Examination of Survivorship Care Planning Efficacy and Impact (R21 Clinical Trial Optional) | PA 18 012

Opportunity Information: Apply for PA 18 012

The National Institutes of Health funding opportunity "Examination of Survivorship Care Planning Efficacy and Impact (R21 Clinical Trial Optional)" (Funding Opportunity Number PA-18-012) supports early-stage, developmental research focused on whether and how survivorship care planning actually improves outcomes for people who have completed cancer treatment. The central theme is practical impact: the FOA is looking for studies that can show what survivorship care planning changes in the real world, for which survivors, in which settings, and at what cost. Because this is an R21 mechanism, the emphasis is on exploratory or proof-of-concept work that can establish feasibility, generate preliminary effect estimates, refine measures, and lay the groundwork for larger trials or implementation studies. Clinical trials are allowed but not required, meaning applicants can propose experimental, quasi-experimental, or observational designs as long as the approach is appropriate for testing key assumptions and generating actionable evidence.

The FOA targets survivorship challenges that occur after treatment, especially the late and long-term effects of cancer therapy and the ongoing need for coordinated follow-up care. It highlights specific survivor behaviors and outcomes that survivorship care plans are expected to influence, including self-management of treatment-related late effects, adherence to medications, adherence to recommended cancer screening, alignment with health behavior guidelines (for example, physical activity, diet, tobacco cessation), and the use of recommended follow-up care. In addition to physical health endpoints, the announcement explicitly points to survivors' psychosocial outcomes, signaling interest in areas such as distress, quality of life, anxiety about recurrence, functional status, and overall well-being. A key underlying question is whether survivorship care planning is more than a document or a handoff ritual, and instead functions as a measurable intervention that changes behavior, care utilization patterns, and health trajectories.

The research goals are organized around four major aims. First, the FOA calls for the development and testing of metrics that can credibly evaluate survivorship care planning, which implies that existing measures may be inconsistent, incomplete, or not sufficiently tied to meaningful outcomes. This could include measures of plan quality, fidelity to care planning processes, survivor comprehension and engagement, provider uptake, timing of delivery, or integration into electronic health records and workflows. Second, it seeks direct evaluation of the impact of survivorship care planning on survivor outcomes such as morbidity, self-management capacity, adherence to recommended care, and patterns of follow-up care utilization. Third, the FOA broadens the lens to systems outcomes, encouraging applicants to assess costs and resource implications as well as effects on providers and organizations responsible for implementing care planning. This includes organizational burden, workflow disruptions or improvements, staffing needs, and financial or operational tradeoffs. Fourth, the FOA encourages identification of care models and processes that make survivorship care planning more effective, which can include variations in who delivers the plan (oncology, primary care, nurse navigators), how it is delivered (in-person visits, telehealth, digital tools), how it is tailored (risk-stratified approaches), and how it is maintained over time (updates, triggers, and shared-care pathways).

Another notable aspect of the opportunity is its attention to implementation context. The FOA explicitly mentions organizational-level factors that shape whether survivorship care planning is adopted, delivered with fidelity, sustained, and scaled, along with the costs that accompany those realities. This invites research that examines barriers and facilitators inside health systems, such as leadership support, reimbursement constraints, clinical workload, interoperability of health IT, staff training, and coordination between oncology and primary care. In practice, NIH is signaling interest not only in whether survivorship care planning can work under ideal conditions, but also in whether it can work in routine settings and what it takes for clinics and health systems to do it well.

In terms of administrative details, this is a discretionary NIH grant under CFDA 93.399, with an award ceiling listed as $200,000. The original closing date provided in the source is January 7, 2019, and the creation date is November 2, 2017. Eligibility is broad and includes many types of U.S. governmental entities (state, county, city/township, special districts), educational institutions (public and private institutions of higher education), independent school districts, Native American tribal governments (federally recognized), tribal organizations (including those other than federally recognized tribal governments), public housing authorities/Indian housing authorities, nonprofits with and without 501(c)(3) status, and for-profit organizations (including small businesses and other for-profits). The FOA also explicitly calls out additional eligible applicant categories such as Historically Black Colleges and Universities, Hispanic-serving institutions, Tribally Controlled Colleges and Universities, Alaska Native and Native Hawaiian Serving Institutions, and Asian American Native American Pacific Islander Serving Institutions, as well as faith-based or community-based organizations, regional organizations, U.S. territories or possessions, eligible federal agencies, and even non-U.S. entities (foreign organizations). That breadth reflects an intent to encourage diverse settings and populations in survivorship research, including underserved communities and a variety of care delivery environments.

Overall, the opportunity is aimed at building a stronger evidence base around survivorship care planning by improving how it is measured, testing whether it changes survivor behaviors and health outcomes, evaluating what it costs and how it affects care systems, and identifying delivery models that make it more effective. The longer-term objective is practical: generate enough science to inform better interventions and more reliable follow-up care for cancer survivors, so that survivorship care planning becomes an evidence-driven component of survivorship care rather than a compliance exercise.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Examination of Survivorship Care Planning Efficacy and Impact (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.399.
• This funding opportunity was created on 2017-11-02.
• Applicants must submit their applications by 2019-01-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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