>> GOOD MORNING.
I WOULD LIKE TO CALL TO ORDER
THE OPEN SESSION OF THE 87TH
MEETING OF THE NATIONAL ADVISORY
COUNCIL FOR COMPLEMENTARY AND
INTEGRATIVE HEALTH.
I AM MARTINA SCHMIDT, AND I'M
SERVING AS THE EXECUTIVE
SECRETARY FOR THE NCCIH NATIONAL
ADVISORY COUNCIL FOR
COMPLEMENTARY AND INTEGRATIVE
HEALTH.
I NOTE FOR THE RECORD THAT THIS
MEETING IS BEING HELD IN PERSON
AND IT'S BEING RECORDED AND
BROADCAST LIVE TO THE PUBLIC VIA
NIH VIDEOCAST.
THIS COUNCIL MEETING IS CONVENED
AS IS REQUIRED BY TITLE 42 OF
THE U.S. CODE OF LAW THAT
GOVERNS THE NIH IN GENERAL AND
NCCIH SPECIFICALLY IN SECTION
287C-21.
AND IN ACCORDANCE WITH THE
FEDERAL ADVISORY ACT.
I NOTE THE CLOSED SESSION OF
THIS COUNCIL WAS HELD EARLIER
THIS MORNING AND WAS CLOSED TO
THE PUBLIC IN ACCORDANCE WITH
THE GOVERNMENT AND THE SUNSHINE
ACT.
WITH THOSE BUSINESS ITEMS
COVERED, I'M GOING TO ASK
DR. LANGEVIN, DIRECTOR OF NCCIH,
TO OFFER A FEW WELCOMING
REMARKS.
DR. LANGEVIN.
>> THANK YOU.
SORRY.
WE'RE SO EXCITED TO SEE YOU ALL
HERE, AND THOSE OF YOU WHO ARE
JOINING US BOTH ON ZOOM AND ON
VIDEOCAST.
WELCOME.
IT'S JUST A PLEASURE.
WE'RE GOING TO HAVE A VERY
EXCITING PROGRAM, LOTS OF REALLY
DIVERSE PRESENTATIONS FOR YOU
TODAY, AND LOOKING FORWARD TO
IT.
>> THANK YOU.
SO THE OPEN SESSION TODAY WILL
INCLUDE THESE OPENING PROCEDURE
REMARKS FOLLOWED BY
DR. LANGEVIN'S NCCIH DIRECTOR'S
REPORT TO COUNCIL, FOLLOWED BY
OUR COUNCIL WORKING GROUP ON
SPIRITUAL HEALTH, WHICH WILL
THEN PRESENT AN UPDATE.
AND AFTER THAT, WE WILL BREAK
FOR LUNCH.
THIS SHOULD BE AROUND
12:50 TODAY, AND WE WILL
RECONVENE AT 1:50.
FOLLOWING LUNCH, THERE WILL BE
AN UPDATE ON NCCIH PORTFOLIO
ANALYSIS AND OUR STRATEGIC
PLANNING PROCESS.
WE WILL BREAK FOR 10 MINUTES
AFTER THAT, AND THEN
DR. LANGEVIN WILL GIVE AN UPDATE
ON THE NIH HEAL INITIATIVE,
FOLLOWED BY PRESENTATIONS ON THE
NCCIH UPDATED CLINICAL TRIAL
FUNDING OPPORTUNITIES AND SOME
RECENTLY APPROVED CONCEPTS.
AND WITH THIS, OUR FIRST ORDER
OF BUSINESS TODAY WILL BE TO
APPROVE THE JANUARY 2024 COUNCIL
MINUTES, WHICH WERE PROVIDED TO
ALL COUNCIL MEMBERS VIA THE
ELECTRONIC COUNCIL BOOK.
A COPY OF THE MEETING MINUTES IS
DISPLAYED ON THE SCREEN RIGHT
NOW.
SO ARE THERE ANY CORRECTIONS TO
THE GENERAL COUNCIL MEETING
MINUTES?
NO?
OWOKAY.
THEN DO I HAVE A MOTION TO
APPROVE THE MINUTES?
DO WE HAVE A SECOND?
ANY DISCUSSION?
NO?
OKAY.
SO ALL IN FAVOR IN THE ROOM AS
WELL AS THOSE ON ZOOM, PLEASE
RAISE YOUR HAND, YOUR DIGITAL
HAND AND YOUR ACTUAL HAND TO
VOTE TO APPROVE THE MINUTES.
YOU'RE GOOD, THERE'S NO
ABSTENTIONS, SO WITH THIS, THE
MEETING MINUTES HAVE BEEN
APPROVED UNANIMOUSLY.
NOW, ARE THERE ANY QUESTIONS
BEFORE WE MOVE ON?
NO?
IF NOT, THEN I'M HANDING THE
MEETING BACK OVER TO
DR. LANGEVIN FOR HER DIRECTOR'S
REPORT.
>> THANK YOU VERY MUCH.
IT'S NOW MY PLEASURE TO PRESENT
OUR REPORT ON ACTIVITIES OF
NCCIH, AND ALSO NIH IN GENERAL.
SINCE OUR LAST COUNCIL MEETING.
I HAVE A DIFFERENT FORMAT NOW
FOR THIS REPORT THAT WE STARTED
BACK IN JANUARY.
WE TRIED TO REALLY PARE THINGS
DOWN FOR MORE HIGHLIGHTS.
IN YOUR COUNCIL BOOK THERE IS
ADDITIONAL INFORMATION ON
FUNDING OPPORTUNITIES, ET
CETERA, IF YOU WANT TO CHECK
THAT OUT TO SEE MORE.
SO FIRST, FIRST SOME GENERAL
NEWS AND THE FIRST NEWS IS
UNFORTUNATELY A SAD ONE.
IS THE PASSING OF A FORMER NCCIH
PROGRAM DIRECTOR, DR. EVE
REIDER.
SOME OF YOU MAY REMEMBER
DR. REIDER.
SHE HAD A TREMENDOUS IMPACT
DURING HER TIME AT NCCIH.
SHE WORKED BOTH AT NCCIH, AT
NIDA, NATIONAL INSTITUTE OF DRUG
ABUSE, AND ALSO AT NATIONAL
INSTITUTE OF MENTAL HEALTH.
SHE REALLY WAS A CHAMPION FOR
PREVENTION RESEARCH, YOUTH AND
MENTAL HEALTH DISPARITIES AND
SUICIDE RISK, AND NOTABLY, SHE
WON A NCCIH'S DIRECTOR AWARD FOR
HER LEADERSHIP IN ESTABLISHING
THE TRANS AGENCY NIH DOD VA
MANAGEMENT COLLABORATORY WHICH
RESULTED IN THE FUNDING OF
COORDINATING CENTER AND 11
PRAGMATIC TRIALS THAT ARE STILL
GOING ON RIGHT NOW, SO SHE HAD A
REALLY BIG IMPACT, AND WE MISS
HER.
DR. EDWARDS WILL BE REPRESENTING
NCCIH ON A ROUNDTABLE ABOUT
EVE'S LEGACY AT THE SOCIETY FOR
PREVENTION RESEARCH ANNUAL
MEETING ON MAY 29TH.
NOW WE WELCOME A NEW DIRECTOR AT
NIH, DR. KATHLEEN NEUZIL.
SHE IS THE NEW DIRECTOR OF THE
FOGARTY INTERNATIONAL CENTER,
AND DR. NEUZIL WILL BE THE FIRST
WOMAN TO HOLD THIS POSITION
SINCE ITS START IN 1968.
SHE WAS PREVIOUSLY THE DIRECTOR
OF THE CENTER FOR VACCINE
DEVELOPMENT AND GLOBAL HEALTH,
AND THE CHIEF OF DIVISION OF
GEOGRAPHIC MEDICINE AT
UNIVERSITY OF MARYLAND IN
BALTIMORE.
SHE HAS RECEIVED NIH FUNDING
THROUGHOUT HER CAREER ON A
VARIETY OF DISEASES INCLUDING
INFLUENZA, TYPHOID AND COVID-19.
SHE HAS A STRONG COMMITMENT TO
MENTORING THE NEXT GENERATION OF
SCIENTISTS AND WE REALLY LOOK
FORWARD TO WORKING WITH HER.
NEXT SLIDE IS -- WE ARE --
BITTERSWEET DEPARTURE OF THE
NIMH DIRECTOR, DR. JOSHUA
GORDON, WHO IS LEAVING US TO
RETURN TO COLUMBIA UNIVERSITY AS
CHAIR OF THE DEPARTMENT OF
PSYCHIATRY.
DR. GORDON HAS BEEN THE DIRECTOR
OF NIMH FOR QUITE SOME YEARS
NOW, FOR EIGHT YEARS.
HE'S OVERSEEN AN EXTENSIVE
PORTFOLIO OF BASIC,
TRANSLATIONAL AND CLINICAL
RESEARCH THAT AIMS TO TRANSFORM
THE UNDERSTANDING OF TREATMENT
FOR MENTAL ILLNESS.
WE'VE HAD LOTS OF OPPORTUNITIES
TO COLLABORATE WITH NIMH,
NOTABLY THROUGH THE BRAIN
INITIATIVE, AND HE REALLY WILL
BE MISSED.
DR. SHELLI AVENEVOLI WILL SERVE
AS ACTING DIRECTOR WHILE A
SEARCH IS UNDERWAY.
I WANT TO ALSO POINT OUT
SOMETHING I'VE MENTIONED BEFORE,
BUT NOW IT'S NOW TAKING EFFECT.
NEW CHANGES TO GRANT
APPLICATIONS AND REVIEW.
AND TO ASSIST IN THIS EFFORT,
NIH HAS RELEASED A GUIDE NOTICE
LAST MONTH THAT PROVIDES
INFORMATION AND RESOURCE ON
THESE CHANGES.
SO THERE WILL ALSO BE WEBINARS
ABOUT THESE CHANGES AND THE NEXT
TWO ARE GOING TO BE ON JUNE 5TH
AND SEPTEMBER 19TH.
AND I ALSO WANT TO DRAW YOUR
ATTENTION NOW, WE'RE GOING TO
USE QR CODES ON OUR SLIDES, SO
IF YOU HOVER YOUR SMARTPHONE
CAMERA OVER THIS CODE AND THEN
CLICK, YOU CAN SEE IF THAT
ACTUALLY WORKS FOR YOU.
WE'RE TRYING THIS FOR THE FIRST
TIME.
AND I'M GOING TO BE USING THIS
THROUGHOUT MY PRESENTATION.
IS ANYBODY ABLE TO DO IT?
DOES IT WORK?
IT WORKS!
YAY!
LOOK AT THAT.
OKAY.
NOW, NEXT I WANT TO MENTION AN
IMPORTANT NEW PROGRAM AT NIH
THAT IS REALLY SPURRED BY THE
NIH DIRECTOR, DR. MONICA
BERTAGNOLLI.
SHE HAS REALLY BEEN A CHAMPION
RESOURCE IN PRIMARY CARE
SETTINGS, AND SHE IS NOW UNDER
HER LEADERSHIP, WE ARE LAUNCHING
A NEW COMMON FUND PROGRAM TO
SUPPORT THE DEVELOPMENT OF
NIH RESEARCH NETWORKS TO SUPPORT
RESEARCH THAT IS DELIVERED IN
THE SETTING OF PRIMARY CARE
CLINICS.
FOR EXAMPLE, WITH A FOCUS ON
RURAL HEALTH AS WELL AS
FEDERALLY QUALIFIED HEALTHCARE
CENTERS.
THIS IS REALLY IN RESPONSE TO A
VERY, VERY SERIOUS PROBLEM,
REALLY A DECLINING OF HEALTH IN
THE U.S. POPULATION MANIFESTED
AS DECREASE IN LIFE EXPECTANCY,
WHICH IS REALLY ONGOING.
THIS IS A PROBLEM THAT'S JUST
GETTING WORSE INSTEAD OF BETTER,
DESPITE THE FACT WE ARE SPENDING
ANY MORE THAN ANY OTHER
DEVELOPED NATION ON HEALTHCARE
SO SOMETHING IS NOT RIGHT.
DR. BERTAGNOLLI IS REALLY TAKING
THE BULL BY THE HORNS HERE, AND
SHE REALLY POINTS OUT,
RIGHTFULLY, THAT A BIG PART OF
THIS PROBLEM IS THAT THERE'S
TREMENDOUS HEALTH INEQUITY IN
THE U.S.
AND A LOT OF THE POPULATION THAT
IS UNDERSERVED IN TERMS OF
HEALTHCARE IS ALSO UNDERSERVED
IN TERMS OF RESEARCH.
SO PEOPLE WHO LIVED IN A LOT OF
RURAL AREAS, FOR EXAMPLE, WHO DO
NOT HAVE ACCESS TO UNIVERSITY,
FOR EXAMPLE, CENTERS WHERE
RESEARCH IS BEING CONDUCTED,
THEY DO NOT HAVE THE
OPPORTUNITIES TO PARTICIPATE IN
CLINICAL RESEARCH AS
PARTICIPANTS.
HOW DO WE APPROACH THIS?
WELL, WE HAVE TO DO THE RESEARCH
IN THE PLACES WHERE THE
HEALTHCARE IS ACTUALLY
DELIVERED.
AND ONE OF THE REASONS WHY THIS
IS OF PARTICULAR INTEREST TO
NCCIH IS BECAUSE THIS IS WHAT
THE PRAGMATIC TRIALS
COLLABORATORY HAS BEEN NOW
WORKING ON FOR THE LAST 10
YEARS.
IF YOU RECALL, THE PRAGMATIC
TRIALS COLLABORATORY WAS ANOTHER
COMMON FUND PROGRAM, RIGHT?
FOR 10 YEARS, THE COMMON FUND
FUNDED THE COLLABORATORY THAT
DEVELOPED THIS REALLY, REALLY
IMPORTANT INFRASTRUCTURE AND
EXPERTISE TO CONDUCT PRAGMATIC
TRIALS IN THE REAL WORLD.
AND SO BECAUSE OF THIS EXPERTISE
IN THE COLLABORATORY, NCCIH IS
VERY INVOLVED IN THIS, I AM
ACTUALLY ONE OF THREE CO-CHAIRS
OF THE OVERSIGHT COMMITTEE ALONG
WITH DR. JOANIE RUDDER OF NCATS
AND DR. DEB TUCCI OF THE -- OF
NIDCD AND WE ARE REALLY IN THE
PROCESS OF LAUNCHING THIS
PROGRAM.
SO THIS PROGRAM IS GOING TO BE
VERY, VERY QUICK LAUNCH.
THIS YEAR THERE'S GOING TO BE
$5 MILLION IN FUNDS FROM THE
OFFICE OF THE DIRECTOR, FROM THE
COMMON FUND, TO SET UP SOME
PILOT PROJECTS, AND THE IDEA
HERE IS TO CONNECT EXISTING
CLINICAL TRIAL NETWORKS WITH
ADDITIONAL OPPORTUNITIES FOR
EXTENDING THEIR REACH THROUGH
MULTIPLE OTHER SITES THROUGHOUT
THE COUNTRY WITH AN EMPHASIS ON
RURAL HEALTH AN UNDERSERVED
COMMUNITIES.
SO THE IDEA IS THAT IF WE CAN
DEMONSTRATE THAT THIS IS
FEASIBLE, THERE WOULD BE A KIND
OF QUICK RAMP-UP OF THE BUDGET
OF THIS OVER COMING YEARS.
SO THIS IS VERY EXCITING, AND
WE'LL BE HAVING MORE NEWS ON
THAT HOPEFULLY IN THE FALL.
NEXT SLIDE.
SO THIS IS ACTUALLY SOMETHING
VERY IMPORTANT FOR ALL
INVESTIGATORS TO KNOW ABOUT.
THIS IS THE NIH CLOUD LAB.
THIS IS A NO-COST 90-DAY PROGRAM
FOR RESEARCHERS TO REALLY KIND
OF TRY OUT COMMERCIAL CLOUD
SERVICES TO DEPOSIT THEIR DATA
AND ACTUALLY -- AND ACTUALLY
WORK ALSO ON DATA IN THE CLOUD
PLATFORMS.
SO THE TEAM -- CLOUD LAB NOW HAS
A STIPEND.
YOU CAN ACTUALLY GET SOME
FREE -- WHY IS MY SLIDE NOT
ADVANCING?
THE SLIDE IS STUCK.
THERE WE GO.
SO THERE IS ACTUALLY SOME FREE
KIND OF FUNDING THAT YOU CAN
GET, IF YOU GO TO THIS LAB PAGE,
AGAIN USE THE QR CODE, AND YOU
CAN REQUEST AN ACCOUNT, LOG IN
AND TRY THIS OUT.
SO YOU CAN TRY VARIOUS DIFFERENT
PLATFORMS, SEE WHAT WORKS FOR
YOU.
IT'S VERY USEFUL.
SO I WOULD ENCOURAGE YOU ALL
TO -- AND THIS IS FOR RECIPIENTS
OF FUNDED RESEARCHERS BUT ALSO
PEOPLE WHO ARE APPLYING FOR NIH
FUNDING AS WELL AS STUDENTS.
I ALSO WANT TO ANNOUNCE ANOTHER
VERY, VERY EXCITING DEVELOPMENT
HERE, WHICH IS GOING TO BE THE
LAUNCH OF THE NCCIH COALITION
FOR WHOLE PERSON HEALTH.
THIS IS A COALITION TO LEAD
ADVOCACY EFFORTS AT THE FEDERAL
LEVEL TO PROMOTE AND EDUCATE ALL
STAKEHOLDERS ON THE IMPORTANCE
OF RESEARCH OF THE NCCIH AND
FURTHERING RESEARCH ON
INTEGRATIVE, INTERPROFESSIONAL,
PATIENT-CENTERED AND WHOLE
PERSON CARE.
NOW ORGANIZATIONS ARE GOING TO
BE WELCOME TO JOIN THIS
COALITION STARTING VERY SOON.
I WOULD THINK WE SHOULD -- FOR
MORE INFORMATION, CONTACT MARY
BETH KESTER.
WE'RE GOING TO HAVE A PAGE ON
OUR WEBSITE THAT'S GOING TO GIVE
INFORMATION ABOUT THE COALITION.
THIS IS FOR ORGANIZATIONS, MUST
BE 501(C)3 OR 501C6 OR SIMILAR
AND WILL BE REPRESENTED BY ONE
DELEGATE PER ORGANIZATION.
SO THIS IS NOT FOR INDIVIDUALS.
THIS IS ONLY FOR REPRESENTATIVES
OF ORGANIZATIONS, SUCH AS
SOCIETIES, ET CETERA, ALL KINDS
OF ORGANIZATIONS THAT HAVE AN
INTEREST IN COMPLEMENTARY -- IN
SUPPORTING COMPLEMENTARY AND
INTEGRATIVE HEALTH.
SO THIS IS GOING TO BE MORE ON
THAT, AGAIN, AT FUTURE COUNCIL
MEETINGS.
NOW FOR SOME STAFF UPDATES.
WE'RE VERY EXCITED THAT
DR. MISHA BACKONJA IS NOW OUR
NEW NCCIH CLINICAL DIRECTOR.
HE HAD PREVIOUSLY BEEN THE
ACTING DIRECTOR, AND
DR. BACKONJA HAS WASTED NO TIME
SINCE HIS START AT NCCIH IN
LAUNCHING SOME VERY IMPORTANT
EDUCATIONAL INITIATIVES, A NICE
LECTURE SERIES UNDER HIS
LEADERSHIP ALSO, HE IS REALLY
PROMOTING A LOT OF COORDINATION
ACROSS THE INTRAMURAL PROGRAM ON
PAIN PHENOTYPING, SO WE'RE VERY
EXCITED TO HAVING HIM AS OUR
PERMANENT CLINICAL DIRECTOR.
ALSO A NEW ARRIVAL IN OUR
DIVISION OF EXTRAMURAL
ACTIVITIES, DR. MEI QIN, WHO IS
JOINING US AS A NEW SCIENTIFIC
REVIEW OFFICER.
IN THE OFFICE OF SCIENTIFIC
REVIEW.
SHE WILL BE SETTING UP SPECIAL
EMPHASIS PANELS FOR APPLICATIONS
AND PRIOR TO COMING TO NCCIH,
DR. QIN WAS AT THE NATIONAL
INSTITUTE OF MENTAL HEALTH AND
NATIONATIONAL INSTITUTE OF DRUG
ABUSE.
SHE HAS A LOT OF EXPERIENCE AT
NIH AND SHE HAS SPER TEET IN
BEHAVIORAL ASSAYS, NEUROIMAGING,
MEASURING BRAIN PROTEIN,
METABOLISM AND NEURAL SIGNAL
TRANSDUCTION, SO A LOT OF
RELEVANT EXPERTISE TO US.
I ALWAYS -- WE ALWAYS HAVE SOME
STAFF UPDATES, PEOPLE WHO HAVE
JOINED US AND I'VE LISTED THEM
HEHERE, SINCE THE LAST COUNCIL
MEETING, AS WELL AS PEOPLE THAT
WE'VE SAID GOODBYE TO.
AND WE ALWAYS HAVE A LOT OF
PEOPLE COMING AND GOING
BECAUSE -- AND PART OF THIS IS,
YOU KNOW, NCCIH AND NIH IN
GENERAL IS A GREAT PLACE FOR
PEOPLE TO PASS THROUGH SOMETIMES
OR STAY, AND WE CONTRIBUTE A
LOT, I THINK -- WE THINK, TO
SCIENCE THROUGHOUT THE COUNTRY,
VIA ALL THESE OPPORTUNITIES THAT
WE OFFER AT NIH FOR ALL KINDS OF
DIFFERENT JOBS, FELLOWSHIPS, ET
CETERA.
LET'S SEE.
MORE ARRIVALS AND DEPARTURES,
MANY IN OUR INTRAMURAL DIVISION.
NOW OUR BUDGET.
SO, BUDGET IS FLAT THIS YEAR.
WHICH IS ACTUALLY NOT THE WORST
NEWS.
POSSIBLE.
[LAUGHTER]
YOU KNOW, IT'S BEEN A DIFFICULT
YEAR FOR US.
FIRST OF ALL, WE HAD TO WAIT A
LONG TIME BEFORE GETTING OUR
BUDGET, BUT WE'RE GLAD NOW WE
ACTUACTUALLY HAVE A BUDGET, WE W
IT'S FLAT, WE CAN ACT ON IT.
AND AS YOU CAN SEE HERE, OUR
FINAL TOTAL AMOUNT, $170,000,894
IS PRETTY MUCH EXACTLY WHAT WE
HAD BEFORE, AND WE ARE -- YOU
KNOW, WHAT HAPPENS WHEN A BUDGET
IS FLAT, RIGHT?
INFLATION IS STILL -- DOESN'T
STOP, SALARIES GO UP, YOU KNOW,
COST OF LIVING, ET CETERA.
SO WE HAVE TO DEAL WITH THIS, SO
AS EVERYBODY ELSE AT NIH, BUT
WE'RE ACTUALLY VERY HAPPY THAT
IT WAS NOT WORSE THAN THAT.
SO GIVEN THIS BUDGET CLIMATE, WE
ARE VERY EXCITED, THOUGH, TO
SHOW YOU HOW WELL WE HAVE BEEN
DOING FROM THE POINT OF VIEW
OF -- THE CLICKER IS JUST --
REALLY ANNOYING.
THAT'S WHAT I'VE BEEN DOING.
OKAY.
NOW, JUST TO SHOW YOU THAT WE
HAVE BEEN AUGMENTING OUR BUDGET
VERY EFFECTIVELY, SO IN GREEN,
YOU CAN SEE OUR TOTAL THAT WE
ARE ABLE TO SPEND ON EXTRAMURAL
GRANTS.
$90,000,796 IN 2023, WHICH IS
THE LAST NUMBER THAT WE CAN
ACTUALLY GIVE YOU A TOTAL FOR.
BUT YOU CAN SEE IN THE BLUE IS
THE ADDITIONAL FUNDING THAT WE
GET THROUGH THE HEAL INITIATIVE.
AND IMPORTANTLY, IN RED, ALL THE
ADDITIONAL FUNDING THAT WE GET
FROM OTHER INSTITUTES AND
CENTERS AT NIH.
SO YOU CAN SEE THAT WE ARE
REALLY AUGMENTING OUR BUDGET IN
A VERY SIGNIFICANT WAY BY ALL OF
THE COLLABORATIONS THAT WE
SECURE THROUGH ALL THE HARD WORK
THAT PEOPLE DO THROUGHOUT THE
CENTER IN MAINTAINING
RELATIONSHIPS WITH OTHER
INSTITUTES AND CENTERS,
PARTICIPATING IN PROGRAM FUNDING
OPPORTUNITIES AT OTHER CENTERS,
COLLABORATE WITH US, AND ALSO IN
THESE BIG TRANS-NIH PROGRAMS
THAT I MENTIONED, THE HEAL
INITIATIVE, THE BRAIN
INITIATIVE, THE COMMON FUND, ET
CETERA.
SO I THINK WE'RE DOING QUITE
WELL IN REALLY DOING THE BEST
THAT WE CAN WITH THE MONEY THAT
WE HAVE AND, YOU KNOW, IN
SECURING ADDITIONAL FUNDS.
SO I'M GOING TO POINT OUT NOW
JUST A COUPLE OF RESEARCH
SPOTLIGHTS.
ONE OF THEM HAS TO DO, TWO
PAPERS PUBLISHED BY THE
PRAGMATIC TRIAL COLLABORATORY,
WHICH AGAIN, REALLY HIGHLIGHT
THE IMPORTANCE OF THE WORK THE
COLLABORATORY HAS DONE IN WHAT
WE CALL CREATING LEARNING
HEALTHCARE SYSTEMS.
WHAT DOES THAT MEAN?
IT MEANS EMBEDDING RESEARCH IN
HEALTHCARE SYSTEMS WITH THE
PRIOR BUY-IN AND THE INTEREST
AND THE -- WORKING WITH THE
HEALTHCARE SYSTEMS THEMSELVES IN
THE DESIGN OF THE RESEARCH,
ANSWERING -- AND ADDRESSING AND
ANSWERING QUESTIONS THAT THE
HEALTHCARE SYSTEMS ACTUALLY CARE
ABOUT ENSURES THAT AT THE END OF
THE STUDY, THAT THE RESULTS OF
THE RESEARCH WILL BE USED IN
ACTUALLY CHANGING THE HEALTHCARE
SYSTEM AT IMPLEMENTING THE
RESULTS OF THE STUDY.
WHETHER THEY WERE POSITIVE OR
NEGATIVE.
VERY, VERY, VERY IMPORTANT.
AND THIS IS WHAT THE
COLLABORATORY DOES IN SPADES.
THIS IS THE EXPERTISE OF THE
COLLABORATORY THAT REALLY
DEVELOPED THIS KIND OF ENGINE
OF -- AND THIS IS WHAT THESE TWO
PAPERS TALK ABOUT.
WHAT ARE THE EFFECTS OF CLINICAL
TRIALS ON THIS SORT OF POST
TRIAL SUSTAINING AND
IMPLEMENTATION OF THE STUDY
INTERVENTIONS AND THE RESULTS OF
THE STUDY.
SO I ENCOURAGE YOU TO CHECK
THESE PAPERS OUT.
THEY'RE VERY IMPORTANT, AND AS I
MENTIONED, THEY WILL BE VERY
IMPORTANT IN GUIDING THIS NEW
TRANS-NIH PRIMARY CARE NETWORK
INITIATIVE THAT I TALKED ABOUT
EARLIER.
I ALSO WANT TO POINT OUT ANOTHER
NICE PAPER THAT COVERS THE NIH
APPROACH TO ADVANCING RESEARCH
TO IMPROVE YOUTH MENTAL HEALTH
AND REDUCE DISPARITIES.
AND THIS IS A PAPER THAT WAS
ALSO CO-AUTHORED BY OUR OWN
DR. BEDA JEAN-FRANCOIS WHO WROTE
THIS ON ADDRESSING BIAS, RACISM
AND MENTAL HEALTH DISPARITIES
THROUGH RESEARCH.
PRACTICE AND POLICY.
I ALSO WANT TO POINT OUT ANOTHER
SPECIAL ISSUE ON THE MECHANISMS
OF MANUAL THERAPIES.
THIS SPECIAL ISSUE WAS PUBLISHED
THIS YEAR BY THE NETWORK, THE
U24 RESEARCH NETWORK GROUP ON
THE FORCE BASED MANIPULATION
GROUP OF STUDIES THAT WE FUNDED.
NOW, WE HAVE FUNDED SEVERAL NOW
OF THESE U24 NETWORKS, ONE OF
THEM ON MUSIC AND HEALTH, ONE ON
MECHANISMS OF MANUAL THERAPIES,
AND WE ARE VERY EXCITED -- THIS
WAS ACTUALLY THE FIRST ONE THAT
WE FUNDED, AND WE'RE HAPPY TO
SEE THE RESULTS OF THESE
NETWORKS THAT ARE REALLY
INVOLVED IN PRETTY MUCH DOING
WHAT WE WERE HOPING THEY WERE
GOING TO DO, WHICH IS REALLY
BASICALLY GETTING A COMMUNITY OF
RESEARCHERS TOGETHER TO WORK
TOGETHER ON REALLY SETTING THE
GROUNDWORK FOR A NEW FIELD,
DOING META-ANALYSES, FOR
EXAMPLE, DEFINING TERMS, DOING
ONTOLOGIES, REALLY WORKING ON
THE BASIC GROUNDWORK THAT IT
TAKES TO LIFT UP A FIELD THAT
DIDN'T EXIST BEFORE.
SO WE'RE VERY PLEASED WITH THIS
SPECIAL ISSUE OF PAPERS.
I'M NOW GOING TO GO INTO THE
PROGRAM NEWS, WHICH IS ORGANIZED
NOW ACCORDING TO OUR COLORED
CIRCLES, AND I WANT TO REALLY
POINT OUT THESE CIRCLES.
WE'VE BEEN WORKING ON THEM QUITE
A BIT.
THE REASON IS THAT NOT ONLY IS
THIS USEFUL FOR ORGANIZING THIS
DIRECTOR'S REPORT, BUT AS YOU
WILL SEE LATER ON IN THE DAY,
DR. ANGELA ARENSDORF IS GOING TO
GIVE A PRESENTATION ON OUR
PORTFOLIO ANALYSIS THAT SHE HAS
BEEN DOING.
THAT FOLLOWS THIS SAME SCHEMA,
AND AS YOU CAN SEE, WE ARE
REALLY -- AND THIS IS ALSO GOING
TO BE VERY USEFUL FOR US FOR OUR
NEW STRATEGIC PLAN.
SO AS THROUGHOUT THE REST OF MY
PRESENTATION, I ENCOURAGE YOU TO
LOOK AT THE UPPER RIGHT CORNER
OF THE SLIDE AND TO SHOW YOU THE
MAIN TOPIC THAT IS REQUESTING TO
BE COVERED.
AS ANGELA WILL SHOW YOU, WE HAVE
A LOT OF ACTIVITIES THAT COVER
MORE THAN ONE AREA.
THAT MAKES SENSE, RIGHT?
SO PAIN RESEARCH MIGHT ALSO
INVOLVE MIND AND BODY THERAPIES,
FOR EXAMPLE.
AND MORE POSITIVE HEALTH
PROCESSES.
WHOLE PERSON RESEARCH MIGHT
INVOLVE NATURAL PRODUCT OR
NUTRITION, MIGHT ALSO INVOLVE
POSITIVE HEALTH -- SO THIS BY
DEFINITION IS GOING TO BE VERY
CROSS-CUTTING.
HOWEVER, WHAT WE ARE REALLY
TRYING TO LOOK AT IS WHAT I'M
GOING TO BE SHOWING YOU IS THAT
THERE'S USUALLY A MAIN THEME
THAT A PARTICULAR ACTIVITY
PERTAINS TO AND THAT'S GOING TO
BE AT THE UPPER RIGHT CORNER AND
THERE WILL BE OTHER THEMES I
WILL MENTION AS WELL.
SO LET'S START WITH PAIN.
SO OBVIOUSLY, YOU KNOW, PAIN IS
ALWAYS A BIG FOCUS AT NCCIH, AND
IN PARTICULAR, IN THIS
PARTICULAR CASE HERE, THIS IS A
SYMPOSIUM AT THE -- THAT IS
GOING TO BE UPCOMING IN JUNE AT
THE ANNUAL SICKLE CELL DISEASE
RESEARCH EDUCATIONAL SYMPOSIUM
THAT ILLUSTRATES THE
INTERSECTION OF PAIN RESEARCH AS
WELL AS WHOLE PERSON RESEARCH AS
WELL AS WORKFORCE DEVELOPMENT
AND SPECIAL POPULATIONS.
SO THAT'S WHY WE'VE LISTED ALL
THREE HERE.
THIS IS GOING TO BE ORGANIZED BY
DR. INNA BELFER, AND ON UNMET
NEEDS, ME CAN NIS TICS AND
TRANSLATIONAL STUDIES OF SICKLE
CELL DISEASE AS A WHOLE PERSON
HEALTH CHALLENGE.
SO WE'RE VERY MUCH LOOKING
FORWARD TO THAT.
ALSO IN KIND OF -- IN PARALLEL
TO THIS, STAY TUNED FOR AWARD
ANNOUNCEMENTS THIS SUMMER ON
MULTIDISCIPLINARY MECHANISTIC
AND TRANSLATIONAL STUDIES OF
SICKLE CELL DISEASE PAIN.
WE'RE GOING TO BE ANNOUNCING THE
RESULTS OF THAT VERY SOON.
NOW I WANT TO LOOK BACK TO THE
PARTICIPATION THAT NIH HAD,
NCCIH HAD, AT THE INTERNATIONAL
ASSOCIATION -- I'M SORRY, NO,
THIS IS THE FUTURE.
