Writing an Excellent Title VII Grant Proposal

							 Writing an Excellent Title VII Grant Proposal
         Workshop Session WF09: Friday, May 15, 2009, 4:00PM

Speakers:

P. Preston Reynolds, MD, PhD
Professor of Medicine, Division of General Medicine, Geriatrics, and Palliative Care
University of Virginia Health System
PO Box 800744; Charlottesville, VA 22908
(434) 982-4227        ppr8q@virginia.edu

Olveen Carrisquillo, MD, MPH
Associate Professor of Medicine and Health Policy & Management
Columbia University, Presbyterian Hospital
622 West 168th St, Room 9E-105K; New York, NY 10032
(212) 305-9782        oc6@columbia.edu

Angela Jackson, MD
Associate Professor of Medicine
Director of the Primary Care Residency Training Program
Boston University Medical Center
850 Harrison Avenue, 3rd Floor; Boston, MA 02118
(617) 414-5951        angela.jackson@bmc.org

Margaret L. Plews-Ogan, MD, MS
Associate Professor of Clinical Internal Medicine
Division Head, Division of General Medicine and Geriatric Medicine
University of Virginia Health System
PO Box 800744; Charlottesville, VA 22908
(434) 924-1931        mp5k@virginia.edu

Mark D. Schwartz, MD
Associate Professor of Medicine
NYU School of Medicine
VA NY Harbor Healthcare System
423 East 23rd Street, Suite 15N; New York, NY 10010
(212) 686-7500 x6135          Mark.schwartz3@va.gov
Writing an Excellent Title VII Grant Proposal*

Will Your Objectives Meet the Purpose of Title VII Grant Programs?
Training in:
1. Residency Training in Primary Care
2. Physician Faculty Development in Primary Care
3. Predoctoral Training in Primary Care
4. Academic Administrative Units in Primary Care

Does Your Program Meet Eligibility Requirements?
FOR:
   • Residency Training in Primary Care
   • Pre-doctoral Training in Primary Care
   • Physician Faculty Development in Primary Care (fellows and faculty)
   • Academic Administrative Units in Primary Care
Accredited schools of medicine or osteopathic medicine, accredited residency training
program in public or nonprofit hospitals.

What Do You Want to Do? The IDEA (Objectives)
   • Can you state what you want to do in educational terms?
   • Does it relate to the training of medical students, residents, fellow and faculty
     development, improvement of academic administrative units, improvement in the
     clinical instruction in family medicine, general internal medicine, and/or general
     pediatrics?

Why Do You Want to Do These Objectives? (Rationale)
   • Did your institution have a recent accreditation review that now requires you to
     make some corrections?
   • Are there new emerging topics in medical education that you want to incorporate
     into your curriculum?
   • Do you need to develop faculty skills related to a new curriculum?
   • Does your faculty need training or re-training for the ACGME Core Competencies?
   • Do you want to expand your Division of General Internal Medicine or General
     Pediatrics or Department of Family Medicine?
   • Does a recent needs assessment among students, residents and/or faculty
     demonstrate a need for enhanced competency in a specific area, e.g. cultural
     competency, quality improvement?
   • Does local and national data/literature demonstrate your proposed program of
     critical importance to the future of primary care?
Is Your Institution Committed to Primary Care and a Diverse
Workforce?
   • Is there a recruitment plan for minority trainees and faculty?
   • Is there evidence that the institution is committed to retaining disadvantaged and
     underrepresented minority students, residents and faculty?
   • Does your institution have a successful track record of placing graduates into
     underserved communities?
   • Does your institution have a successful track record of graduating students and
     residents into primary care careers?

Will Your Idea Include at Least One of the Areas of Special
Consideration Listed in the Grant Guidance?
   • Special Populations: Elderly, Homeless, Victims of Domestic Violence, Substance
     Abuse, Patients with HIVIAIDS
   • Areas of Innovation: (FY2008): Quality Improvement/Patient Safety, Health
     Literacy/Cultural Competency

Can You Justify the Need for this Activity? (Needs Assessment,
Literature Review)
   • Did you perform a needs assessment?
   • Did you survey your students, residents or faculty and they indicated that they
     lacked this competency or core clinical skill once they were out in practice?
   • Does the literature support your rationale?
   • Does the literature support your methodology?
   • Have you researched the literature on the topic? Can you provide an explanation of
     the rationale and assumptions upon which the project objectives will be based?
   • Has this particular activity been developed and is available off the shelf? If so, what
     are you developing that is different?

How Do You Plan to Accomplish the Activity? (Methodology)
   • Do you plan to develop a new curriculum with new assessment instruments and
     performance measures?
   • Do you plan to launch a faculty development program with instruction, mentoring,
     project design and implementation, and evaluation?
   • Do you plan to launch a new curriculum in care of the urban underserved through
     improved access to medical services with placement of medical residents in
     community health centers or urban inner-city clinics?

