensure that NCI’s efforts encompass and benefit minority and underserved populations. As such, the agency supports various NCI initiatives to increase the number of minority scientists in biomedical research and to enhance the careers of those already in the field.

NCI’s Comprehensive Minority Biomedical Branch and its Applied Sociocultural Research Branch are just two efforts that promote cancer-related research and training activities by minorities. CMBB, for example, concentrates on broadening participation of underrepresented groups in cancer research; increasing participation of minority researchers, physicians, nurses and students in clinical trials; and building an extensive resource network for the cancer community. Through these efforts, CMBB provides funding for research, training and resources for minorities, including those entering research late in their careers.

“NCI wants to encourage more applications, research and training across the board,” asserted Dr. Lisa Begg of the NCI’s Office of Centers, Training and Resources in Rockville, Md. “We need to train more researchers. There are disparities, inequities and reluctance among various populations to participate” in medical research.

Other components of NIH are also working to alleviate those disparities through research, including the National Institute of Nursing Research. “Nursing has a presence within NIH,” affirmed Janice Phillips, R.N., Ph.D., program director of NINR, which supports clinical and basic research in such areas as chronic illness, behavioral changes and interventions, and compelling public health concerns, such as infectious disease.

Most of the applications submitted to her organization are investigator-driven and often do not relate directly to these specified areas of NINR interest, Phillips commented. The institute’s research also extends to problems encountered by families and caregivers of those with illness. In addition, it emphasizes the special needs of at-risk and underserved populations.

Other government agencies and private foundations also support cancer-related research and pay added attention to occurrence rates among minorities. The U.S. Department of Defense, for example, funds four programs through its congressionally directed medical research programs: breast, prostate and ovarian cancer, plus neurofibromatosis. “Our goal is to eradicate those four diseases,” said Dr. Barbara Terry-Koroma, special populations program manager for the DOD in Fort Detrick, Md. “In order to do that, we need to study all populations.”

From Application to Acceptance

The DOD’s Web site on medical research, http://cdmrp.army.mil, contains program announcements, job opportunities and a listing of currently funded proposals. Similarly, a list of projects funded by NINR is available on the Web at www.nih.gov/ninr. Phillips encouraged seminar participants to talk to agency representatives involved with these efforts and to use successful grants as models for writing their own proposals.

“There is a skill to putting a proposal together, using the right buzzwords and so on,” she noted. “And it is essential that the applicant keep in mind the mission of the institute from which he or she is seeking funds.”

Alexander agreed, noting that program directors can often be rich sources of insight. “Pick up the phone and give us a call,” he said.

This advice was well received by the audience, including Lynette Gibson, R.N., a Ph.D. candidate at the University of South Carolina in Greenville. Gibson said the seminar encouraged her to pursue guidance from the experts when writing a grant application. “I gained a greater appreciation of their willingness to support minority researchers in cancer control research, provided that we ask for their help both in writing the applications and in planning our research careers,” she explained. “Previously, I was leery of making a personal call to the experts for fear of being thought of as unprepared and being vulnerable to unfavorable evaluation by them. I now realize that it is expected of us to contact them and that the greater the contact, the greater our chances for funding.”

First-time investigators may find such guidance particularly helpful, as the submission process can be tedious for the uninitiated. Eric J. Bailey, Ph.D., M.P.H., program director of CMBB, noted that while the Internet holds a wealth of information for nursing researchers, personal connections provide an unparalleled advantage, especially for minorities.

“It’s important to network and get information that’s not on the Web,” he said. “I always felt isolated, as though I was the only minority at my institution. That’s ridiculous—there are neighboring institutions where you can go to network.”

Beyond advancing the cause of cancer research for minorities, Bailey said that CMBB has a broader mission. “We want to promote individuals’ careers, not just hand out money. You have to plan [your career] yourself, but share your strategy with us,” he advised. “Once you get into our system, we can fund you from start to finish.”

Indeed, whether a researcher is just beginning his or her career or entering from a different route, CMBB—and another NCI program, the Continuing Umbrella of Research Experiences (CURE)—can help. Their funding initiatives provide opportunities to minority high school, undergraduate and graduate students, as well as those in postdoctoral training and biomedical investigation (see Funding Sources).

Persistence Pays Off

The time from submission of an application to approval can take one to two years, Phillips noted. In the interim, the researcher may receive a summary statement from reviewers pointing out shortfalls in the funding application. “They should continue with their scholarly activities of publishing, doing presentations and, if there are deficits in their proposal, work to address those deficiencies,” she advised. “Sometimes, the applicant will need to conduct a pilot study of some sort that can be used to strengthen the resubmission.”

Researchers may also use the time to seek out other sources of funding, but Phillips cautioned that applicants should check to see if there are any restrictions regarding this, especially if they are planning on resubmitting their original application or receiving funding from their initial source.

In wrapping up the seminar, Bailey encouraged the audience not to be discouraged if their proposals are rejected. “Sometimes it’s the most minute issue that gets you rejected,” he said. “Resubmit it, adhering to the reviewers’ comments. Be persistent.”

Look for more information about careers in research and the basics of grant-writing in upcoming issues of Minority Nurse. Special thanks to Sandra Millon Underwood, R.N., Ph.D., FAAN, Lynette Gibson, R.N., and Barbara Fowler, Ed.D., R.N., for their assistance in writing this article. Readers interested in more information or participating in a similar program may contact Dr. Underwood via e-mail at underwoo@csd.uwm.edu.

Paula Lipp is editorial manager of Minority Nurse. E-mail her at paula.lipp@casscom.com.

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