SORRY.
I'M BACKWARDS HERE.
THIS IS AT IASP, COMING UP.
SO THIS IS THE INTERNATIONAL
ASSOCIATION FOR THE STUDY OF
PAIN MEETING IN AMSTERDAM IN
AUGUST, AND I AM DELIGHTED THAT
I WILL BE GIVING A PLENARY ON A
WHOLE PERSON APPROACH TO PAIN
RESEARCH.
AND IN THIS LECTURE, I'M GOING
TO BE EMPHASIZING TWO THINGS.
GAPS IN PAIN RESEARCH THAT
REALLY NCCIH IS VERY MUCH
LOOKING FORWARD TO WORKING VERY
CLOSELY, ESPECIALLY WITH THE
HEAL INITIATIVE, TO ADDRESS.
ONE IS THE CONNECTION OF THE
BRAIN AND THE REST OF THE BODY
IN UNDERSTANDING PAIN.
AND THE OTHER GAP THAT WE DON'T
REALLY UNDERSTAND VERY WELL IS
ENDOGENOUS PAIN RESOLUTION, AND
HOW WE HAVE MECHANISMS THAT ARE
KIND OF BUILT IN THAT HELP US TO
RESOLVE PAIN AND WE NEED TO
UNDERSTAND HOW TO PROMOTE THIS.
SO THAT'S WHAT I'M GOING TO BE
TALKING ABOUT.
ANOTHER EXCITING THING THAT'S
GOING TO BE HAPPENING AT THE
IASP MEETING IS A SYMPOSIUM TO
PROMOTE MUSCULOSKELETAL HEALTH
BEYOND SYMPTOM MANAGEMENT, AND
DR. HEATHER TICK IS ORGANIZING
THIS AND I'LL BE PARTICIPATING
THEN ALONG WITH DR. MARY BARBE
AND CARLA STECCO.
ALSO AT IASP, THERE'S GOING TO
BE A SYMPOSIUM ON THE GLY M.P.H.
ATIC SYSTEM AT THE CROSS ROAD OF
INTEGRATIVE HEALTH APPROACHES IN
CHRONIC PAIN PRESENTED BY
DR. INNA BELFORT AS WELL AS A
SYMPOSIUM, A TRANSLATIONAL,
GLOBAL AND HISTORICAL
PERSPECTIVE ON TER PE TERPENS AR
CANNABINOIDS FOR PAIN ALSO IN
AMSTERDAM.
NOW I WANT TO GIVE YOU A HEADS
UP ABOUT A NOFO.
YOU ALL UNDERSTAND OF COURSE
WHAT NOFO MEANS?
THIS IS OUR NEW ACRONYM.
NOTICE OF FUNDING OPPORTUNITY.
SO ON THE UP LEFT CORNER, THIS
IS TO INDICATE WHAT KIND OF
THING THIS IS.
THIS IS ON THE SAFETY AND EARLY
EFFICACY OF PSYCHEDELIC-ASSISTED
THERAPY FOR CHRONIC PAIN IN
OLDER ADULTS.
THIS IS A FUNDING OPPORTUNITY
THAT WE'RE SIGNING ON TO.
IT WAS ACTUALLY INITIATED BY THE
NATIONAL INSTITUTE ON AGING.
AND WE ARE VERY EXCITED TO BE
COLLABORATING WITH NIA ON THIS.
THIS IS A NEW AREA THAT'S QUITE
INTERESTING.
IT'S HOW PEOPLE ARE STARTING TO
USE, OF COURSE UNDER MEDICAL
SUPERVISION, PSYCHEDELICS TO
HELP PEOPLE WITH A VARIETY OF
PROBLEMS INCLUDING DEPRESSION,
FOR EXAMPLE, BUT THIS PARTICULAR
ONE IS FOCUSING ON CHRONIC PAIN.
AND DR. SEKAI CHIDEYA-CHIHOTA IS
THE CONTACT ON THIS.
THE EATHE EARLIEST SUBMISSION DS
IN SEPTEMBER.
OKAY.
NOW WE'RE MOVING TO ORANGE, THE
MIND AND BODY CONNECTION.
IN JUNE IS GOING TO BE, AGAIN,
OUR FORCE-BASED MANIPULATION
NETWORK IS GOING TO HAVE ITS
ANNUAL INVESTIGATOR MEETING, AND
I'M MENTIONING THIS, THERE IS
THIS QR CODE THERE YOU CAN GO,
THIS IS GOING TO BE VIDEOCAST,
THE KEYNOTE LECTURE BY
DR. VALERIA VASQUEZ, IN THE
FINE-TUNING OF MECHANOSENSITIVE
ION CHANNELS FROM BASIC SCIENCE
TO TRANSLATIONAL RESEARCH.
SO EVEN THOUGH THE MEETING IS AN
INVESTIGATOR MEETING THAT'S NOT
OPEN TO THE PUBLIC, BUT THE
KEYNOTE LECTURE IS.
SO YOU CAN VIEW THAT IF YOU LI
LIKE.
NEXT, POSITIVE HEALTH PROCESSES.
SO WHAT ARE POSITIVE HEALTH
PROCESSES?
FOR EXAMPLE, EMOTIONAL
WELL-BEING IS AN EXAMPLE OF
THIS.
HEALTH RESTORATION WOULD BE
ANOTHER EXAMPLE.
AND RESILIENCE WOULD BE ANOTHER
EXAMPLE.
SO WE HAVE AS A PAST EVENT HERE
THE INVESTIGATOR MEETING FOR OUR
EMOTIONAL WELL-BEING GROUP, AND
THIS WAS VERY -- THERE WAS A
VERY, VERY NICE KEYNOTE
DELIVERED BY DR. ERIC GARLAND
THAT WAS ALSO VIDEOTAPED, SO ANY
OF YOU WHO WANT TO VIEW THAT,
YOU CAN JUST GO ON OUR WEBSITE
AND CLICK OP THAT AND YOU CAN YN
SEE IT.
IT WAS ON MINDFULNESS-ORIENTED
RECOVERY ENHANCEMENT BUILDS
EMOTIONAL WELL-BEING BY
RESTRUCTURING REWARD, MEANING
AND SELF, VERY, VERY NICE TALK.
NEXT IS ANOTHER OF THE NOFO
SIGN-ONS.
THIS IS AN INITIATIVE BY THE
OFFICE OF ODP OR OFFICE OF
DISEASE PREVENTION ON
MULTI-SECTORAL PREVENTIVE
INTERVENTIONS THAT ADDRESS
SOCIAL DETERMINANTS OF HEALTH IN
POPULATIONS THAT EXPERIENCE
HEALTH DISPARITIES.
SO YOU CAN SEE -- THIS IS ALSO
TO BUILD RESILIENCE, AND SO
DR. BAUMGARTNER IS OUR CONTACT
ON THIS, SO WE'VE LISTED THIS
UNDER POSITIVE HEALTH PROCESSES,
AND ALSO UNDER WORKFORCE DEVE
DEVELOPMENT AND SPECIAL
POPULATION.
NEXT IS NUTRITION AND NATURAL
PRODUCTS.
UPCOMING IS A SYMPOSIUM ON --
EXCUSE ME, INVESTIGATOR MEETING,
THE NCCIH CANNABINOID RESEARCH
PRINCIPAL INVESTIGATORS MEETING
ON EXPLORING THE MECHANISMS
UNDERUNDERLYING THE ANALGESIC
PROPERTIES OF MINOR CANNABINOIDS
AND TERPENES.
THIS IS GOING TO BE ON JUNE 4TH
AND THE KEYNOTE IS GOING TO BE
DR. DANIELE PIOMELLI, OVERVIEW
OF SAFETY AND EFFICACY OF
CANNABIS-BASED PRODUCTS IN
ANIMAL MODELS.
YOU CAN VIEW THIS, I BELIEVE,
RIGHT, ON VIDEOCAST.
ALSO UPCOMING, JUNE 10TH AND
11TH A SYMPOSIUM ON
COMPLEMENTARY AND INTEGRATIVE
INTERVENTIONS TO PREVENT AND
MITIGATE THE EFFECTS OF
ENDOCRINE-DISRUPTING CHEMICALS.
THIS IS SPONSORED BY BOTH NCCIH,
AS WELL AS THE NATIONAL
INSTITUTE OF ENVIRONMENTAL
HEALTH SCIENCES.
WE THINK THIS IS REALLY
IMPORTANT, BECAUSE WE ARE
SURROUNDED BY ALL KINDS OF
PRODUCTS THAT WE ARE EXPOSED TO
THROUGH THINGS THAT WE TOUCH,
CARPETS AND CLOTHING AND OUR
WATER BOTTLES AND ALL KINDS OF
THINGS THAT ARE REALLY -- WE
DON'T KNOW WHAT EFFECT THEY HAVE
ON OUR HEALTH, BUT WHAT WE DO
KNOW IS THAT WE REALLY WANT TO
BE PROACTIVE IN FIGURING OUT
WHAT KIND OF MITIG MITIGATING
STRATEGIES COULD WE EXPLORE AND
DEVELOP TO PREVENT AND TO REDUCE
THE NEGATIVE IMPACTS THESE
COMPOUNDS HAVE ON HEALTH.
ONE OF THE AREAS THAT IS OF
PARTICULAR INTEREST TO NCCIH IS
THE EFFECTS OF STRESS, BECAUSE
WE KNOW THAT STRESS CAN COMPOUND
THE EFFECTS OF MANY SORT OF
ENVIRONMENTAL STRESSORS, AND SO
WE REALLY WANT TO EXPLORE HOW
ADDRESSING BOTH STRESS, BUT ALSO
GOOD NUTRITION, PHYSICAL
ACTIVITY, ALL THOSE KINDS OF
LIFESTYLE INTERVENTIONS THAT WE
ARE STUDYING AND PROMOTE COMPANY
PERHAPS ALSO HELP WITH DEALING
WITH NEGATIVE INFLUENCES FROM
THE ENVIRONMENT.
SO AGAIN, THIS IS THE
INTERSECTION OF WHOLE PERSON
HEALTH WITH THE BIOLOGY, THE
BEHAVIOR, THE SOCIAL, AND THE
ENVIRONMENT.
SO THIS IS A VERY IMPORTANT
INITIATIVE, I THINK, THAT WE
WANT TO -- WE'RE GOING TO BE
FOLLOWING CLOSELY AND THIS
WORKSHOP IS GOING TO BE
IMPORTANT TO GET THAT -- AND GET
THE INPUT OF THE COMMUNITY ON
THIS.
I WANT TO TALK ABOUT THE CARBON
PROGRAM WHICH IS ISSUED, THREE
IMPORTANT FUNDING ANNOUNCEMENT
OPPORTUNITIES.
ONE IS A LIMITED COMPETITION,
AND OF COURSE CARBON IS A
PROGRAM THAT'S LONG-STANDING AND
HAS BEEN A COLLABORATION WITH
THE OFFICE OF DIETARY
SUPPLEMENTS.
THIS LIMITED COMPETITION IS FOR
A RESEARCH RESOURCE FOR NATURAL
PRODUCT NMR, NUCLEAR MAGNETIC
RESONANCE DATA, AND THIS IS OPEN
TO THE EXISTING CENTER THAT HAS
ALREADY -- BECAUSE WE WANT TO BE
ASSURED THAT WE HAVE CONTINUITY
IN THIS VERY, VERY IMPORTANT
RESOURCE.
THE NEXT IS LEVERAGING DATA AT
SCALE TO UNDERSTAND NATURAL
PRODUCT IMPACTS ON WHOLE PERSON
HEALTH.
THIS IS A R01 PROGRAM THAT IS
REALLY TO BUILD THE PORTFOLIO OF
NATURAL PRODUCTS TO MOVE IN A
TRANSLATIONAL DIRECTION TOWARDS
TESTING A LOT OF THE PROMISING
INTERVENTIONS THAT WE'RE SORT OF
BEGINNING TO UNDERSTAND MORE
FROM A BIOCHEMICAL POINT OF VIEW
AND TO MOVE INTO UNDERSTANDING
HOW CAN WE NOW MOVE TOWARDS
HUMAN RESEARCH.
THE OTHER ONE IS, AGAIN, ANOTHER
PROGRAM ON BOTANICAL DIETARY
SUPPLEMENTS TRANSLATIONAL
RESEARCH TEAM, RM1 CLINICAL
TRIAL REQUIRED.
AGAIN, THIS IS TO BUILD -- TO
MOVE TOWARDS DEVELOPING THE
SCIENCE THAT WILL ALLOW FUTURE
LARGE SCALE CLINICAL TRIALS ON
NATURAL PRODUCTS THAT WE'RE
STARTING TO UNDERSTAND MORE
ABOUT.
SO THIS IS KIND OF THE EVOLUTION
OF OUR STRATEGY ON NATURAL
PRODUCTS FROM REALLY
UNDERSTANDING NATURAL PRODUCTS
FROM A FUNDAMENTAL PERSPECTIVE
TOWARDS REALLY IMPLEMENTING THIS
KNOWLEDGE INTO TRANSLATIONAL AND
CLINICAL RESEARCH.
BE AND WE'RE VERY EXCITED TO BE
WORKING WITH ODS ON THIS.
WHOLE PERSON NOW.
THIS IS WHAT WE DID AT THE
INTERNATIONAL CONGRESS FOR
INTEGRATIVE MEDICINE & HEALTH
THIS PAST APRIL.
I WAS VERY HAPPY TO PARTICIPATE
IN A PLENARY SESSION WITH
DR. ALEX KRIST, WHERE WE
DISCUSSED THE RECOMMENDATIONS
FROM THE NATIONAL ACADEMIES OF
SCIENCE, ENGINEERING AND
MEDICINE ON WHOLE HEALTHCARE TO
INFORM RESEARCH AND POLICY.
WE ARE VERY INTERESTED, OF
COURSE, IN THIS REPORT, WHICH
WAS VERY MUCH A BUILDING ON
EXPERTISE FROM THE VETERANS'
ADMINISTRATION'S WHOLE HEALTH
PROGRAM AND REALLY EXPLORING HOW
THE IMPLICATIONS OF WHAT WE ARE
LEARNING ON WHOLE HEALTH TO
REALLY INFLUENCE HEALTHCARE AS
IT'S DELIVERED OVERALL IN THE
ENTIRE COUNTRY.
NOW, OF COURSE, IN ORDER TO DO
THAT SUCCESSFULLY, WE NEED
RESEARCH, AND SO NCCIH IS VERY
INTERESTED IN THIS WHOLE FIELD
OF UNDERSTANDING HOW TO MEASURE
WHOLE HEALTH.
WE ARE -- WE HAVE BEEN
COLLABORATING WITH THE VA ON
WHAT WE ARE LOOKING AT NCCIH IN
TERMS OF THE IMPORTANCE OF
UNDERSTANDING BOTH
PATIENT-REPORTED MEASURES OF THE
WHOLE PERSON, AND ALSO OBJECTIVE
MEASUREMENTS OF HEALTH AND HOW
TO BEST COMBINE THE TWO TO
DELIVER THE BEST QUALITY
RESEARCH TO ENVELOPE US HOW TO
MOVE THESE KINDS OF PROGRAMS
FORWARD.
ALSO AT THE INTERNATIONAL
CONGRESS ON INTEGRATIVE MEDICINE
AND HEALTH WAS A REALLY VERY
NICE SESSION THAT WE HAD, I
THINK YOU SEE THERE, IT WAS
STANDING-ROOM ONLY, WHICH WAS A
SESSION THAT WAS PUT TOGETHER BY
DR. EMRIN HORGUSLUOGLU ON
SEVERAL DIFFERENT INITIATIVES ON
DEVELOPING METHODS TO PURSUE THE
WHOLE PERSON HEALTH RESEARCH
AGENDA.
DOING RESEARCH ON WHOLE PERSON
HEALTH IS NOT EASY.
IT TAKES A LOT OF DIFFERENT
PIECES TO PUT TOGETHER.
ONE OF THE PIECES THAT WE
DISCUSS IS I GAVE A JOINT
PRESENTATION WITH DR. PATRICIA
HERMAN ON OUR MRS. M EXAMPLE,
AND THIS IS SOMETHING THAT I'VE
PRESENTED AT THIS COUNCIL IN THE
PAST, COMPARING TWO DIFFERENT
SCENARIOS FOR A TYPICAL PATIENT.
ONE USING CONVENTIONAL CARE, THE
OTHER ONE USING WHOLE PERSON
CARE, AND LOOKING AT THE
FINANCIAL IMPACTS OF THESE TWO
APPROACHES OVER 40 YEARS OF
MRS. M'S LIFE.
AND WE HAVE A PAPER SUBMITTED ON
THIS THAT'S CURRENTLY UNDER
REVIEW.
DR. JEFF DUSEK ALSO PRESENTING
SOME VERY, VERY NICE DATA ON THE
BRAVEWELL-FUNDED PATIENT CARE
NETWORK, PRACTICE-BASED NETWORK
THAT COVERS A GOOD PART OF THE
COUNTRY NOW, AND THEY'RE
COLLECTING OUTCOME MEASURES OF
COMPLEMENTARY AND INTEGRATIVE
CENTERS, AND I'M MENTIONING
THIS, VERY IMPORTANT, BECAUSE
THIS WHOLE EMPHASIS THAT NIH NOW
IS PLACING ON BUILDING NETWORKS
OF PRIMARY CARE, YOU CAN SEE
THAT THIS IS THE NEXT POSSIBLE
EXTENSION OF THIS, RIGHT, IS
INCORPORATING THIS NETWORKS --
THIS RESEARCH INTO NETWORKS OF
COMPLEMENTARY AND INTEGRATIVE
HEALTH THAT ARE DELIVERING THESE
INTERVENTIONS.
SO WE'RE FOLLOWING THIS VERY,
VERY CLOSELY.
AND FINALLY, DR. AARON LEE
PRESENTED A VERY, VERY NICE
REPORT ON THIS BRIDGE TO A.I.
PROJECT ON SALUTOGENESIS, I'VE
BEEN TELLING YOU THIS ON PAST
COUNCILS.
THIS IS A COMMON FUND PROJECT
THAT FUNDED A VERY LARGE SCALE
STUDY THAT IS STUDYING PATIENTS
WITH EARLY DIABETES AND DOING
MULTIPLE MEASUREMENTS TO REALLY
LOOK AT THEIR WHOLE PHYSIOLOGY
AND HOW THAT CHANGES OVER TIME,
WHETHER PATIENTS ARE GOING
TOWARDS HEALTH OR AWAY FROM
HEALTH.
AND SO THIS IS A VERY -- IT WAS
A VERY INTERESTING SESSION
BECAUSE IT COVERED MANY, MANY
DIFFERENT ASPECTS OF WHOLE
PERSON HEALTH.
SHOWING THAT WE REALLY CAN DO
RESEARCH IN THIS AREA.
WE JUST REALLY HAVE TO WORK ON
IT TOGETHER.
OTHER SESSIONS AT IC IMH THAT
WERE VERY -- OF NOTE AND WELL
ATTENDED, ADVANCING THE SCIENCE
OF EMOTIONAL WELL-BEING, NIH
OPEN ACCESS REPOSITORIES, HOW TO
ACCESS THEM AND LEVERAGE THEM,
NAVIGATING EARLY CAREER STAGE
TRANSITIONS, AND ALSO
DISSEMINATION AND IMPLEMENTATION
SCIENCE.
SO AS YOU CAN SEE, WE'RE ALWAYS
VERY BUSY AT ICIMH AND THIS YEAR
WAS NO EXCEPTION.
ANOTHER NOTICE OF INTENT TO
PUBLISH.
VERY IMPORTANT.
IN THE PAST, YOU'VE ALL HEARD
ABOUT OUR REACH CENTER, SO THIS
WAS A CENTER THAT WAS FUNDED
LAST YEAR TO THE RAND
CORPORATION TO CREATE A SUPPORT
FOR COMPLEMENTARY AND
INTEGRATIVE INSTITUTIONS TO HELP
THEM SUBMIT GRANT APPLICATIONS,
AND TO REALLY SUPPORT GROWING
THE INTEGRATIVE HEALTH
INSTITUTIONS IN THEIR EFFORTS TO
RESEARCH THAT IS DIRECTLY
INVOLVING THOSE INSTITUTIONS.
AND SO THAT EARLY FIRST CENTER
WAS FUNDED AND NOW WE HAVE
RE-ISSUED THIS, WE'RE GOING
TO -- ACTUALLY WE'VE NOT
REISSUED IT YET, THIS IS JUST A
NOTICE BUT IT WILL BE REISSUED.
DR. LANAY MUDD IS THE PROGRAM
OFFICER ON THIS, SO WE ARE
REALLY LOOKING TO FUND MORE OF
THESE RESEARCH CENTERS.
BECAUSE WE THINK THAT THIS IS A
VERY, VERY IMPORTANT THING TO
KEEP DOING.
I NOW WANT TO BRING YOUR
ATTENTION TO SEVERAL HIGH
RISK/HIGH REWARD FUNDING
OPPORTUNITIES, AGAIN FUNDED BY
THE COMMON FUND.
THESE ARE REALLY, REALLY
IMPORTANT, AND I REALLY WANT TO
ENCOURAGE ALL OF YOU TO GO TO
THESE WEBSITES AND CHECK THEM
OUT.
THIS IS TO FUND RESEARCH THAT IS
OUT OF THE BOX, OKAY?
THIS IS RESEARCH THAT IS
EXPLORING NEW PARADIGMS, NEW
APPROACHES, AND WHAT WE DO HERE
AT NCCIH, A LOT OF IT IS OUT OF
THE BOX.
THIS IS WHAT WE TRY TO DO.
WE REALLY TRY TO LOOK AT
DIFFERENT WAYS TO THINK ABOUT
HEALTH, DIFFERENT WAYS TO THINK
ABOUT DIFFERENT KINDS OF THER
THERAPIES, LIFESTYLE, ALL THOSE
KINDS OF THINGS, AND SO THE NIH
DIRECTOR'S INNOVATION AWARD, THE
NIH DIRECTOR'S EARLY
INDEPENDENCE AWARD.
THE NEXT ONE IS THE -- ON THE
NEXT SLIDE IS THE TRANSFORMATIVE
RESEARCH AWARD, AND THE NIH
DIRECTOR'S PIONEER AWARDS ARE
ALL OPPORTUNITIES TO SUBMIT
GRANT APPLICATIONS THAT ARE VERY
NEW AND CUTTING EDGE AND THAT WE
ARE INCREASINGLY VERY HAPPY TO
SEE THAT A LOT OF THE
INVESTIGATORS WHO ARE SOME OF
THE INVESTIGATORS PREVIOUSLY
FUNDED BY NCCIH HAVE STARTED TO
GO TO THESE MECHANISMS AND TAKE
ADVANTAGE OF THESE FUNDING
OPPORTUNITIES.
SO WE'RE REALLY ENCOURAGING ALL
OF YOU TO LOOK AT THAT.
ALSO, UPCOMING IS NIH PRAGMATIC
TRIALS COLLABORATORY.
I'VE MENTIONED THE COLLABORATORY
QUITE A FEW TIMES IN THIS
PRESENTATION, AND THIS IS THEIR
ANNUAL WORKSHOP IN JULY.
THIS IS ALSO GOING TO HAVE A
PART OF IT -- OR IS THE WHOLE
THING VIDEOCAST, RIGHT?
IS THE WHOLE THING VIDEOCAST?
THIS IS VERY IMPORTANT TO GIVE A
SENSE OF REALLY THIS -- THE
THEME THAT I TALKED ABOUT
ALREADY.
IT'S ADDRESSING THE VERY URGENT
HEALTHCARE ISSUES THAT WE'RE
HAVING THROUGH PRAGMATIC
RESEARCH.
AND REALLY ENCOURAGING THIS
LEARNING HEALTHCARE SYSTEM
APPROACH TO IMPROVING HEALTHCARE
THROUGH PRAGMATIC TRIAL.
ANOTHER NOTICE OF SPECIAL
INTEREST, NOW THIS IS AN AREA OF
METHODS AND DATA SCIENCE.
I MENTIONED EARLIER THE CLOUD,
UTILIZING CLOUD-BASED DATA
SERVICES.
THIS PARTICULAR ONE IS FOR MORE
EXTENSIVE LARGER PROJECTS.
THE EARLIER -- WHAT I TALKED
ABOUT EARLIER IS MORE FOR PEOPLE
TO KIND OF TRY THINGS OUT, BUT
THERE'S NOT ENOUGH IF YOU HAVE A
VERY LARGE PROJECT, FOR EXAMPLE,
TO USE CLOUD-BASED SERVICES, YOU
MAY NEED ADDITIONAL RESOURCES
AND THIS IS WHAT THIS IS ABOUT.
THIS IS PUBLISHED BY THE OFFICE
OF DATA SCIENCE STRATEGY, AND
THEY HAVE FUNDING FOR PEOPLE WHO
REALLY WANT TO USE CLOUD
SERVICES AND NEED ADDITIONAL
SUPPORT TO DO THIS.
SO, WE'VE COME TO THE END OF
THIS.
OUR NEXT MEETING IS GOING TO BE
SEPTEMBER 13.
IT'S GOING TO BE AGAIN IN
PERSON, AND WE ARE REALLY
LOOKING FORWARD TO SEEING YOU IN
SEPTEMBER.
AND I HA WILL STOP HERE AND WOUD
LOVE TO HEAR ANY QUESTIONS OR
COMMENTS.
DO WE HAVE TIME FOR QUESTIONS?
HOW ARE WE DOING WITH OUR TIME?
>> YOU'RE DOING OKAY UNTIL
12:20.
>> PERFECT.
ALL RIGHT.
QUESTIONS, COMMENTS, REACTION?
BEN.
>> THANKS FOR THAT UPDATE,
DR. LANGEVIN.
I WONDER IF YOU HAVE ANY NEWS
ABOUT -- I KNOW THERE'S BEEN A
TRANS-NIH WORKING GROUP ON WHOLE
PERSON OUTCOMES, ET CETERA, THAT
YOU'VE BEEN REALLY SPEARHEADING,
AND I WONDER IF YOU HAVE ANY
NEWS ABOUT THAT OR UPDATES ON
THAT.
>> WE ARE ALMOST THERE.
WE HAD A CONCEPT CLEARANCE ON
ISSUING A FUNDING OPPORTUNITY
FOR DEVELOPING A KNOWLEDGE BASE
ON WHOLE PERSON RESEARCH.
I CANNOT SAY MORE THAN THAT
RIGHT NOW, BUT THERE WILL BE
SOME NEW DEVELOPMENTS VERY SOON,
RIGHT?
I CAN SAY THAT?
I CAN.
WE HAVE THIS -- THAT'S RIGHT,
THANK YOU, EMMELINE.
THIS WAS -- WE ARE -- OUR
WORKING GROUP ON WHOLE PERSON
RESEARCH HAS BEEN EXTREMELY
SUCCESSFUL.
WE HAVE NOW 17 INSTITUTES, 17
INSTITUTES, CENTERS AND OFFICES.
I REALLY WANT TO COMMEND THE
WORK OF DR. ERIN AND -- SHE'S
VIRTUAL?
THEY HAVE MOVED MOUNTAINS.
I DON'T KNOW IF YOU KNOW WHAT
IT'S LIKE TO DEVELOP A FUNDING
OPPORTUNITY WITH 17 INSTITUTES,
CENTERS AND OFFICES ON A TOPIC
AS COMPLEX AS WHOLE PERSON
HEALTH.
I CAN ONLY TELL YOU, YOU SEE THE
SMILE ON MY FACE.
SO YOU CAN READ MY LIPS, THIS IS
GOING TO BE AWESOME.
SO YOU'LL HEAR ABOUT THIS VERY
SOON.
>> CAN I JUST ADD, JUST SUPER
QUICK THANKS FROM THE WHOLE
COUNTRY AND THE WORLD FOR TAKING
THAT ON?
BECAUSE I THINK IT REALLY
REFLECTS THE MOVEMENT IN NIH
TOWARDS A MORE EXPANSIVE
APPROACH BEYOND JUST LOOKING AT
SPECIFIC DISEASES, AND I DON'T
THINK WE'D BE GETTING THERE
WITHOUT YOU AND THE NCCIH
LEADERSHIP.
>> THE FACT THAT WE'VE GOTTEN
MOST OF -- I MEAN, THE MAJORITY
OF NIH INSTITUTES AND CENTERS TO
COLLABORATE ON THIS IS IF HE
KNPHENOMENAL, I THINK, I'M VERY,
VERY EXCITED THAT PEOPLE ARE
BUYING IN.
YES, HELEN.
>> JUST A QUICK QUESTION ON THE
PROJECT BECAUSE OF THE HEAL
INITIATIVE FUNDING, YOU KNOW,
WAXING AND WANING, IS THERE ANY
PARTICULAR REASON FOR THAT?
>> FOR HEAL?
WELL, CERTAIN LARGE PROGRAMS
HAVE BEEN HIT A LOT MORE THAN
THE INSTITUTES AND CENTERS
THEMSELVES.
YOU KNOW, CONGRESS DECIDES THAT.
WE DON'T HAVE ANY SAY OVER THAT.
SO CONGRESS THIS YEAR DECIDED TO
CUT SEVERAL LARGE PROGRAMS,
INCLUDING SOME OF HEAL.
THE ALL-OF-US INITIATIVE WAS
CUT.
THE BRAIN INITIATIVE SUFFERED A
SEVERE CUT.
THE NIH INSTITUTES AND CENTERS
WERE MOSTLY SPARED.
SO, YOU KNOW, THAT'S WHAT
HAPPENED.
SO WE'RE HOPING THAT SOME OF
THIS FUNDING FOR ALL-OF-US AND,
YOU KNOW, BRAIN AND HEAL WILL
EVENTUALLY BE RESTORED.
THE GOOD NEWS, HOWEVER, IS WE
HAVE TO KEEP REMEMBERING, WE'RE
VERY FORTUNATE TO HAVE THESE
LARGE INITIATIVES IN THE FIRST
PLACE, RIGHT?
HEAL HAS BEEN A WONDERFUL THING
TO HAVE.
IT HAS REALLY ACCELERATED
RESEARCH ON PAIN AND OPIOID USE
DISORDER TO THE POINT WHERE WE
ARE -- I MEAN, THE SUCCESS IS
JUST PHENOMENAL IN CREATING A
WHOLE COMMUNITY OF
INVESTIGATORS, AND WE'RE ALSO,
OF COURSE, NOT FOR GETTING ALL L
THE RESEARCH ON PAIN THAT'S
OCCURRING OUTSIDE OF HEAL, AND
THERE'S NOW A BIG EFFORT THROUGH
THE NEWS AND I'VE BEEN TALKING
ABOUT THAT -- I'LL BE TALKING
ABOUT THAT IN MY NEXT
PRESENTATION ON HEAL.
SO IT'S SAD BUT YOU KNOW, IT
HAPPENS.
NADIA.
>> IT'S REALLY A GRADE SUMMARY,
SUPER INTERESTING, EXCITING
STUFF GOING ON.
I JUST WANTED TO SPECIFICALLY
POINT HOW EB THEUS YAS TICK
ENTHUSIASTIC I AMTO SEE THE NOFN
NUTRITION AND NATURAL PRODUCTS
AREA.
I KNOW THAT'S BEEN A TREMENDOUS
EFFORT TO ENVISION THE FUTURE OF
THE CARBON PROGRAM AND BY A LOT
OF PEOPLE AT NCCIH, CRAIG
HOFFMAN, PATRICK STILL AND FOLKS
AT ODS AND PROBABLY MANY OTHERS,
REALLY EXCITING TO SEE THE
R01 MECHANISM COMING IN THERE,
WHICH I THINK WILL BE A REALLY
GOOD OPPORTUNITY MAYBE FOR SOME
INVESTIGATORS WHO HAVEN'T BEEN
ABLE TO BE PARTICIPATING IN THE
U GRANTS TO COME IN WHICH IS
SOMETHING THAT WE'VE BROUGHT UP
AT PREVIOUS MEETINGS, SO REALLY
EXCITED TO SEE THAT.
JUST WANT TO SAY THANKS TO
EVERYBODY THAT'S BEEN INVOLVED.
I KNOW IT'S A TREMENDOUS AMOUNT
OF EFFORT.
>> YEAH, WE'RE VERY EXCITED
ABOUT THESE DEVELOPMENTS AS
WELL.
DR. PASIACOS, THE NEW DIRECTOR
OF THE OFFICE OF DIETARY
SUPPLEMENTS HAS BEEN EXTREMELY
INTERESTED IN COLLABORATING WITH
US.
HE HAS A BIG INTEREST IN
CLINICAL TRANSLATION, AND WE ARE
VERY MUCH IN AGREEMENT THAT
THAT'S WHERE WE WANT TO GO.
>> YEAH, THAT'S GREAT TO SEE.
AND IT'S BEEN OBVIOUSLY A LONG
TIME IN COMING, THINKING ABOUT
TAKING A STEP BACK FROM SOME OF
THE INITIAL TRIALS AND THINKING
ABOUT HOW TO MOVE IN THAT
DIRECTION, BUT IT'S REALLY
EXCITING TO SEE IT GOING THAT
WAY.
>> WE'RE IN A DIFFERENT PLACE
NOW.
>> YEAH, VERY DIFFERENT.
>> WE HAVE A LOT MORE
CAPABILITIES IN TERMS OF
TECHNIQUES, YOU KNOW, DATA
RESOURCES, AND ALSO THE CENTERS
THAT WERE FUNDED THROUGH CARBON
ARE GOING TO HELP WITH THAT.
>> RIGHT.
>> SO YEAH, I THINK WE'RE IN A
GOOD PLACE, SO, YEAH.
>> AGREED.
