Canadian Institutes of Health Research (CIHR): Institutes of Population and Public Health; Aboriginal Peoples' Health; Circulatory and Respiratory Health; Gender and Health; Infection and Immunity; Neurosciences, Mental Health and Addiction; Health Services and Policy Research; Aging; Musculoskeletal Health and Arthritis; Genetics; Cancer Research; Human Development, Child and Youth Health and Nutrition; Metabolism and Diabetes
in partnership with:
Agriculture and Agri-Food Canada/The Rural Secretariat
Canadian Health Services Research Foundation (CHSRF)
Canadian Institute for Health Information (CIHI)/Canadian Population Health Initiative (CPHI)
CANARIE Inc.,
Health Canada/Office of Rural Health
Natural Sciences and Engineering Research Council (NSERC)
Social Sciences and Humanities Research Council (SSHRC)
Statistics Canada
| October 1, 2002 | Application Deadline (full proposal must be sent by courier and stamped by this date) *Please note that there is no registration/Letter of Intent stage for this RFA |
| December 2002 | Notification of Decision |
| January 2003 | Anticipated start date |
| February 2003 | Anticipated planning meeting with successful applicants |
| Duration of Project | Up to 1 year |
| November 1, 2003 | National Consensus Forum - draft report due |
| January 2004 | Final report due |
| Funds Available | Up to $100,000 per grant |
Table of Contents
IntroductionIntroduction
CIHR and its partners are pleased to announce the launch of the RFA entitled "Building Healthy Communities through Rural and Northern Health Research". This RFA has evolved from extensive consultations on the development of a Canadian rural and northern health research strategic initiative.
The goal of this strategic initiative is to foster research on understanding and enhancing health, and health services and policy, in small and remote communities around three key research themes: (1) understanding and improving the health status of rural and northern populations, (2) designing health systems (services and policy) that work for small and remote communities and (3) knowledge translation - making health research more accessible and useable by rural/northern practitioners, policy-makers and citizens. At the same time, this RFA is an opportunity to develop and strengthen interdisciplinary research teams that are interested in healthy communities and in rural and northern health-related issues.
Background
Rural and Northern Canada at a Crossroads: The health of rural and northern Canadians is a priority of the Government of Canada and a strategic priority of CIHR. Canada's rural/northern population1 is scattered across 96% of the second largest nation on earth (Statistics Canada). Canada's culture, identity and economy are firmly based on the need for sustainable rural communities. At least forty percent of Canada's exports are derived from natural resources found in and around these communities, and the most basic components for urban living (e.g., food, water, energy, building materials, respite) are intimately linked to rural/northern communities. Yet, as a result of many social and economic forces including urbanization, these communities have experienced enormous change in socio-economic circumstances, demographics, and their place in the Canadian landscape and psyche.
Despite the benefits of living in small communities, research comparing urban and rural communities suggests that living in some rural and northern communities poses a health hazard. The following are several indicators that demonstrate the need for Canadian researchers to pay close attention to health and health service in rural and northern communities: rates of mortality and morbidity, cancer and cardio-vascular disease incidence and treatment outcomes, workplace and recreational injuries, access to and quality of core health care services (particularly hospitals and physicians), personal health practices (e.g., eating, physical activity, tobacco and alcohol use), food security, the absence of health promotion and disease prevention services, socio-economic determinants, and a rapidly aging population.
Aboriginal Peoples' Health: Over 50% of Aboriginal Canadians live in rural and northern communities. The health of Aboriginal Canadians, in comparison with the health status of the population as a whole, is relatively poor. Health indicators include: prevalence rates for many chronic diseases, suicide, alcohol and substance abuse, family violence, and communicable diseases. For example, the incidence of Diabetes for First Nations and Inuit Peoples (adjusted for age and gender) reveals a 30% increase in prevalence for women ages 55 to 64, and at least 15% for men of the same age when compared to the general population2.
Good health and timely access to appropriate health care are central to sustaining rural and northern communities. It has been increasingly recognized that many urban-centric policies and practices may not have contributed to improved health and health service in rural and northern communities.