Do Your Objectives Relate to Healthy People 2010?
Healthy People Overarching Goals:
   1. Increase quality and years of healthy life
   2. Eliminate health disparities
Can the Objectives Be Accomplished in Three Years? (Timeline)
  • How long it will take to develop, implement, and evaluate he objectives?
  • Do you need a planning year?
  • Do you need to recruit faculty to accomplish the goals and objectives of the project
    and will this be achievable in the three year grant period?
  • Who do you need to collaborate with to implement the project?
  • Is it possible for your trainees (e.g. faculty fellows) to complete the entire program
    in two to three years (especially if offering an MPH)?
  • Can you show an impact of your program in three years among trainees and/or
    among patients or communities targeted in the grant application?

What Obstacles May Prevent You from Accomplishing the Objectives or
Make It Difficult to Complete the Objectives? (Resolution of Challenges)
  •   Will you need to move the course to a different year?
  •   Will you need to change another faculty member's course?
  •   Will the Dean or Department Chair or Curriculum Committee agree to the change?
  •   If you plan to put students in a rural community for an extended time, will there be
      housing for the students or residents? How will this impact married students or
      residents?
  •   Will there be sufficient number of community preceptors?
  •   Will community preceptors make time to attend the proposed training?
  •   Are there sufficient numbers of faculty interested in the faculty development
      training?
  •   Will you be able to recruit students, residents, or fellows into the proposed
      program?

Who Will Be Responsible for Accomplishing the Objectives?
  • Do you have faculty with experience and expertise in the required subject area? If
    so, do their curriculum vitas and biographical statements reflect that expertise?
  • What faculty or staff will teach and mentor students, residents, or fellows?
  • Do you need to hire the services of a consultant to help develop a component of the
    program? If so, have you obtained a commitment for their time and a letter of
    support if their role is critical?
  • Do key personnel have the necessary expertise in evaluation and performance
    outcomes assessment?
  • If partnering with another academic institution or school (e.g. School of Public
    Health, community health center), who will be responsible for overseeing the
    training of students, residents or fellows at that institution?
Where Will this Activity Be Placed in the Curriculum? Will this
Activity Replace Another Course?
  • Do you have support from the Dean, Department Chair or Residency Director to
    develop this curriculum or rotation?
  • Do you have letters of support from faculty from other departments, institutions,
    community sites, or consultants?
  • Does the letter identify what the person will contribute toward implementation of
    the objectives?

How Will You Know You Have Accomplished the Objectives?
(Evaluative Strategies)
  • Can the objectives be measured?
  • What kind of assessment tools are you using? Are they qualitative or quantitative?
  • What data will you collect at the end of each year? How often will your trainees be
    assessed for added competencies?
  • Can you show an impact of your program in three years among trainees and/or
    among patients or communities targeted in the grant application?

What Resources Are Available at the Institution and Community
Level? (faculty, staff, facilities, community organizations)
  • Have you discussed with the community health center administrator about placing
    the medical students or residents in their facility? If so, do you have a letter of
    support from this individual?
  • What sites, facilities and resources are currently available?
  • Are there faculty in other departments or schools who can serve as critical resources
    for your students, residents, and fellows?

What Resources Do You Need from HRSA to Accomplish the Objectives?
(Budget Request)
  • Have you included a detailed budget for year 1 and a consolidated budget for years
    1,2 and 3?
  • Once the consultants have completed their task how will you retain the expertise at
    your institution?
  • Have you requested adequate time from the faculty or staff to accomplish their part
    of the project?
  • Have you adequately justified the amount of time commitment/money requested?
  • Are all items requested in the budget related to the objectives? Are all items
    requested in the budget necessary to complete the objectives, e.g., computers,
    PDAs?
  • Is your budget realistic?
What Will the Institute Contribute to the Costs of the Project?
   • Can you describe in-kind contributions of facility time, or direct contributions of
     supplies, or equipment?
   • Are there additional sources of funding to carry out your project?

Can the Results of Your Project Be Used by Other Institutions after
You Have Developed It? (Dissemination)
   • Have you developed cases on cultural competency that can be used at other
     institutions?
   • Have you designed a dissemination strategy that includes websites, peer review
     journal articles, presentations at regional and national meetings?
   • Does your faculty have a history of success with professional presentations and
     publication of educational innovations?