>> ALSO I WANT TO MENTION AN
IMPORTANT COLLABORATION WITH THE
OFFICE OF NUTRITION RESEARCH.
WE ARE IN THE MIDDLE NOW OF
PREPARING A MANUSCRIPT WHERE WE
HAVE NCCIH, THE OFFICE OF
NUTRITION RESEARCH, OFFICE
DIETARY SUPPLEMENTS AND ALSO THE
OFFICE OF NURSING RESEARCH.
WE'RE REALLY INTERESTED IN
LOOKING -- WE'VE CALLED IT THE
NUTRITION CONTINUUM.
SO ALL THE WAY FROM, YOU KNOW,
THE ENVIRONMENTAL ASPECTS TO
FOOD INSECURITY, FOR EXAMPLE, N
IMR IS VERY INTERESTED IN THAT,
TO SOCIAL ASPECTS OF FOOD --
TEACHING KITCHENS, FOR EXAMPLE,
FOOD LITERACY, TO NUTRITION
ITSELF, TO THE COMPONENTS OF
FOOD, TO THE CONSTITUENTS OF
FOOD, TO DIETARY SUPPLEMENTS.
YOU SEE, THE WHOLE THING.
AND IT'S REALLY GREAT THAT NIH
AGAIN -- THIS IS THE WHOLE
PERSON, SO BIOLOGICAL,
BEHAVIORAL, SOCIAL,
ENVIRONMENTAL, WHY WORK
SEPARATELY WHEN WE COULD WORK
TOGETHER?
SO IT'S -- NUTRITION, I THINK,
THIS NUTRITION CONTINUUM EFFORT
THAT WE'RE DOING NOW ACROSS NIH
IS ANOTHER EXAMPLE OF HOW WHOLE
PERSON HEALTH CONCEPT IS REALLY
HELPING PEOPLE TO WORK TOGETHER.
EVERYBODY GETS IT.
IT'S LIKE IT AMAZING, RIGHT?
HOW IT HAS BEEN ALMOST LIKE A
RALLYING CALL.
THAT HAS GOTTEN A LOT OF PEOPLE
TO WORK TOGETHER.
ANY OTHER THOUGHTS, COMMENTS?
SHOULD WE MOVE FORWARD TO OUR
NEXT PROGRAM ITEM?
GOOD LUCK, WHOEVER IS GOING TO
USE THIS CLICKER NEXT.
OH, YOU HAVE YOUR OWN.
GOOD.
I HOPE IT WORKS BETTER.
NEXT ON OUR AGENDA IS A VERY
IMPORTANT UPDATE.
AS PEOPLE KNOW AND ON THIS
COUNCIL, WE HAVE ESTABLISHED,
AFTER MANY DISCUSSIONS WITH YOU
ALL IN THE PAST AND INPUT FROM
THE COMMUNITY, A COUNCIL WORKING
GROUP ON THE TOPIC OF SPIRITUAL
HEALTH.
WE'RE VERY PLEASED THAT THIS
GROUP HAS BEEN FORMED, AND IS
BEING HELD AND LED BY DR. HELEN
BENVENISTE, WHO HAS GRACIOUSLY
AGREED TO CHAIR THE GROUP.
AND DR. BENVENISTE IS GOING TO
GIVE US A QUICK OVERVIEW OF THE
INITIAL PHASES OF THIS WORKING
GROUP.
THIS IS A WORK IN PROGRESS, BUT
WE'VE BEEN VERY PLEASED THAT THE
GROUP HAS MET SEVERAL TIMES
SINCE OUR LAST COUNCIL.
THEY HAVE REALLY BEEN VERY
ENGAGED, AND THAT ALSO DR
DR. LINSITINIB SHINTO, FORMER
COUNCILMEMBER WHO HAS BEEN
ENGAGED IN THIS WORKING GROUP IS
NOW JOINING US ON ZOOM FOR THIS
PRESENTATION AND ENSUING
DISCUSSION.
AND I WANT TO REALLY APPLAUD THE
GROUP FOR TAKING A VERY COMPLEX
TOPIC AND REALLY BEING VERY,
VERY THOUGHTFUL FROM WHAT I CAN
HEAR.
SO DR. BENVENISTE, TAKE IT AWAY.
>> THANK YOU VERY MUCH,
DR. LANGEVIN, FOR THIS
INTRODUCTION, AND ALSO IT'S AN
HONOR TO BE CHAIRING THIS GROUP,
AND I WILL TRY TO INTRODUCE THE
CONCEPT THAT WE HAVE BEEN -- THE
CHARGE THAT WE HAVE BEEN GIVEN
AND ALSO A LITTLE MORE ABOUT
WHAT WE HAVE ACTUALLY ACHIEVED.
BUT I WANT TO START BY LISTING
AND HIGHLIGHTING THE MEMBERS ON
THE COMMITTEE.
AS YOU CAN SEE HERE, THE
COUNCILMEMBERS AND ALSO A GREAT
THANKS TO MARTINA SCHMIDT,
EXECUTIVE SECRETARY, WHO IS
SUPPORTING THE PROCESS AND YOU
CAN SEE THE NAMES HERE, I'M NOT
GOING TO LIST THEM, BUT IT'S
BEEN A WONDERFUL EXPERIENCE FOR
ME PERSONALLY TO WORK WITH THE
COUNCILMEMBERS ON THIS.
AS I SAID OR AS DR. LANGEVIN WAS
MENTIONING, I THINK IN EARLY
MARCH WE WERE APPROACHED BY THE
NCCIH AND COUNCIL WAS ASKED IF
SOMEBODY -- WHO OF US WERE
INTERESTED IN GETTING ON THE
WORKING GROUP TO COME UP WITH
RECOMMENDATIONS REGARDING THIS
PARTICULAR TOPIC, AND THESE WERE
THE MEMBERS THAT JUMPED TO THE
OPPORTUNITY.
SO I THINK I'M GOING TO JUST
MENTION BRIEFLY, DR. LANGEVIN
HAS ALREADY KIND OF ALLUDED TO
THE FACT THAT WHY SHOULD WE HAVE
A WORKING GROUP ON SPIRITUALITY,
SO WHY IS THE NCCIH DOING THIS,
AND I THINK IN A LOT OF PEOPLE
ARE THINKING IT'S A NATURAL
EVOLUTION OF THE NCCIH STRATEGIC
PLANNING, BASED ON T ON THE
INTERACTIONS WITH THE COMMUNITY
AND IT'S NOT A NEW TOPIC, PER
SE.
THE V.A. CERTAINLY HAS ALREADY
EMBRACED SPIRITUALITY FRONT AND
CENTER IN THE WHOLE HEALTH
PATIENT CARE MODEL.
DR. LANGEVIN POSTED A VERY
IMPORTANT MESSAGE IN 2023 AND
POSED THE QUESTION REGARDING
INCLUDING SPIRITUALITY INTO A
FULLER PICTURE OF RESEARCH ON
WHOLE PERSON HEALTH, AND IT'S
ALSO BEEN THE FOCUS AREA AT THE
RECENT INTEGRATIVE HEALTH
CONFERENCE.
SO IT'S SOMETHING THAT IS ON
EVERYBODY'S MIND, SO TO SPEAK,
SO IT'S NOT SURPRISING AGAIN
THAT WE ARE NOW -- THE TIME IS
RIGHT, SO TO SPEAK, TO ACTUALLY
APPROACH IT A LITTLE MORE
CAREFULLY.
SO THE CHARGE THAT WE GOT, THE
GROUP GOT, IS LISTED HERE.
AND I'M GOING TO READ THE THINGS
IN BOLD, SO THE FIRST CHARGE IS
HOW DO SPIRITUAL PRACTICES AND
SPIRITUAL HEALTH FIT IN THE
CONCEPT OF WHOLE PERSON HEALTH?
AND AGAIN, SHOULD SPIRITUAL BE A
SEPARATE WHOLE PERSON HEALTH
DOMAIN?
I'M GOING TO SHOW THIS A LITTLE
MORE IN DETAIL LATER.
AND WHAT ARE THE RESEARCH GAPS
THAT ARE IN NEED OF BEING
ADDRESSED WITH RESPECT TO, LET'S
SAY, SPIRITUAL PRACTICES,
SPIRITUAL HEALTH, AND WHAT
RESEARCH METHODS ARE NEEDED TO
ADDRESS THE GAPS AND UNDER WHAT
RESEARCH CATEGORY SHOULD THIS
FIT INTO: MIND AND BODY
CONNECTION, POSITIVE HEALTH
PROCESSES, WHOLE BODY HEALTH --
PERSON HEALTH, OR MORE THAN ONE.
AND WE JUST HEARD ABOUT THOSE
CATEGORIES FROM DR. LANGEVIN IN
HER PRESENTATION.
WHAT I'M GOING TO AGAIN REFRESH
EVERYBODY'S MEMORY ABOUT THE
WHOLE PERSON HEALTH CONCEPT, YOU
CAN SEE WE HAVE THE HEALTH TO
DISEASE.
IT TAKES A WHOLE ARMY TO STUDY,
TO GET TOGETHER ON THIS, TO
UNDERSTAND, AND WHAT WE ARE
FOCUSING ON IS ON THE INDIVIDUAL
WHERE YOU CAN SEE THE DIFFERENT
DOMAINS THAT ARE INTEGRATED
ALREADY, BIOLOGICAL, BEHAVIORAL,
SOCIAL, AND ENVIRONMENT.
IN THE PROCESS OF HEALTH TO
DISEASE.
AND NOW THE QUESTION OR THE
CHARGE IS, SHOULD SPIRITUAL BE A
SEPARATE DOMAIN HERE?
AND AGAIN, JUST HIGHLIGHTING
AGAIN THE NEW GROUPINGS THAT I
THINK ARE VERY HELPFUL, SO THESE
CONCEPTS, THESE GROUPINGS AS WAS
ALSO MENTIONED BY DR. LANGEVIN
ARE OVERLAPPING.
WE HAVE THE WHOLE PERSON HEALTH
THERE IN THE MIDDLE, AND YOU
WILL SEE IT BETTER ON THIS NEXT
ONE, THAT THE NCCIH HAS ACTUALLY
ALREADY THOUGHT ABOUT SPIRITUAL
PRACTICES IN THE THERAPEUTIC
INPUT DOMAINS AS YOU CAN SEE
HERE.
AND THE MIND-BODY PRACTICES
UNDER PSYCHOLOGICAL HAS LISTED
SPIRITUAL PRACTICES.
SO IT'S NOT LIKE COMING OUT OF
NOWHERE, AND WE ALL KNOW, LIK
LIKE -- AND I'M LEARNING, BEING
PART OF THE GROUP, LIKE YOGA CAN
BE AN EXERCISE OR IT CAN BE A
SPIRITUAL EXPERIENCE DEPENDING
ON THE INTENT OF THE INDIVIDUAL
DOING THESE THINGS.
AND THIS IS KIND OF FLOATING
AROUND IN MANY DIFFERENT DOMAINS
AND THIS IS WHAT WE ARE TRYING
TO ADDRESS.
ONE OF THE THINGS THAT THE GROUP
CAME TO REALIZE WAS THAT IT IS
EXTREMELY IMPORTANT THAT WE
HARMONIZE LANGUAGE.
WE WERE GIVEN THE CHARGE LOOKING
AT SPIRITUAL HEALTH.
BUT IT IMMEDIATELY BECAME CLEAR
THAT THE SPIRITUAL HEALTH VERSUS
SPIRITUAL WELL-BEING NEEDED TO
BE DISCUSSED.
THESE ARE TWO TERMS THAT ARE
BEING USED, AND WE DECIDED TO
DISCUSS THIS IN MORE DETAIL, AND
IN TERMS OF THE SPIRITUAL
WELL-BEING, USING THAT AS A
TERM, THE WHO AND THE V.A. HAVE
BEEN OPERATING WITH SPIRITUAL
WELL-BEING.
IT'S A CONSENSUS TO REFER TO
THIS TERM BY MANY.
AND IT'S ALSO A GENERAL CONCEPT
AMONG NATIVE AMERICANS, ABOUT
HEALTH.
THE TERM WELLNESS IS MENTIONED
IN THEIR WHEEL OF LIFE.
AND THE WELL-BEING HAS DIFFERENT
FACETS, AND MANY ARE THINKING
THAT THE TERM WELL-BEING IS LESS
CONTROVERSIAL.
BUT YOU ALSO HAVE THE OTHER
OPINION THAT HEALTH IS LESS
JUDGMENTAL, AT MIND AND BODY
INTERSECTION WITH SPIRITUAL
HEALTH, THAT'S ALREADY KIND OF
INCORPORATED IN THE NCCIH KIND
OF PLAN, AND ALSO HEALTH IS PART
OF WELL-BEING AS A CONCEPT, AND
AGAIN MIGHT BE BETTER ALIGNED
WITH THE NCCIH MISSION GOALS.
SO YOU CAN SEE THERE'S PROS AND
CONS, AND GIVEN THIS, WE DECIDED
TO EMBRACE BOTH.
SO WE ARE TALKING ABOUT
SPIRITUAL HEALTH AND WELL-BEING
FOR NOW.
SO YOU CAN SEE THIS IS NOT FAST
PROCESS.
LOTS OF DISCUSSION GOING ON AND
TRYING TO CONVENE ON THINGS THAT
WE CAN ALL AGREE ON.
THERE'S ALSO MANY WORKING
DEFINITIONS OF WHAT DO PEOPLE
MEAN OR WHAT ARE THEY REFERRING
TO IN TERMS OF SPIRITUALITY, AND
THIS PARTICULAR DEFINITION IS
NOT ALSO TAKEN OUT OF THE BLUE.
IT HAS BEEN ENDORSED BY MANY
WORKING IN THE WHOLE BODY HEALTH
AND PALLIATIVE CARE MEDICINE.
AND YOU CAN SEE THIS IS JUST ONE
OF THE DEFINITIONS THAT ARE
MENTIONING MANY WORDS THAT MANY
CAN RELATE TO.
SPIRITUALITY IS DEFINED AS A
DYNAMIC AND INTRINSIC ASPECT OF
HUMANITY THROUGH WHICH PERSONS
SEEK ULTIMATE MEANING, PURPOSE
AND TRANSCENDENCE AND EXPERIENCE
RELATIONSHIP TO SELF, FAMILY,
OTHERS, COMMUNITY, SOCIETY,
NATURE, AND THE SIGNIFICANT OR
SACRED.
SPIRITUALITY IS EXPRESSED
THROUGH BELIEFS, VALUES,
TRADITIONS AND PRACTICES.
VERY BROAD, BUT THERE ARE MANY
OTHER DEFINITIONS OF
SPIRITUALITY, AND THIS IS JUST
ONE OF THEM.
I MEAN, WE ARE NOT EMBRACING ONE
OR THE OTHER, BUT WE THOUGHT --
THE WORKING GROUP THOUGHT THIS
WAS VERY BROAD AND TOOK AWAY AND
INCLUDING A LOT OF THE CONCEPTS
THAT WERE DISCUSSED IN THE
GROUP.
IN TERMS OF OU ARE SPIRITUAL HEH
AND WELL-BEING PART WHOLE PERSON
HEALTH, THAT'S THE FIRST CHARGE.
NOW HERE'S SOME OF THE COMMENTS
AND THOUGHTS AND THIS AGAIN IS A
PROCESS AND THERE ARE MANY
DISCUSSIONS WITHIN THE GROUP.
SO SPIRITUAL ASPECTS OF LIFE
EXIST, BUT WHETHER PEOPLE
BELIEVE IT OR NOT IN
SPIRITUALITY, WHICH CAN ALSO BE
CONSIDERED SPIRITUAL INCLINA
INCLINATION, AFFECTS THE WAY
THEY FUNCTION AND THEIR HEALTH.
MIND AND BODY AND SPIRIT ARE
DIFFERENT ENTITIES, IMPLYING
THAT SPIRITUAL HEALTH SHOULD BE
THOUGHT OF IN A DIFFERENT
CATEGORY.
SO YOU CAN SEE THAT ONE WOULD
SAY IT SHOULD BE A SEPARATE
DOMAIN.
THEN THERE'S THIS ONE, SPIRITUAL
HEALTH -- REPRESENTS AN
INCREDIBLE VARIETY OF DOMAINS,
SPEAR TREUL STATES CAN LEAD TO
WELL-BEING AS WELL AS DISTRESS.
RECOGNIZING THE OTHER SIDE HERE.
SPIRITUALITY IS PART OF WHOLE
PERSON HEALTH, EMPHASIZED WITH
MENTAL HEALTH SERVICES.
AND SOME PRACTICES NCCIH IS
STUDYING ON WHOLE PERSON HEALTH
FROM SOME ASPECTS OF SPIRITUAL
PRACTICES.
AND THERE'S ALSO THIS OPINION
THAT SPIRITUALITY AS AN ELEMENT
IN WHOLE BODY HEALTH COULD BE
PROBLEMATIC, BUT INCLUDING IT AS
A COVARIATE THAT INFLUENCES
WHOLE BODY HEALTH MAY BE A
REASONABLE THING TO DO, AND
DESCRIBE HOW PEOPLE LIVE THEIR
LIVES.
SO AGAIN MOVING FORWARD, WHAT WE
ARE CONTINUING -- WE ARE
CONTINUING WORKING TOGETHER ON
ASPECTS OF THE CHARGE.
AND THERE'S A LOT THAT WE -- WE
STILL HAVE A LOT OF WORK TO DO,
AND THE PRELIMINARY OUTCOMES
THAT WE ARE ENDORSING OR WE ARE
GETTING CLOSE TO CONVENE ON IS
THAT IT NEEDS TO BE A STEP-WISE
APPROACH IN ALL OF US TO ASSESS
WHETHER OR NOT SPIRITUAL HEALTH
AND WELL-BEING SHOULD BE
CONSIDERED A DOMAIN OF WHOLE
BODY HEALTH.
AND AGAIN I THINK THERE'S --
WE'RE LEANING THAT IT MIGHT BE
BETTER THOUGHT OF INITIALLY AS A
COVARIATE RATHER THAN A FULL
DOMAIN, AND THIS IS PROBABLY THE
RECOMMENDATION FOR THE TIME
BEING THAT IT IS A COVARIATE AND
WE SHOULD MOVE TO INVESTIGATE IT
AS AN INTERVENTION, AND THEN WE
COULD DEFINE IT LATER ON AS A
SEPARATE WHOLE BODY HEALTH
DOMAIN.
AND AGAIN, WE RECOGNIZE THERE'S
BOTH POSITIVE AND NEGATIVE
EFFECTS OF SPIRITUALITY AND THAT
NEEDS TO BE KIND OF THOUGHT OF
VERY CAREFULLY.
SO THESE ARE THE PRELIMINARY
OUTCOMES OF THE GROUP, AND WE
ARE MOVING AHEAD, WE'LL CONTINUE
MEETING TO ADDRESS AS MANY OF
THESE CHARGES AS WE CAN, AND
COME OUT WITH A MORE FULL
RECOMMENDATION LATER ON FOR THE
NEXT COUNCIL MEETING.
SO THANK YOU FOR LISTENING.
>> WOW, THANK YOU SO MUCH.
I MEAN, THIS WAS SUCH A GREAT
SUMMARY OF WHAT I UNDERSTAND
HAVE BEEN REALLY DEEP
DISCUSSIONS.
AND I REALLY COMMEND YOU FOR
BEING ABLE TO REALLY GIVE US
THAT SORT OF STEP BACK, YOU
KNOW, I UNDERSTAND THAT
OBVIOUSLY YOU'RE JUST STARTING,
RIGHT, BUT I CAN SAY THAT THIS
IS REALLY WHAT WE WERE HOPING
THAT THIS COMMITTEE WOULD DO.
SO I REALLY WANT TO THANK YOU
PROFOUNDLY.
>> THANK YOU.
AND I WANT TO REALLY THANK THE
MEMBERS OF THE WORKING GROUP.
I'M PROBABLY THE ONE THAT KNOWS
THE LEAST ABOUT THIS TOPIC, AND
IT'S BEEN A TREMENDOUS
EXPERIENCE FOR ME TO LEARN, SO
THANK YOU, EVERYBODY.
>> SOUNDS LIKE -- SO I -- IT
SOUNDS LIKE YOU HAD ALSO A
VARIETY OF DIFFERENT
PERSPECTIVES IN THE GROUP, WHICH
I THINK IS VERY VALUABLE, RIGHT?
>> YES, VERY MUCH SO, AND LIS
LISTENING AND WE ARE STILL
DISCUSSING, AND THAT I THINK IS
EVIDENT FROM EVERY MEETING WE
HAVE HAD, THAT THE OPINIONS ARE
VERY DIVERSE.
AND I THINK IT'S A
REPRESENTATIVE -- YOU KNOW, WE
ARE ALSO A REPRESENTATIVE OF THE
POPULATION, SO TO SPEAK, RIGHT?
SO WE ARE TAKING THIS VERY
STEP-WISE AND HOPEFULLY WE CAN
CONVERGE ON YOUR OTHER VERY
IMPORTANT QUESTIONS TO ADDRESS.
>> WELL, I WANT TO OPEN THIS UP
TO DISCUSSION FROM THE REST OF
THE GROUP.
ANY COMMENTS, QUESTIONS,
REACTIONS?
>> THANKS.
THIS IS REALLY INTERESTING.
I WONDER IF YOU DISCUSSED AND IF
THERE'S A WAY OF DIVIDING UP THE
DIFFERENT FACETS.
SO THERE'S PERSONAL MEANING AND
TRANSCENDENCE, INTERPERSONAL,
THEN ENGAGING IN A SOCIAL
PRACTICE WITH OTHER PEOPLE WHO
MIGHT EVEN PHYSICALLY CARE FOR
ONE ANOTHER.
SO IT JUST OCCURRED TO ME
THERE'S DIFFERENT FACETS.
>> YOU'RE FAST FORWARDING.
WE HAVEN'T EVEN GOTTEN THERE
YET, BUT YES, THIS IS ON THE
PRACTICES AND, YOU KNOW,
ACTUALLY THE METRICS OF BEING
ABLE TO STUDY AND DEFINING THESE
THINGS, WE WILL HAVE TO LOOK AT
THESE PARTICULAR ENTITIES THAT
YOU ARE MENTIONING.
BUT WE'RE NOT THERE YET.
BY THE WAY, IF ANYBODY FROM THE
WORKING GROUP WANTS TO COMMENT,
YOU KNOW, IT SHOULDN'T JUST BE
ME.
I'M JUST SPEAKING FOR THE GROUP
AS CHAIR, BUT -- YEAH.
>> I'D JUST LIKE TO MAKE SOME
GENERAL COMMENTS.
I'M JUST VERY EXCITED ABOUT OUR
DISCUSSIONS THAT WE'VE HAD IN
THIS WORK GROUP.
I REALLY APPRECIATE ALL OUR
COLLEAGUES AND BEING ABLE TO
REALLY TALK ABOUT A SUBJECT
THAT'S COMPLEX AND HAS A LOT OF
DIFFERENT TYPES OF MEANINGS.
THANK YOU, DR. LANGEVIN, ALSO,
WHOLE PERSON HEALTH, THIS ALL
TIES IN NICELY AS WELL TO WHOLE
PERSON HEALTH, AND WITH NATIVE
AMERICAN PEOPLE SPEAKING -- I
CAN'T MAKE A DEFINITIVE
STATEMENT ON THIS BUT NATIVE
AMERICANS, YOU KNOW, ROUTINELY
INCLUDE SPIRITUALITY AS
RECOGNIZING THAT ROLE PART OF
OUR HEALTH AND WELL-BEING.
THAT CAN BE ANYTHING FROM NATIVE
AMERICAN TRADITIONAL PRACTICES
AND SPIRITUALITY TO RELIGIONS
AND EVERYTHING IN BETWEEN.
AND OUR ELDERS OFTEN EMPHASIZE
THAT WE ARE SPIRITUAL BEINGS AND
WHATEVER SPIRITUAL PRACTICES YOU
HAVE ARE EMPHASIZED AS BEING
SOMETHING YOU SHOULD -- OR
RECOMMENDED TO SEEK FURTHER AND
INCORPORATE INTO YOUR OWN
HEALTH.
SO JUST SOME GENERAL COMMENTS.
>> THANK YOU.
BEN.
>> I JUST WANT TO ECHO THE
THANKS TO YOU ALL FOR TA TAKINGT
ON, AND NOT THAT WE NEED MORE
EVIDENCE OF ITS IMPORTANCE, BUT
AS PART OF THE WORK WE'RE DOING
IN V.A. TO DEFINE A WELL-BEING
MEASUREMENT FRAMEWORK, WE DID A
NUMBER OF KIND OF FOCUS GROUPS
AND WHAT THEY CALL
HUMAN-CENTERED DESIGN
QUALITATIVE WORK THROUGH THE
VETERANS EXPERIENCE OFFICE WITH
GROUPS OF VETERANS, REALLY
DIVERSE GROUPS, DIFFERENT AGES,
DIFFERENT ETHNICS, DIFFERENT ALL
KINDS OF DIFFERENT BACKGROUNDS,
AND WE ASKED THEM TO RATE AS WE
WERE WORKING ON WHAT DOMAINS WE
WOULD INCLUDE IN THE WELL-BEING
MEASUREMENT FRAMEWORK, WE ASKED
THEM TO GIVE US THEIR SENSE OF
WHAT DOES IT MEAN TO THEM TO
HAVE A SENSE OF WHOLE PERSON
WELL-BEING AND MENTAL HEALTH,
PHYSICAL HEALTH AND SPIRITUAL
HEALTH WERE BASICALLY ALL TIED
AT THE TOP.
AND THEN OF COURSE THERE WAS
LOTS OF OTHER THINGS, SOCIAL
CONNECTION, ECONOMIC WELL-BEING,
SO THERE WAS A REAL -- WE WERE
ALSO DEBATING HOW TO INCLUDE
SPIRITUAL WELL-BEING IN OUR
FRAMEWORK, AND IT WAS QUITE
CLEAR FROM THE VETERANS VOICE
THAT THAT WAS CRUCIAL.
SO I THINK THERE'S JUST MORE AND
MORE MOUNTING EVIDENCE ABOUT THE
PEOPLE FEEL THAT WE CAN'T REALLY
LOOK AT WHOLE PERSON HEALTH
WITHOUT REALLY TACKLING THAT
AREA, SO THANK YOU.
>> AND I JUST WANTED TO -- THANK
YOU.
I JUST WANTED TO SAY, BEN, THAT
WE ARE USING THE V.A.
DOCUMENTATIONS AND THE PLATFORM
CREATED BY THE V.A. A LOT, YOU
KNOW, AS REFERENCE MATERIAL.
IT'S EXTREMELY IMPORTANT TO THE
GROUP.
>> FIRST I WANT TO JUST THANK
HELEN FOR DOING A REALLY NICE
SUMMARY OF THE WORKING GROUP'S
DISCUSSIONS AND ALSO FOR
CHAIRING THE SESSIONS.
IT'S BEEN A REALLY GOOD LEARNING
EXPERIENCE.
I HAD A QUESTION ABOUT THE -- I
THINK THERE WAS A CALL FOR
COMMENT FROM THE PUBLIC ABOUT
THIS ISSUE.
AND I JUST WONDERED IF ANYONE
COULD GIVE US A SUMMARY OF WHAT
KIND OF COMMENTS CAME IN, EITHER
NOW OR IF THAT WOULD BE OPEN TO
THE WORKING GROUP AT SOME POINT.
IS MARY BETH ON?
CAN MARY BETH COMMENT ON IT?
>> I JUST WANT TO POINT OUT,
IT'S ACTUALLY UPLOADED ON ECB,
ALL THE COMMENTS, SO IF YOU
DON'T GET ALL THE DETAILS, YOU
HAVE ACCESS TO ALL THE COMMENTS.
>> OKAY, THANK YOU.
>> I HAVE SEEN THEM, SO I WILL
SHARE WITH YOU ALL.
I APOLOGIZE FOR MISSING THAT.
>> OKAY, SO THAT'S -- I DIDN'T
KNOW IF MARRY BETH W MARY BETH E
A COMMENT ABOUT THAT, ABOUT THE
PROCESS OF GATHERING ALL THESE
COMMENTS OR --
>> NO, I HAVE NOTHING ADDITIONAL
TO ADD.
>> OKAY.
ALL RIGHT.
OTHER COMMENTS?
I HAVE A QUESTION.
>> GREAT JOB.
I SEE THE DEFINITION YOU HAVE
FOR SPIRITUALITY.
IS IT ALL ENCOMPASSING OR WILL
YOU BE TASKED TO COME UP WITH A
NEW DEFINITION?
AND IF SO, WOULD YOU ALSO BE
ABLE TO COME UP WITH A SCALE
THAT MEASURES SPIRITUALITY?
>> THE THOUSAND -- MILLION
DOLLAR QUESTION, I WOULD SAY.
BUT IN TERMS OF THE DEFINITIONS,
I MEAN, THIS IS -- I'VE
HIGHLIGHTED JUST ONE.
THERE'S MANY.
WE'RE NOT TASKED WITH COMING UP
WITH REINVENTING ANOTHER
DEFINITION OF SPIRITUALITY.
IN TERMS OF THE SCALE AND
METRICS, YOU KNOW, GETTING IN
DEEPER INTO ACTUALLY
INCORPORATING IT, YOU KNOW,
ADDRESSING THE CHARGE, WE ARE
GOING TO HAVE TO GO BACK AND
DELVE INTO THE LITERATURE AND
ALSO TO THE NEWER LITERATURE
HIGHLIGHTING DIFFERENT SCALES OF
THIS PHENOMENON IF WE WANT TO
CALL IT THAT.
BASED ON THE DEFINITION.
SO IT COMPLEX.
>> IT WOULD BE NICE TO SEE --
SOME LEVEL OF EVIDENCE TO
RECOMMEND BECAUSE THERE'S TOO
MUCH CONFUSION ABOUT WHAT
SCHEDULE SHOULD BE UTILIZED, S
SO -- FROM THIS GROUP I TOOK
QUITE A BIT.
>> VERY IMPORTANT.
>> SO MY QUESTION IS A LITTLE
BIT ABOUT SOMETHING THAT I THINK
MOTIVATED THIS FROM THE START,
IS THE IDEA THAT FROM THE POINT
OF VIEW OF RESEARCH, IF, FOR
EXAMPLE, EITHER SPIRITUAL HEALTH
OR WELL-BEING VERSUS SPIRITUAL
PRACTICES.
YOU COULD THINK OF THEM PERHAPS
IN TERMS OF INPUT AND OUTPUT
VARIABLES, RIGHT?
SO SPIRITUAL PRACTICE WOULD BE
THE INPUT VARIABLE OR THE
INDEPENDENT VARIABLE AND THEN
THE OUTCOME MIGHT BE SPIRITUAL
WELL-BEING OR HEALTH OR WHATEVER
ONE WE WANT TO CALL IT, AND THEN
ALL THE IDEAS, THERE COULD BE A
COVARIATE.
IT COULD BE SOMETHING THAT
INFLUENCES THE INPUT -- THE
OUTPUT OF A GIVEN EXPERIMENT,
THERAPY OR WHATEVER.
WHATEVER IT IS, INPUT, OUTPUT,
COVARIATE, WHATEVER, IT NEEDS TO
BE MEASURED.
IT NEEDS TO BE DEFINED AND
MEASURED AND EVERYTHING.
I'M JUST WONDERING WHETHER
THINKING ABOUT THAT IN A
RESEARCH SETTING MIGHT HELP
NARROW DOWN SOME OF THE
QUESTIONS, AND I DON'T KNOW, I'M
SURE YOU'VE PROBABLY STARTED
DISCUSSING THIS, RIGHT?
BUT I WAS CURIOUS ABOUT THE
COMMENT ABOUT USING SPIRITUAL
HEALTH OR SOMETHING AS A
COVARIATE, HOW WOULD THAT BE
DIFFERENT THAN USING IT AS AN
OUOUTCOME?
>> WELL, I THINK IT NEEDS TO BE
LOOKED AT FROM THE POINT OF VIEW
OF DOING THIS STEP WISE.
SO YOU HAVE ON THE WHOLE PERSON
HEALTH, YOU HAVE THE BIOLOGY,
YOU HAVE PSYCHOLOGY, YOU HAVE
BEHAVIOR AND ENVIRONMENT.
AND IN A WAY, YOU CAN THINK OF
THESE DIFFERENT FACTORS AS A
COVARIATE TOO, RIGHT?
ANYWAY, I MEAN, SOCIOECONOMICS,
ZIP CODE, THINGS LIKE THAT.
>> EXACTLY.
>> SO I THINK IT'S, AGAIN, THE
LANGUAGE HARMONIZATION THAT IS
IMPORTANT TO THE GROUP THAT WE
THINK OF IT AS A STEP-WISE
APPROACH, LET'S FIGURE OUT A WAY
TO MEASURE IT, THEN GO IN AND
LET'S SEE IF IT ACTUALLY HAS AN
EFFECT AS WERE YOU SAYING,
REGARDLESS OF WHAT PRACTICE WE
ARE TALKING ABOUT AND THEN MAYBE
INSERT IT AS A FULL DOMAIN ONCE
THAT --
>> MAYBE THE ISSUE OF THE DOMAIN
WAS PREMATURE.
>> I THINK THE GROUP FEELS THAT
THAT OTHER STEP NEEDS TO BE DONE
FIRST.
WE NEED BETTER MEASURES AND WE
NEED TO IMPLEMENT IT MORE
CAREFULLY, AND IF I'M NOT
REFLECTING THIS CORRECTLY,
PLEASE, THE WORKING GROUP IS
HERE, SO PLEASE FEEL FREE TO ADD
TO MY STATEMENT.
BUT THAT'S HOW I UNDERSTOOD IT.
>> YEAH, THAT'S ACCURATELY
REFLECTING IT.