Moving Rural and Northern Health Research Forward: Across the country, in provincial, territorial and federal health and development consultation meetings, rural citizens have repeatedly identified the need to take bold steps to improve rural/northern health care systems and health status. New, rural/northern-tailored approaches are required and CIHR can provide national leadership to facilitate this process with respect to research and knowledge translation. A solid evidence base from which to formulate appropriate action will accelerate progress and overcome conditions that are responsible for the poor health status that characterizes many rural and northern communities.
The Rural and Northern Health Research Strategic Initiative was launched to provide an integrated and focused approach to research that contributes to health and health service in Canada's rural and northern communities. The Strategic Initiative is organized into three phases: (1) the Design Phase (2001-2), (2) the Foundation Phase (2002-3) and (3) the Strategic Action Phase (2003-7).
The Design Phase focused on consultations and planning toward the development of a national strategy for rural and northern health research. Steps included: a literature review, a discussion paper on rural and northern health research, a menu of research topics involving all thirteen CIHR Institutes, the establishment of a National Steering Committee to help draft the strategy, meetings with potential partners on this initiative, and the development of a CIHR research competition on Diagnostic and Integrative Studies in Rural Health (August, 2001).
The Foundation Phase (which we are now entering) builds upon the Design Phase. It will include systematic analyses and discussions leading to an integrated foundation of current knowledge and recommendations for strategic action. A major component of this phase is this RFA and the associated National Consensus Forum.
The anticipated Strategic Action Phase will focus on the research development, training, capacity building and knowledge translation aspects of this initiative. In other words, this is the core "project" component of this initiative. This phase will be comprised of four primary strategies, namely: a Canada rural communities cohort study; a centres of excellence competition; a rural health post-doctoral awards program and a knowledge exchange/translation program.
Partners
Canadian Institutes of Health Research:Institute of Gender and HealthAgriculture And Agri-Food Canada/Rural Secretariat
Institute of Population and Public Health
Institute of Aboriginal Peoples' Health
Institute of Aging
Institute of Cancer Research
Institute of Genetics
Institute of Circulatory and Respiratory Health
Institute of Health Services and Policy Research
Institute of Human Development, Child and Youth Health
Institute of Infection and Immunity
Institute of Musculoskeletal Health and Arthritis
Institute of Nutrition, Metabolism and Diabetes
Institute of Neurosciences, Mental Health and Addiction
Specific Objectives and Eligible Research Areas
Objectives
This Request for Applications is designed to solicit applications in response to the following objectives:
Eligible Research Themes
This RFA focuses on three research themes:
A description of the content areas under each theme is given below.
Eligible Content Areas for Each Theme (Only one content area will be funded per research team.)
| 1. Understanding and Improving the Health Status of Rural Populations | |
| Content Areas | CIHR Institute Partners |
| a.Macro-Level Analysis of the Health of Rural and Northern Canadians - What do existing population-level data suggest about rural/northern population health status and its determinants (including positive aspects of rural living)? How do these data compare to urban communities and across types of rural/northern communities? | IPPH |
| b.Healthy Communities - What makes some rural/northern communities healthy and others not? How do the indicators of health in rural/northern communities compare with urban communities; e.g. community resilience, social capital? | |
| c.Water Safety - What is known about water safety and its determinants in rural and northern communities, with particular emphasis on agricultural, environmental contamination, and public health service? | III |
| d.Economic Insecurity and Health - Most rural and northern communities have experienced considerable transitions in their economic base, particularly in communities that depend primarily on lumber, fishing, mining, ship-building, and agriculture, etc. What do we know about the impact of these economic challenges on health? | IGH |
| e.Men and Women's Health - What understanding does a gender-based analysis yield with respect to health in rural and northern communities? What are the similarities and differences in men and women's health, and the determinants of men and women's health? | IGH |
| f.Workplace Health - What is known about workplace health in rural and northern communities, particularly in high-risk work settings? What information on seasonal work, shift-work, occupational health and safety and work culture in primary resource-based industries can add to our knowledge of workplace health? What are the unique types of work settings in rural and northern communities that can affect health status? | IPPH |
| g.Child and Youth Developmental Trajectories in Rural/Northern Versus Urban Communities - Accumulating evidence suggests substantive impacts of socialization and context on human development. What is the status of child and youth health and what are the key issues of child and youth development in rural and northern communities? | IHDCYH |
| h.Recreation and Youth Health - What is the role of recreation and leisure time activity in youth development? How do urban and rural recreation opportunities compare with respect to health outcomes? What policies and practices would improve opportunities for youth, especially youth in poverty, in rural and northern communities? | IHDCYH |