Do You Have a History of Grant Funds from HRSA in the Same
Program Area that You Are Requesting Funding, e.g., Residency
Training (Progress Report)
   • Did you accomplish your previous objectives?
   • Did you disseminate your results?
   • Were there problems in implementing the objectives? If so, how did you resolve the
     problems?
APPLICATION REVIEW INFORMATION (2008)
1. Review Criteria (Total Score = 100)

Procedures for assessing the technical merit of grant applications have been instituted to
provide for an objective review of applications and to assist the applicant in understanding the
standards against which each application will be judged. Critical indicators have been
developed for each review criterion to assist the applicant in presenting pertinent information
related to that criterion and to provide the reviewer with a standard for evaluation. Applicants
should pay strict attention to addressing all these criteria, as they are the basis upon which the
reviewers will evaluate their applications. The sections of the project narrative that should
be addressed under each review criteria are indicated.

All competitive applications will be reviewed and scored using the following criteria and
weights:

Criterion 1: Need (Score = 10 Points)
(Narrative section: Needs Assessment) The need for the project is well established with a
description of the problem and associated contributing factors. Local or national data and
reference to literature document the need.

Criterion 2: Response (Score = 30 Points)
(Narrative sections: Methodology, Work Plan, Resolution of Challenges) The extent to which
the proposed project responds to the “Purpose” included in the program description; the clarity
of the proposed goals and objectives and their relationship to the identified project; the extent
to which the activities described in the application are capable of addressing the problem and
attaining the project objectives; the proposed plan for resolution of challenges (overcoming
barriers) to achieve the project objectives. In the case of collaboration, collaborative proposals
must demonstrate joint planning, implementation, training and evaluation, and should include
shared faculty appointments and administrative staff.

Criterion 3: Evaluative Measures (Score = 10 Points)
(Narrative sections: Evaluation and Technical Support) The effectiveness of the method
proposed to monitor and evaluate the project results. Evaluative measures must be able to
assess: (1) to what extent the program objectives have been met, and (2) to what extent these
can be attributed to the project.

Criterion 4: Impact (Score = 10 Points)
(Narrative sections: Outcome Measures and Dissemination) The extent and effectiveness of
plans for dissemination of project results and/or the extent to which project results may be
national in scope and/or the degree to which the project activities are replicable.

Criterion 5: Resources/Capabilities (Score = 15 Points)
(Narrative sections: Organizational Information, Work Plan, and Progress Report) The
extent to which project personnel are qualified by training and/or experience to implement and
carry out the projects. The capabilities of the applicant organization, partner organization(s),
quality and availability of facilities and personnel to fulfill the needs and requirements of the
proposed project. The commitment of the institution to meet the diversity of health professions
workforce, which includes disadvantaged and minority students, residents, and faculty and
placement of graduates in underserved communities. For competing continuation applications,
past performance will be considered.

Criterion 6: Support Requested (Score = 10 Points)
(Budget Justification) The reasonableness of the proposed budget in relation to the objectives,
the complexity of the activities and the anticipated results.

Criterion 7: Specific Program Criteria (Score = 15 Points)
(Special Considerations): The extent to which the proposed project responds to preparing
practitioners to care for underserved populations and other high risk groups such as the elderly,
individuals with HIV/AIDS, substance abusers, homeless, and victims of domestic violence.

The extent to which the proposed project responds to preparing practitioners specific training
and/or learning experiences to develop knowledge and appreciation of how cultural and
language influences health literacy improvement and the delivery of high quality, effective and
predictably safe health care service.
               SUMMARY: WRITING A STRONG GRANT APPLICATION

   •   Have you included information related to preferences and priorities?
   •   Have you proofread your grant application? Is the grammar and spelling correct?
   •   Have you addressed each item in the Project Narrative?
   •   Did you provide sufficient details for each section?
   •   Have you addressed at least one of the areas of special consideration?
   •   How does the project relate to Healthy People 2010?
   •   Did you include letters of support and biographical sketches?
   •   Is it clear how the objectives will improve the educational training and competencies of
       students, residents, fellows or faculty?
   •   Is the equipment or supplies requested in the budget directly related to the objectives?
   •   What is the benefit or advantage of having an electronic format vs. traditional
       textbooks?
   •   How do the proposed objectives differ from the previous funded project?
   •   Are the objectives presented in a way that justify they should be funded by the Federal
       government as opposed to the institution itself?
   •   Is the methodology clearly presented?
   •   Are the roles and responsibilities of the faculty and staff clearly presented?
   •   Are the roles and experience of the consultants identified?
   •   Are there sufficient faculty with the necessary expertise to accomplish the objectives?
   •   Is the evaluation summative or formative? Is it objective with realistic outcomes
       measures?
   •   Did you include the budget justification?
   •   Did you check the calculations in your budget tables?
   •   Is the dissemination plan realistic?
   •   If you were funded within the last four years, have you included a progress report?




*Hand-out was adapted from material prepared and used by HRSA staff in the Division of
Medicine and Dentistry, Bureau of Health Professions for purposes of technical assistance to
HRSA grantees