WE'RE GRADUALLY BECOMING LESS
CONFUSED.
BUT IT'S BEEN AN INTERESTING
PROCESS.
BUT YEAH, THAT'S EXACTLY HOW IT
KIND OF --
>> BECAUSE WE STARTED WITH THAT.
SHOULD IT BE A DOMAIN?
BECAUSE THAT'S KIND OF WHAT THE
INPUT WE WERE GETTING FROM THE
COMMUNITY WAS, YOU MISSED -- WE
MISS SOMETHING.
THAT WAS THE INITIAL FEEDBACK
THAT WE HAD, RIGHT?
SO OKAY, WE MISSED SOMETHING.
ALL RIGHT.
AND THEN NOW WE'RE REALLY
LOOKING INTO WHAT EXACTLY ARE WE
MISSING, MAYBE PUTTING THAT
QUESTION ASIDE OF SHOULD IT BE
ITS OWN DOMAIN, AND REALLY
FOCUSING ON HOW CAN WE DEFINE,
MEASURE, UTILIZE IN RESEARCH,
THEN AFTER THAT HAS BEEN FIGURED
OUT, MAYBE THE DOMAIN QUESTION
WILL BECOME MORE CLEAR.
>> I THINK AND ALSO AS I SAID TO
BEN, WE REALLY ARE LEARNING A
LOT FROM WHAT'S GOING ON AT THE
V.A. TOO, BECAUSE I THINK IN A
WAY, THAT'S THE SAME KIND OF
STEP-WISE APPROACH, ALTHOUGH
MAYBE IT'S KIND OF INTEGRATED
QUICKLY -- I MEAN NOT QUICKLY
BUT IN THAT WHOLE BODY HEALTH
MODEL.
BUT I THINK THE GROUP WANTS TO
DO IT THIS WAY.
>> GOOD.
WELL, THAT'S GREAT.
THAT SOUNDS LIKE A GOOD
DEVELOPMENT, AND SHORT
PROGRESS -- I MEAN QUICK
PROGRESS, RIGHT?
>> HELEN?
>> THERE ARE MULTIPLE GROUPS
THAT ARE INVOLVED IN DEFINING
SPIRITUAL HEALTH AND WELL-BEING,
INCLUDING THE NIH GROUP, AND I
THINK IT WOULD BE IMPORTANT TO
SYNCHRONIZE OUR EFFORTS WITH
ESPECIALLY THE NIH AND THE V.A.
>> THAT'S RIGHT, THERE IS AN
NIH -- TRANS-NIH GROUP ON
SPIRITUAL -- SPIRITUALITY THAT'S
BEEN ONGOING FOR QUITE A WHILE.
THERE HAS NOT BEEN -- WE HAVE A
MEMBER OF THIS GROUP HERE.
>> WE HAVE BEEN TALKING ABOUT
IT.
THE GROUP PRIMARILY, THEY HAVE A
LOT OF SPEAKERS, SO WE'RE
LOOKING AT THOSE PRESENTATIONS
BUT THE GROUP HAS NOT STARTED
COMING OUT WITH THEIR OWN
RECOMMENDATIONS, SO FOR US IT'S
A GREAT RESOURCE TO JUST LOOK AT
WHAT PRESENTERS HAD THERE.
>> WE REALLY FELT THAT WE NEEDED
TO ADDRESS THIS ISSUE FROM THE
POINT OF VIEW OF NCCIH, BUT IT'S
NOT THAT WE'RE IGNORING WHAT'S
HAPPENING IN ALL OF NIH, AS A
MATTER OF FACT, WE HAVE A
REPRESENTATIVE OF NCCIH ON THAT
WORKING GROUP.
>> HI, THIS IS RUSSELL AGAIN
FROM THE CONSORTIUM OF HEALTH
AND -- PERFORMANCE.
SPIRITUALITY IS ONE WE HAVE IN
OUR HOLISTIC APPROACH TO
HEALTHCARE, AND IT'S AN ONGOING
DISCUSSION WE HAVE, AND ONE OF
THE THINGS WE HAVE COMING UP IS
NEXT JANUARY, WE'RE HAVING A
PSYCHOLOGICAL, SOCIAL AND
SPIRITUAL SUMMIT, WHICH WILL BE
IN ROCKLEDGE THAT WILL BE
BRINGING IN LOTS OF INDIVIDUALS
TO DISCUSS THIS VERY TO PICK.
TOPIC SO IF
PEOPLE ARE INTERESTED IN IT,
PLEASE LET US KNOW.
>> WONDERFUL.
IS THIS AN OPEN MEETING OR
CLOSED?
>> IT WILL BE OPEN.
>> OPEN MEETING?
GREAT.
>> YES, MA'AM.
>> SEND US THE COORDINATES.
WONDERFUL.
THANK YOU.
ANY OTHER THOUGHTS OR QUESTIONS?
>> JUST TO ADD ON, WE HAVE
BEEN -- THEY ALREADY STARTED
ALSO AND I'M JUST COMMENTING ON
THIS BECAUSE I'M SITTING AND
LISTENING TO IT, THEY HAVE
ALREADY DONE A GREAT JOB LOOKING
AT THINGS LIKE OUT COME
MEASURES.
THE GROUP DIDN'T FEEL THEY WERE
READY, SO -- BUT THIS IS -- IT
IS COMING SO IT IS ON
EVERYBODY'S MIND, AND WE'RE ALSO
TRYING TO REACH OUT TO SOME
EXPERTS IN THE AREA TO GET SOME
ADDITIONAL FEEDBACK FOR WHAT
THEY ARE DOING THERE.
>> AND TO HIGHLIGHT HELEN'S
COMMENT, IT IS REALLY IMPORTANT
THAT WE INTEGRATE -- WE'RE NOT
REINVENTING SOMETHING, BUT
AGAIN, WE ARE GETTING SOME OF
THESE SPEAKERS FROM THE NIH
GROUP TO COME AND PRESENT TO US.
THAT IS THE GOAL FOR THIS NEXT
PHASE.
>> DEPENDING ON HOW WELL THINGS
GO, WE MAY HAVE ANOTHER UPDATE
IN SEPTEMBER OR LATER, DEPENDING
ON -- WHENEVER IT'S READY AND --
READY TO GO.
SO WE ARE SO THANKFUL.
SO THANK YOU AGAIN.
ALL RIGHT.
SO, NOW WE ARE -- ARE WE A
LITTLE AHEAD OF SCHEDULE?
JUST A LITTLE BIT.
>> A FEW MINUTES.
BUT I THINK WE'LL STICK WITH THE
SCHEDULE.
>> NOBODY MINDS HAVING A FEW
EXTRA MINUTES?
>> NOBODY IS UPSET WE'LL HAVE 10
MINUTES MORE FOR LUNCH BREAK.
>> SO WE ARE GOING TO RECONVENE
NOW AT --
>> 1:50.
>> OKAY, LET'S GET STARTED
AGAIN.
WELCOME BACK, EVERYBODY, FROM
LUNCH.
GLAD TO SEE EVERYBODY MADE IT
BACK.
GOOD.
LET'S CONTINUE, AND I'M HANDING
THIS OVER TO YOU, HELENE, FOR
INTRODUCING OUR NEXT SPEAKER.
>> WELCOME BACK.
THANK YOU.
WE'RE GOING TO BE HAVING TWO
PRESENTATIONS FROM THE NCCIH
OFFICE OF POLICY PLANNING AND
EVALUATION.
THE FIRST ONE WILL BE FROM
DR. ANGELA ARENSDORF, HEALTH
SCIENCE POLICY ANALYST, WHO WILL
SHARE AN ANALYSIS OF NCCIH'S
PORTFOLIO WITH A WHOLE PERSON
HEALTH RESEARCH FOCUS.
>> SO I'M GOING TO GIVE A A SHOT
PRESENTATION, AND THEN WHAT WE
REALLY WANT IS TO HAVE A LIVELY
DISCUSSION ABOUT THE PORTFOLIO
AND THE NEW BUSINESS OF
VISUALIZATION, SO I'M HOPING TO
LEAVE LOTS OF TIME FOR THAT.
SO WHY AM I TALKING TO YOU
TODAY?
IT'S BECAUSE WE ARE STARTING TO
THINK ABOUT OUR NEXT STRATEGIC
PLAN.
FOR THOSE OF YOU WHO ARE NEW AND
DON'T THINK ABOUT THIS DOCUMENT
ALL THE TIME LIKE WE DO, IT IS A
CONGRESSIONALLY MANDATED
DOCUMENT THAT WE HAVE TO PREPARE
EVERY FIVE YEARS, WE UPDATE IT.
WE GO THROUGH A LONG PUBLIC
COMMENT PROCESS IN WHICH WE GET
INPUT FROM NOT ONLY OUR NCCIH
STAFF BUT STAKEHOLDERS AND
SCIENTIFIC ADVISORS IN THE
GENERGENERAL PUBLIC.
THROUGH THIS DOCUMENT, WE SET
THE STRATEGIC PRIORITIES OR WHAT
WE CONSIDER OUR STRATEGIC
PRIORITIES TO HELP ADVANCE OUR
OVERALL MISSION AT NCCIH.
AND EVERY TIME WE DO THIS, EVERY
TIME WE START ON THIS PROCESS,
WE DO EXTENSIVE PORTFOLIO
ANALYSES, AND THE TWO QUESTIONS
THAT WE'RE ALWAYS TRYING TO
ADDRESS ARE WHERE ARE THE
POTENTIAL GAPS IN OUR PORTFOLIO,
AND WHAT SHOULD OUR STRATEGIC
PRIORITIES BE.
SO AS DR. LANGEVIN HAS SHOWN AND
YOU'VE SEEN THIS MANY TIMES
TODAY, NCCIH HAS A LOT OF
INTEREST AREAS.
AND SO WE'RE TALKING ABOUT
THESE, AND WHAT WE KNOW IS THAT
THESE AREAS TEND -- ARE VERY --
THE RESEARCH THAT WE SUPPORT
THESE AREAS ARE VERY INTEGRATED
WITHIN THEM.
SO THE QUESTION IS, HOW CAN WE
NOT ONLY VIEW THE PORTFOLIO
ACROSS ALL OF THESE INTEREST
AREAS, BUT REALLY CAPTURE THAT
INTEGRATIVE NATURE OF THE
PORTFOLIO.
AND THEN IDEALLY BE ABLE TO
TRACK THIS INTEGRATIVE NATURE
OVER TIME.
SO THIS GETS -- I'M SURE YOU CAN
APPRECIATE, THIS GETS VERY
COMPLICATED VERY, VERY QUICKLY,
AND SO WE DECIDED TO SEE IF WE
COULD VISUALIZE OUR PORTFOLIO
USING A NETWORK MAP.
AND SO THIS IS THE BEAUTIFUL
NETWORK MAP, WHICH BASICALLY
THAT'S THE MAP YOU'RE GOING TO
BE SEEING THROUGHOUT THE WHOLE
PRESENTATION.
SO WHAT THIS MAP IS SHOWING IS,
IT'S REALLY A SNAPSHOT IN TIME
OF OUR FY -- OUR FISCAL YEAR
2023 EXTRAMURAL RESEARCH
PORTFOLIO.
TO AR YENT YOU, EACH OF THOSE
LITTLE DOTS YOU SEE ARE A GRANT
THAT WE EITHER ADMINISTERED OR
FUNDED.
THE GREY BOXES ARE THOSE -- THE
FIVE WHAT WE CALL THE WHAT
THEMES, THE COLORED DOTS THAT
YOU SAW ON THE PREVIOUS SLIDE.
THE GREY LINES CONNECTING THE
DOTS TO A THEME IS A CONNECTION,
IT'S ESSENTIALLY SAYING THAT
GRANT HAS SOME -- TOUCHES SOME
ASPECT OF THAT THEME, AND THEN
THE DOTS ARE COLOR-CODED BY HOW
MANY OF THOSE THEMES THEY TOUCH.
SO JUST BY LOOKING AT IT, YOU
CAN SEE ONE THEME, TWO THEMES,
THREE THEMES, FOUR THEMES, AND
WE HAVE NO FIVE THEMES.
SO THIS IS VERY HELPFUL IN
TAKING A VERY COMPLEX
INTERACTION AND DISTILLING IT
DOWN TO SOMETHING THAT YOU CAN
VISUALLY APPRECIATE.
ANOTHER THING TO ORIENT YOU IS
THE POSITION OF THE GRANTS ARE
IMPORTANT.
YOU CAN IMAGINE THAT THERE'S A
TUG OF WAR HAPPENING BETWEEN THE
DIFFERENT THEMES AND THE RESULT
OF THAT TUG OF WAR IS WHERE THE
DOT ENDS UP.
THIS IS -- SO JUST BY LOOKING AT
IT, YOU GET A SENSE OF WHAT
THEMES A GRANT PARTICIPATES IN.
YOU ALSO SEE LOTS OF CLUSTERS.
THE CLUSTERS ARE IMPORTANT
BECAUSE THE CLUSTERS ARE TELLING
YOU THAT ALL OF THOSE GRANTS ARE
TOUCHING THE SAME THEMES, AND SO
YOU GET A SENSE OF THE
SATURATION OR HOW MUCH ARE WE
INVESTING IN CERTAIN AREAS -.
SO THERE'S A LOT OF INFORMATION
IN THIS THAT WE CAN DISCUSS.
ONE THING -- I'M NOW GOING TO
SHOW YOU SOME EXAMPLES OF THESE
CLUSTERS OF HOW THEY -- HOW THEY
ARE HELPFUL IN NOT ONLY
VISUALIZING THE PORTFOLIO BUT
ALSO GROUPING LIKE THINGS
TOGETHER AND MAKING IT EASIER TO
IDENTIFY GAPS AND POTENTIAL
OPPORTUNITIES.
SO FIRST THIS CLUSTER RIGHT HERE
ARE GRANTS THAT -- THIS CLUSTER
IS REPRESENTED BY GRANTS THAT
FALL WITHIN THE NUTRITION AND
NATURAL PRODUCTS THEME.
I'VE PICKED OUT ONE GRANT THAT
IS PRESENT WITHIN THIS CLUSTER,
AND YOU CAN SEE FROM IT THAT IT
IS FOCUSING ON A NATURAL
PRODUCT.
IT IS EVALUATING THE
PHARMACOLOGY, THE SYNTHESIS AND
TARGET ASSIGNMENT ASSOCIATED
WITH THAT NATURAL PRODUCT.
LOOKING AT THIS, I HOPE YOU CAN
APPRECIATE THAT IT CLEARLY IS A
PURE NATURAL PRODUCTS GRANT.
IT REALLY DOESN'T SEEM TO HAVE
MUCH OVERLAP WITH OTHER -- THE
OTHER THEMES.
SO COMPARE THAT WITH THIS
CLUSTER, WHICH INTEGRATES THE
MIND-BODY CONNECTION WITH PAIN
AND PAIN MANAGEMENT, AND AGAIN,
I'VE PULLED OUT A GRANT FOR YOU
HERE.
THIS ONE IS LOOKING AT
MINDFULNESS AND THE CONNECTION
BETWEEN MINDFULNESS AND PAIN
MANAGEMENT.
I HAVE A THIRD CLUSTER, IF I CAN
ADVANCE.
THERE WE GO.
THIS CLUSTER IS AN INTEGRATION
OF WHOLE PERSON RESEARCH,
NATURAL PRODUCTS, NUTRITION,
PAIN AND PAIN MANAGEMENT.
THERE'S A LOT GOING THERE.
SO THE GRANT I SELECTED HERE IS
A MULTISYSTEM INVESTIGATION.
FOCUSING ON CANNABINOIDS, AND
THEIR INPUT -- THEIR INFLUENCE
ON PAIN AND INFLAMMATION.
YOU CAN SEE THAT THIS GRANT IS
VERY DIFFERENT FROM THE PREVIOUS
NATURAL PRODUCTS GRANT THAT I
SHOWED YOU, AND THIS IS EVIDENT
BY THE FACT THAT IT IS IN TWO
VERY DIFFERENT PLACES IN THE
MAP, SO THIS MAP ALLOWS YOU TO
SORT AND IDENTIFY THESE UNIQUE
TYPES OF GRANTS.
THE LAST EXAMPLE THAT I WANT TO
SHOW YOU, THIS IS AN EXAMPLE OF
A CLUSTER THAT INTEGRATES FOUR
THEMES, AND AGAIN, THIS IS VERY
DIFFERENT FROM THE GRANTS I'VE
SHOWN YOU BEFORE.
EVEN THOUGH IT TOUCHES ON MANY
OF THE SAME THEMES THAT WE HAD
BEFORE.
SO I WENT THROUGH THAT VERY
QUICKLY BECAUSE I WANT TO FOCUS
ON THE DISCUSSION, SO JUST TO
WRAP UP, I HOPE I'VE CONVINCED
YOU THAT THE NETWORK MAPPING IS
A GOOD WAY TO VISUALIZE THE
INTEGRATIVE NATURE OF OUR
PORTFOLIO.
IT ALLOWS US TO SORT LIKE GRANTS
AND IT PROVIDES A NEW WAY FOR US
TO IDENTIFY GAPS AND
OPPORTUNITIES WITHIN OUR
PORTFOLIO.
WHAT IT HAS SHOWN US SO FAR IS
THAT OUR PORTFOLIO IS
PREDOMINANTLY INTEGRATED, WHICH
WE SUSPECTED BUT NOW WE HAVE
DATA TO BACK IT UP.
WITH THE MAJORITY OF THE GRANTS
THAT WE HAVE FUNDED COVERING TWO
OR MORE THEMES.
SO WITH THAT, I WILL TAKE
QUESTIONS AND OPEN IT UP FOR
DISCUSSION.
>> I HAVE A QUESTION.
OH, GO AHEAD.
>> NO, YOU FIRST.
>> ALL RIGHT.
I REALLY LIKE THAT VISUALIZATION
A LOT ACTUALLY.
IT'S A WONDERFUL GRAPH.
I THINK IT SERVES US A LOT.
I'M WONDERING HOW YOU DEFINE
WHOLE PERSON EXACTLY, BECAUSE
MAYBE BY DEFINITION, IT CAN MEAN
A LOT OF THINGS.
MAYBE IT'S NOT WHOLE, WHOLE
PERSON BUT MAYBE FOR NOW MAYBE
IT'S MULTISYSTEM OR -- YEAH, HOW
DO YOU CATEGORIZE THINGS?
>> SO WE'VE SPENT A LOT OF TIME
TALKING ABOUT THIS.
AND THE WAY THAT THE CODING ON
THIS WORKS IS THAT WE CODE
SUBAREAS AND THEN BY DEFINITION
THOSE ROLL UP TO HIGHER AREAS,
AND SO THEN THE THEME IS A
GROUPING OF SMALLER AREAS.
AND THE SMALLER AREAS THAT WE
HAVE FOR WHOLE PERSON RESEARCH
ARE INTEGRATIVE MULTISYSTEM
INVESTIGATIONS, SO THAT
ESSENTIALLY MEANS THAT WE'RE
LOOKING AT ONE OR MORE BODY
SYSTEM OR THE WHOLE PERSON
DOMAINS INTERACTING OR
INFLUENCING EACH OTHER.
THE OTHER IS MULTISYSTEM
THERAPEUTIC OUTPUTS, SO NOW YOU
NEED TO HAVE AN INTERVENTION AND
THEN YOU'RE LOOKING AT THE
EFFECTS IN TWO OR MORE SYSTEMS
OR DOMAINS.
WE HAVE MULTICOMPONENT
INTERVENTIONS, SO INTERVENTIONS
THAT ARE STUDYING TWO OR MORE
THINGS AND THEY CAN EITHER BE
INFLUENCING -- LOOKING AT THE
IMPACT ON MULTIPLE SYSTEMS OR
JUST THE INTERACTION BETWEEN THE
TWO.
AND THEN THIS IS ALSO WHERE WE
PUT THE TRADITIONAL, TRADITIONAL
WHOLE HEALTH SYSTEMS.
SO ANY OF THOSE IS WHAT WE'RE
CALLING WHOLE PERSON RESEARCH.
AT LEAST FOR THIS ANALYSIS.
>> WE STRUGGLE SOMETIMES WITH
THE WORD WHOLE PERSON, AS YOU
POINTED OUT.
BECAUSE SOMETIMES IT'S EASIER TO
CONCLUDE, OH, IT HAS TO BE ABOUT
THE WHOLE PERSON.
IT'S REALLY INTEGRATIVE.
IT'S TOWARDS UNDERSTANDING THE
WHOLE PERSON.
AND THAT'S THE WAY WE'VE DEFINED
IT ALL ALONG, IS YOU CAN PUT TWO
OR MORE PIECES OF A PUZZLE
TOGETHER TOWARDS UNDERSTANDING
THE WHOLE PUZZLE.
>> DR. HANEY.
>> I ALSO REALLY LIKED THAT
VISUALIZATION.
YOU MIGHT HAVE MENTIONED IT, BUT
WHAT WAS IN THE OTHER CATEGORY?
IT LOOKED LIKE YOU HAD A LOT.
>> I DID NOT MENTION THE OTHER
CATEGORY, BUT IF YOU REMEMBER
ALL OF THOSE DOTS -- NOT THE
NETWORK DOTS BUT THE BUBBLES
THAT WE STARTED WITH, WE HAD
WORKFORCE DEVELOPMENT AND WE HAD
DATA METHODS AND THINGS LIKE
THAT.
WHAT IS IN THAT REALLY
REPRESENTS THOSE THINGS, SO IT'S
DIVERSITY PROGRAMS, IT'S
TRAINING THAT DOESN'T HAVE
NECESSARILY A RESEARCH FOCUS
THAT FALLS INTO ONE OF THE OTHER
BUCKETS.
>> OKAY, SO THAT WILL FEED INTO
WHAT'S MISSING CATEGORIES?
>> RIGHT, RIGHT.
>> OKAY.
>> YES.
>> I ALSO LIKE THAT
VISUALIZATION A LOT.
YOU MENTIONED USING TO FOLLOW
CHANGES OVER TIME.
HAVE YOU DONE THAT
RETROSPECTIVELY AND SEEN HOW
THINGS CHANGED OVER THE LAST
FIVE YEARS WITH THE INTRODUCTION
OF WHOLE PERSON HEALTH AS A --
>> I HAVE DABBLED.
WE DON'T HAVE ANYTHING OFFICIAL
YET, PARTLY BECAUSE WE'VE BEEN
REALLY DECIDING HOW WE'RE GOING
TO DEFINE EVERYTHING.
BUT WE HAVE SEEN SHIFTS.
I'VE LOOKED AT 2018 AND 2019.
WE'VE SEEN SHIFTS BUT WE'RE NOT
READY TO PRESENT THAT OR -- BUT
YES, IT IS SOMETHING WE COULD
TRACK OVER TIME.
>> I THINK IT'S REALLY
FASCINATING AND I LOVE THE
OPPORTUNITY TO VISUALIZE SORT OF
WHAT WE'VE FELT HAPPENING.
AND FROM A VISUAL PERSPECTIVE,
IT'S INTERESTING HOW IT SEEMS AS
THOUGH THERE'S SORT OF A LESS
BUILT UP PART, AND SO THE
TEMPTATION IS TO SAY THAT
THERE'S A GAP THERE, BUT THEN I
RECOGNIZE THAT NOT ALL OF THOSE
CIRCLES ARE NECESSARILY EQUAL,
AND I WONDER IF THERE MIGHT BE
FURTHER VISUAL ANALYTICS YOU
COULD USE TO QUANTIFY, FOR
INSTANCE, WHOLE PERSON HEALTH IS
QUITE DIFFERENT FROM A
REDUCTIONISTIC NATURAL PRODUCT
APPROACH, OR GRANT OR PROJECT OR
SOMETHING LIKE THAT, SO I'M
STRUSTRUGGLING A LITTLE BIT WITH
BEAUTY OF THE VISUAL SORT OF
OPPORTUNITY, BUT WANTING TO BE
CAREFUL TO MATCH IT WITH THE
CONTENT.
>> AND I THINK IT'S IMPORTANT TO
REMEMBER THAT THIS ISN'T ONLY
ANALYSIS WE'LL DO WHEN WE'RE
STARTING TO EVALUATE THE
PORTFOLIO.
WHAT I THINK THIS DOES REALLY
WELL IS MAKING IT EASY FOR YOU
TO SEE WHICH AREAS DO WE HAVE A
LOT OF GRANTS IN, I MEAN, WE CAN
CUT AND DICE THE DATA AND REALLY
GET DOWN INTO OKAY, WELL, IN
THIS CLUSTER, WHAT TYPE OF
GRANTS ARE WE TALKING ABOUT, OR
THINGS LIKE THAT, BUT IT'S NOT
OUR ONLY TOOL, BUT IT IS HELPFUL
IN VISUALIZING THOSE COMPLEX
INTERACTIONS AND ASKING HOW MUCH
ARE WE REALLY INVESTING IN THIS
SPECIFIC AREA.
>> YOU MENTIONED AN EXAMPLE,
RIGHT, OF A NATURAL PRODUCTS
GRANT THAT WOULD BE KIND OF IN
ITS OWN KIND OF BUBBLE, BUT AS I
MENTIONED IN MY PRESENTATION,
WE'RE REALLY LOOKING TO MOVE OUR
PORTFOLIO IN AN INTEGRATIVE
DIRECTION.
SO YOU WOULD EXPECT THAT IN THE
FUTURE YEARS, YOU MIGHT SEE MORE
NATURAL PRODUCTS GRANTS THAT
WOULD BE CONNECTED TO OTHER
THINGS.
LIKE RESILIENCE, LIKE WE ARE
DOING SOME OF THAT.
SO, YOU KNOW, THAT'S THE IDEA,
IS THAT OVER TIME, YOU WOULD
EXPECT TO SEE MORE OF THESE
GRANTS ENDING UP IN THE MIDDLE
OF THE THING BUT WE DON'T KNOW.
WE'LL HAVE TO SEE IF THAT
ACTUALLY HAPPENS, RIGHT?
DEPENDS WHAT GRANTS PEOPLE SEND
US.
DO YOU WANT TO RESPOND TO THAT
POINT OR --
>> YEAH, I KIND OF DID, BUT --
>> I JUST WANTED TO ADDRESS THE
NATURAL PRODUCTS AND
REDUCTIONIST RESEARCH.
THAT IS PART OF IT, BUT OF
COURSE WITH NATURAL PRODUCTS
BEING MULTICOMPONENT MIXTURES
WHICH COULD HAVE MULTIPLE
EFFECTS, I THINK THERE'S NO
REASON WHY A NATURAL PRODUCTS
PRODUCT RESEARCH SHOULD ALSO NOT
ADDRESS WHOLE PERSONAL HEALTH.
>> YOU COULD SEE THAT IN THE
NETWORK MAP.
NOT ALL OF THE NATURAL PRODUCTS
GRANTS WERE SINGLE.
WE HAD THEM TOUCHING ALL OF THE
DIFFERENT --
>> ABSOLUTELY, RIGHT.
>> THE ONLY THING I WANT TO NOT
LOSE SIGHT OF IS THAT THERE IS A
TIME AND A PLACE WHEN ONE HAS TO
DO THAT FIRST.
AND BEFORE YOU CAN DO AN
INTEGRATED APPROACH, YOU HAVE TO
GET IN AND UNDERSTAND A
MECHANISM OF SOMETHING BEFORE
YOU CAN TAKE TO THE NEXT LEVEL,
AND PARTICULARLY NATURAL
PRODUCTS AND EVEN SOME OF THE
NON-PHARMACOLOGICAL TREATMENTS,
WE NEED TO UNDERSTAND THAT
BEFORE WE CAN START SAYING WELL,
WE NEED TO FOLLOW THIS WHOLE
PERSON APPROACH.
SO THERE'S -- I DON'T WANT TO
LOSE SIGHT OF THOSE -- IN ANY
WAY.
>> -- EVEN IN THE END.
>> YEAH, AND WHILE IT'S
IMPORTANT, WE JUST NEED TO KEEP
IN MIND THAT THERE'S SOME REAL
BASIC STUFF THAT STILL HAS TO BE
DONE IN ORDER TO MOVE SCIENCE
FORWARD.
>> I UNDERSTAND THAT.
>> OTHER COMMENTS, THOUGHTS,
QUESTIONS?
COMPLAINTS?
PEOPLE LIKE THIS?
WE'RE EXCITED ABOUT IT.
I MEAN, WE'VE BEEN WORKING ON
THIS FOR MANY YEARS NOW, AND IT
SEEMS, YOU KNOW, IN TERMS OF
PLAYING AROUND WITH THESE TYPES
OF NETWORK GRAPHS, IT SEEMS LIKE
WE'VE KIND OF ARRIVED SOMEWHERE
WHERE WE NOW HAVE A TOOL THAT WE
CAN USE AND THE FACT THAT THIS
IS NOW THE BEGINNING OF OUR
STRATEGIC PLAN IS A NICE -- NICE
TIMING, EXACTLY.
SO THANK YOU, ANGELA, FOR DOING
THIS IMPORTANT WORK.
SO OUR NEXT -- SPEAKING OF EXTRA
STRATEGIC PLAN, OUR NEXT SPEAKER
IS MS. MARY BETH KESTER, WHO IS
DIRECTOR OF OUR POLICY OFFICE
AND WHO WILL UPDATE US ON THE
STRATEGIC PLANNING PROCESS THAT
WE WILL BE KICKING OFF THIS
YEAR.
MARY BETH.
>> THANK YOU.
SORRY I CAN'T BE THERE WITH YOU
IN PERSON TODAY.
CAN YOU ALL SEE MY SCREEN?
OH KAY.
OKAY.I WILL BE SUPER BRIEF WITHY
ONE SLIDE.
SO JUST TO GIVE YOU AN IDEA OF
THE TIMELINE WE HAVE COMING UP.
OUR CURRENT PLAN GOES THROUGH FY
25.
SO WE ARE WORKING RIGHT NOW
INTERNALLY WITH OUR DUR STAFF
AND SENIOR STAFF TO DO THE
PORTFOLIO ANALYSIS THAT ANGELA
JUST SHOWED YOU AND THINK
THROUGH OUR HIGH PRIORITY
RESEARCH TOPICS.
WE WILL BE PUTTING OUT AN RFI
PROBABLY IN THE FALL, SOMETIME
SEPTEMBER THROUGH NOVEMBER FOR
THE COMMUNITY JUST TO GET
PEOPLE'S THOUGHTS ON THE CURRENT
PLAN AND WHERE WE MIGHT HAVE
SUCCEEDED OR FAILED AND WHAT ARE
THE GAPS AND OPPORTUNITIES THAT
WE SHOULD LOOK AT AND THINK
ABOUT, AND THEN OUR PLAN IS TO
POST A DRAFT PLAN TO THE NCCIH
WEBSITE IN AUGUST OF NEXT YEAR,
AND OPEN THAT UP FOR PUBLIC
COMMENT ON THE DRAFT, AND THEN
HAVE THE FINAL PLAN COMPLETED IN
EARLY 2026.
AND YOU ALL WILL BE HEARING
ABOUT THIS --
[SPEAKER FROZEN]
[PLEASE STAND BY]
>> SO I GUESS I CAN FINISH.
BASICALLY JUST GOING THROUGH
THIS AGENDA, YOU CAN SEE THAT
OUR TIMELINE IS BASICALLY TO GET
US TO A DRAFT POSTED A YEAR FROM
AUGUST.
SO WE HAD ESSENTIALLY A YEAR TO
DIGEST ALL THE INFORMATION THAT
WE'RE GOING TO EITHER COLLECT
OURSELVES OR -- AND THAT WE'RE
GOING TO GATHER FROM -- OH,
YOU'RE BACK, MARY BETH.
>> SORRY ABOUT THAT.
>> I WAS PITCH HITTING FOR YOU.
>> SORRY ABOUT THAT.
DID YOU HEAR THE TIMELINE?
>> NO -- WELL, YOU WERE
PARTLY -- PARTWAY THROUGH IT.
>> OKAY.
>> YOU WERE IN AUGUSTA.
>> I'LL PUT IT BACK UP THERE.
SO YES, WE'LL POST THE DRAFT
PLAN IN AUGUST OF NEXT YEAR AND
HAVE PUBLIC COMMENT PERIOD, AND
THEN HOPEFULLY WE'LL HAVE THE
FINAL PLAN COMPLETED IN EARLY
2026, AND YOU ALL WILL HAVE
PLENTY OF OPPORTUNITY TO COMMENT
ON EVERYTHING THROUGH THE
PROCESS AND HEAR ABOUT IT AT ALL
THE COUNCIL MEETINGS BETWEEN NOW
AND JANUARY OF 2026.
SO HOPEFULLY I DID NOT FREEZE
THAT TIME.
>> THANK YOU.
SO ANY QUESTIONS ABOUT THAT
PROCESS?
PRETTY STRAIGHTFORWARD.
WONDERFUL.
ALL RIGHT.
THANK YOU, MARY BETH.
SO WE'RE AHEAD OF SCHEDULE AND
WE THOUGHT THAT SINCE SOME OF
YOU AND MOST OF YOU HAVE PLANES
TO CATCH, WE COULD JUST KEEP
GOING IN OUR PROGRAM, RIGHT?
WE'RE NOT GOING TO HAVE IT, WE
DON'T NEED A BREAK NOW, WE JUST
CAME BACK FROM LUNCH.
SO WE WILL KEEP GOING.
WAIT A MINUTE, WHO'S NEXT?
>> YOU ARE.
>> ME?
OH, IT'S ME.
OKAY.
I AM GOING TO BE NOW TALKING
ABOUT -- THANK YOU.
SOME PRETTY EXCITING CHANGES.
I ALREADY ALLUDED TO THOSE IN MY
DIRECTOR'S REPORT ON THE HEAL
INITIATIVE.
