This FOA issued by AHRQ invites grant applications for funding to conduct Large Research Projects (R01) that propose to advance the base of knowledge for detection, prevention, and reduction of Healthcare-Associated Infections (HAIs). This FOA describes the broad areas of HAI research for which funds are available to support Large Research Projects.This Funding Opportunity Announcement (FOA) invites grant applications for funding to conduct Large Research Projects (R01) that propose to advance the base of knowledge for detection, prevention, and reduction of Healthcare-Associated Infections (HAIs). This FOA describes the broad areas of HAI research for which funds are available to support Large Research Projects.

Background

HAIs are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting. These infections are a significant cause of preventable illness and death in the United States. At any given time, about 1 in every 31 hospital patients has a HAI. Tens of thousands of patients lose their lives from HAIs each year, and these infections impose billions of dollars in excess costs annually.

For these reasons, the prevention of HAIs is a top priority for the U.S. Department of Health and Human Services (HHS). The Department published the National Action Plan to Prevent Healthcare-Associated Infections (HAI NAP), which is available at: http://www.hhs.gov/ash/initiatives/hai/actionplan/index.html. In 2015, the White House announced the National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB NAP), and in 2020, the CARB NAP was updated for 2020-2025 (available at: https://www.hhs.gov/sites/default/files/carb-national-action-plan-2020-2025.pdf). AHRQ’s HAI-related activities contribute significantly to achieving the goals of both the HAI NAP and the CARB NAP.

It should be noted that, in addition to this R01 FOA and the companion R18 FOA (PA-21-264) for HAI prevention, AHRQ has also published a set of FOAs to invite applications focused on CARB issues of combating antibiotic resistance and promoting antibiotic stewardship. Applications that are primarily focused on HAI prevention should be submitted in response to the HAI FOAs. Applications for proposed projects that are primarily focused on CARB issues should be submitted in response to the CARB FOAs. It will be helpful for applicants to follow this guidance. However, because prevention of HAIs is intimately connected to achieving the aims of the CARB NAP, AHRQ will consider applications on HAI prevention and/or CARB issues responsive if submitted to either set of FOAs.

Objectives

AHRQ collaborates with other HHS Agencies to prevent and reduce HAIs and has funded initiatives in all of the settings identified in the HAI NAP: Acute care hospitals; ambulatory settings, such as ambulatory surgical centers, outpatient care clinics and offices, and hemodialysis centers/end-stage renal disease facilities; and long-term care settings. AHRQ projects have addressed a variety of HAI types, prominently among them: central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), surgical site infection (SSI), ventilator-associated pneumonia (VAP), methicillin-resistant Staphylococcus aureus (MRSA), and Clostridioides difficile

(C. diff).

AHRQ intends to continue supporting research and demonstration projects that address more effective ways to prevent HAIs and promote the wide-scale adoption of evidence-based approaches. This FOA announces the availability of funds to support Large Research Projects, using the R01 mechanism, in the following broad areas of HAI research:

Determination of the clinical efficacy and effectiveness of preventive interventions, including unintended adverse consequences.
Characterization and assessment of relevant epidemiological aspects of HAIs, including but not limited to patient risk factors, clinical presentation, and sources of antibiotic-resistant organisms involved in the development of HAIs.
AHRQ is interested in R01 projects directed to any of the healthcare settings acute care hospitals, ambulatory care settings, and long-term care settings as scientifically warranted. AHRQ is interested in all aspects of HAI prevention, including, but not limited to, ambulatory care, ambulatory surgery, long-term care, linkage between the various settings of care to improve tracking and prevention of HAIs, antibiotic stewardship, multidrug-resistant organisms, C. diff, and prevention of respiratory viral HAIs. AHRQ is interested in HAI research conducted in under-resourced health care settings.

A companion FOA (PA-21-264) announces the availability of funds to support Large Health Services Research Demonstration and Dissemination Projects, using the R18 mechanism, in the following broad areas of HAI research:

Demonstration, dissemination, and evaluation of strategies and approaches for prevention and reduction of HAIs.
Research regarding adoption and implementation (including sustainment and spread/scale-up) of evidence-based approaches for prevention of HAIs.
In AHRQ’s research funding framework, R01 projects on HAIs are intended to produce evidence to determine the effectiveness of interventions to prevent HAIs or to identify the epidemiological factors associated with HAIs, whereas R18 projects on HAIs are intended to take interventions that have been shown to be effective on a small scale or in a particular setting and to demonstrate and disseminate their application more widely or to explore issues of implementation and adoption.

Promoting equity is an important societal goal. AHRQ intends that research funded by the agency contribute to this goal by addressing equity. AHRQ encourages applicants responding to this FOA to consider whether there are equity issues in their proposed projects and, where relevant, to address these issues in the proposed research plan.

Pursuant to its authorizing legislation, see 42 U.S.C. 299(c), AHRQ conducts and supports research for AHRQ priority populations (see Section IV.7 for a list of priority populations). AHRQ is interested in HAI research that includes a focus on priority populations such that meaningful subgroup analysis can be conducted and results stratified by priority population can be produced.