| i.Older Adults Living in Small and Remote Communities - How do changing demographics, economic conditions, and availability of health services impact the health and well-being of older adults living in rural/northern communities? | IA |
| j.Access to Healthy Foods - Geographic, climatic, economic and cultural conditions often make access to healthy and personally acceptable foods very difficult, particularly in the more remote areas of Canada. Such factors lead to health problems such as diabetes and obesity. What is known about these issues and best practices to address them? | INMD |
| 2. Health Systems that Work for Rural and Northern Communities | |
| Content Areas | CIHR Institute Partners |
| a. Macro-Level Analysis of Health Services in Rural and Northern communities - What is known about access to health services and best practices for rural and northern communities (e.g., maternity and pre-natal services, emergency services, surgical services, treatment of neurological diseases such as Parkinson's disease and epilepsy)? (For background information please visit www.chsrf.ca/docs/pconsult/frpt_e.shtml) |
IHSPR |
| b. Health Promotion/Illness Prevention - What services/supports are required to facilitate a culture of health in rural and northern communities? What is the current situation regarding health promotion and how can it be improved (e.g., personal health practices and community based initiatives)? | IPPH |
| c.Mental Health and Mental Illness - What is the status of mental health and illness in rural and northern communities as compared to urban communities? What is the current status and effectiveness of health service? What research and policy would improve conditions? | INMHA IAPH |
| d.Genetic Counselling/Genetic Services - What is the current status of genetic counselling in rural and northern communities? What does research suggest could be done to improve access to high quality genetic counselling? | IG |
| e.Rehabilitation - What is the status of rehabilitation service for acute and chronic health problems and disabilities in rural and northern communities? For example, arthritis and multiple sclerosis. What is known about best practice and innovation in rehabilitation that could improve access to high quality service? | IMHA |
| f. Cancer Care - What is the status of cancer care in rural and northern communities in Canada? What research, policies and practices would improve health status and health services? | ICR |
| g. Treatment of Cardiovascular Disease - What is the status of cardio-vascular health and illness in rural and northern communities in Canada? What research, policies and practices would improve health status and health service? | ICRH |
| h. Tele-health service - What is the current status of tele-health in rural and northern communities in Canada? What tele-health research, policies and practices would improve health status and health service? | IHSPR |
| i. Oral Health - What is the current status of oral health service in rural and northern communities in Canada? What research, policies and practices would improve oral health status and health service? | IMHA |
| j. Pharmaceuticals - What are the differences in prescribing practices, drug use monitoring mechanisms, and access to medications in rural, as compared with urban communities? What best practices and innovations would improve service? |
IHSPR |
| k. Health Human Resources - Many rural and northern communities are struggling with attracting and retaining highly skilled health professionals. What is known about this issue and about best practices to address it? What research would contribute to clarifying the issues and testing potential strategies? | IHSPR |
| l. Clinician-Scientists in Rural Communities - Small communities provide excellent contexts to examine health issues and test strategies. However, rural clinicians across all the health professions (e.g., nurse-practitioners, nurses, physiotherapists, physicians) have limited resources, few linkages to centres of research and little support to facilitate the development of a program of research. What do we know about clinician-researchers in rural communities and how can opportunities for rural, community-based clinical research be enhanced? | ICRH |
| 3. Knowledge Translation - making health research more accessible and useable by rural / northern practitioners, policy-makers and citizens | |
| Content Area | CIHR Institute Partners |
| a. There are many challenges for health service providers and policy-makers in the uptake of research in rural and northern communities. How can health research be made more accessible, and user-friendly for rural and northern practitioners, policy-makers and citizens? What insights can be gained about the current use of research information related to rural and northern health? What strategies for knowledge translation should be developed and tested? | CIHR- Knowledge Translation Branch |
For additional background information, please refer to the CIHR Rural and Northern Health Research Strategic Initiative Documents
Project Guidelines
The results of successful projects will vary depending on the topic. However, the criteria below are provided as indicators of expected content in the context of the final project reports. These projects are not simply reviews of literature. They will use multiple methods to critically analyse and integrate research, and to identify gaps in current knowledge, and to advance recommendations for research, policy and practice. Potential methods include, but are not limited to: secondary data analyses, best practice analyses, meta-analyses, policy analyses, research meetings, interviews and focus groups.