SO IF I COULD PLEASE HAVE THE
SLIDES.
SO AS MOST OF YOU I'M SURE ARE
AWARE, THE HEAL INITIATIVE IS A
VERY IMPORTANT PROGRAM THAT WE
ARE VERY MUCH INVOLVED IN AT
NCCIH.
ONE OF THE REASONS IS, PRETTY
OBVIOUS, THAT HEAL IS -- IT
STANDS FOR HELP TO END ADDICTION
LONG TERM.
SO THE HEAL PROGRAM WAS
ORIGINALLY CREATED IN RESPONSE
TO THE OPIOID CRISIS, AND AS WAS
EVIDENT FROM THE START, IT WAS
AT THE BEGINNING, ANYWAY, OF
THIS KIND OF OPIOID OVERDOSE
EPIDEMIC THAT WE HAD, A LOT OF
IT WAS DRIVEN BY PRESCRIPTIONS
FOR OPIOIDS.
NOW OF COURSE THIS SITUATION
WITH THE OPIOID OVERDOSES HAS
EVOLVED GREATLY SINCE THEN.
NOW WE HAVE -- HAVE HAD VARIOUS
WAVES OF DIFFERENT -- WITH
HEROIN AND NOW FENTANYL AND
OTHER TYPES OF STIMULANTS, AND
IT JUST KEEPS CHANGING.
HOWEVER, THE PROBLEM THAT
STARTED THIS WHOLE THING IS PAIN
MANAGEMENT.
WHICH HAS CONTINUED.
SO EVEN THOUGH THE PRESCRIPTION
OF OPIATES BY VARIOUS TYPES OF
HEALTHCARE PROVIDERS HAS
STABILIZED, IT STILL REMAINS TOO
HIGH.
SPECIFICALLY THERE IS NOT ENOUGH
UTILIZATION OF NON-ADDICTIVE AND
ESPECIALLY NON-PHARMACOLOGICAL
METHODS THAT WE KNOW ARE
EFFECTIVE, AND SO IT'S REALLY A
PROBLEM STILL.
SO THIS IS WHY THE HEAL
INITIATIVE WAS ORIGINALLY
CREATED.
AT ITS BEGINNING.
SO THIS WAS A LARGE INITIATIVE
THAT WAS OF THE ORDER OF HALF A
BILLION DOLLARS A YEAR.
IT WAS -- INITIALLY THE -- THIS
WAS A PROGRAM THAT WAS SET UP
WITHIN THE OFFICE OF THE NIH
DIRECTOR.
AT THE TIME.
DR. COLLINS' OFFICE WAS RUNNING
IT.
EVEN THOUGH RIGHT FROM THE
BEGINNING, THE MONEY WAS
ACTUALLY APPROPRIATED TO TWO
SPECIFIC INSTITUTES, THE
NATIONAL INSTITUTE OF DRUG
ABUSE, NIDA, FOR THE OPIATE
PART, AND THE OPIOID USE
DISORDER PART AND THE NATIONAL
INSTITUTE OF NINDS, NEUROLOGICAL
DISEASES AND STROKE, FOR THE
PAIN.
THE PROGRAM WAS RUN LIKE THIS
FOR A NUMBER OF YEARS, VERY
SUCCESSFULLY.
AND THIS YEAR, EARLIER THIS
YEAR, THE DECISION WAS MADE THAT
IT WAS TIME TO MOVE THE PROGRAM
OUT OF THE OFFICE OF THE
DIRECTOR.
AND THIS HAPPENS, A LOT OF TIMES
PROGRAMS THAT GERMINATE
ESSENTIALLY THAT ARE STARTED OUT
AT THE OFFICE OF THE DIRECTOR
EVENTUALLY MIGRATE TO THEIR
INSTITUTES THAT WERE THERE MORE
APPROPRIATELY LOCATED.
SO THIS IS WHAT'S HAPPENING
RIGHT NOW.
IT STARTED HAPPENING BACK IN
SEPTEMBER OF LAST YEAR.
THE SITUATION IS DIFFERENT FOR
THE OPIOID USE DISORDER AND THE
PAIN.
BECAUSE NIDA IS THE ONE
INSTITUTE AT NIH THAT
ESSENTIALLY IS DEDICATED TO THE
STUDY OF OPIOID USE DISORDER,
THE OUD, AS WE CALL IT, PART OF
IT RESIDES AT NIDA, IS REALLY
ADMINISTERED BY NIDA.
WITH PAIN, THOUGH, BECAUSE WE
HAVE A LARGE NUMBER OF
INSTITUTES AND CENTERS AT NIH,
WHO ARE INVOLVED IN PAIN
RESEARCH, NOT JUST ONE, WE
DECIDED THAT IT WAS BETTER TO
HAVE A STRUCTURE, AN
ADMINISTRATIVE STRUCTURE THAT
WAS MORE DISTRIBUTED, OF ALL THE
INSTITUTES AND CENTERS THAT HAVE
AN INTEREST IN PAIN RESEARCH
WOULD BE ESSENTIALLY INVOLVED IN
THE ACTUAL ADMINISTRATION OF THE
HEAL PROGRAM.
SO THIS IS WHAT'S HAPPENING AND
THIS HAS ALREADY STARTED TO
HAPPEN.
SO WHAT I WANTED TO SHOW YOU --
KEEP GOING.
OKAY.
LET'S MOVE TO THE OD GOVERNANCE,
THE NEXT ONE.
ALL RIGHT.
SO AS I WAS JUST TELLING YOU,
THE GOVERNANCE NOW OF WHAT WE
CALL HEAL 2.0, WHICH IS THIS NEW
VERSION OF HEAL, IS DR. VOLKOW,
WHO'S THE NIDA DIRECTOR, AND DRS
DIRECTOR, ARE ESSENTIALLY
ADMINISTERING ALL THAT HAS TO DO
WITH THE MONEY, RIGHT, BECAUSE
THE MONEY COMES FROM THEIR
INSTITUTES.
THAT'S WHERE THE MONEY RESIDES.
HOWEVER, EVERYTHING ELSE IN
TERMS OF, FOR EXAMPLE, COMING UP
WITH THE FUNDING OPPORTUNITIES,
CREATING THE INITIATIVES,
REVIEWING THE APPLICATIONS,
COMING UP WITH THE PAY PLANS,
AND ADMINISTERING THE AWARDS
AFTER THEY'RE FUNDED, ALL OF
THAT IS DISTRIBUTED ACROSS ALL
THE INSTITUTES THAT YOU CAN SEE.
THAT'S WHAT I JUST SAID.
KEEP GOING.
SO THE PAIN PART OF THE HEAL 2.Y
THREE INSTITUTE DIRECTORS,
DR. KOROSHETZ, DR. LINDSAY
CRISWELL, DIRECTOR OF THE
NATIONAL INSTITUTE FOR ARTHRITIS
AND MUSCULOSKELETAL SKIN
DISEASES, AND MYSELF.
I GUESS I DON'T HAVE MY NAME
THERE.
[LAUGHTER]
>> WE KNOW YOU.
SO THERE IS A GROUP OF INSTITUTE
DIRECTORS THAT -- THERE'S MANY
OF US AND I THINK THE LIST -- WE
HAVE THE LIST ON A DIFFERENT
SLIDE?
IT'S ON A PREVIOUS SLIDE.
ANYWAY, YOU SAW THE LIST.
BIG LIST.
SO IT INCLUDES, FOR EXAMPLE,
CHILD HEALTH, IT INCLUDES DENTAL
AND CRANIOFACIAL, IT INCLUDES
KIDNEY, NIDID, IT INCLUDES ALL
OF THESE INSTITUTES.
AND THE REALITY IS, BECAUSE NIH
IS CUT UP INTO DIFFERENT
DISEASES AND BODY PARTS, THERE'S
NOT A PART OF THE BODY THAT
ISN'T SOMEHOW INVOLVED IN PAIN,
RIGHT?
CANCER, ANY DISEASE BASICALLY.
SO YOU CAN SEE THAT A LOT OF
THESE INSTITUTES HAVE COME
TOGETHER HERE, SO IT'S VERY NICE
BECAUSE IT REALLY MEANS THAT WE
HAVE A PROGRAM THAT'S VERY
DIVERSE.
SO THIS JUST TELLS YOU A LITTLE
BIT, AND THIS IS A LITTLE BIT
MORE KIND OF INSIDE, YOU KNOW,
THE INSIDE SCOOP, BUT JUST TO
GIVE YOU A SENSE OF HOW ALL OF
THIS WORK GETS DONE.
SO YOU HAVE ALMOST LIKE A
FUNNEL.
SO -- AND THIS GOES THROUGH A
CYCLE THAT GOES ON FOR OVER A
YEAR.
IT TAKES A LONG TIME.
SO FIRST THERE ARE DIFFERENT
TEAMS AND PROGRAM STAFF THAT
PARTICIPATE IN COMING UP WITH
IDEAS FOR INITIATIVES, BECAUSE
SO FAR, AND I DON'T KNOW IF THIS
IS GOING TO CONTINUE EXACTLY,
BUT THOSE OF YOU THAT HAVE
PARTICIPATED IN A HEAL
INITIATIVE HAVE NOTICED PROBABLY
THAT ALL OF HEAL, THERE'S NO
INVESTIGATOR INITIATED GRANTS TO
HEAL.
IT'S ALL I IN RESPONSE TO FUNDIG
ANNOUNCEMENTS, OPPORTUNITIES.
SO THAT MIGHT CHANGE BUT FOR
NOW, THAT'S HOW IT IS.
SO IN ORDER TO CREATE A FUNDING
OPPORTUNITY, THE PROGRAM STAFF
GET TOGETHER, THEY DISCUSS THESE
IDEAS AND THEN THEY COME UP
LIKE, FOR EXAMPLE, THIS
INITIATIVE ON -- WE'VE HAD --
NCCIH HAS PROMOTED RECENTLY AND
SUCCESSFULLY LAUNCHED THE
MYOFASCIAL PAIN INITIATIVE TO
DEVELOP BIOMARKERS AND METHODS
TO MEASURE MYOFASCIAL PAIN.
THAT WAS AN IDEA THAT KIND OF
MANY DIFFERENT -- EVEN THOUGH WE
INITIATED IT, BUT IT WAS WITH
THE COLLABORATION OF MANY
OTHERS, ESPECIALLY
MUSCULOSKELETAL, SKIN,
BIOMEDICAL ENGINEERING, THERE
WERE MANY OTHER INSTITUTES THAT
WERE ALSO INTERESTED IN THIS.
SO WHEN YOU HAVE MANY DIFFERENT
INSTITUTES THAT WANT TO DO THE
SAME -- SOMETHING TOGETHER, THIS
IS WHAT HEAL IS REALLY, REALLY
GOOD FOR.
BECAUSE IT IS A WAY THAT ALL OF
THIS COMBINED SWORD OF ENERGY
AND IDEAS CAN COME TOGETHER AND
RESULT IN A PRETTY EXCITING
FUNDING OPPORTUNITY WHICH
HAPPENS TO BEING A BE ALSO FUNDY
HEAL.
SO THIS IS REALLY GREAT.
SO YOU CAN SEE AT THE TOP, YOU
HAVE IDEAS, CONCEPTS, ET CETERA.
ALL OF THIS GETS DISTILLED DOWN
INTO IDEAS THAT THEN GETS
PROPOSED TO A STEERING
COMMITTEE.
AND THE STEERING COMMITTEE IS
COMPOSED OF REPRESENTATIVES FROM
ALL OF THE ICs, INSTITUTES AND
CENTERS THAT ARE INVOLVED IN THE
PAIN SIDE OF HEAL.
THEN THEY GET RANKED, THE
STEERING COMMITTEE, AND THIS IS
AT THE PROGRAM STAFF LEVEL.
THEY GET RANKED AND PEOPLE GIVE
THEIR VARIOUS ENTHUSIASM FOR THE
CONCEPT, THEN IT GOES TO A FINAL
INSTITUTE DIRECTOR COMMITTEE.
THIS IS THE COMMITTEE THAT
WALTER KOROSHETZ, LINDSAY
CRISWELL AND I SHARE AND DECIDE
WHETHER THE CONCEPT IS GOING TO
GO FORWARD OR NOT.
THEN ONCE THE CONCEPT GOES
FORWARD AND THE REQUEST FOR
APPLICATION GOES OUT, THE WHOLE
PROCESS STARTS AGAIN BECAUSE
THEN YOU HAVE A CERTAIN AMOUNT
OF TIME THAT THE APPLICATION --
THE CONCEPT IS WHAT WE CALL ON
THE STREETS, WHICH IS WHAT GIVES
PEOPLE A CERTAIN AMOUNT OF TIME
TO RESPOND AND I'LL GET TO THAT
AMOUNT OF TIME IN A MINUTE
BECAUSE THAT'S IMPORTANT.
PEOPLE HAVE A CERTAIN AMOUNT OF
TIME TO REACT TO THE CONCEPT,
COME UP WITH A PROPOSAL -- WITH
A GRANT APPLICATION, WRITE IT,
SUBMIT IT, AND WE ALL KNOW HOW
HARD IT IS TO RESPOND TO THAT.
I'LL TALK ABOUT THAT IN A
MINUTE.
SO -- AND THEN THE APPLICATIONS
COME IN AT A CERTAIN DEADLINE.
THEN WE HAVE TO ORGANIZE
REVIEWS.
REVIEW GROUPS AS APPROPRIATE.
AND THAT GOES TO THE INDIVIDUAL
IC.
SO FOR EXAMPLE, NCCIH WILL
REVIEW SOME OF THOSE PROPOSALS
HERE DEPENDING ON THE EXPERTISE,
ET CETERA.
THEN THE FUNDING -- THE
APPLICATIONS GET SCORED AND THEN
HAVE TO GO TO A COUNCIL SUCH AS
THIS ONE.
THEN THE FUNDING DECISIONS ARE
MADE, WE REPEAT THE PROCESS WITH
THE STEERING COMMITTEE AND THE
INSTITUTE DIRECTOR COMMITTEE AND
FINALLY THE FINAL FUNDING
DECISION IS MADE BY HEAL.
SO YOU CAN SEE IT'S A PROCESS
THAT IS PLEX BUT BELIEVE IT OR
NOT, IT'S A LOT LESS COMPLEX
THAN IT USED TO BE.
BECAUSE BEFORE, THERE WAS AN
ADDITIONAL LAYER ON TOP OF ALL
OF THIS AT THE OFFICE OF THE
DIRECTOR.
AND THE PROBLEM BEFORE IS THAT
THE TIME THAT A CONCEPT WAS ABLE
TO BE ON THE STREET WAS
EXTREMELY SHORT.
BECAUSE IT TOOK SO LONG TO GET
THESE CONCEPTS PASS PASS PAST AF
THESE LAYERS.
OH, AND I FORGOT ONE LAYER
ACTUALLY, THE MULTIDISCIPLINARY
WORKING GROUP.
WHICH IS AN EXTERNAL BOARD THAT
REVIEWS THE CONCEPTS BEFORE THEY
GET APPROVED AND THE PAY PLANS
BEFORE THEY GET APPROVED SO YOU
CAN SEE HOW THERE WAS JUST A LOT
OF GEARS THAT HAD TO GRIND
BEFORE FIRST OF ALL THE
PROCESS -- THE CONCEPT COULD BE
PUBLISHED, SO YOU ALL COULD HEAR
ABOUT IT.
AND THEN YOU'D HAVE TO SCRAMBLE
FOR 90 DAYS OR SOMETHING AND I
MEAN, I USED TO BE AN
INVESTIGATOR.
IF SOMEBODY WOULD SAY YOU'RE
GOING TO WRITE A GRANT IN 90
DAYS I WOULD HAVE LAUGHED,
RIGHT?
BUT THAT'S WHAT IS THE REALITY
IS WITH THESE RFAs, IS THEY'RE
EXTREMELY SHORT.
THE IDEA HERE IS TO TRY TO
EXPAND THAT, SO THAT WE WOULD BE
ABLE TO PUBLISH THE REQUEST FOR
APPLICATION SOONER BECAUSE THE
OTHER PART THAT'S SQUEEZED AT
THE END IS THE FISCAL YEAR.
WE HAVE A CERTAIN BUDGET AND WE
HAVE TO FINISH OUR BUDGET BEFORE
THE BEGINNING OF THE FISCAL YEAR
WHICH IS OCTOBER 1ST, SO IF WE
HAVE MONEY FOR A CERTAIN FISCAL
YEAR FOR A GIVEN PROJECT, IT HAS
TO BE SPENT BEFORE OCTOBER 1ST
SO YOU CAN SEE THAT WE CAN'T
JUST DELAY THE RECEIPT DATE TOO
LATE BECAUSE THEN WE HAVE TO
REVIEW THESE APPLICATIONS.
AND SO -- AND THEN WE SWR TO
PROCESHAVE TOPROCESS THE AWARDSM
SO IT GETS SQUEEZED AT BOTH
ENDS.
SO WHAT WE'RE HOPING AND SO FAR
I THINK WE'RE MAKING GREAT
PROGRESS TOWARDS THAT, IS TO BE
ABLE TO SIMPLIFY THE PROJECT SO
THAT WE CAN PUBLISH THE RFAs
FASTER SO IT GIVES MORE TIME FOR
THEM FOR PEOPLE TO WRITE THE
APPLICATIONS AND ALSO LESS
PRESSURE ON OUR REVIEW GROUP AND
ON OUR GRANTS MANAGEMENT SO THAT
THE AWARDS CAN GET OUT THE DOOR
BEFORE OCTOBER 1ST.
DOES THAT MAKE SENSE?
YOU CAN SEE HOW IT'S REALLY HARD
AND I THINK UNLESS THE REASON I
WANT TO EXPLAIN ALL OF THIS TO
YOU IS I KNOW IT'S NOT SOMETHING
THAT'S IMMEDIATELY APPARENT FROM
THE OUTSIDE.
A LOT OF TIMES PEOPLE THINK WHY
ARE WE GIVEN ONLY SUCH A SHORT
AMOUNT OF TIME TO WRITE THESE
GRANTS?
WELL, THAT'S WHY.
SO IT'S NOT EASY.
NEXT SLIDE.
THIS IS TO GIVE YOU AN IDEA OF
THE AMOUNT OF PEOPLE INVOLVED IN
THE HEAL INITIATIVE.
I CAN'T EVEN READ IT.
ANYWAY, A LOT OF PEOPLE.
OKAY.
LET'S NOW START ABOUT THE
STRATEGIC PLANNING PROCESS,
BECAUSE AS A RESULT OF THIS HEAL
2.0 REBOOT -- NOT REALLY REBOOT
BUT, YOU KNOW, RESTRUCTURING, WE
HAVE THE OPPORTUNITY TO HAVE A
NEW STRATEGIC PLAN FOR HEAL,
WHICH IS HOPEFULLY GOING TO BE A
GROWTH AND WILL GIVE US THE
OPPORTUNITY TO LOOK AT SOME PART
OF THE HEAL PORTFOLIO THAT HAVE
KIND OF NOT BEEN ADDRESSED
SUCCESSFULLY OR EITHER -- YOU
KNOW, WHY DO WE HAVE PERCEIVED
WHAT WE CALL GAPS, RIGHT?
WELL, WE MAY HAVE GAPS BECAUSE
THERE'S SOME AREAS OF RESEARCH,
IN THIS CASE PAIN RESEARCH,
WHERE THERE HAS NOT BEEN ENOUGH
OR SUFFICIENT FUNDING
OPPORTUNITIES, OR THERE MAY HAVE
BEEN FUNDING OPPORTUNITIES BUT
WE DIDN'T GET THE APPLICATIONS.
THAT HAPPENS SOMETIMES.
OR WE GOT APPLICATIONS BUT NONE
OF THEM SCORED WELL.
THAT HAPPENS TOO.
SO WE HAVE TO ADDRESS THAT, AND
SO PART OF THAT IS TO DO A BIG
PORTFOLIO ANALYSIS SIMILAR TO
WHAT ANGELA JUST SHOWED US FOR
HERE, BUT YOU CAN IMAGINE WHEN
YOU'RE LOOKING AT SOMETHING AS
COMPLICATED AS HEAL, WHICH
INVOLVES THE ENTIRE NIH PRETTY
MUCH, BUT IT GETS COMPLEX.
THE OTHER THING WE WANT TO
REALLY UNDERSTAND IS HOW MUCH OF
PAIN RESEARCH IS HAPPENING AT
NIH IN HEAL, AND HOW MUCH IS
HAPPENING OUTSIDE OF HEAL?
AND WE WANT THE TWO TO NOT -- TO
BE COMPLEMENTARY TO EACH OTHER,
AND SO WE HAVE TO UNDERSTAND
THAT, AND SO THAT INVOLVES A LOT
OF WORK TO EVEN FIGURE THAT OUT,
BECAUSE YOU CAN IMAGINE THE
NUMBER OF GRANTS THAT THIS
INVOLVES.
THE OTHER THING I MYSELF AM
PARTICULARLY INTERESTED IN, I
MENTIONED THE TALK I'M GOING TO
BE GIVING AT THE INTERNATIONAL
ASSOCIATION FOR THE STUDY OF
PAIN IN AUGUST, IS I REALLY FEEL
THAT THERE ARE SOME AREAS OF
PAIN RESEARCH THAT SO FAR HAVE
REALLY NOT BEEN, YOU KNOW,
REALLY EVEN LOOKED AT.
AND SO I THINK THIS IS GOING TO
BE AN OPPORTUNITY FOR US AT
NCCIH TO HAVE INPUT ON THE KIND
OF RESEARCH THAT WE WOULD LIKE
HEAL TO CONSIDER, AND SO THIS IS
A GREAT, GREAT OPPORTUNITY.
SO WE HAVE A COMMITTEE, AND
IT'S -- THIS IS -- WE ARE IN THE
MIDDLE OF FORMING A COMMITTEE AS
A WORKING GROUP OF THE NINDS
ADVISORY COUNCIL, BECAUSE THAT'S
HOW THOSE COMMITTEES ARE FORMED,
TO MAKE RECOMMENDATIONS ON THESE
RESEARCH PRIORITIES.
AND WE ARE TOTALLY DELIGHTED
THAT ONE OF US, DR. KATHLEEN
SLUKA, IS GOING TO CO-CHAIR THIS
COMMITTEE, ALONG WITH ROB GEREAU
AT WASH-U AND THE TWO TOGETHER,
I UNDERSTAND NOW, ARE HARD AT
WORK ALREADY TO FORM THE
COMMITTEE, AND WE'RE SO
THANKFUL, KATHLEEN, THAT YOU
HAVE AGREED TO DO THIS.
AND THIS IS GOING TO BE REALLY,
REALLY IMPORTANT TO DEVELOP TRA
TSTRATEGIC RESEARCH PROJECTS FOR
HEAL PAIN.
AND AN IMPORTANT PART OF THIS IS
TO LOOK AT THE INTERFACE BETWEEN
HEAL AND OPIOID USE DISORDER,
BECAUSE THERE IS A BIG IMPORTANT
AND TRICKY INTERFACE.
PEOPLE WHO ARE -- HAVE AN OPIOID
USE DISORDER WHO HAVE AN
ADDICTION TO OPIATES, THEY HAVE
PAIN TOO.
RIGHT?
EVEN SOMEBODY WHO IS NO LONGER
USING OPIOIDS BUT WHO HAS
DIFFICULTY WITH, YOU KNOW,
VARIOUS ASPECTS OF OPIOID, YOU
KNOW, ADDICTION DOESN'T
NECESSARILY STOP IF YOU STOP
USING THEM.
ANY EXPOSURE TO OPIOIDS IN
SOMEBODY WHO HAS A HISTORY OF
OPIOID USE DISORDER IS A
PROBLEM.
SO HOW DO YOU MANAGE PAIN, YOU
KNOW, IN PEOPLE WITH THAT -- IN
THAT SITUATION?
VERY, VERY IMPORTANT.
THERE'S ALSO VERY IMPORTANT
ISSUES AROUND SPECIAL
POPULATIONS THAT ARE AT RISK FOR
BOTH PAIN AND OPIOID USE
DISORDER.
ONE OF THEM BEING AMERICAN
INDIAN AND ALAS K ALASKAN NATIV.
THE NATIVE AMERICAN POPULATION
IS THE MOST AT RISK POPULATION
FOR OPIOID USE DISORDER, BY FAR,
IN THIS COUNTRY.
AND SO WE WANT TO WORK VERY
CAREFULLY, CLOSELY, WITH NIDA,
WITH THE NATIONAL INSTITUTE OF
DRUG ABUSE, TO WORK ON SOME VERY
SPECIAL INITIATIVES AND PROGRAMS
YOU'LL BE HEARING MORE ABOUT ON
THIS.
SO HEAL PAIN STRATEGIC PLANNING,
THIS IS THE TIMELINE, VERY
SIMILAR TO OUR OWN STRATEGIC
PLAN.
WE THINK THAT WE ARE VERY
FORTUNATE THAT OUR STRATEGIC
PLAN AND THE HEAL STRATEGIC PLAN
ARE HAPPENING KIND OF IN
PARALLEL, WHICH IS, WE THINK,
VERY EXCITING.
WE ARE GOING TO BE ABLE TO HAVE
A LOT OF INPUT INTO THIS.
AND HAVING TO SAY, WE HAVE
ALREADY HAD A LOT OF INPUT INTO
THE HEAL INITIATIVE.
I CAN'T SAY ENOUGH ABOUT HOW
IMPORTANT THE INPUT OF NCCIH IS
FOR SHAPING SOME PROGRAMS SUCH
AS PRISSMM AND BRIM.
SO THESE ARE TWO PROGRAMS THAT
YOU'VE ALL BEEN HEARING QUITE A
LOT ABOUT.
PRISSMM IS PRAGMATIC TRIALS TO
REDUCE -- WHAT DOES PRISSMM
MEAN?
PRAGMATIC STUDIES TO WHAT?
THERE YOU GO.
PRAGMATIC AND IMPLEMENTATION
STUDIES TO IMPROVE THE -- OKAY,
SO BASICALLY PRAGMATIC TRIALS OF
PAIN, AND THEN BRIM IS BIO --
BEHAVIORAL -- I'M TERRIBLE WITH
ACRONYMS.
I CAN NEVER FIGURE OUT WHAT THEY
MEAN.
BUT IN ANY CASE, ONE IS --
THEY'RE BOTH PROGRAMS THAT ARE
REALLY UTILI UTILIZE THE PRAGMAC
STUDY DESIGN AND IMPLEMENTATION
SCIENCE IN ORDER TO REALLY LOOK
AT THE MANAGEMENT OF PAIN AND
OPIOID USE DISORDER IN THE REAL
WORLD, KIND OF WHAT I WAS
TALKING ABOUT EARLIER, ABOUT THE
IMPORTANCE OF STUDYING RESEARCH
THAT IS IN THE HEALTHCARE
SYSTEMS OR WHEREVER THE CARE IS
BEING DELIVERED.
AND SO BOTH PRISSMM AND BRIM ARE
REALLY FLAGSHIP PROGRAMS OF THE
HEAL INITIATIVE THAT HAVE BEEN
THERE SINCE THE BEGINNING AND
NONE OFANDDUE TO THE EFFORTS OFD
SHURTLEFF, WENDY WEBER HAVE BEEN
VERY INSTRUMENTAL, PETE MURRAY,
WITH BRIM, WHO HAVE REALLY
INFLUENCED THE VERY DIRECTION OF
HEAL BECAUSE AT THE VERY
BEGINNING OF HEAL, A BIG
EMPHASIS WAS ON DRUG
DEVELOPMENT.
AND BECAUSE I BELIEVE OF THE
DIRECTION THAT NCCIH HAS REALLY
IMPARTED ON THE HEAL, A LOT OF
IT ENDED UP BEING ABOUT
NON-PHARMACOLOGICAL APPROACHES,
AND IF IT WASN'T FOR NIH'S
INPUT, PROBABLY WOULD NOT HAVE
BEEN QUITE SO MUCH.
SO THIS WAS REALLY IMPORTANT,
AND WE'RE CONTINUING TO REALLY
HAVE, I THINK, A BIG IMPACT ON
THE OPPORTUNITIES THAT ARE
AVAILABLE THROUGH THE HEAL
INITIATIVE.
SO MORE TO COME ON THAT.
OKAY.
SO ANY QUESTIONS ABOUT THIS OR
ANY COMMENTS?
>> THIS IS SUPER INTERESTING AND
EXCITING STUFF.
I WANTED TO -- YOU MAY HAVE
ALLUDED TO THIS A LITTLE BIT,
THERE ARE SOME AREAS OF PAIN
RESEARCH THAT HAVEN'T REALLY
BEEN LOOKED AT AND THAT MAYBE
HEAL SHOULD CONSIDER AND I
WONDERED IF YOU COULD MAYBE
SHARE IF YOU HAVE ANY THOUGHTS
ABOUT WHAT THOSE GAPS ARE.
>> WELL, SOME OF THEM, WE'VE
ALREADY STARTED.
SO ANY AREA OF MUSCULOSKELETAL
PAIN, THERE HAS BEEN A PENDULUM
SHIFT THAT HAS TAKEN PLACE.
IF YOU GO BACK AND, YOU KNOW,
BACK IN 19 -- MAYBE 1980, 1990,
IT WAS ALL ABOUT FIXING WHAT'S
BROKEN, RIGHT?
YOU HAD BACK PAIN, YOU HAD AN
MRI AND YOU HAD MAYBE SURGERY OR
WHATEVER OR SPINAL INJECTION OR
SOMETHING LIKE THAT.
IF YOU HAD ARTHRITIS, IT WAS
ABOUT THE JOINT -- THE
CARTILAGE, ET CETERA.
AND THEN AFTER ABOUT 1990, THERE
WAS THIS BIG SHIFT TOWARDS
REALLY UNDERSTANDING THE
EMOTIONAL AND PSYCHOLOGICAL
DIMENSIONS OF PAIN AND THE
NEURAL MECHANISMS OF PAIN, AND
FOR GOOD REASONS, BECAUSE A LOT
OF PAIN, ESPECIALLY CHRONIC
PAIN, DOES INVOLVE SENT
TIIZSENSITIZATIONMECHANISMS IN T
PERPETUATE THE PAIN.
BUT THE PENDULUM HAS SWUNG SO
FAR IN THAT DIRECTION RIGHT NOW
THAT IF YOU LOOK AT THE
LITERATURE, THERE'S VERY, VERY
LITTLE ABOUT THE PERIPHERAL
TISSUES ANYMORE.
A LOT OF OF THE PAIN RESEARCH IS
NOW ABOUT THE NERVOUS SYSTEM AND
PSYCHOSOCIAL ASPECTS OF PAIN.
I'VE WRITTEN ABOUT THIS AND I
THINK THE VERY IMPORTANT PIECE
OF THIS IS TO BRING THE TWO BACK
TOGETHER, AND SO WE'VE ALREADY
STARTED DOING THAT WITH THE HEAL
INITIATIVE.
ONE IS WE'RE DEVELOPING BETTER
BIOMARKERS AND IMAGING, FOR
EXAMPLE, FOR ALL OF THOSE
TISSUES, THOSE SOFT TISSUES THAT
NOBODY EVER LOOKS AT.
X-RAYS ARE REALLY GOOD AT
LOOKING AT BONES AND CARTILAGE,
AND THEY'RE TERRIBLE AT LOOKING
AT LIGAMENTS AND FASCIA AND
MUSCLE.
YOU CAN'T -- YOU KNOW, YOU
REALLY CAN'T SEE, AND YOU CAN'T
TELL WHAT'S WRONG ANYWAY, IF
THERE'S SOMETHING WRONG, YOU
CAN'T SEE IT.
SO WE'RE DOING THAT, BUT AT THE
SAME TIME, THERE'S ANOTHER
INITIATIVE WITHIN HEAL CALLED
REJOIN THAT IS ABOUT LOOKING AT
A JOINT NOT JUST FROM THE POINT
OF VIEW OF THE INSIDE OF THE
JOINT, THE CARTILAGE, BUT THE
WHOLE JOINT, THAT ALL THE OTHER
PARTS OF THE JOINT, THE
CAPSULES, LIGAMENTS, FASCIA, ALL
THE STUFF THAT REALLY WE DON'T
EVEN KNOW WHETHER THEY CAN
GENERATE PAIN OR NOT BECAUSE WE
CAN'T EVEN LOOK AT IT.
SO REJOIN IS MAPPING THE SENSORY
INNERVATION OF ALL OF THESE
TISSUES, AND THEN THERE'S BAC
PAC, WHICH IS A BACK PAIN
CONSORTIUM THAT IS DEVELOPING
VERY, VERY ELABORATE MODELS AND
TESTING THESE MODELS FOR BACK
PAIN, BUT IMPORTANTLY, WE'LL BE
ABLE TO INCORPORATE THE DATA M
KOLLING FROM THESE OTHER
PROGRAMS, LIKE MYOFASCIAL AND
REJOIN, IN ORDER TO IMPROVE OUR
UNDERSTANDING OF PAIN -- OF BACK
PAIN BEYOND JUST THE FACET
JOINTS AND THE INTERVERTEBRAL
DISKS, BECAUSE THERE'S SO MUCH
WE DON'T KNOW.
SO THAT'S A PART OF PAIN,
MUSCULOSKELETAL PAIN, WHICH
ALREADY IS MOVING IN A MORE
INTEGRATIVE DIRECTION, PARTLY
BECAUSE OF WORK THAT WE'VE DONE
HERE AT NCCIH.
BUT I REALLY FEEL THIS NEEDS TO
CONTINUE.
THE OTHER DIRECTION AS I
MENTIONED ALREADY THIS MORNING
IS ENDOGENOUS PAIN RESOLUTION.
