Center for Health Equity Research and Promotion

VISN4 Investigators are invited to apply. CHERP’s primary research focus, improving the quality and equity of health and health care for vulnerable Veteran populations, is CHERP’s top priority. This central focus targets the following groups (1) racial and ethnic minorities; (2) women; (3) people experiencing homelessness or housing instability; (4) individuals with diminished autonomy or limited life expectancy; (5) those with serious mental illness, traumatic brain injury, post-traumatic stress disorder, or stigmatizing or disabling medical conditions; (6) people who have experienced military sexual trauma, intimate partner violence, or elder abuse; (7) individuals living in rural or low-resource urban areas; (8) specific military cohorts; and (9) LGBTQ+ populations. Understanding and addressing Social Determinants of Health (SDOH) — i.e., the economic, social, and structural factors outside the healthcare system that contribute to health inequities in the United States – is an important priority for CHERP and VA HSR&D. SDOH include access to safe housing and healthy food; reliable transportation; air and water quality; employment and job security; history of incarceration; exposure to stress, including violence, institutional racism, and discrimination; and social connectedness. CHERP is interested in understanding how evolving models of care (e.g., expanded VA Community Care) impact Veteran populations at risk for poor outcomes, as well as the association of workforce diversity, equity, and inclusion with quality and equity of care for Veterans. CHERP’s secondary research focus, improving the quality, equity, safety, and value of clinical therapeutics, targets the appropriate use of medications, devices, and procedures to promote optimal management of acute and chronic illness. CHERP embraces projects that address therapeutic adherence; de-prescribing of inappropriate therapies; use of genomics and other data to personalize therapeutics; and appropriate and equitable use of medications, devices, and procedures. CHERP is also interested in understanding the effects of receiving care outside VA through other forms of health insurance (e.g., Medicare, Medicaid) or VA Community Care on the clinical therapeutics used by enrolled Veterans.  

REQUEST FOR APPLICATIONS
CHERP Competitive Pilot Program Fiscal Year 2022
Submission Deadline – Friday, June 25

For full application, please contact Kelly.Burkitt@va.gov (CHERP Pittsburgh) or Kimberly.Brown6@va.gov  (CHERP Philadelphia)



OVERVIEW
The Center for Health Equity Research and Promotion (CHERP), a VA Health Services Research & Development (HSR&D) Center of Innovation, invites VISN4 investigators to apply for up to $50,000 in pilot project support during VA fiscal year 2022. The intent of this program is to support preliminary projects that will inform future, larger HSR&D applications and other Veteran-centric research or quality improvement initiatives. Support for this program is provided by VISN4 and VA HSR&D. Proposed projects must be of a reasonable size and scope to be completed within the 1-year time frame (October 1, 2021-September 30, 2022). The deadline for submission of completed applications is June 25, 2021. Funding decisions will be announced in August 2021.

FOCUSED AREAS OF INTEREST
Competitive pilot applications will align with CHERP’s primary or secondary foci, as described below. CHERP welcomes projects that address these foci within the context of COVID-19.
CHERP’s primary research focus, improving the quality and equity of health and health care for vulnerable Veteran populations, is CHERP’s top priority. This central focus targets the following groups (1) racial and ethnic minorities; (2) women; (3) people experiencing homelessness or housing instability; (4) individuals with diminished autonomy or limited life expectancy; (5) those with serious mental illness, traumatic brain injury, post-traumatic stress disorder, or stigmatizing or disabling medical conditions; (6) people who have experienced military sexual trauma, intimate partner violence, or elder abuse; (7) individuals living in rural or low-resource urban areas; (8) specific military cohorts; and (9) LGBTQ+ populations. Understanding and addressing Social Determinants of Health (SDOH) — i.e., the economic, social, and structural factors outside the healthcare system that contribute to health inequities in the United States – is an important priority for CHERP and VA HSR&D. SDOH include access to safe housing and healthy food; reliable transportation; air and water quality; employment and job security; history of incarceration; exposure to stress, including violence, institutional racism, and discrimination; and social connectedness. CHERP is interested in understanding how evolving models of care (e.g., expanded VA Community Care) impact Veteran populations at risk for poor outcomes, as well as the association of workforce diversity, equity, and inclusion with quality and equity of care for Veterans.
CHERP’s secondary research focus, improving the quality, equity, safety, and value of clinical therapeutics, targets the appropriate use of medications, devices, and procedures to promote optimal management of acute and chronic illness. CHERP embraces projects that address therapeutic adherence; de-prescribing of inappropriate therapies; use of genomics and other data to personalize therapeutics; and appropriate and equitable use of medications, devices, and procedures. CHERP is also interested in understanding the effects of receiving care outside VA through other forms of health insurance (e.g., Medicare, Medicaid) or VA Community Care on the clinical therapeutics used by enrolled Veterans.
 

