The intent of the FY24 Transforming Care Award (TrCA) is to support research that provides answers and solutions in critical areas to improve quality of life, reduce caregiver burden and stress, reduce health disparities, and increase support for the individual with a diagnosis of Alzheimer's disease and related dementias (AD/ADRD), their care partner/caregiver, and/or both, as well as the impact on families and/or communities. For this mechanism, family is broadly defined as the family of choice and/or the family of origin. Additionally, the TrCA definition of care does not include medical care (such as medical interventions administered by a physician), as the care landscape extends beyond that of medical interventions to be inclusive of research into integration, education, and support.
The PRARP requires projects to ensure strategies maintain the dignity of the individual living with a dementia diagnosis and their family/care/social communities.
All applications submitted to this funding opportunity must clearly indicate how the project addresses a critical unmet need, explain how the research will be representative of the population it intends to benefit, and demonstrate cultural competence. Culturally competent research factors the cultural background and diversity of the intended beneficiaries of the research outcomes when developing research ideas, conducting research, and implementing the research findings. Cultural competency in research is critical in reducing health disparities and enhancing the quality and impact of research by ensuring inclusivity, understanding, and responsiveness to the needs of diverse populations.
The TrCA targets research that includes, but is not limited to, improvements in long-term care, quality of life, psychosocial wellness, and supporting aging-in-place, belonging, and community living for individuals, care partners, and families living with a dementia diagnosis. Studies may include, but are not limited to, topics such as considerations for dementia care that are specific to military Service Members and/or Veterans and their Families, navigating the AD/ADRD diagnosis and care path, and overcoming care partner/caregiver stress.
Projects may address knowledge gaps, interventions, strategies, technologies, and/or tools. Clinical research and clinical trials are allowed, however, clinical trials solely testing or evaluating pharmacological interventions do not meet the intent of this funding opportunity.
Key elements of this award mechanism are:
Person-centered research: All applications to the FY24 PRARP TrCA should be person- centered. This mechanism is intended to provide answers and solutions in critical areas to improve quality of life, reduce burden and stress, and increase support for individuals living with a diagnosis, their families, and their care partners (hereafter referred to as Community(ies) in this Funding Opportunity). The research should have near-immediate impact on the intended beneficiaries. To facilitate success, the TrCA requires Community collaboration for all projects.
Focus on outcomes: The intent of the TrCA is to advance knowledge and capacity in the AD/ADRD care field. As such, applicants should clearly articulate outcomes, clearly demonstrate a pathway of feasibility, and identify realistic approaches to scaling and Community level implementation for widespread use. Additionally, applications should plan for and describe how the research will be manualized (i.e., compiled in a manual) and fed back into the research, lived experience, and care communities. See Attachment 6, Research Manual and Progression Plan.
Representation: Awards supported by the PRARP are expected to address gaps in representative AD/ADRD data sets. Applicants must prioritize diversity and equity in clinical study populations including, but not limited to, social and structural determinants of health such as sex, gender, ethnicity, culture, socioeconomic status, geography, and health care access, are expected.
Projects supported by this mechanism must represent a non-incremental advance in the care field. Preliminary data are required. For this mechanism, studies utilizing animal models do not meet the intent of the mechanism and are not allowed.
Milestone meeting: The Principal Investigator (PI) will be required to present an update on progress toward accomplishing the goals of the award at a Milestone Meeting to be held in the National Capital Area during years 2-4 of the period of performance. The PI may bring up to three additional members of the research team, including their Community partner, to the meeting. The Milestone Meeting will be attended by members of the PRARP Programmatic Panel, CDMRP staff, the USAMRAA Grants/Contracts Officer, and other stakeholders.
Optimizing research impact through Community collaboration: Research funded by the FY24 PRARP should be responsive to the needs of Communities in the remainder of the Funding Opportunity, maximizes the translational and impact potential of the proposed research. Establishing and utilizing effective and equitable collaborations and partnerships with members of the AD/ADRD lived experience Communities is essential to maximize the translational and impact potential of the proposed research.
Collaborative research approaches feature shared responsibility and ownership for the research project to ensure fully integrated involvement of Community members within the research team. Collaborative research approaches such as Community-based participatory research, participatory action research, and integrated knowledge transition, generate partnerships between scientific researchers and Community members to create knowledge useable by both sets of stakeholders. Recognizing the strengths of each partner, scientific researchers and Community members must collaborate and contribute their expertise equitably on all aspects of the project, which may include needs assessment, planning, research intervention design, implementation, evaluation, and dissemination. Research results are jointly interpreted, disseminated, fed back to affected communities, and may be translated into interventions or policy. These methods are critically important for Community-level interventions and can also augment the potential impact of a research program on people living with dementia, their families, and/or their care partners.
These collaborative relationships are often established through integrating Community members into research teams as co-researchers, advisors, and consultants. Some examples for Community collaborations include:
Lived Experience Consultation: The research team includes at least one project advisor with AD/ADRD lived experience who will integrate with the research team to provide consultation throughout the planning, implementation, and dissemination of the research project. Lived experience consultants (LECs) may include individuals with an AD/ADRD diagnosis, their family members, care partners, or others as appropriate.
Partnership with a Community-Based Organization: The research team establishes partnerships with at least one Community-based organization that provides consultation throughout the planning, implementation, and dissemination of the research project. Community-based organizations may include advocacy groups, service providers, policymakers, or other formal organizational stakeholders.
Community Advisory Board (CAB): A CAB is composed of multiple Community stakeholders and can take many forms, from a board of LECs to a coalition of Community-based organizations, or any combination thereof. As with LECs and organizational partners, the CAB provides consultation throughout the planning, implementation, and dissemination of the research project.
Career Initiation or Transition (CIT) Partnership Option: The FY24 PRARP encourages applications that include meaningful and productive collaborations between two principal investigators. To promote enhanced research capacity within the AD/ADRD field, the FY24 TrCA includes an option for a CIT Principal Investigator (PI) to partner with an experienced investigator to jointly address a research question.
The CIT PI must have nominal, if any, research support in the field and may be either one of the following:
The Career Initiation PI must be an early-career researcher, at least 3 years post their terminal degree but no more than 7 years into their independent position. Both PIs may have similar or disparate expertise, but each PI is expected to bring distinct and complimentary contributions to the application.
The Career Transition PI must be an investigator (at any stage) who is new to the military health, TBI, or AD/ADRD field(s). New to the field is defined as having only nominal, if any, publications in the field. The other partnering investigator must have complimentary experience (as evidenced by publications) in military health, TBI, and/or AD/ADRD field(s).
The CIT is structured to accommodate two PIs. One PI will be identified as the Initiating PI and will be responsible for most of the administrative tasks associated with application submission. The other will be identified as a Partnering PI. Either PI can be the CIT PI. Both PIs should contribute significantly to the development of the proposed research project, including the Project Narrative, Statement of Work (SOW), and other required components. Both PIs may have experience in similar or disparate scientific disciplines, but each PI is expected to bring distinct and complimentary contributions to the application. If recommended for funding, each PI will be named to an individual award within the recipient organization(s). For individual submission requirements for the Initiating and Partnering PI, refer to Section II.D.2, Content and Form of the Application Submission.