SO WHEN WE THINK OF PAIN
MANAGEMENT, WE USUALLY THINK OF
IT AS ANALGESIA, RIGHT?
A METHOD THAT WILL REDUCE THE
PAIN AND BUT THAT IS TEMPORARY.
THAT WHEN YOU STOP, YOU KNOW,
TAKING THE DRUG OR WHATEVER, THE
PAIN COMES BACK.
EVEN SOMETHING LIKE, YOU KNOW,
ACUPUNCTURE IS USUALLY THOUGHT
OF AS AN ANALGESIC.
BUT IF YOU LOOK AT PEOPLE WHO'VE
HAD TREATMENTS LIKE ACUPUNCTURE
OR -- OVER A LONG PERIOD OF
TIME, YOU SEE THAT SOMETIMES
WHAT HAPPENS IS THAT PEOPLE WILL
HAVE A COURSE OF ACUPUNCTURE
TREATMENTS FOR TWO OR THREE
MONTHS AND THEN THEY STOP, BUT A
YEAR LATER, THEY'RE STILL
BETTER.
AND SOME RESEARCH HAS
CORROBORATED THIS.
SO WHAT HAS HAPPENED?
THIS IS WHAT WE CALL HEALTH
RESTORATION.
THE BODY HAS ACTUALLY HEALED
SUCH THAT YOU DON'T -- THERE'S
NO LONGER A NEED TO ACTUALLY --
TO TAKE MORE ANALGESICS.
THIS IS A MECHANISM THAT'S
RELATED TO OVERALL RESTORATION
OF HEALTH, WHICH WE UNDERSTAND
VERY LITTLE ABOUT.
WHY?
BECAUSE IT IS NOT SOMETHING THAT
INVOLVES ONE MOLECULE OR ONE --
IT'S A WHOLE PERSON THING.
IT INVOLVES A LOT OF COMPLICATED
THINGS.
IT INVOLVES CHANGING ONE'S
BEHAVIOR PROBABLY, IT INVOLVES
RESOLUTION OF PHENOMENA THAT MAY
BE OCCURRING IN THE TISSUES AND
THE NERVOUS SYSTEM PROBABLY
TOGETHER ALONG WITH BEHAVIOR,
PERHAPS ALONG WITH, YOU KNOW,
SOCIETAL, YOU KNOW, INFLUENCES.
THERE'S A LOT OF THINGS THAT GO
INTO THIS.
AND SO THIS IS WHY WE THINK THIS
IS VERY MUCH RELATED TO A
WHOLE -- TAKING A WHOLE PERSON
APPROACH AND UNDERSTANDING
BUILT-IN MECHANISMS THAT PEOPLE
HAVE IN ORDER TO GET BETTER.
WHETHER IT'S FROM PAIN OR
SOMETHING ELSE.
AND THIS IS WHERE THE APPROACH
TO WHOLE PERSON HEALTH IS SO
IMPORTANT.
SO THESE ARE THE TWO.
THAT WAS A LONG ANSWER TO YOUR
QUESTION, I'M SORRY.
BUT THAT'S ESSENTIALLY WHAT I'M
GOING TO TALK ABOUT AT IASP.
I JUST GAVE YOU A SNEAK PREVIEW.
ANY OTHER QUESTIONS?
>> WE'RE FINE.
ANY OTHER -- YES.
>> THAFNTI TWO POTENTIAL QUESTI.
WE'LL SEE WHAT HAPPENS WITH THE
OTHER IF I HAVE TIME TO ASK
ANOTHER ONE TOO.
I'M WONDERING, SO I THINK MY
UNDERSTANDING OF HEAL IS THAT
IT'S GOT TO BE SHOVEL-REDI, IT'S
GOT TO BE VERY PATIENT FOCUSED.
I'M WONDERING WHAT THE PLACE --
WHERE THE PLACE IS FOR BASE UK C
RESEARCH OF FUNDAMENTAL RESEARCH
ON PAIN ITSELF AND WHERE DOES IT
COME FROM.
>> SO WHEN YOU SAY PATIENT
FOCUSED, MY FIRST QUESTION WAS,
HMM, NOT ENTIRELY.
THE BIG FOCUS ON HEAL, FOR HEAL,
IS THERAPEUTICS DEVELOPMENT.
THAT WAS FROM THE BEGINNING.
IT WAS THE IDEA WAS WHEN MONEY
WAS APPROPRIATED FROM CONGRESS,
THE IDEA WAS WE'RE GOING TO
DEVELOP BETTER DRUGS THAT ARE
NOT ADDICTIVE.
THAT WAS THE IDEA.
SO THERE WAS THIS WHOLE PIPELINE
OF, YOU KNOW, TARGET DEVELOPMENT
AND, YOU KNOW, IDENTIFICATION OF
COMPOUNDS, FOR EXAMPLE, THAT
MIGHT INTERACT WITH VARIOUS
MOLECULES, XYZ RECEPTOR,
WHATEVER, AND A LOT OF THE STUFF
IS GOING ON, SO THAT'S NOT
PATIENT-FOCUSED.
THAT'S REALLY THERAPEUTICS
DEVELOPMENT.
THERE'S ALSO SOME OF IT THAT IS
BASED ON LOOKING FOR DEVICES OF
VARIOUS DIFFERENT STAGES OF
DEVELOPMENT.
THERE'S ALSO THAT OTHER END OF
ALL THE PRAGMATIC RESEARCH THAT
I WAS TALKING ABOUT.
THAT'S VERY -- THAT'S VERY
CLINICAL.
BUT WHAT I BELIEVE YOU'RE
TALKING ABOUT IS MORE BASIC
RESEARCH ON PAIN MECHANISMS LIKE
IN ANIMALS, WHATEVER.
MOST OF THAT IS NOT AT HEAL.
MOST OF THAT, A LOT OF THAT IS
FUNDED BY NINDS.
SOME OF IT IS FUNDED BY US BUT I
WOULD SAY MOST OF IT, RIGHT, I
IS -- NIAMS I SHOULD HAVE
MENTIONED, YES.
SO THE IDEA IS THAT HEAL FROM
THE START WAS NOT -- AND
PROBABLY NIDCR.
FROM THE START, HEAL WAS NOT
DESIGNED AS A PROGRAM TO DO
BASIC RESEARCH ON PAIN.
IT WAS REALLY FOCUSED ON FINDING
TREATMENTS.
THAT'S CHANGING A LITTLE BIT.
AS YOU CAN SEE, THE PROGRAM ON
MYOFASCIAL PAIN IS NOT -- WELL,
IT'S -- THERE'S A THERAPEUTIC
COMPONENT TO IT, BUT THE MAJOR
PART OF IT IS ABOUT DEVELOPING
THE MEASUREMENTS.
AND THAT WAS A CHANGE.
I MEAN, IT WAS A TRICKY THING TO
ACTUALLY GET HEAL TO AGREE TO
FUND THAT.
THE REJOIN PROGRAM IS PRETTY
BASIC.
IT'S REALLY LOOKING AT
SENSORY -- A LOT OF IT IS IN
ANIMALS, SOME USING HUMAN
TISSUE.
BUT I WOULD SAY THAT HOPEFULLY
THERE WILL BE INCREASING
OPPORTUNITIES TO FUND DIFFERENT
KINDS OF RESEARCH THROUGH THE
HEAL INITIATIVE AS WE CAN MAKE
THE CASE FOR IT.
DID THAT ANSWER YOUR QUESTION?
DOESN'T LOOK LIKE IT.
>> YES, BUT.
>> OKAY.
>> I THINK THERE'S ALSO --
THERE'S BASIC MECHANISTIC
RESEARCH IN AN INTERNATIONAL
FALLSIN ANIMALS AND ALSO INHUMAE
IT PAINTS IS WE'RE CONSTANTLY
LEARNING ABOUT SENSORY
EXPERIENCE, OPINION ON PAIN, THE
MEANING OF PAIN AND SO SOME OF
THE REASONS THAT PEOPLE DEVELOP
CHRONIC PAIN IS BECAUSE THESE
LEARNING MECHANISMS ARE
DISREGULATED.
SO THAT'S KIND OF ONE EXAMPLE OF
SORT OF HUMAN RESEARCH THAT I
DON'T THINK HAS A GOOD HOME,
BECAUSE IT ISN'T ABOUT A
PARTICULAR CONDITION, SO IT
WOULDN'T BE NIAMS OR NINDS, IT'S
ABOUT THE PROCESS OF, YOU KNOW,
LEARNING AND ADAPTATION USING
PAIN AS A -- YOU KNOW, AS --
>> YOU'RE ACTUALLY SINGING MY
SONG HERE.
ONE SLIDE ACTUALLY THAT WAS NOT
PART OF THE SLIDE DECK, I'M
SORRY, IT WAS SHOWING THE FOUR
GROUPS, I DON'T KNOW WHY THAT
WASN'T THERE, OKAY, SO -- THE
FOUR TEAMS.
SO INITIALLY, THERE WERE TWO OF
THE LAST FOUR WERE TWO TEAMS.
THERE WAS A BASIC TEAM THAT WAS
MAINLY ABOUT DEVELOPING
THERAPEUTICS, DRUGS, AND THEN
THERE WAS A CLINICAL TEAM THAT
WAS MORE INTO CLINICAL TRIALS.
THE KIND OF RESEARCH YOU'RE
TALKING ABOUT FALSE IN BETWEEN
THOSE TWO.
SO WE WERE HAVING A LOT OF HARD
TIMES SOMETIMES FINDING A HOME
FOR THOSE TYPES OF CONCEPTS.
NOW I'M GLAD TO SAY THERE ARE
FOUR TEAMS.
ONE OF THE TEAMS, I FORGET WHAT
IT'S CALLED NOW.
DO YOU REMEMBER?
INTEGRATIVE PAIN MECHANISMS.
MUCH BETTER, RIGHT?
SO THERE'S GOING TO BE A TEAM
FOR THAT NOW.
NOT TO SAY THAT A PROGRAM NEEDS
TO NECESSARILY BELONG TO A TEAM,
BUT BEFORE LACK OF A HOME AND A
TEAM WAS DEFINITELY AN OBSTACLE
TO GETTING A CONCEPT THROUGH,
IT'S GOING TO BE EASIER NOW AND
IT'S NOT GOING TO BE QUITE SO
PRESCRIPTIVE BUT THE FACT THAT
THERE'S NOW A TEAM DEDICATED TO
THAT KIND OF PROBLEM IS GOOD.
AND WE'RE GOING TO HAVE A
PRESENCE ON THAT TEAM OBVIOUSLY.
SO YEAH, SO EXCELLENT QUESTION.
>> SO JUST TO ADDRESS THIS ISSUE
ABOUT THE PATIENTS THAT YOU
MENTIONED, WHEN HEAL STARTED, IT
WAS REALLY TO ADDRESS A PUBLIC
HEALTH EMERGENCY.
SO IT'S AN ALL HANDS ON DECK
APPROACH TO ADDRESS THE OPIOID
CRISIS AND THE PAIN MANAGEMENT
ISSUES, AND SO THE TENDENCY WAS
TO GO MORE TOWARDS THE IMMEDIATE
APPLIED APPROACH TO REALLY
ADDRESS THIS EMERGENCY.
AND I THINK WHAT'S HAPPENING AS
HELENE HAS ILLUSTRATED, THE
PROGRAM IS EVOLVING.
AND CHANGING AND WITH THE
STRATEGIC PLANNING THAT
CATHERINE WILL BE INVOLVED IN
AND OTHERS, I THINK THAT WILL
REALLY REDEFINE WHAT HEAL IS
MOVING FORWARD.
BUT THAT'S HISTORICALLY WHY YOU
MIGHT HAVE GOT THE SENSE IT WAS
PATIENT FOCUSED, BUT FOR GOOD
REASON.
>> THAT'S A GOOD POINT, DAVID,
THAT'S RIGHT, EXACTLY.
IT WAS A VERY GOOD THING THAT
HEAL HAPPENED IN RESPONSE TO
THAT, AND IN FACT, WHAT WE'RE
SEEING IS THAT IT REALLY HELPED
TO GROW THE PAIN FIELD.
IF YOU LOOK, THE HEAL
INVESTIGATOR MEETINGS, I MEAN,
WE HAVE A WHOLE CADRE NOW OF
INVESTIGATORS -- IT WAS -- PAIN
RESEARCH IS HARD, YOU KNOW, AND
IT'S HARD TO PRACTICE PAIN TO BE
A PRACTITIONER WHO TREATS
PATIENTS WITH PAIN, IT'S
DIFFICULT, AND IT'S ALSO HARD TO
DO RESEARCH ON PAIN.
IT IS NOT TYPICALLY -- IT'S AN
AREA OF RESEARCH WHERE IT HARD
TO ATTRACT INVESTIGATORS AND SO
I THINK WHAT THIS IS DOING IS
REALLY GIVING NEW LIFE INTO PAIN
RESEARCH THAT IS GOING TO HELP,
BUT IT NOW, AS DAVID SAID, IT'S
DEFINITELY EVOLVING, AND A LOT
OF IT IS IN RESPONSE TO THE
NEEDS AND FEEDBACK THAT WE'RE
GETTING FROM PEOPLE AND SO,
YEAH, SO -- YEAH.
KATHLEEN.
>> AND I'LL TELL YOU THAT -- I
MEAN, I KNOW THE CONCERN IS THAT
BECAUSE WE NOW HAVE HEAL,
THERE'S LESS MONEY GOING INTO
PAIN RESEARCH ELSEWHERE.
THIS IS KIND OF WHAT THE GENERAL
COMMITTEE, BUT IT'S NOT TRUE.
AND WE LOOKED AT THE NUMBERS AND
WE LOOKED AT THE GRAPHS, AND
ACTUALLY THERE'S A SMALL
INCREASE IN NON-HEAL FUNDING FOR
PAIN RESEARCH IN ADDITION TO
HAVING THE HEAL FUNDING ON TOP
OF THAT.
SO THAT WAS REALLY ENCOURAGING
TO ME.
CONSIDERING PEOPLE LIKE ME HAVE
BEEN FIGHTING TO INCREASE PAIN
RESEARCH SINCE WE WERE YOUNG
SCIENTISTS A FEW YEARS AGO.
BUT YEAH, SO IT WAS REALLY
ENCOURAGING TO SEE THAT.
AND I DO THINK, YOU KNOW,
THERE'S GOING TO BE A GROUP
THAT'S GOING TO THINK THROUGH
HOPEFULLY WHEN WE GET THEM ALL
APPOINTED WHAT THE BIG
INITIATIVES SHOULD BE AND WHERE
THEY SHOULD GO, BUT THEY ARE
WRAPPED AROUND THINGS THAT WILL
HOPEFULLY IMPROVE MANAGEMENT IN
THE LONG RUN.
BUT ALL THOSE MANAGEMENT ONES
ARE NOW GOING THROUGH HEAL, SO A
LOT OF THEM AREN'T GOING INTO
THE STANDARD STUDY SECTIONS,
RIGHT?
SO THAT OPENS UP THAT MONEY AND
THOSE SLOTS FOR OTHER RESEARCH,
IN MY EYES.
SO I THINK IT'S A GOOD THING.
>> IT COULD VERY WELL BE, AND IN
FACT, CONGRESS APPROPRIATED US
$5 MILLION LAST YEAR AND THIS
YEAR, TO NCCIH, SPECIFICALLY
TORE PFORPAIN RESEARCH.
>> OH, DID THEY?
>> IN ADDITION TO OUR BUDGET.
YEAH.
>> THAT'S NICE.
>> AND IN ADDITION TO WHAT WE
ARE DOING WITH HEAL.
SO OUR PAIN PORTFOLIO IS VERY
WELL ALIVE, YOU KNOW, EVEN
OUTSIDE OF HEAL.
OTHER QUESTIONS?
OKAY.
GOOD.
SO NOW, THE NEXT PART OF OUR
PROGRAM IS -- I SEE WENDY THERE
SO IT MUST BE WENDY.
I DON'T KNOW WHERE I AM.
>> WE'RE GOING TO BE MOVING --
>> OKAY.
SO I'M NOW PLEASED TO WELCOME TO
THE PODIUM DR. WENDY WEBER.
SHE'S THE BRANCH CHIEF OF OUR
CLINICAL RESEARCH BRANCH AND
DIVISION OF EXTRAMURAL RESEARCH,
AND SHE'S GOING TO SHARE WITH US
A BRIEF UPDATE ON OUR CLINICAL
TRIALS FUNDING OPPORTUNITIES.
>> GREAT.
GOOD AFTERNOON, EVERYONE.
SO I GET TO GIVE YOU AN UPDATE
ON SOME RECENT ACTIVITY OF OUR
CLINICAL RESEARCH BRANCH AND
WHAT WE'VE BEEN WORKING HARD ON
FOR MANY, MANY MONTHS NOW.
SO AS WE THINK ABOUT THE
CLINICAL RESEARCH BRANCH, WE
FUND -- OR WE SUPPORT AND
PROVIDE PORTFOLIO MANAGEMENT FOR
THE RESEARCH STUDIES THAT WE
FUND THAT ARE REALLY ABOUT
OUTCOMES AND CLINICAL OUTCOMES,
DEVELOPING INTERVENTIONS,
REFINING THOSE INTERVENTIONS,
AND TESTING THEM FOR EFFICACY
EVENTUALLY INTO PRAGMATIC
TRIALS, OUR COLLEAGUES IN THE
BASIC AND MECHANISTIC BRANCH DO
MORE OF THE MECHANISTIC CLINICAL
TRIALS AND OVERSEE THOSE
ACTIVITIES AS WELL AS ALL OF OUR
BASIC SCIENCE RESEARCH.
SO I'M FOCUSING MORE ON WHAT I'M
CALLING LIKE THE CLINICAL OUT
COME STUDIES WHICH CAN INCLUDE
HEALTH SERVICES RESEARCH BUT
ALSO MANY OF OUR TRIALS AND
INTERVENTION DEVELOPMENT.
AND AS WE THINK ABOUT SORT OF
WHAT ARE OUR GOALS FOR THIS
PROGRAM, WHAT KINDS OF RESEARCH
DO WE WANT TO SUPPORT, OF COURSE
WE WANT TO ALIGN WITH OUR
STRATEGIC PLAN, AND WE WANT TO
BE CONDUCTED AT THE APPROPRIATE
STAGE BASED ON WHAT'S CURRENTLY
ALREADY KNOWN ABOUT THE
INTERVENTIONS AND ABOUT THOSE
INTERVENTIONS USED IN DIFFERENT
CLINICAL CONDITIONS.
WE ALWAYS WANT OUR INVESTIGATORS
TO UTILIZE RIGOROUS METHODS THAT
ARE APPROPRIATE FOR THAT
PARTICULAR STAGE OF RESEARCH AND
TO TEST A HYPOTHESES THAT WILL
GUIDE FUTURE RESEARCH.
AND AS ALWAYS, YOU KNOW,
APPROPRIATE BUDGET AND REALISTIC
TIME FRAMES AND SORT OF THE
SCOPE OF WORK THAT CAN BE DONE
WITHIN AN INDIVIDUAL
APPLICATION.
AND ULTIMATELY OUR GOAL IS TO
SUPPORT IMPACTFUL TRIALS, AND
THAT CAN BE RESULTS OF FULLY
POWERED STUDIES THAT ARE GOING
TO INFLUENCE GUIDELINES AND
INFLUENCE HEALTHCARE POLICIES,
BUT IT CAN ALSO BE REALLY
IMPORTANT FEASIBILITY WORK THAT
WILL INFORM THE DESIGN OF THAT
ULTIMATE FULLY POWERED TRIAL.
SO HOPEFULLY THIS GRAPHIC IS
FAMILIAR TO MANY OF YOU.
THIS IS OUR RESEARCH FRAMEWORK,
AND WE WORKED ACROSS THE
BRANCHES TO REALLY SORT OF TRY
TO BUILD A FRAMEWORK THAT WORKS
FROM VERY BASIC RESEARCH ALL THE
WAY THROUGH EFFICACY TRIALS AND
ULTIMATELY DISSEMINATION
IMPLEMENTATION SCIENCE TYPES OF
WORK.
AND AT EACH ONE OF THESE
CIRCLES, YOU'LL SEE THERE'S A
QUESTION THAT'S ASSOCIATED WITH
IT OF THE KIND OF RESEARCH
THAT'S DONE AT THAT PARTICULAR
STAGE.
AND IT DOESN'T MEAN THAT YOU
HAVE TO MOVE ALONG THE PIPELINE.
YOUR RESEARCH MAY BE FOCUSED IN
ONE OF THESE CIRCLES BUT YOU MAY
ALSO TAKE RESEARCH THAT DOES
MOVE DOWN THIS PIPELINE.
AND AS WE HAVE LOOKED AT OUR
FUNDING OPPORTUNITIES, WHAT
WE'VE TRIED TO DO IN THE
CLINICAL RESEARCH BRANCH AND
HONESTLY WITHIN THE BASIC BRANCH
AS WELL IS TO MAKE SURE THAT WE
HAVE FUNDING OPPORTUNITIES FOR
EACH OF THESE DIFFERENT STAGES
OF RESEARCH, AND SO WHAT WE'VE
TRIED DO IS MAP ON TO THIS
FRAMEWORK THE INDIVIDUAL FUNDING
OPPORTUNITY -- OR NOW NOFOs,
NOTICE OF FUNDING OPPORTUNITIES,
THAT MATCH TO EACH OF THESE
DIFFERENT STAGES OF RESEARCH.
I'M HAPPY TO ANNOUNCE WE HAVE UP
UPDATED OUR WEBSITE.
THIS WAS A MAJOR EFFORT WE DID
WITH OUR OFFICE OF
COMMUNICATIONS AND PUBLIC
LIAISON AND OUR CLINICAL
RESEARCH BRANCH.
WE'VE DONE A LOT OF WORK TO
UPDATE ALL OF THE DIFFERENT
LINKS HERE.
ON THE LEFT SIDE WE'VE UPDATED
AND PUT A NAVIGATION SET OF
BULLETS ON THE LEFT SIDE HERE,
SO THAT YOU CAN FIND THINGS MORE
EASILY.
INCLUDING THE WHOLE SUITE OF NEW
FUNDING OPPORTUNITIES.
WE HAVE REISSUED 11 FUNDING
OPPORTUNITIES TO SUPPORT ACROSS
THIS ENTIRE STAGE OF RESEARCH
FOR BOTH OUR MIND AND BODY
INTERVENTIONS AND THEN OUR
NUTRITION AND NATURAL PRODUCT
INTERVENTIONS.
AND SO WE ALSO UPDATED ALL OF
THE FREQUENTLY ASKED QUESTIONS.
THERE'S ALSO A LINK FOR
RESOURCES.
WE'VE REALLY TRIED TO MAKE THIS
REALLY COMPREHENSIVE AND
HOPEFULLY EASIER TO FIND THE
FUNDING OPPORTUNITY TO MATCH THE
STAGE OF RESEARCH THAT YOU'RE
WANTING TO DO.
SO YOU'LL SEE I'VE HIGHLIGHTED
WITH ARROWS HERE THE TWO
DIFFERENT CLICKS THAT YOU CAN DO
TO GO TO THE MIND-BODY OR TO THE
NATURAL PRODUCTS.
IF YOU GO TO THE NEXT SLIDE,
WHAT YOU'LL SEE WHEN YOU GO TO
THIS IS THERE'S NOW A DROPDOWN
LIST FOR THE FUNDING
OPPORTUNITIES FOR EACH ONE OF
THOSE INDIVIDUAL CIRCLES.
SO IF YOU WANT TO KNOW WHAT
BASIC FUNDING OPPORTUNITIES WE
HAVE, YOU CAN CLICK THERE.
IF YOU WANT TO KNOW WHAT FUNDING
OPPORTUNITIES WOULD BE BEST FOR
EFFICACY RESEARCH, YOU CAN CLICK
THERE.
SO WE'VE TRIED TO MAKE THIS MUCH
MORE USER-FRIENDLY AND EASY TO
FIND.
AS WE'VE REISSUED ALL OF THESE
FUNDING ANNOUNCEMENTS AT THE
SAME TIME, WE'VE WORKED REALLY
CLOSELY WITH OUR OFFICE AND OUR
COLLEAGUES IN THE SCIENTIFIC
REVIEW OFFICE AND THE DIVISION
OF EXTRAMURAL ACTIVITIES AS
WE'VE DONE ALL OF THESE UPDATES,
AND ALIGNING THINGS WITH OUR
STRATEGIC PLAN, UPDATING OUR
PRIORITIES A LITTLE BIT, THERE'S
A NEW PLAN FOR ENHANCING DIVERSE
PERSPECTIVES, THE PEDP, WHICH IS
NOT ONLY ABOUT ENGAGING DIVERSE
PARTICIPANTS IN RESEARCH BUT
ALSO DIVERSIFYING OUR WORKFORCE
AND THE TEAMS THAT WORK ON YOUR
RESEARCH STUDIES.
SO WE ASK FOR A PLAN THAT
DESCRIBES YOUR APPLICATIONS
APPROACH TO DOING THAT.
YOU'RE GOING TO START TO SEE
THOSE ACROSS MORE AND MORE
FUNDING OPPORTUNITIES ACROSS
NIH, SO WE HAVE ADDED THAT
REQUIREMENT FOR OUR APPLICANTS
AS WELL.
WE TRIED TO CLARIFY THE
NONRESPONSIVE CRITERIA,
INCLUDING SOME UPDATES OF NOT
ALLOWING FOR WEIGHT LESS
CONTROLS, WE'RE TRYING TO
ENHANCE RIGOR, AND MOST OFTEN
OUR TRIALS USE THE USUAL CARE
CONTROLS IF THEY'RE USING
EFFECTIVENESS QUESTIONS OR
TIME -- IF THEY'RE DOING
EFFICACY DESIGNS.
AND EVEN IN OUR FEASIBILITY
WORK, WE WANT PEOPLE TO FIND OUT
IF IT'S FEASIBLE TO KEEP PEOPLE
IN STUDIES WITH THE COMPARISON
GROUPS THEY'RE ULTIMATELY GOING
TO USE.
IMPORTANTLY WE'VE UPDATED OUR
LANGUAGE TO MAKE IT VERY CLEAR,
WE DON'T WANT YOU TO DO UNDER
POWER TESTS OF EFFICACY.
YOU'RE NOT POWERED, JUST DON'T
LOOK.
SO WE'VE UPDATED THAT LANGUAGE
AND INSTEAD IF YOU'RE DOING
FEASIBLE WORK, FOCUS ON
FEASIBILITY OUTCOMES SO WE'VE
GOT A LOT OF GUIDANCE ABOUT
THAT.
WE'VE ALSO TRIED TO CLARIFY WHEN
YOU'RE DOING MULTICOMPONENT
INTERVENTIONS, HELPING DIRECT
YOU TO WHICH IS THE RIGHT
FUNDING OPPORTUNITY DEPENDING ON
WHAT YOUR RESEARCH QUESTION IS
AND HOW MUCH IS KNOWN ABOUT THE
DIFFERENT COMPONENTS THAT YOU'RE
COMBINING.
SO THAT HAS BEEN UPDATED ACROSS
THE WHOLE SUITE OF MIND AND BODY
FUNDING OPPORTUNITIES AND THE
WHOLE SUITE OF NATURAL PRODUCT
FUNDING OPPORTUNITIES.
SO SPECIFIC CHANGES WE'VE MADE
TO THE MIND-BODY FUNDING
OPPORTUNITIES, THERE'S NOW A
WHOLE SECTION WITHIN EACH OF
THOSE THAT ARE DESIGN
CONSIDERATIONS, WHERE WE TALK
AGAIN ABOUT THE WAIT LIST AND
COMPARATOR ARM SELECTION,
HELPING PEOPLE TO -- WHAT'S YOUR
RESEARCH QUESTION AND THEN LET
THAT DRIVE WHAT YOUR COMPARISON
GROUP WOULD BE.
EMPHASIZING THOSE FEASIBILITY
STUDIES SHOULDN'T TRY TO ASSESS
EFFICACY.
WE'VE GOT SOME SUGGESTIONS IN
THERE ABOUT THINKING ABOUT
POWER, AND MANY OF OUR
INTERVENTIONS END UP WITH A
GROUP ELEMENT TO THEM AND SO WE
HAVE SOME INSTRUCTIONS IN THERE
ABOUT GROUP-BASED INTERVENTIONS,
BECAUSE YOU DO HAVE TO ACCOUNT
FOR THAT IN YOUR POWER
CALCULATIONS, AND YOU OFTEN WILL
HAVE A SIMILAR FACILITATOR THAT
INTRODUCES SOME CLUSTERING IN
THOSE STUDIES, AND IT'S
SOMETHING THAT WE'VE JUST -- ARE
WELL AWARE OF ACROSS ALL OF OUR
STUDIES AND WANT PEOPLE TO BE
THINKING ABOUT.
AND THEN WE'VE ALSO TRIED TO
CLARIFY WHEN MECHANISTIC
OUTCOMES MAKE SENSE.
YOU KNOW, IF YOU'RE DESIGNING
FOR AN EFFICACY STUDY, DESIGN
FOR THE EFFICACY STUDY.
IF YOU WANT TO STUDY HOW
SOMETHING WORKS, DESIGN A
MECHANISTIC TRIAL.
AND NOT TRY TO DO BOTH NOT SO
GREAT.
AT THE SAME TIME.
IS OFTEN WHAT WE THINK ABOUT.
SO WE'VE TRIED TO GIVE SOME
GUIDANCE ABOUT THAT AND WHEN
YOUR QUESTIONS MIGHT BE A BETTER
FIT WITH ANOTHER FUNDING
ANNOUNCEMENT.
EUI'M NOT GOING TO LIST ALL THEE
BUT I WANTED THEM IN THE SLIDE
DECK THAT'S GOING TO BE POSTED
SO THEY'RE ALL THERE AVAILABLE
FOR YOU.
I'VE MAPPED THEM HERE DIRECTLY
ON TO ALL OF THE CIRCLES ACROSS
THE FRAMEWORK.
YOU'LL NOTICE IN RED ARE THE
ONES THAT WE'VE JUST RECENTLY
PUBLISHED.
IN BLUE UNDER EACH ONE OF THE
DIFFERENT ONES ARE THE EXISTING
PARENT FUNDING OPPORTUNITIES
THAT CAN BE USED FOR THE OTHER
AREAS OF RESEARCH, INCLUDING OUR
BASIC AND MECHANISTIC RESEARCH
AS WELL AS THE DISSEMINATION AND
IMPLEMENTATION SCIENCE.
THOSE HAVE EXISTING FUNDING
OPPORTUNITIES ACROSS NIH THAT
ARE AVAILABLE.
ALMOST DONE.
FOR NATURAL PRODUCTS, WE UPDATED
A FEW THINGS.
WE DID MAKE A CHANGE IN TERMS OF
THE LANGUAGE THAT WE'RE USING.
WE HAD BEEN USING THE
TERMINOLOGY OF BIOLOGICAL
SIGNATURE, AND WE'VE HAD A LOT
OF QUESTIONS THAT CAME UP IN
REVIEW AND FROM INVESTIGATORS
ABOUT WHAT IF IT'S NOT A
BIOLOGICAL MEASURE, WHAT IF IT'S
MORE OF A TARGET ENGAGEMENT,
MAYBE A PSYCHOLOGICAL PROCESS.
I THINK OUR DEFINITION OF
BIOLOGICAL SIGNATURE INCLUDED
ALL OF THOSE OTHER THINGS, BUT
IT DID GET CONFUSING SO WE'VE
SWITCHED TO JUST TARGET
ENGAGEMENT LANGUAGE JUST TO MAKE
IT A LITTLE MORE CLEAR FOR
EVERYBODY.
SIMILAR UPDATES TO OUR
NONRESPONSIVENESS CRITERIA.
OUR PORTFOLIO RESEARCH IS ON
NATURALLY OCCURRING PRODUCTS, SO
SYNTHETICALLY MODIFIED COMPOUNDS
ARE NOT A FIT FOR US.
THAT WOULD BE MORE IN THE DRUG
DEVELOPMENT AND WOULD PROBABLY
BE A BETTER FIT WITH OTHER
INSTITUTES AND CENTERS.
ALL OF THESE FUNDING
OPPORTUNITIES ARE FOR CLINICAL
TRIALS, SO ANIMAL STUDIES ARE
NOT APPROPRIATE.
AND LOOK FOR AN UPDATE AROUND
PRIORITIZING STUDIES THAT REALLY
ADDRESS THE DIETARY INTAKE AND
THE BACKGROUND NUTRITIONAL
STATUS BEING REALLY IMPORTANT
FOR MANY OF THESE NATURAL
PRODUCTS THAT PEOPLE GET IN
THEIR BACKGROUND DIET AS WELL,
AND THAT'S AN IMPORTANT ELEMENT
FOR THESE STUDIES TO I TO ADDRES
EITHER IN THEIR STUDY DESIGN BUT
ALSO POTENTIALLY THEIR ANALYTIC
APPROACHES.
SO SIMILAR LIST HERE OF ALL OF
THOSE FUNDING ANNOUNCEMENTS.
AS I SAID, THERE ARE 11 OF THEM.
WE'VE MAPPED THEM AGAIN ACROSS
ALL OF THE DIFFERENT FUNDING
ANNOUNCEMENTS TO EACH OF THE
DIFFERENT CIRCLES, SO THAT YOU
CAN SEE WHERE THOSE MIGHT FIT.
WE'VE ALREADY HAD OUR FIRST
RECEIPT DATE.
IT WAS IN FEBRUARY.
THE NEXT ONES COME IN IN JUNE,
AND THEY ARE ACTIVE THROUGH
OCTOBER OF 2026.