A list of information generally expected in each project report is as follows:
Project Requirements
Each funded research team will be expected to deliver:
CIHR is committed to timely translation of research findings to improve health and healthcare. The research team must, as a condition of funding, work with CIHR and its partners on the dissemination of results. This will include working collaboratively to synthesize and disseminate research results for researchers, policy and other decision makers and other identified audiences and the general public through reports, electronic (web-based) files and other appropriate communication tools. CIHR encourages the publication of results in peer-reviewed journals.
Who is Eligible to Apply?
Eligibility criteria for all CIHR research funding programs apply. Please refer to the Eligibility for CIHR Grants and Awards on the CIHR website for detailed information.
The business office of the institution of an eligible Principal Applicant generally administers CIHR funds. The eligibility requirements for institutions are found on the CIHR website in the Financial Administration of Funds Guide.
Specific Eligibility Requirements
This RFA requires applications from interdisciplinary teams. Each eligible team will include:
Peer Reviewers may consider partnership engagement in assessing the strength of teams. We encourage:
Mechanism of Support
This RFA is funded as one component of the Rural and Northern Health Strategic Initiative. This competition is designed to solicit project grant applications with duration of up to one year.
Funds Available
Allowable costs
Applicants should consult CIHR's guidelines on Eligibility of Expenses for a complete listing and description of allowable costs and activities. Specific expenses also eligible under this RFA include:The full application must provide a detailed justification of all costs.
How to ApplyEvaluation Process and Criteria for Peer Review
Peer Review
A separate CIHR peer-review committee will evaluate applications in relation to the evaluation criteria stated in this RFA. Committee members are selected based on suggestions from many sources including the Institutes and partners. The members will consist of distinguished national and international researchers and experts, including policymakers and practitioners in relevant fields related to rural and northern health research. Their names will be published on the CIHR website.
In determining scientific excellence, the peer review committee will follow the CIHR Peer Review Process for Grants and consider the following criteria to determine how each project proposal will meet the RFA objectives:The application should illustrate, through a clear and concise methodology, the potential for new knowledge, and the importance and originality of its contribution to the advancement of rural and northern health research.
How appropriate to the research proposed is the training or track record and/or experience of the applicants? How confident are the reviewers that the team can sucessfully complete the work proposed? (The proposed time commitment to the project may influence this judgment.)
The application should provide evidence that the team has experience to achieve collaborative outcomes.
The application should provide the following information on community partnerships and commitments: identified partners, a brief description of their role during the project, and their contribution to the project. Contributions may be intellectual, in-kind, and/or in cash, where feasible.
Will the proposed project facilitate rural health research and knowledge translation experience for researchers, policy makers, front line workers, community organizations and community members in rural and northern communities? What role will students and post-doctoral trainees play in this project?
Funding Decision and Notification of applicants
On completion of the peer review process, CIHR, the Institutes and funding partners will receive the ranking lists, merit scores (ratings) and recommendation of the committee for the applications submitted. Applicants will be funded according to rank and funding resources within each content area. Applications receiving a score less than 3.0 will not be considered for funding. CIHR will send out notification to successful teams. Successful teams will be posted on the web-pages of CIHR and partnering organizations.
