Innovative Questions in Symptom Science and Genomics (R21)

Innovative Questions in Symptom Science and Genomics (R21)DNAstethoscopesmaller
Department of Health and Human Services
National Institutes of Health

Research Objectives

Symptom Science

  • What are the biological and behavioral dynamics of symptoms (e.g., dyspnea, fatigue, impaired sleep/insomnia, pain, depression) that can change the trajectory of chronic illnesses, and how can the dynamics be optimized and maintained to prevent symptom relapse?
  • What innovative care delivery models (e.g. interdisciplinary, family-based), research methods (e.g. community engaged research, pragmatic trials) and technologies (e.g. eHealth) can be leveraged to improve symptom management and change the chronic illness trajectory especially among individuals who experience disparate health outcomes?
  • How do lifestyle factors, environmental conditions, symptom clusters and symptom treatments impact quality of life and symptom management in different chronic conditions?
  • How do symptom precursors (e.g. biomarkers or conditions such as obesity) contribute to the physiology of symptom risk, severity, duration and response to treatment?
  • What are the ‘omic’, phenotypic and state dependent indicators related to the mechanism, assessment and management of high impact symptoms (e.g. pain, fatigue, dyspnea) and what is the added value of these indicators beyond clinical parameters in explaining physical and psychological symptoms in both patients and their informal caregivers?
  • What are the common mechanistic pathways (e.g. stimulus to perception, perception to report) that can distinguish underlying symptom cluster trajectories that are amenable to intervention at various points along those pathways?
  •  What are the personalized markers (e.g. biomarkers and clinical factors) that can be used to stratify subgroups of patients with different patterns among symptoms to determine the symptom management strategies most effective in improving quality of life?
  • What innovative methodologies (e.g. modeling) can be used to analyze symptom management algorithms to identify the interventions most likely to be successful in clinical or pragmatic trials?
  • How can we create a standardized, feasible, valid, and relevant data and technology infrastructure to routinely collect and aggregate symptom data from patient health records but also from other types of assessments (biological, physiological, performance) to inform clinical care and research?
  • What are the biological indicators that can help determine the presence and severity of subjective symptoms in individuals who cannot self-report (e.g. small children; individuals with cognitive decline) to help improve clinical assessment and management? Is there a role for fMRI?
  • What state-of-the-art research designs/methods (e.g. mixed methods, SMART, MOST) should investigators use to test personalized symptom management strategies to include scalable interventions?
  • What are the biologic, physiologic and/or omic mechanisms underlying symptoms and patient outcomes?
  • Based on individual omics, environmental factors, and behavior what are the most effective and targeted interventions that can be expedited for translation to reduce risk and promote health?
  • What are the relative contributions of omic markers and phenomic data in predicting individual responses to therapeutic interventions that improve patient outcomes such as quality of life?
  • For high risk patients who are at the end of life, how can genetic assessment and DNA banking be used to address familial risk?
  • How should omic discoveries be used to create and test technologies (such as clinical tools) that can be used to diagnose clinical problems, predict the clinical course and promote optimal outcomes?
  • In what ways can genomic information be used to promote adherence and improve self-management of chronic conditions?
  • How does the social environment interact with gene expression to influence resilience in coping with life challenges?
  • The evolution and vitality of the biomedical sciences require a constant infusion of new ideas, techniques, and points of view. These may differ substantially from current thinking or practice and may not yet be supported by substantial preliminary data. By using the R21 mechanism, the NIH seeks to foster the introduction of novel scientific ideas, model systems, tools, agents, targets, and technologies that have the potential to substantially advance biomedical research.

General Information

Document Type: Grants Notice
Funding Opportunity Number: PA-16-023
Funding Opportunity Title: Innovative Questions in Symptom Science and Genomics (R21)
Opportunity Category: Discretionary
Funding Instrument Type: Grant
Category of Funding Activity: Education
Category Explanation:
Expected Number of Awards:
CFDA Number(s): 93.361 — Nursing Research
Cost Sharing or Matching Requirement: No
Posted Date: Oct 30, 2015
Creation Date: Oct 30, 2015
Original Closing Date for Applications: Jan 7, 2019  
Current Closing Date for Applications: Jan 7, 2019  
Archive Date: Feb 7, 2019
Estimated Total Program Funding:
Award Ceiling: $200,000
Award Floor:


Eligible Applicants:
Small businesses
Nonprofits that do not have a 501(c)(3) status with the IRS, other than institutions of higher education
Special district governments
Private institutions of higher education
City or township governments
Native American tribal governments (Federally recognized)
Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education
Public and State controlled institutions of higher education
Public housing authorities/Indian housing authorities
Native American tribal organizations (other than Federally recognized tribal governments)
Others (see text field entitled “Additional Information on Eligibility” for clarification)
For profit organizations other than small businesses
Independent school districts
County governments
State governments
Additional Information on Eligibility: Other Eligible Applicants include the following: Alaska Native and Native Hawaiian Serving Institutions; Asian American Native American Pacific Islander Serving Institutions (AANAPISISs); Eligible Agencies of the Federal Government; Faith-based or Community-based Organizations; Hispanic-serving Institutions; Historically Black Colleges and Universities (HBCUs); Indian/Native American Tribal Governments (Other than Federally Recognized); Non-domestic (non-U.S.) Entities (Foreign Organizations); Regional Organizations; Tribally Controlled Colleges and Universities (TCCUs) ; U.S. Territory or Possession.

Additional Information

Agency Name: National Institutes of Health
Description: This initiative seeks to optimize innovation, insight and cutting edge conceptual and technological breakthroughs by catalyzing research that emanates from the identified innovative questions in symptom and genomic nursing science. These innovative questions are reflective of broad domains from which more specific novel hypotheses or problems to be solved can be derived.
Link to Additional Information:
Contact Information: If you have difficulty accessing the full announcement electronically, please contact:

NIH OER Webmaster FBOWebmaster@OD.NIH.GOV
If you have any problems linking to this funding announcement, please contact the NIH OER Webmaster

For More Grant Opportunities on this Topic please See:




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