WE ARE AWARE WE'RE GOING TO HAVE
TO UPDATE FOR THE NEW REVIEW
CRITERIA SO WE'LL GET TO REISSUE
THEM ALL AGAIN IN JANUARY, BUT
JUST TO THE NEW REVIEW CRITERIA.
AND THEN OUTREACH, WHAT ARE WE
DOING TO TELL ALL OF YOU ABOUT
THIS?
THIS IS ONE ELEMENT OF THAT
OUTREACH.
OF COURSE THEY WERE ALL
PUBLISHED IN THE NOTICE TO THE
GUIDE.
WE'VE UPDATED OUR WEBSITE AND
PROVIDED ALL THIS INFORMATION
THERE.
WE'VE ALSO DONE A DIRECTED EMAIL
OUTREACH TO ANYONE WHO'S
PREVIOUSLY APPLIED IN THE LAST
THREE YEARS, WE REACHED OUT AND
SOME OF YOU MAY HAVE GOTTEN
THOSE EMAILS RECENTLY.
TO TELL PEOPLE WHAT THE KEY
CHANGES ARE.
AND AS OF THIS MORNING, WE HAVE
LAUNCHED A NEW PLACE ON OUR
WEBSITE OF A LIBRARY OF VIDEOS
THAT WE ARE GOING TO BE MAKING
AVAILABLE, REALLY SHORT 3 TO
5 MINUTE CLIPS TO HELP
INVESTIGATORS THINK ABOUT
PUTTING TOGETHER APPLICATIONS,
AND SO THE REVIEW OFFICE,
DR. MACALVENE DID ONE ON MAKING
SURE YOUR APPLICATION GETS
REVIEWED, SO MAKING SURE YOUR
APPLICATIONS ARE COMPLETE,
COMPLIANT AND WHAT'S THE THIRD
ONE?
JESSICA IS NOT HERE.
THERE'S THREE.
COMPLETE, COMPLIANT AND I THINK
RESPONSIVE ARE THE THREE KEY
ELEMENTS TO THAT.
AND THEN I DID ONE SORT OF
OUTLINING THE FRAMEWORK, THE
SLIDES WILL LOOK VERY FAMILIAR
TO WHAT YOU JUST SAW FOR THAT
FIRST SET OF VIDEOS, BUT MORE TO
COME WITH THAT, AND WE'RE REALLY
EXCITED ABOUT THOSE AND YOU'LL
SEE A BLOG HERE VERY SOON
ROLLING OUT THAT NEW VIDEO
LIBRARY.
AND I THINK THAT'S IT.
I'M HAPPY TO TAKE ANY QUESTIONS.
OH, JUST RESOURCES.
HERE ARE ALL THE LINKS TO ALL OF
THIS INFORMATION SO YOU CAN FIND
IT ON OUR WEBSITE.
>> SO YOU MENTIONED THIS WOULD
BE ON YOUR WEBSITE.
WILL IT BE ON NCCIH WEBSITE TOO?
SO IT WILL BE ACCESSIBLE IN BOTH
PLACES?
>> YEAH, SO THIS IS ON THE NCCIH
WEBSITE.
IF YOU SEARCH FOR JUST OUR
FRAMEWORK YOU'LL FIND IT BUT
ALSO IN THE DROP DOWN LIST UNDER
CLINICAL TRIAL FUNDING
OPPORTUNITIES, THIS IS THE
LANDING PAGE THAT YOU'LL END UP
ON WITH ALL THIS INFORMATION.
>> PERFECT.
THANKS.
>> DR. HANEY.
>> THANKS FOR THAT.
I DON'T DO THESE STUDIES SO FEEL
FREE TO EXPLAIN WHY -- BUT I DO
REVIEW A LOT OF STUDIES THAT USE
WEIGHTLESS CONTROL.
WHAT'S THE REASON THEY'RE NO
LONGER ACCEPTABLE?
>> SO WE DID THINK A LOT ABOUT
THIS INTERNALLY BEFORE WE SORT
OF MADE THIS DECISION, AN AND A
WEIGHT LESS CONTROL DOES A
COUPLE OF DIFFERENT THINGS.
ONE, IT INFORMS THE INDIVIDUALS
WHO GET PUT INTO THAT CONDITION,
THAT SOMETIMES THEY DO NOT SEEK
OUT OTHER CARE AND SO IN A USUAL
CARE CONDITION, THEY'RE SORT OF
TOLD TO KEEP DOING WHATEVER IT
IS YOU WOULD DO NORMALLY FOR
YOUR TREATMENT.
IN THE WEIGHTLESS SITUATION,
THERE'S ACTUALLY SOME PUBLISHED
LITERATURE THAT SHOWS THAT
INDIVIDUALS WHO END UP IN A
WEIGHTLESS ACTUALLY DEFER CARE
AND DON'T SEEK CARE BECAUSE
THEY'RE WAITING FOR WHAT THEY'RE
GOING TO GET AT THE END OF THE
STUDY.
IN ADDITION, IT EXTENDS THE
DURATION OF THE TRIAL AND THE
PARTICIPANT'S ACTIVITY IN THE
TRIAL, AND YOU OFTEN HAVE SOME
RETENTION PROBLEMS AND OTHER
THINGS THAT CAN OCCUR BECAUSE OF
THAT.
IT INCREASES THE COST TO THE
FUNDER SIDE BECAUSE NOW YOU HAVE
TO PROVIDE THE INTERVENTION FOR
EVERYBODY INVOLVED AND IT
EXTENDS THE TIMELINE BECAUSE
AFTER EVERYONE FINISHES, YOU
ALSO HAVE TO HAVE THE WHOLE TIME
PERIOD AGAIN OF THE INTERVENTION
BEING DELIVERED.
SO -- AND FROM A RIGOR
PERSPECTIVE, WAIT LIST CONTROLS
AREN'T QUITE AS RIGOROUS AS --
CERTAINLY AS A TIME AND
ATTENTION CONTROL FOR AN
EFFICACY STUDY, AND FOR
EFFECTIVENESS TRIALS, YOU OFTEN
WANT PEOPLE DOING WHAT THEY
WOULD NORMALLY BE DOING IN A
USUAL CARE SETTING.
SO KIND OF FOR ALL OF THOSE
COMBINATION OF REASONS, THAT'S
SORT OF WHY WE WENT WITH THAT
DECISION.
>> THANK YOU.
>> THERE ARE SOME FEASIBILITY
STUDIES THAT ARE DONE WITHOUT A
COMPARISON GROUP, AND SO IF YOU
DON'T NEED FEASIBILITY DATA
ABOUT THE COMPARATOR GROUP, IF
IT ALREADY EXISTS, FOR EXAMPLE,
YOU'RE USING A VERY COMMON
COMPARISON GROUP IN YOUR FUTURE
STUDY, YOU MAY NOT NEED TO
COLLECT FEASIBILITY DATA, SO YOU
MAY NOT NEED TO EVEN HAVE A
COMPARATOR ARM IN SOME
FEASIBILITY TRIALS.
MORE OFTEN THAN NOT, YOU'RE
WANTING TO DO A FEASIBILITY OF
ARE PEOPLE WILLING TO BE
RANDOMIZED TO THE TWO CONDITIONS
THAT YOU'LL EVENTUALLY USE IN
YOUR FUTURE EFFICACY STUDY.
>> AND IS THIS AN NIH-WIDE DO
YOU THINK KIND OF APPROACH NOW?
>> NO, THIS IS NCCIH-SPECIFIC,
SO THIS IS ONLY THESE PARTICULAR
FUNDING OPPORTUNITIES THAT HAVE
THESE SPECIFIC REQUIREMENTS, AND
WITHIN EACH OF THE FUNDING
OPPORTUNITIES, YOU'LL SEE A LIST
OF NONRESPONSIVE CRITERIA, AND
WE'RE TRYING TO MAKE PEOPLE
AWARE OF THIS BECAUSE IF YOUR
APPLICATION IS NONRESPONSIVE, IT
WILL NOT GET REVIEWED.
AND SO YOU REALLY NEED TO LOOK
AT EVERY FUNDING OPPORTUNITY YOU
APPLY TO TO MAKE SURE YOU DON'T
ACCIDENTALLY FIT ONE OF THOSE
THINGS.
I WILL SAY ACROSS THE DIFFERENT
INSTITUTES AND CENTERS, THERE
ARE VERY DIFFERENT APPROACHES,
AND THERE ARE CERTAINLY IN SOME
CONDITIONS, POTENTIALLY FOR
EXAMPLE IN RARE CONDITIONS, RARE
DISEASES AND OTHER PLACES WHERE
A WAIT LIST CONTROL GROUP MAY BE
MORE APPROPRIATE OR MORE
ACCEPTABLE IN CERTAIN SCENARIOS.
I WOULD ALSO SAY THERE ARE TIMES
WHEN WE SEE MORE COMPLEX DESIGNS
THAT MIGHT BE LIKE A STEPPED
WEDGE ROLLOUT DESIGN WHERE SOME
PEOPLE MIGHT CALL IT A WAIT LIST
WHEN IN REALITY, IT'S REALLY
MORE OF A KIND OF USUAL CARE
SORT OF AS THEY'RE WAITING TO
GET IT ROLLED OUT.
SO I THINK TALKING WITH A
PROGRAM OFFICER AND MAKING SURE
THAT YOU'RE USING THE LANGUAGE
THAT REALLY DESCRIBES WHAT
YOU'RE DOING IN YOUR TRIAL FOR
WHEN IT MAKES SENSE TO
POTENTIALLY DO THAT.
>> GREAT.
THANKS SO MUCH.
>> YEP.
GREAT QUESTIONS.
>> I HOPE YOU CAN SEE CERTAINLY
FROM -- WE SPENT A LOT OF TIME
THINKING ABOUT HOW TO
COMMUNICATE INFORMATION ABOUT
FUNDING OPPORTUNITIES, FOR
EXAMPLE, ABOUT THINGS LIKE, YOU
KNOW, RULES AND THINGS TO NOT
LIST, BECAUSE WE REALIZED HOW
DIFFICULT IT IS, RIGHT, TO
NAVIGATE ALL THIS INFORMATION.
IT IS HARD -- NOT ONLY IS IT
HARD FROM YOUR -- FROM YOU ALL
TO UNDERSTAND, IT'S HARD FOR US
TO GET ALL THAT OUT IN A WAY
THAT IS -- BECAUSE THERE'S A LOT
OF COMPLEXITY UNDER THE HOOD IF
YOU SEE WHAT I MEAN.
SO WE REALLY WELCOME, RIGHT,
YOUR FEEDBACK ON THAT, YOU KNOW,
ESPECIALLY -- AND I THINK THIS
IS A GREAT EXAMPLE, RIGHT, THAT
WEBPAGE THAT WENDY JUST
DESCRIBED, PLEASE GO ON IT.
YOU ARE OUR COUNCIL, RIGHT?
WE WOULD LOVE FOR YOU ALL TO
GIVE US FEEDBACK ON THAT.
IF YOU LIKE IT OR YOU DON'T LIKE
IT, YOU KNOW, PLEASE LET US
KNOW, BECAUSE WE REALLY WANT TO
MAKE THIS AS USEFUL AS POSSIBLE.
SO --
>> I JUST WENT ON THE WEBSITE.
IT'S BEAUTIFUL, AND IT'S
REALLIREALLYEASY TO FOLLOW.
I REALLY LIKE THE WAY YOU GUYS
HAVE THOUGHT THROUGH CLINICAL
TRIALS AND, YOU KNOW, AGAIN, 10
YEARS AGO, WE DIDN'T DO A LOT OF
GREAT -- WE DID A LOT OF GREAT
CLINICAL TRIALS BUT WE DID A LOT
OF NOT SO GREAT CLINICAL TRIALS
TOO.
MAYBE THAT'S THE WORD.
AND I'M REALLY THANKFUL THAT
WE'RE NOW THINKING THROUGH THIS,
AND YES, NOT EVERY INSTITUTE HAS
REALLY THOUGHT THROUGH THAT -- I
THINK NIAMS HAS A SIMILAR
SYSTEM, BUT THEY DON'T ALL, AND
I THINK IT IS SOMETHING THAT IF
WE'RE GOING TO REALLY PROMOTE
HIGHEST RIGOR IS SO NEEDED.
SO THANK YOU, AND THANK YOU FOR
ALSO PUTTING TOGETHER THE
DETAILS OF THAT TOO, BECAUSE I
THINK THAT'S REALLY HARD FOR
PEOPLE TO UNDERSTAND WHAT DOES
THAT MEAN WHEN IT'S FEASIBILITY
VERSUS JUST A TRIAL OR EVEN JUST
GETTING TO THE POINT WHERE YOU
CAN DO FEASIBILITY.
SO IT IS NICE TO SEE IT ACROSS
THE BOARD.
>> YEAH, AND ONE THING THAT
WE'VE DISCOVERED IS WHAT WE'VE
HEARD FROM INVESTIGATORS BEFORE
WE HAD THIS WHOLE SUITE, WAS
THAT IT WAS HARD TO SORT OF --
LIKE YOU COULD FIND FUNDING
MAYBE SOMEWHERE TO DO A SMALL
PILOT.
AND THEN YOU COULD FIND
FUNDING -- YOU COULD COME IN AND
GET LIKE AN R01, WHICH MAY NOT
HAVE BEEN ENOUGH MONEY TO REALLY
BE REALLY WELL POWERED FOR THAT
STUDY.
BUT THE IN BETWEEN WAS MISSING,
AND SO MANY OF OUR
INTERVENTIONS, ESPECIALLY ON THE
MIND AND BODY SIDE, ARE REALLY
COMPLEX TO DELIVER.
AND TO DO THE FULLY POWERED
STUDY, YOU'RE LIKELY GOING TO BE
NEEDING TO ENROLL ACROSS MANY
SITES.
AND SO WE HAVE A SPECIFIC
R01 THAT'S A SMALLER R01 THAT'S
MEANT FOR DOING MULTISITE
FEASIBILITY TO FIGURE OUT HOW DO
YOU GET ALL OF THE SITE TO
DELIVER THE INTERVENTION WITH
FIDELITY ACROSS ALL OF THOSE
PLACES, BECAUSE IT'S HARD TO DO.
AND SO WE'VE JUST LEARNED THAT
WE'VE HAD ENOUGH TRIALS STRUGGLE
WITH THOSE ACTIVITY THAT WE FELT
THAT THAT WAS A REALLY IMPORTANT
ELEMENT.
THE OTHER THING YOU'LL SEE IN
OUR SUITE THAT I DIDN'T DRAW OUT
IS WE HAVE A SPECIFIC FUNDING
ANNOUNCEMENT FOR VIRTUAL OR
MHEALTH LIKE APP-DELIVERED
INTERVENTIONS OR STUDIES THAT DO
ALL OF THEIR DATA COLLECTION AND
ENROLLMENT WITHOUT ACTUALLY
SEEING THE PATIENT.
AND BECAUSE THE PRACTICALITIES
OF THAT ARE A LITTLE BIT
DIFFERENT, AND THEY DON'T
REQUIRE AN INDEPENDENT DATA
COORDINATING CENTER, THEY CAN BE
DONE CENTRALLY WITH SORT OF
OUTREACH ACROSS THE COUNTRY, AND
SO WE'VE CREATED A SPECIFIC
ANNOUNCEMENT FOR THAT AS WELL.
>> DATA COORDINATING CENTER
THEN?
>> WE DO.
>> TH.THAT WE CAN WORK WITH, NOE
TO BRING ONE IN, FIND ONE.
>> WE THOUGHT ABOUT THAT TOO.
AT THIS POINT, WE STILL ASK
PEOPLE TO BRING THEIR OWN.
IF THEY'RE DOING A FULLY POWERED
MULTISITE EFFICACY TRIAL, WE DO
ASK FOR A SET OF APPLICATIONS.
THE CLINICAL COORDINATING CENTER
AND A DATA COORDINATING CENTER
THAT'S INDEPENDENT SO THEY KEEP
ALL OF THE DATA AND CAN DO THE
SITE MONITORING ACTIVITIES IS
HOW WE'VE SET IT UP.
SIMILAR TO MANY OTHER INSTITUTES
THAT HAVE THAT SORT OF MODEL,
YEAH.
>> THANK YOU FOR THAT GREAT
PRESENTATION, AND I'M REALLY
LOOKING FORWARD TO GOING AND
LOOKING AT THAT WEBSITE.
HI A QUESTION I HAD A QUESTION N
TRAINING GRANTS THAT MIGHT WANT
TO DO A CLINICAL STUDY.
WHAT WOULD YOU ADVISE THEM ABOUT
WHAT INFORMATION ON THAT WEBSITE
IS RELEVANT TO THEM?
AND SHOULD THEY BE LOOKING
ELSEWHERE AS WELL OR -- BECAUSE
THE NOFOs THAT YOU MENTIONED
PROBABLY DON'T APPLY TO THEM.
>> RIGHT.
SO WE HAVE A WHOLE SEPARATE
SUITE OF FUNDING ANNOUNCEMENTS
THAT ARE NIH-WIDE FOR TRAINEES.
FELLOWS, POSTDOCTORAL FELLOWS,
PREDOCTORAL FELLOWS, F31 AND
F32s BY NIH POLICY CANNOT DO A
STANDALONE CLINICAL TRIAL.
THEY SHOULD BE WORKING ON THEIR
MENTORS OR THEIR SPONSORS'
ACTIVITIES AND GETTING INVOLVED
IN CLINICAL RESEARCH.
BUT THOSE AWARDS JUST DON'T
PROVIDE FUNDS TO BE ABLE TO
SUPPORT STANDALONE CLINICAL
TRIALS.
THE K AWARDS DO ALLOW FOR THAT.
WE OFTEN RECOMMEND THAT PEOPLE
THINK ABOUT SORT OF THE EARLIER
ALONG IN THE PIPELINE OF THE
SUITE OF FUNDING ANNOUNCEMENTS,
SO FOR NATURAL PRODUCTS
RESEARCH, KIND OF THE SCOPE THAT
YOU MIGHT SEE IN OUR R61 OR IN
OUR MECHANISTIC CLINICAL TRIALS,
AND THEN FOR ON THE MIND AND
BODY SIDE, IT MIGHT BE THINGS
LIKE A SINGLE SIDE OR
POTENTIALLY MULTISITE BUT THOSE
K AWARDS HAVE VERY LIMITED
BUDGETS SO SCOPING WHAT CAN BE
DONE WITHIN THE TIME AND THE
BUDGET THAT'S AVAILABLE IS THE
CONVERSATION WE HAVE WITH OUR
APPLICANTS TO THOSE FUNDING
MECHANISMS.
BUT THEN THEY'RE OFTEN SET UP
WITH THE PRELIMINARY DATA TO
COME IN FOR THE NEXT ONE, SO
MAYBE THEY CAN COME IN FOR THE
MULTISITE FEASIBILITY OR THEY
CAN COME IN FOR AN R33 ON THE
NATURAL PRODUCT SIDE AND HAVING
GATHERED THEIR PRELIMINARY DATA
IN THEIR K AWARDS.
YEAH.
JUDITH.
>> THANKS, WENDY.
SO WE HAVE THIS ONGOING
CONVERSATION, MY COLLEAGUES AND
I, ABOUT WHETHER OR NOT YOU NEED
TO DO AN EFFICACY TRIAL BEFORE
YOU APPLY FOR AN EFFECTIVENESS
TRIAL.
SO YOU START WITH THE R34, SO
YOU HAVE ONE SITE FEASIBILITY
DATA, AND THEN YOU MOVE TO THE
R01 WHICH WE CALL THE MINI R01,
WHERE -- SINCE IT'S NOT MUCH
MONEY AND YOU HAVE ENOUGH FOR
FEASIBILITY AT TWO SITES, AND
THEN YOU MOVE DOWN THE CONTINUUM
TO THE EFFECTIVENESS TRIAL.
BUT I HAVE SO MANY COLLEAGUES
THAT SAY, YOU KNOW WHAT, IF YOU
DON'T HAVE PRELIMINARY EFFICACY
DATA, YOU'LL NEVER GET FUNDED ON
THE EFFECTIVENESS TRIAL.
SO THEY'RE RETICENT TO GO FROM
THE R34 TO THE R01 MULTISITE
FEASIBILITY STUDY BECAUSE
THEY'RE AFRAID THEY WON'T HAVE
EFFICACY DATA TO THEN APPLY FOR
AN EFFECTIVENESS TRIAL.
>> SO THE FUNDING ANNOUNCEMENT
THAT SUPPORTS THE EFFECTIVENESS
STUDIES ALSO SUPPORTS EFFICACY
TRIALS.
SO YOU CAN USE THAT UG3UH3 AND
U24 PAIR FOR EITHER.
AND WHAT I WOULD SAY IS YOU'VE
GOT TO MAKE THE CASE TO
REVIEWERS AND TO THE FUNDER OF
WHAT IS THE APPROPRIATE QUESTION
THAT NEEDS TO BE ASKED AND
WHAT'S THE APPROPRIATE
COMPARISON GROUP FOR THAT
RESEARCH QUESTION.
IF YOUR QUESTION IS IS THIS
INTERVENTION THAT HAS A SPECIFIC
EFFECT AND IT'S MORE THAN JUST
THE TIME AND ATTENTION THE
INDIVIDUAL IS GETTING, THEN AN
EFFICACY QUESTION WHERE MAYBE
IT'S NOT A SHAM INTERVENTION BUT
MAYBE IT'S A TIME AND ATTENTION
CONTROL WITH AN EFFICACY DESIGN
WOULD BE THE APPROPRIATE DESIGN.
IF YOUR QUESTION IS DOES THIS
INTERVENTION WORK BETTER THAN
USUAL CARE, THAN AN
EFFECTIVENESS DESIGN MAY STILL L
BE IN A RESEARCH SETTING, NOT IN
A CLINICAL SEGHT BUT LIKE A
REGULAR EFFECTIVENESS STUDY
MIGHT BE THE QUESTION YOU'RE
TRYING TO ENS A.
YOU'VE GOT TO MAKE THE
CONVINCING CASE TO REVIEWERS AND
TO THE FUNDERS THAT THE QUESTION
YOU'RE ASKING, THERE'S
SUFFICIENT PRELIMINARY DATA FOR
THAT PARTICULAR QUESTION.
WE HAVE A LIST OF WHAT
PRELIMINARY DATA IS NEEDED FOR
EITHER THE EFFICACY OR THE
EFFECTIVENESS QUESTION IN THAT
FUNDING ANNOUNCEMENT.
GREAT QUESTION, THOUGH.
GREAT QUESTION.
DR. LAVRETSKY.
>> AFTER SERVING ON THE COUNCIL
BUT ALSO LEAVING IT, THE
INSTITUTE HAS MADE AN INVESTMENT
INTO FEASIBILITY STUDIES OF ALL
SORTS.
AND I'M JUST -- AND IT'S
REASONABLE GIVEN THE STATE OF
THE FIELD.
I'M JUST CURIOUS ABOUT THE
CONVERSION TO R01s OR OTHER --
MORE OF THOSE MECHANISMS, DO YOU
FOLLOW THE RATE OF CONVERSION
FROM FEASIBILITY TO R01 AND
EFFECTIVENESS TRIALS.
>> YEAH, IT'S SOMETHING WE'RE
TRACKING INTERNALLY.
IT MIGHT BE SOMETHING WE WANT TO
BRING AND PRESENT HERE
EVENTUALLY.
I THINK WE ARE STARTING TO SEE
THOSE APPLICATIONS COME IN.
PEOPLE ARE FINISHING NOW THE
MULTI-SIDE FEASIBILITY WORK.
WE'VE GOT OUR FIRST WAVE OF
THOSE THAT ARE COMPLETING AND WE
ARE STARTING TO SEE THOSE
APPLICATIONS.
WE'RE ALSO STARTING TO SEE THOSE
INDIVIDUALS GO TO THE HEAL
INITIATIVE OR OTHER PLACES FOR
FUNDING OF THE MULTISITE
EFFICACY STUDIES, BUT WE ARE
STARTING TO SEE PEOPLE MOVE DOWN
THAT TRANSITION ALONG THAT PIPE
LINE.
THE OTHER THING I WILL SAY IS
THAT THE LAST TIME H WE REVAMPED
THESE FUNDING ANNOUNCEMENTS WE
TRIED TO UPDATE THEM SO PEOPLE
COULD CITE THE LITERATURE OF
OTHER FEASIBILITY WORK SO THAT
YOU DO NOT NEED TO REPEAT
FEASIBILITY WORK.
I OFTEN WILL GIVE THE EXAMPLE
LIKE WE KNOW MOST PEOPLE CAN DO
YOGA OR MOST PEOPLE CAN
MEDITATE.
LIKE YOU DON'T NEED TO SHOW ME
IN THIS SPECIFIC POPULATION THAT
PEOPLE CAN DO THIS KIND OF
THING.
SO YOU'RE OFTEN ABLE TO CITE THE
LITERATURE AND MOVE TO THE NEXT
STAGE WHICH MIGHT BE MULTISITE
FEASIBILITY OR IT MAY BE GOING
STRAIGHT TO AN EV EFFICACY OR
EFFECTIVENESS STUDY.
WE'RE TRYING TO MAKE SURE PEOPLE
DON'T HAVE TO GO BACK AND START
AT THE BEGINNING EVERY SINGLE
TIME BUT INSTEAD YOU CAN CITE
THE LITERATURE OF PEOPLE WHO'VE
DONE SIMILAR WORK WITH A SIMI
SIMILAR -- OR IN A SIMILAR
PATIENT POPULATION IS THE WAY WE
FRAMED IT AS AS PRELIMINARY DATA
REQUIREMENT.
GREAT QUESTION.
>> ONE QUESTION.
I WAS LOOKING AT THE WEBSITE, AT
THE MHEALTH ONE FOR EXAMPLE, AND
SO IT LOOKS LIKE THAT WILL GO TO
A SPECIAL EMPHASIS PANEL SO THAT
IT'S ALL ONLINE AND THEY RE --
THE REVIEW PANELS UNDERSTAND
THAT.
WAS THAT THE LOGIC OR HOW DID
YOU COME ABOUT CREATING THAT
RFA, WHY IS THAT NEEDED FOR
NCCIH SPECIFICALLY AS OPPOSED TO
THE BROADER RFA?
>> I FEEL LIKE I SHOULD HAVE MY
COLLEAGUE DR. MUDD COME UP AND
ANSWER THIS QUESTION BUT I'LL
TRY MY BEST.
WHAT WE IDENTIFIED WAS -- WELL,
FIRST OF ALL FOR ALL OF THESE
FUNDING OPPORTUNITY
ANNOUNCEMENTS THAT I'VE TALKED
ABOUT TODAY, WE HAVE A SPECIAL
EMPHASIS PANEL AT NCCIH THAT
REVIEWS ALL OF THEM, OUR
CLINICAL TRIAL SUITE.
AND WE ARE FORTUNATE THAT WE'RE
ABLE TO WORK WITH OUR COLLEAGUES
IN REVIEW AND WE ACTUALLY ORIENT
ALL OF OUR REVIEWERS TO THE
SPECIAL REVIEW CRITERIA THAT WE
HAVE ACROSS ALL OF THESE.
SO WE REALLY TRY HARD TO MAKE
SURE THAT THE REVIEWERS AREN'T
GIVING MESSAGES OF WHAT'S NOT
ALLOWED, SO WE DON'T ALLOW EARLY
TEST OF EFFICACY SO WE REALLY
DON'T WANT YOU TO GET A COMMENT
IN YOUR SUMMARY STATEMENT SAYING
WHY AREN'T YOU LOOKING AT
EFFICACY?
AND IT'S BEEN A GREAT
COLLABORATION WITH PROGRAM AND
REVIEW IN THAT WAY.
WITH THE APPROPRIATE SEPARATION
THAT WE NEED TO HAVE THERE.
WHAT WE REALIZED AN THIS WAS
BEFORE THE PANDEMIC IS WE
STARTED TO SEE MORE AND MORE
MHEALTH TYPES OF APPLICATIONS
WITH APPS AND OTHER THINGS LIKE
THAT IN OUR EXISTING SUITE OF
FUNDING OPPORTUNITIES JUST
DIDN'T FIT, BECAUSE FOR OUR
LARGER MULTISITE TRIALS, WE WANT
TO HAVE AN INDEPENDENT DATA
COORDINATING CENTER AND A
CLINICAL COORDINATING CENTER.
AS WE WERE TALKING TO M AL CAN'T
THAT WERE COMING IN WITH MHEALTH
APPLICATIONS WE'RE LIKE THIS
DOESN'T MAKE SENSE, WHY DO I
HAVE TO HAVE A WHOLE SEPARATE
GROUP DO THIS WHEN I'M NOT
DELIVERING CLINICAL CARE AND WHY
DO I NEED -- LIKE IT JUST DIDN'T
FIT.
AND SO THAT'S WHY WE CREATED THE
SEPARATE ONE FOR THE
R01 SPECIFICALLY FOR THAT.
IS THAT IT JUST SEEMED TO FIT
MUCH BETTER WITH THE KIND OF
SCIENCE AND THE WAY THAT THOSE
TRIALS ARE DESIGNED.
>> WE SHOULD ALSO SPECIFY THIS
IS NOT AN RFA, RIGHT?
>> CORRECT.
THESE ARE --
>> THAT'S IMPORTANT TO
UNDERSTAND.
ALL THESE ACRONYMS GET VERY
CONFUSING.
>> THEY DO.
>> SO WE TALK NOW ABOUT FUNDI
FUNDING -- NOTICE OF FUNDING
OPPORTUNITIES.
WHEN THERE IS A SETASIDE AMOUNT
OF MONEY FOR A SPECIFIC SET OF,
YOU KNOW, AN OPPORTUNITY, THEN
IT'S AN RFA.
SO NONE OF THESE ARE RFAs SO
FAR.
THAT WE WENDY TALKED ABOUT.
>> IT ALSO MEANS WE HAVE
MULTIPLE RECEIPT DATES FOR
THESE, SO WE ACCEPT FOR THAT
PARTICULAR FUNDING OPPORTUNITY,
APPLICATIONS EVERY CYCLE.
AND SO PEOPLE CAN COME IN
MULTIPLE TIMES AND IT'S --
PEOPLE COMPETE FOR THE COMPETING
LINE AND THEY'RE ALL CONSIDERED
INVESTIGATOR INITIATED
APPLICATIONS.
EXCELLENT DISCUSSION.
ONE MORE QUESTION?
>> YOU CAN CUT ME OFF.
I JUST -- THIS IS ABOUT THE -- I
GUESS THE MIND-BODY
INTERVENTIONS, AND I THINK I
UNDERSTAND KIND OF WHAT'S IN, TA
CHEE, YOGA, ACUPUNCTURE,
MEDITATION, BUT I'M NOT CLE SURF
THERE'S A CLEAR DEFINITION OF
WHAT'S OUT.
SO IS THERE SOME NEW VARIANT OF
CBT, NEUROSTIMULATION --
>> YEAH, I MEAN, I THINK
CERTAINLY IT'S WITHIN THE RANGE.
I WOULD SAY THINGS THAT ARE --
CBT FOR DEPRESSION IS REALLY
WELL DONE, SO WHAT WOULD BE NEW
IN THAT SPACE, AND WE ARE OFTEN
HAVING CONVERSATIONS WITH OUR
COLLEAGUES ACROSS THE REST OF
NIH TO SEE WHAT WILL THEY FUND,
WHAT WON'T THEY FUND, SORT OF
WHERE WE HAVE OVERLAP WITH OUR
PARTNERS ACROSS NIH.
BUT I THINK -- TALK TO US IS
WHAT I WOULD SAY, AND CONTACT A
PROGRAM OFFICER IF YOU'RE NOT
SURE IF IT'S A GOOD FIT.
I DON'T THINK WE HAVE A VERY
SPECIFIED DEFINITION POTENTIALLY
IN SOME WAYS ON OUR WEBSITE BUT
GO AHEAD.
>> WE'VE CHANGED OUR LANGUAGE,
RIGHT?
WE HAVE CHANGED OUR LANGUAGE, WE
TALK ABOUT BIG CATEGORIES OF
NUTRITIONAL, PSYCHOLOGICAL AND
PHYSICAL AS OPPOSED TO BEFORE WE
USED TO SAY THE TERM MIND AND
BODY TO SORT OF REFER TO A
CERTAIN GROUP OF MOSTLY
COMPLEMENTARY THERAPIES.
SINCE THE BEGINNING OF THE
PREVIOUS STRATEGIC PLAN, WE'VE
BROADENED THAT.
SO AN INTERVENTION CAN BE
PRIMARILY HAVE A PSYCHOLOGICAL
INPUT AND THAT WOULD INCLUDE
SOMETHING LIKE CBT, MIGHT ALSO
INCLUDE MEDITATION, A PROJECT
MIGHT HAVE A PRIMARY PHYSICAL
BUT NOT ENTIRELY PHYSICAL LIKE
MASSAGE FOR EXAMPLE, OR IT COULD
BE A COMBINATION OF PSY
PSYCHOLOGICAL AND PHYSICAL.
YOGA MIGHT FIT NIEZLY IN THERE.
NICELY IN THERE.
SO WE'VE KIND OF BROADENED THE
BOUNDARIES OF IT AND THAT'S
ACTUALLY IMPORTANT SO PEOPLE
DON'T FEEL LIKE THERE ARE A
SPECIFIC LIST OF THINGS THAT I
WILL FUND OR DON'T FUND.
>> ONE THING WHICH FALLS INTO
THIS CATEGORY IS THAT ALL THE
FUNDING OPPORTUNITIES THAT WENDY
HAS BEEN TALKING ABOUT ARE
PARs.
ONLY NCCIH IS SUPPORTING THEM.