ADDITIONAL CRITERIA FOR CHERP PILOT PROJECTS
CHERP is committed to supporting pilot projects that:
1. Align with VA Priorities. Applicants are strongly encouraged to align their project focus with VA HSR&D priority areas, VA’s strategic plan, ongoing community care transformation (e.g., MISSION Act), and other priority areas identified by VA.
2. Involve one or more VA health system and/or community partners to maximize the relevance and impact of the proposed work. Strong partnerships ensure the relevance of CHERP pilot projects to the VA health care system; enable access to data, study populations, and resources; and facilitate rapid translation of evidence into practice and policy. Examples of potential VA health system partners include local VA Medical Center and VISN 4 clinical and administrative leaders; Office of Health Equity; Office of Rural Health; Women’s Health Services; Pharmacy Benefits Management; and others. Potential community partners include the Commonwealth of Pennsylvania, Veterans Service Organizations, RAND Corporation, and local health care organizations (e.g., UPMC Center for High-Value Health Care, Penn Medicine Center for Health Care Innovation and Nudge Unit).
3. Incorporate stakeholder (e.g., Veteran, caregiver, provider) input across the project continuum. Engagement with the people who may be affected by the conduct or outcomes of the project establishes credibility, improves relevance, anticipates controversy, enhances quality, and increases dissemination and uptake of findings. CHERP encourages stakeholder engagement in developing project ideas and aims, selecting recruitment methods, refining data collection instruments, interpreting results, and disseminating findings. Pilot applications should reflect or describe methods for incorporating stakeholder input in the development and/or execution of the project. If desired, Drs. Kelly Burkitt (kelly.burkitt@va.gov) and Kimberly “Max” Brown (kimberly.brown6@va.gov) will facilitate investigator access to established Veteran Community Advisory Boards at the Pittsburgh and Philadelphia VA Medical Centers and support investigators in convening project-specific stakeholder advisory boards.

ELIGIBLE APPLICANTS
Applications will be accepted from doctoral-level clinician and non-clinician investigators in VISN4 with at least 5/8ths VA support.
• Applications from investigators who do not have >5/8th VA appointment or are not affiliated with CHERP must include a CHERP core investigator as a Co-Principal Investigator. For assistance in establishing such collaborations, please contact Kelly Burkitt, PhD (kelly.burkitt@va.gov) in Pittsburgh or Kimberly “Max” Brown, PhD (kimberly.brown6@va.gov) in Philadelphia.
• Applicants without prior independent research support (e.g., PI on VA IIR/Merit Review award or NIH/AHRQ R01 grant or equivalent) are required to identify a project mentor and submit a letter of commitment from the mentor detailing his/her role in the proposed project.
• CHERP fosters and prioritizes diversity, equity, accessibility and inclusion and encourages pilot applications from individuals underrepresented in health-related sciences.
 
BUDGET
Proposals with budgets up to $50,000 will be accepted. Budgets may cover VA salary support for non-clinical (i.e., non-Title 38) Principal Investigators, co-investigators and staff including research coordinators and assistants, computer programmers, data managers, biostatisticians, and qualitative research staff. In developing the budget, investigators should consider all expenses for the proposed work, including costs of instrument development; data collection, development, and management; participant compensation; computer programming and statistical analyses; and qualitative data transcription, collection, coding and analyses.
Funds may not be used to support fellow or graduate student salaries; travel, tuition, or publication costs; computer hardware or software; refreshments; or physical plant infrastructure.
Applicants are encouraged to engage the CHERP Biostatistics and Informatics Core (BIC), Qualitative Methods Core, Equity Capacity Building Core, and/or Dissemination and Implementation Core to obtain relevant expertise required by the project.
All budgets must undergo local CHERP review prior to submission. Local budget review is required prior to submission. If one of CHERP’s infrastructure cores in engaged in the proposed project, budgetary review should be obtained by the Director of the involved core. Please develop the budget and budget justification with Kimberly Hansen, MA, CHERP Program Analyst (kimberly.hansen1@va.gov) in Pittsburgh or Kimberly “Max” Brown, PhD (kimberly.brown6@va.gov) in Philadelphia.
Awardees may be asked to modify budget requests based on recommendations of the Review Committee. Expenditures will be audited by CHERP leadership to ensure that spending is consistent with approved budgets. Awarded funds not expended by September 30, 2022 will be swept by the VA Medical Center and lost to the program.

REVIEW CRITERIA
CHERP Pilot applications are reviewed in a two-step process. The initial review, completed by the CHERP Intramural Research Committee, is to evaluate the scientific and technical merit of the application. Applications that are deemed scientifically meritorious by the Intramural Research Committee are then reviewed by CHERP leadership, who will make funding decisions based on both the considerations of scientific merit as rated by the Intramural Research Committee, and the relevance and responsiveness of the proposal to CHERP priorities. Funding will be awarded based on the following criteria:
• Qualifications of the Principal Investigator(s)
• Qualifications of Research Team and Mentor (if applicable)
• Significance and how project addresses identified scientific, policy, or practice gaps
• Innovation
• Methodological rigor of approach and methods
• Feasibility to be completed within 1 year and with the resources requested
• Likelihood that the pilot work will lead to future VA HSR&D or QUERI funding
• Engagement with operations/clinical partners and Veteran stakeholders
• Alignment with CHERP’s mission and funding priorities

Reviewers are also asked to comment on the budget and budget justification but asked to score the proposal without consideration of these comments.