General CIHR Guidelines and Conditions of Funding
All conditions, as specified in CIHR Grants and Awards Guide, shall apply to those funded through this initiative. Conditions cover areas such as Applicant and Institutional Responsibilities, Ethics, Official Language Policy, Access to Information and Privacy Acts, Acknowledgement of CIHR support etc. Successful recipients will be informed of any special financial conditions when they receive CIHR's Authorization for Funding Form (AFF). The principal applicant (with funding responsibilities) will be required to submit a final report to CIHR summarizing the results and describing how the grant funds were used.
In addition to CIHR standard guidelines and requirements, the following shall apply:
Communication RequirementRecipients who receive funding are required to acknowledge CIHR Institute(s)/ partner(s) in any communication or publication related to the grant as follows: CIHR-IGH, -IPPH, -IAPH, -IA, -IHSPR, -IHDCYH, -III, -IMHA, -INMHA, -ICR, -IG, -INMD, -ICRH, Social Sciences and Humanities Research Council of Canada (SSHRC), Health Canada-Office of Rural Health, Agriculture and Agri-Food Canada- Rural Secretariat, CANARIE Inc., Natural Sciences and Engineering Research Council (NSERC), Statistics Canada, Canadian Institute of Health Information (CIHI), and the Canadian Health Services Research Foundation (CHSRF).
Performance Measurement and Evaluation
CIHR has made plans to assess performance of this initiative through ongoing monitoring and periodic evaluation. We are committed to informing Canadians about the performance of our initiatives and the results that they deliver.
The following table is intended to further clarify objectives by linking them to expected outcomes and measures. All funded applicants will be expected to participate in the evaluation strategy, contributing advice, data and reports as required for assessment purposes.
| Objective | Expected Outcome | Measure / Indicator |
| To support research integration that will consolidate existing knowledge in rural and northern health, as well as inform policy and practice | Established knowledge base in research and knowledge exchange/translation in rural and northern health research | High quality reports from funded teams |
| Consensus on gaps and opportunities identified by teams | ||
| Identified potential applications of research finding to inform policy and practice | Quality and acceptance of report recommendations | |
| Knowledge exchange/translation implementation plan | ||
| To develop a solid foundation of evidence that will guide future research endeavours | A strengthened research agenda for the Strategic Action Phase |
Consensus on identified research and knowledge exchange/translation priority themes/areas in rural and northern health |
| Level of interdisciplinary participation at the Consensus Forum | ||
| Level of support of the research agenda by the research, policy and program communities | ||
| To enhance capacity to conduct research and knowledge exchange/ translation in rural and northern health | Increased opportunities for research activities, research team development and training in rural/northern health | The level of funding to support this project |
| Increased number of researchers and interdisciplinary teams that applied for this grant | ||
| Percentage and level of involvement of students, trainees and researchers involved in this initiative |
Address for Submitting Application and Contact Information
Send Application by Courier to:
RE: "Building Healthy Communities for Research in Rural and Northern Health"
Canadian Institutes of Health Research
Research Portfolio
410 Laurier Avenue W., 9th Floor
Address Locator 4209A
Ottawa, ONT. K1A 0W9
Contact for Further Information:
For questions on CIHR funding guidelines, or how to apply, contact:
Alex Lamontagne
Program Officer
Canadian Institutes of Health Research
410 Laurier Avenue West, 9th floor, Address Locator 4209A,
Ottawa, ON K1A 0W9
Tel: (613) 954-6054
Fax: (613) 952-2277
Email: alamontagne@cihr-irsc.gc.ca
1 There are different definitions of "rural". For example, Statistics Canada defines it as communities with a population of 10,000 or less, which translate to 6.1 million people, 22% of the population, and 3402 communities (Statistics Canada, 1996). The Rural Secretariat of the Department of Agriculture and Agri-Food, describes three types of rural communities: metro-adjacent, heartland and northern-remote.
2 Young, T.K., Reading, J. Elias, B., O'Neill, J.D., 2000. "Type 2 diabetes mellitus in Canada's First Nations: status of an epidemic in progress." CMAJ; 163: 561-6