SO WHAT SHE HAS BEEN MENTIONING
ABOUT REACHING OUT TO THE
PROGRAM OFFICER IS REALLY
CRITICAL, AND IT'S CRITICAL FROM
A REFERRAL PERSPECTIVE, BECAUSE
IF YOU APPLY TO A NOFO WHERE 10
INSTITUTES ARE SIGNED ON TO, IF
IT'S NOT A GOOD FIT FOR NCCIH,
IT'S ESSENTIALLY WHAT WE CALL
SHOP AROUND, THAT ONE OF THE
OTHER ICs MIGHT FIT IT, BUT
BECAUSE OF THESE, ONLY NCCIH IS
PARTICIPATING.
IF NCCIH LOOKS AT IT AND IT'S
NOT RESPONSIVE, IT IS BEING --
BECAUSE OF THIS, IT'S REALLY
IMPORTANT IF YOU HAVE ANY
QUESTIONS OR ARE NOT SURE TO
TALK TO THE PROGRAM OFFICER
SIMPLY TO MAKE SURE.
>> THERE'S A LOT OF DETAIL.
COMMUNICATING ALL OF THIS STUFF
IS IMPORTANT.
AND DIFFICULT.
SO THIS IS WHY IF YOU HAVE
SUGGESTIONS TO US AND STUFF THAT
IS NOT CLEAR OR THAT YOU FIND
TALKING TO YOUR COLLEAGUES, YOU
SEE THAT A LOT OF PEOPLE ARE, MY
BIG PET PEEVE IS ACRONYMS.
I GET LOST IN THEM ALL THE TIME.
AND MYSELF, YOU KNOW?
SO IF YOU FIND THAT THERE ARE
CERTAIN THINGS THAT YOU FIND
PARTICULARLY CONFUSING, WE
REALLY WANT TO HEAR THAT.
>> I JUST WANTED TO MAKE A QUICK
COMMENT.
I THINK YOU DID AN EXCELLENT JOB
OF ARTICULATING WHY YOU NEEDED
TO HAVE A TWO-SITE FEASIBILITY
STUDY VERSUS AN EFFICACY TRIAL
AT A CERTAIN PHASE.
THAT WAS VERY HELPFUL.
I'VE HEARD A LOT OF GREAT
COMMENTS ABOUT THAT FROM MY
COLLEAGUES.
>> MAYBE THAT WILL BE ONE OF OUR
UPCOMING VIDEOS.
OF THE IMPORTANCE FOR THAT.
YEAH.
THESE CONVERSATIONS WE
FREQUENTLY HAVE WITH APPLICANTS,
THOSE ARE THE ONES THAT WE'RE
TRYING TO, YOU KNOW, GET INTO A
3 TO 5-MINUTE VIDEO SO PEOPLE
CAN FIND THAT INFORMATION AND
FIND IT THEMSELVES AND THAT'S
WHAT WE'RE HOPING TO PUT IN SOME
OF THOSE VIDEOS.
TO MAKE THAT HELPFUL.
WHY NOT WAIT LIST, YOU KNOW, WHY
NOT -- SOME OF THOSE DIFFERENT
QUESTIONS.
BUT THE MULTISITE FEASIBILITY IS
A UNIQUE CHALLENGE FOR
BEHAVIORAL INTERVENTIONS.
>> ALSO I MIGHT ADD BECAUSE IF
YOU'VE BEEN FUNDED BY OTHER
INSTITUTES WHERE, FOR INSTANCE,
YOU KNOW, I HAD AN R21 WHERE THE
REVIEWER CAME BACK AND WE WROTE
IT AS A FEASIBILITY STUDY BUT
YET THEY'RE LIKE, WELL, WE WANT
YOU TO ALSO DO BEGINNING
EFFICACY.
SO YOU KIND OF HAVE IT HAMMERED
INTO YOUR MIND ABOUT, YOU KNOW,
HOW TO APPROACH CERTAIN
APPLICATIONS AND SO IT'S VERY
DIFFERENT FOR NCCIH.
SO THAT'S WHY THE WORK YOU DID
WITH THE TWO-SITE FEASIBILITY
STUDY AND THE ONE-SITE
FEASIBILITY STUDY WAS REALLY SO
NECESSARY TO SORE MANY FOR SO MY
INVESTIGATORS.
>> WE'LL DEFINITELY HAVE A VIDEO
ABOUT THE PRELIMINARY EFFICACY.
THIS HAS BEEN AN ONGOING -- I
THINK IT'S BEEN PROBABLY -- I
THINK WE'VE BEEN TALKING WITHIN
OUR GROUP ABOUT 15 TO 20 YEARS
AS STATISTICIANS OF TRYING TO
INFORM THE COMMUNITY ABOUT HOW
LITTLE WE LEARN FROM LOOKING AT
EFFICACY IN SMALL STUDIES.
THERE'S AN UNFORTUNATE TERM THAT
GETS USED SOMETIMES TALKING
ABOUT SMALL C TRIALS THAT ARE
OUT THERE AND SO -- AND YET
FEASIBILITY WORK IF YOU REALLY
FOCUS ON FEASIBILITY AND, LIKE,
WILL PEOPLE DO IT, DO THEY STAY
IN THE TRIAL, CAN YOU ACTUALLY
RECRUIT, CAN YOU HIT YOUR
TARGETS.
GETTING THAT DONE WELL SETS YOU
UP FOR SUCCESS IN THOSE FUTURE
STUDIES AND THAT'S REALLY WHAT
WE'RE TRYING TO GET PEOPLE TO
FOCUS ON IN THOSE FEASIBILITY
TRIALS.
>> DO YOU SEE THIS BEING PICKED
UP BY OTHER INSTITUTES THIS,
KIND OF APPROACH?
BECAUSE I THINK IT'S REALLY
NICE.
AND I THINK IT'S SUPER NEEDED.
>> I JUST WANT TO REFLECT ON A
COMMENT YOU MADE AT THE
BEGINNING, WE DID A LOT OF GOOD
STUDIES, BUT WE DID A LOT OF BAD
STUDIES EARLY ON AS AN NIH.
I THINK THE CREDIT THIS TEAM,
NCCIH, WHAT YOU'VE DONE, WHAT
THIS TEAM HAS DONE, IS TO PARSE
OUT WHAT REALLY IT TAKES TO DO A
GOOD CLINICAL TRIAL AND IT'S NOT
JUST SUBMITTING AN R01.
YOU'RE GETTING -- MAYBE SOME OF
THEM DON'T TRANSITION BUT THAT'S
A GOOD THING IN A WAY BECAUSE
WE'VE LEARNED MAYBE THEY
SHOULDN'T.
SO WHAT WE'VE DONE IS REALLY
PARSE OUT WHAT IT MEANS TO DO
CLINICAL RESEARCH AND NOT JUST
PUT IT INTO A -- A SQUARE PEG
INTO A ROUND HOLE AND SAY
R01 BECAUSE IT DOESN'T WORK.
ONE OF THE BREAK THROUGHS, WE
GAVE PEOPLE TIME TO PLAN FOR A
STUDY, WE DIDN'T JUST EXPECT
THEM ON DAY ONE UNDER THE R01 TO
START THE PROJECT.
WE GAVE A WHOLE YEAR TO PLAN AND
IF THE PLANNING DOESN'T WORK
OUT, YOU DON'T COMMIT THE FUNDS
TO DO THE STUDY.
SO I THINK IT'S JUST EVOLVING
AND I THINK NIH -- TO YOUR
POINT, I THINK OTHER INSTITUTES
ARE SEEING WHAT WE'RE SEEING.
WENDY, YOU TRAVEL IN THESE
CIRCLES OR HELENE, YOU MIGHT
COMMENT, BUT I THINK -- AND
CERTAINLY WHAT THE NIH DIRECTOR
IS TRYING TO DO WITH THE PRIMARY
CARE NETWORK, I THINK SHE
PROBABLY COULDN'T PROPOSE THAT
HAD WE NOT LEARNED A LOT ABOUT
HOW TO REALLY DO WELL ORGANIZED
RIGOROUS CLINICAL RESEARCH, SO
YEAH, WE'VE COME A LOCK WAY, I
LONG WAY, IGUESS IS THE POINT.
>> BUT I MUST SAY, IT'S A BIT
FRUSTRATING TO INVESTIGATORS.
IT'S SORT OF LIKE WE HAVE TO SIT
ON YOUR HANDS, RIGHT?
SO YOU'VE DONE THIS R34 OR THIS
GREAT FEASIBILITY STUDY, AND
THEN YOU'RE JUST CHOMPING AT THE
BIT TO DO AN EFFICACY TRIAL AND
ALL OF A SUDDEN YOU'VE GOT TO DO
ANOTHER FEASIBILITY STUDY.
AND I THINK IT IS A RETRAINING
OF INVESTIGATORS EN MASSE THAT
IT'S JUST AS GLORIOUS TO DO A
TWO-SITE FEASIBILITY STUDY
VERSUS AN EFFICACY TRIAL.
IT MUCH MORE FLASHY AND MUCH
MORE PRESTIGIOUS TO DO AN
EFFICACY TRIAL.
OH, NUTS, I'VE GOT TO DO A
TWO-SITE FEASIBILITY STUDY NOW.
>> IT DOES TAKE SOME PATIENCE
AND DISCIPLINE, DOESN'T IT, TO
FOLLOW THE STEPS, BUT THAT'S WHY
WE GET FAIRLY GOOD RESULTS,
RIGHT?
WE'RE MORE DELIBERATE THAN WE US
USED TO BE INSTEAD OF JUST JU
JUMMING INTJUMPING INTO THE DEE.
>> THANK YOU SO MUCH, WENDY.
MAYBE WE SHOULD MOVE ON TO THE
NEXT THING BECAUSE I KNOW SOME
PEOPLE HAVE PLANES TO CATCH.
OUR NEXT IS UPDATE ON COP CONCET
FOR REISSUE OF RESEARCH ACROSS
COMPLEMENTARY AND INTEGRATIVE
HEALTH INSTITUTIONS OR REACH
VIRTUAL R RESOURCE CENTERS.
>> USUALLY WE VOTE ON CONCEPTS.
SO YOU ARE HEARING TWO TODAY,
BOTH OF THEM ARE UPDATES.
SO BOTH OF THESE CONCEPTS HAVE
ALREADY RECEIVED COUNCIL
CLEARANCE, BUT WE WANTED TO
PROVIDE AN UPDATE HERE, WHY,
BECAUSE OF WHAT DR. LANGEVIN HAS
JUST BEEN TALKING ABOUT A COUPLE
OF MINUTES AGO, THE CONCEPTS
BECOME FUNDING OPPORTUNITY, THE
FUNDING OPPORTUNITY RESULT IN
APPLICATIONS, AND YOU WILL SEE
THESE APPLICATIONS HERE A SECOND
LEVEL OF REVIEW, SO WE WANTED TO
PROVIDE THIS UPDATE TO YOU.
>> GREAT.
THANK YOU.
WE WERE JUST TALKING ABOUT HOW
DIFFICULT IT IS TO NAVIGATE NIH,
EVEN AS EXPERIENCED
INVESTIGATORS WE HAVE A LOT OF
QUESTIONS SO I'M REALLY PLEASED
TO PRESENT AN UPDATE ON THIS
CONCEPT TO REISSUE THESE VIRTUAL
RESOURCE CENTERS, RESEARCH
ACROSS COMPLEMENTARY AND
INTEGRATIVE HEALTH INSTITUTIONS
OR REACH, AS REALLY OUR OVERALL
GOAL FOR THESE RESOURCE CENTERS
IS THAT IT MAKES IT EASIER FOR
CLINICIAN-SCIENTISTS WHO ARE
LOCATED AT COMPLEMENTARY AND
INTEGRATIVE HEALTH INSTITUTIONS
TO NAVIGATE NIH AND GET FUNDING
FOR THEIR WORK.
SO I'M JUST GOING TO DISCUSS THE
CLEARANCE PROCESS WE USED.
AND THEN TALK A LITTLE BIT ABOUT
THE OUT COME OF OUR PREVIOUS
INITIATIVE.
THIS IS A REISSUE OF THE REACH
CENTER PROGRAM, AND THEN I'LL
GIVE A FULL OVERVIEW OF WHAT
REACH CENTERS ARE.
AS MARTINA SAID, WE DID ALREADY
OBTAIN COUNCIL CLEARANCE TO
REISSUE THE REACH CENTER
INITIATIVE IN MARCH.
WE MOVED FORWARD WITH THAT VIA
EARLY CONCURRENCE, AND REALLY
THE GOAL OF REISSUING THIS
INITIATIVE IS TO CREATE A
NETWORK OF REACH CENTERS THAT
CAN BETTER SUPPORT A DIVERSE
ARRAY OF RESEARCH ACTIVITIES AND
TRAININGS FOR
CLINICIAN-SCIENTISTS.
AND SO OUR PREVIOUS INITIATIVE
WAS IN FY 23, AND WE WERE ABLE
TO FUND ONE CENTER OUT OF THAT
INITIATIVE AT THE RAND
CORPORATION LED BY DRS. PATRICIA
HERMAN AND ANNE COULTER.
IN THAT APPLICATION, THEY
PARTNERED WITH 13 COMPLEMENTARY
AND INTEGRATIVE HEALTH
INSTITUTIONS AND PROPOSED A
COMPREHENSIVE RESOURCE CENTER TO
SUPPORT CLINICIAN, SCIENTISTS
FACULTY LOCATED AT ALL OF THOSE
INSTITUTIONS.
I'VE INCLUDED THE WEBSITE TO
THEIR CENTER HERE SO YOU CAN
LEARN MORE ABOUT ALL OF THE
DIFFERENT RESOURCES THAT THEY
HAVE UP AND RUNNING.
THIS CENTER STARTED IN AUGUST OF
LAST YEAR, AND YOU CAN SEE HERE
A LAUNCH WEBINAR THAT WE
PARTICIPATED IN JOINTLY.
I THINK ONE MORE CLICK.
SO I WANTED TO PROVIDE AN
OVERVIEW OF THE REACH CENTER
PROGRAM.
AS I SAID WE WANTED TO EXPAND A
NETWORK OF THESE RECH CENTE REAS
THAT CAN BE FOCUSED IN DIFFERENT
AREAS OF SCIENCE BUT ALSO USE
DIFFERENT METHODS TO PROVIDE
THESE DIFFERENT RESOURCES.
REALLY TO BACK UP AND PROVIDE A
LITTLE BIT OF THE RATIONALE
HERE, THIS ALIGNS VERY WELL WITH
OUR STRATEGIC PLAN TO ENHANCE
THE COMPLEMENTARY AND
INTEGRATIVE HEALTH RESEARCH
WORKFORCE.
UNDER THAT STRATEGIC PRIORITY WE
HAVE TWO DIFFERENT STRATEGIES
FIRST TO SUPPORT TRAINING AND
CAREER DEVELOPMENT AT THE
INDIVIDUAL LEVEL TO INCREASE THE
DIVERSITY AND NUMBER OF
INDIVIDUALS WHO ARE CONDUCTING
RIGOROUS COMPLEMENTARY AND
INTEGRATIVE HEALTH RESEARCH, AND
WE REALLY FOCUSED ON A FEW
SPECIFIC POPULATIONS AND GROUPS
INCLUDING CLINICIAN-SCIENTISTS,
WHICH IS THE FOCUS OF THIS
INITIATIVE, AND ALSO AS A SECOND
STRATEGY, WE ARE SEEKING TO
FOSTER INTERDISCIPLINARY
COLLABORATIONS NOT ONLY AT THE
INDIVIDUAL LEVEL BUT ALSO AT THE
INSTITUTIONAL LEVEL, WHICH AGAIN
IS THE FOCUS OF THE REACH
CENTERS.
SO NEXT SLIDE, WHY DO WE FEEL
THESE INSTITUTIONAL PARTNERSHIPS
ARE REALLY NECESSARY?
WELL, IF WE JUST THINK ABOUT THE
DIFFERENT TYPES OF ENVIRONMENTS
THAT ARE AVAILABLE AT THESE
DIFFERENT TYPES OF INSTITUTIONS,
WE THINK ABOUT RESEARCH
INTENSIVE INSTITUTIONS TYPICALLY
YOU SEE STRONG RESEARCH
INFRASTRUCTURE AVAILABLE,
GRANTSMANSHIP COURSES, RESEARCH
TRAINING COURSES, THE EXISTENCE
ALREADY OF INTERDISCIPLINARY
NETWORKS, AND A LOT OF PIs
THAT HAVE A HISTORY OF NIH
FUNDING THAT REALLY HELP PEOPLE
NAVIGATE HOW TO FIND FUNDING
OPPORTUNITIES AND APPLY TO THEM,
ET CETERA.
HOWEVER, OFTENTIMES, THESE
RESEARCH INTENSIVE INSTITUTIONS
LACK A STRONG PRESENCE OF
CLINICIAN-SCIENTISTS WHO'VE BEEN
TRAINED IN COMPLEMENTARY AND
INTEGRATIVE HEALTH DISCIPLINES
THAT CAN INFORM IMPORTANT
RESEARCH QUESTIONS.
ON THE OTHER HAND, IF WE LOOK AT
COMPLEMENTARY AND INTEGRATIVE
HEALTH CLINICAL INSTITUTIONS
HERE, WE SEE A CONCENTRATION OF
THESE CLINICIAN-SCIENTISTS WHO
HAVE THAT TYPE OF TRAINING TO
INFORM THE RESEARCH QUESTIONS,
AND THERE'S A STRONG TRAINING
ENVIRONMENT TO CONTRIBUTE TO
KNOWLEDGE GENERATION, BUT THEY
OFTEN LACK RESEARCH
INFRASTRUCTURE IN THAT
ENVIRONMENT AND TRAINING TO
SUPPORT CLINICIAN-SCIENTISTS'
CAREERS.
SO REALLY THE RATIONALE BEHIND
THE REACH RESOURCE CENTERS IS TO
COMBINE THE STRENGTHS OF THESE
DIFFERENT TYPES OF INSTITUTIONS.
SO HERE YOU CAN SEE THE OVERALL
STRUCTURE OF THE REACH RESOURCE
CENTERS, WHICH WOULD BE LOCATED
WITHIN A RESEARCH-INTENSIVE
ENVIRONMENT, AND THEY WOULD BE
SCIENTIFIC HUBS THAT WOULD
FOSTER INSTITUTIONAL
PARTNERSHIPS WITH THE CLINICAL
COMPLEMENTARY AND INTEGRATIVE
HEALTH INSTITUTIONS.
THE REACH CENTER WILL PROVIDE
RESEARCH ACTIVITIES AND TRAINING
FOR FACULTY WHO ARE LOCATED AT A
CLINICAL INSTITUTION.
AND REALLY THE FOCUS HERE IS TO
PROVIDE RESOURCES TO CONDUCT
CLINICAL RESEARCH THAT IS WELL
ALIGNED WITH OUR STRATEGIC PLAN.
THE VIRTUAL RESOURCES, AND I
WANT TO EMPHASIZE THAT WE HAVE
SET THIS UP AS A VIRTUAL
RESOURCE CENTER TO HAVE THE
WIDEST REACH POSSIBLE TO AS MANY
DIFFERENT CLINICAL INSTITUTIONS
AS POSSIBLE.
THESE VIRTUAL RESOURCES WILL
REALLY BE CENTERED AROUND
SUPPORTING DEVELOPMENT,
SUBMISSION AND MANAGEMENT OF
FEDERAL RESEARCH GRANT
APPLICATIONS FOR INVESTIGATORS
THAT ARE INTERESTED IN CLINICAL
RESEARCH ON HEALTH PROMOTION AND
RESTORATION, RESILIENCE, DISEASE
PREVENTION, SYMPTOM MANAGEMENT
INCLUDING PAIN, AND/OR WHOLE
PERSON HEALTH.
AND THE RESOURCES NEED TO BE
BASED ON THE NEEDS OF THE
PARTNERING CLINICAL INSTITUTIONS
BUT THEY MUST COVER ALL FIVE OF
THE CATEGORIES LISTED ON THE
SLIDE.
ADMINISTRATIVE SUPPORT, RESEARCH
SUPPORT, GRANTSMAN SHIP,
MENTORSHIP, AND TEAM BUILDING.
THE PARTNERSHIP ASPECT IS
CRITICAL TO THE SUCCESS OF THIS
PROGRAM SO WE ARE REQUIRING THAT
REACH CENTERS PARTNER WITH AT
LEAST THREE ACCREDITED U.S.
DOMESTIC COMPLEMENTARY AND
INTEGRATIVE HEALTH INSTITUTIONS
FROM A BREADTH OF CLINICAL
DISCIPLINES, AND THAT THE
PARTNERING INSTITUTIONS
DEMONSTRATE A WILLINGNESS TO
ENGAGE IN THESE ACTIVITIES AND
COMMIT TO SUPPORTING AT LEAST
20% PROTECTED TIME FOR FACULTY
TO PARTICIPATE IN THE RESEARCH
TRAINING ACTIVITIES.
AND WE ALSO WANT TO SEE THAT
THEY INCLUDE PLANS TO EXPAND TO
ADDITIONAL PARTNERSHIPS OVER
TIME.
SO REALLY OUR GOAL IS THAT BY
EXPANDING THIS INTO A NETWORK OF
CENTERS, WE WILL BE ABLE TO
IMPROVE THE QUALITY AND QUANTITY
OF FEDERAL RESEARCH GRANT
APPLICATIONS THAT GET SUBMITTED
BY FACULTY AT THESE
COMPLEMENTARY AND INTEGRATIVE
HEALTH INSTITUTIONS, THAT WE
WILL AID IN THE FORMATION OF
INTERDISCIPLINARY PARTNERSHIPS,
AND REALLY HELP TO ENHANCE THE
RESEARCH ENVIRONMENT AT THESE
CLINICAL INSTITUTIONS, AND
OVERALL SUPPORT A PIPELINE FOR
CLINICIAN-SCIENTISTS.
SO HERE IS THE INFORMATION WE
HAVE TO DATE ON OUR PROGRESS
TOWARDS REISSUING THIS
INITIATIVE.
WE HAVE PUBLISHED A NOTICE OF
INTENT TO PUBLISH A FUNDING
OPPORTUNITY, SO THIS IS LIKE A
PREVIEW OF THE MOVIE.
AND SO THERE'S ACTUALLY QUITE A
LOT OF DETAIL WITHIN THAT
NOTICE, SO YOU CAN READ MORE
THERE.
AND YOU CAN SEE OUR ESTIMATED
DATES OF WHEN WE ANTICIPATE
THINGS TO MOVE FORWARD.
WE DO ANTICIPATE SEEING THE FULL
RFA COME OUT SOON, HOPEFULLY BY
THE END OF THE MONTH, AND
EXCITINGLY, I'M HAPPY TO
ANNOUNCE THAT WE HAVE A
TECHNICAL ASSISTANCE AND TEAMING
WEBINAR PLANNED FOR JUNE 18TH,
AND THIS WILL REALLY PROVIDE AN
OVERVIEW OF THE FUNDING
OPPORTUNITY AND WHAT ALL IS
REQUIRED BUT ALSO PROVIDE
DEDICATED TIME FOR POTENTIAL
APPLICANTS FROM RESEARCH
INTENSIVE INSTITUTIONS TO MEET
WITH POTENTIAL PARTNERS FROM
CLINICAL INSTITUTIONS.
SO YOU CAN REGISTER TO ATTEND
THAT AND I'M HAPPY TO TAKE ANY
QUESTIONS.
THANK YOU.
AND I WILL NOTE THAT COUNCIL
PROVIDED A ROBUST DISCUSSION AS
WE WENT THROUGH THE CLEARANCE
PROCESS IN MARCH.
I REALLY APPRECIATED ALL OF THE
INPUT RECEIVED THEN, AND I WANT
TO THANK EVERYONE FOR THE
UNANIMOUS APPROVAL OF REISSUING
THIS CONCEPT.
>> GREAT.
WELL, THANK YOU, LANAY.
GIVEN THAT LOOKS LIKE PEEL ARE
PEELING OFF, THANK YOU, WE'VE
ALREADY BEEN DISCUSSED SO THIS
IS WONDERFUL.
LET'S MOVE ON TO THE UPDATE ON
CONCEPT FOR HEAL RESEARCH
ENHANCEMENT AWARD PROGRAM.
SO HOPEFULLY, ALEX, YOU CAN GIVE
US A SHORT VERSION OF THAT.
>> IT'S ALWAYS HARD BEING THE
LAST ACT IN THE SHOW.
WELL THANK YOU, AND GOOD
AFTERNOON, COUNCILMEMBERS.
ALEX TUTTLE.
THE PROGRAM LEAD FOR COUNCIL'S
NEXT AGENDA ITEM.
THIS PROPOSED CONCEPT IS CALLED
THE HEAL RESEARCH ENHANCEMENT
AWARD PROGRAM.
BECAUSE THE CONCEPT WAS
PREVIOUSLY PRESENTED AND
APPROVED BY THE NINDS'S FEBRUARY
ADVISORY COUNCIL AS AN EN BLOC
PROCESS, MY PRESENTATION TODAY
IS INFORMATIONAL.
I'D LIKE TO START BY DESCRIBING
RESEARCH PRIORITIES IN THE HEAL
INITIATIVE, AND THEN DETAIL THE
PURPOSE OF NIH'S ACADEMIC
RESEARCH ENHANCEMENT AWARD
PROGRAMS.
FINALLY I'LL DESCRIBE THE
PROPOSED INITIATIVE CONCEPT
WHICH IS LESS FURTHER ALONG THAN
LANAY'S PREVIOUS CONCEPT SO WE
DON'T HAVE AS MUCH DETAIL BUT WE
ARE CURRENTLY WRITING A NOFO.
THE HEAL INITIATIVE HAS
PRIORITIZED BUILDING OUT A PRO
BUST PAIN RESEARCH WORKFORCE AND
INCREASING WORKFORCE EQUITY
INCLUSION AND DIVERSITY AS
CROSS-CUTTING RESEARCH GOALS.
CURRENTLY TWO CRUCIAL GAPS EXIST
IN THE WORKFORCE DEVELOPMENT
PROGRAM.
THE FIRST IS LACK OF SUFFICIENT
NUMBER OF INVESTIGATORS FROM
SMALL OR GEOGRAPHICALLY DIVERSE
INSTITUTIONS.
AS WELL THERE'S A LACK OF
SUFFICIENT NUMBER OF
INVESTIGATORS FROM PROFESSIONAL
SCHOOLS OR COLLEGES.
OUR PROPOSED INITIATIVE WILL
ADDRESS BOTH OF THESE GAPS.
ONE WAY TO ADDRESS THE GAPS IS
USING THE NIH RESEARCH
ENHANCEMENT AWARD PROGRAM AS A
GUIDE OR FRAMEWORK.
THESE REA PROGRAMS ARE DESIGNED
TO SUPPORT MERITORIOUS RESEARCH
PROJECTS PROPOSED BY RESEARCHERS
FROM ELIGIBLE UNDERREPRESENTED
U.S. ACADEMIC INSTITUTIONS.
THE REA PROGRAM WILL HOPEFULLY
PROVIDE AN OPPORTUNITY FOR THE
HEAL INITIATIVE TO INCREASE
SCIENTIFIC DIVERSITY IN ITS OWN
FUNDED PROGRAMS.
THE PURPOSE OF NIH'S CURRENT
SUITE OF RESEARCH ENHANCEMENT
AWARDS IS TO SUPPORT SMALL SCALE
RESEARCH GRANTS AT INSTITUTIONS
THAT DO NOT RECEIVE SUBSTANTIAL
FUNDING FROM THE NIH WITH AN
EMPHASIS ON PROVIDING BRY OWE
MEDICAL RESEARCH EXPERIENCE
PRIMARY FOR HEALTH PROFESSIONAL,
UNDERGRADUATE AND GRADUATE
STUDENTS WHILE ENHANCING THE
RESEARCH ENVIRONMENT AT
APPLICANT INSTITUTIONS.
SUPPORT MERITORIOUS RESEARCH AT
INSTITUTIONS THAT HAVE RECEIVED
LESS THAN $6 MILLION OF NIH
FUNDING AND FOR THE PAST SEVEN
YEARS.
FROM A PF I THAT DOES NOT HAVE
ANOTHER ACTIVE NIH RESEARCH --
NIH GRANT AT THE TIME OF AWARD.
THE SECOND GOAL IS TO EXPOSE
STUDENTS TO HANDS-ON RESEARCH
AND A THIRD IMOAL GOAL IS TO
STRENGTHEN AT AWARD E ELIGIBLE
INSTITUTION.
THE NIH CURRENTLY SUPPORTS TWO
SUCH PROGRAMS.
THE FIRST IS THE AREA PROGRAM
THAT EMPHASIZES SMALL SCALE
RESEARCH PROJECTS TO PROVIDE
RESEARCH EXPERIENCE TO
UNDERGRADUATE STUDENTS
PRIMARILY, AS WELL AS REAP
AWARDS THAT EXPOSE UNDERGRAD --
TO RESEARCH EXPERIENCES.
SO AGAIN USING THESE TWO
PROGRAMS AS A GUIDE, OUR
PROPOSED INITIATIVE IS INTENDED
TO SUPPORT PAIN RESEARCHERS AT
UNDERREPRESENTED INSTITUTIONS BY
ACCOMPLISHING THREE KEY GOALS.
THOSE THREE GOALS ARE NOW
LISTED.
THE FIRST IS TO SUPPORT ELIGIBLE
RECIPIENTS FROM UNDERREPRESENTED
INSTITUTIONS TO BUILD
COLLABORATIVE TEAMS FROM
PARTNERS INSTITUTION.
THE SECOND GOAL OF THE PROGRAM
IS TO PRIORITIZE SUPPORT OF PAIN
RESEARCH AT UNDERREPRESENTED
U.S. INSTITUTIONS AND THIRD GOAL
OF THIS PROGRAM IS TO ENHANCE
THE INSTITUTIONAL RESEARCH
ENVIRONMENT THAT STUDENTS FROM
RECIPIENT INSTITUTIONS WILL
BENEFIT FROM EXPOSURE TO AND
PARTICIPATION IN PAIN RESEARCH.
THANK YOU VERY MUCH FOR YOUR
ATTENTION.
HAPPY TO RECEIVE YOUR COMMENTS
AND ANSWER ANY QUESTIONS YOU
HAVE ABOUT THIS PROGRAM.
I GUESS THAT'S -- OKAY, SORRY.
>> OH, MY GOD.
THAT WAS A RECORD.
SPEED RECORD.
ANY QUESTIONS, COMMENTS ABOUT
THIS?
EVERYBODY LOVES IT, RIGHT?
YEA.
>> THANK YOU.
>> WONDERFUL.
WELL, THANK YOU.
WE HAVE A FEW PEOPLE LEFT HERE.
MARTINA.
>> FEW DETAILS I NEED TO GO
OVER.
OKAY.
SO THANK YOU SO MUCH SH
EVERYBODY.
SO THE LAST AGENDA ITEM FOR OUR
OPEN SESSION TODAY IS THE PUBLIC
COMMENT SESSION.
SO A REMINDER THAT ANY MEMBER OF
THE PUBLIC WHO WISHES TO MAKE A
COMMENT MAY DO SO BY SENDING ME
YOUR WRITTEN COMMENTS NO LATER
THAN 15 DAYS BEFORE THE COUNCIL
MEETING IS BEING HELD.
THE COMMENTS YOU ARE SENDING TO
ME EITHER VIA EMAIL OR HARD COPY
LETTER, THESE COMMENTS SHOULD BE
LESS THAN 700 WORDS IN LENGTH,
WHICH IS CONSISTENT WITH AROUND
A FIVE-MINUTE ORAL PRESENTATION,
AND YOUR WRITTEN COMMENTS WILL
BE PRESENTED TO THE MEMBERS OF
COUNCIL VIA OUR ELECTRONIC
COUNCIL BOOK IN ADVANCE OF THE
NEXT MEETING.
AND I WILL ACKNOWLEDGE THE
RECEIPT OF THESE COMMENTS DURING
THE OPEN SESSION.
NOW FOR THIS MEETING, WE DID NOT
RECEIVE ANY PUBLIC COMMENTS
TODAY.
SO, AND WITH THIS, AS THE
MEETING IS DRAWING TO CLOSE, I
WOULD LIKE TO OFFER MY SINCERE
THANKS TO NCCIH STAFF, WHOSE
HELP AND WORK MAKES THIS MEETING
POSSIBLE, AND HONESTLY, EVERY
TIME I'M JUST BLOWN AWAY ABOUT
HOW MUCH WORK GOES INTO
ORGANIZING THIS AND HOW MANY
PEOPLE ARE BEING INVOLVED.
IF YOU ARE NOT IN THE MIDDLE OF
THIS, IT'S REALLY HARD TO EVEN,
YOU KNOW, UNDERSTAND WHAT'S ALL
GOING IN THERE.
SO I'M REALLY GRATEFUL FOR
EVERYBODY WHO IS WORKING HERE ON
THE TEAM DOING THIS.
AND I WOULD ALSO LIKE TO THANK
ALL COUNCILMEMBERS FOR JOINING
US, THE MEETING TODAY, AND FOR
ALL THE ADVICE THEY OFFER NCCIH,
AND FOR THIS, I INVITE THIS OVER
TO DR. LANGEVIN FOR HER
CONCLUDING REMARKS.
>> I'M GOING TO SAY THANK YOU
FOR THOSE OF YOU WHO ARE STILL
HERE FOR HANGING ON UNTIL THE
VERY END.
HAVE A SAFE TRIP HOME, AND WE
LOOK FORWARD TO SEEING YOU IN
SEPTEMBER.
BYE.
>> THE NEXT MEETING IS SEPTEMBEF
THERE ARE NO FURTHER COMMENTS,
THEN I'M GETTING TO DO THIS
AGAIN SO THIS MEANS THE 87TH
MEETING OF THE ADVISORY COUNCIL
IS ADJOURNED.
THANK YOU.