This IRG considers applications seeking to understand and elaborate the broader socioenvironmental contexts in which health and health-related behavior are embedded and to examine the interaction of these socioenvironmental factors with the health and health related behavior of individuals and populations. The socioenvironmental factors studied may include social class, socioeconomic conditions, cultural factors and processes, institutions, social organization, social networks, neighborhood and regional characteristics, media, policies, social and family group membership, and racial and ethnic identity. Specific areas of interest include (but are not limited): studies of socioenvironmental influences on health, behavior, and development; community and organizational interventions for the prevention and modification of risk behaviors; multi-level, multi-contextual studies, behavioral genetics and heritability studies; population processes, composition and distribution, their antecedents and consequences, and their inter-relationships with social, cultural, economic, behavioral, developmental and biomedical factors and processes; health services research on the antecedents and consequences of health services utilization, including multidisciplinary investigations of factors affecting access, organization, costs, quality, and the financing of health services; methodological issues, various statistical techniques, and modeling of phenomena relevant to behavioral and social science research; description, detection, etiology, prevention, treatment, and control of chronic and communicable diseases in the community; and basic and applied research of responses to actual or potential health problems, especially symptom management in acute or chronic illness, approaches to promoting health and preventing disease, and interventions influencing patient health outcomes and reducing costs, nursing systems, and ethics.

This study section reviews applications seeking to understand and elaborate the broader socioenvironmental contexts in which health, disease, health-related behavior, and normal development are embedded; examine the interaction of socioenvironmental factors with individual factors with respect to these outcomes; and develop effective macro-level interventions concerned with the prevention of a broad range of health risk behaviors across the life span. Basic studies may investigate social, cultural and other socioenvironmental factors and processes and their inter-relationships with a broad range of outcomes, including mental and physical health, illness and disorder, risk and protective behaviors and behavior change, health beliefs and attitudes, and normal development and functioning across the lifespan. Intervention research may focus on the modification of health risk behaviors and health-related decision making through environmental change and/or the use of social, organizational, political and legal systems to reduce and prevent risk behaviors within the general or select populations. Community-based interventions and studies to develop and test theories or methods and dissemination studies are included. Research approaches may include ethnographic and other qualitative methods; quantitative and mixed-method studies; cross-sectional, longitudinal, or cohort comparison designs; experimental and quasi-experimental designs; studies that focus on more than one period or transition of the life course; and international studies.

SPECIFIC AREAS INCLUDE BUT ARE NOT LIMITED TO:

I. Studies of socioenvironmental influences on health, behavior, and development. Includes studies with primary emphasis on influences and pathways of influence at the socioenvironmental level. Socioenvironmental factors studied may include social class, socioeconomic conditions, cultural factors and processes, institutions, social organization, social networks, neighborhood and regional characteristics, media, policies, social and family group membership, and racial and ethnic identity. Examples include studies that identify and elaborate social and cultural risk and protective influences; explore complex inter-relationships among economic, social, cultural, and environmental influences and health-related outcomes; examine the influence of laws, law enforcement, or criminal justice institutions on health-related decision-making and behavior change; study the influence of advertising, media and health communications on health behaviors and the influence of ethnic identity and cultural norms on health risk knowledge, attitudes and behaviors.

II. Studies of the social, cultural, and socioenvironmental contexts in which health, disease, behavior and normal development are embedded. Included are basic studies of social and cultural processes that are relevant to health and development; examples include acculturation, diffusion, ideational change, meaning of health and illness, family structure and functioning, networks and social support, power relations, economic inequality, ethnic, racial and class identity, and social, cultural, institutional, and community change.

III. Social environment change. Prevention approaches based on policy development, change, and enforcement; legal analyses of policies and their implementation; information dissemination; health promotion; organization or reorganization in communities, schools, worksites or other relevant environment settings. These may be directed toward the general population or at-risk groups and utilize multiple social contexts of influence (e.g., schools, worksites, religious and non-sectarian organizations, community networks, media and advertising).

IV. Community and organizational interventions for the prevention and modification of risk behaviors. These include: randomized experimental and quasi-experimental designs where the community or other multi-person entity is the unit of assignment; interventions that utilize community resources, organizations and information systems for outreach, health education or preventive service delivery; natural experiments; studies of social and organizational networks as systems for intervention delivery; and studies of organization and community characteristics and change processes underlying successful intervention implementation (e.g., community readiness or organization).

V. Studies of the adoption and dissemination of health-risk behavior preventive interventions. Included are studies of intervention effectiveness given variations in implementation and/or acceptance by the target population; and studies of intervention characteristics affecting adoption, acceptance and fidelity of implementation by organizations and communities.

This study section reviews applications for multi-level, multi-contextual studies, behavioral genetics and heritability studies, and behavioral epidemiologic studies which seek to develop an understanding of the origins, multiple etiologies, natural histories, and consequences of a wide range of behaviors, disorders, diseases, normal functioning, and public health concerns. Applications may include qualitative and quantitative methods and may integrate multiple factors and multiple levels of analysis from the biological to social and cultural levels. Studies may use multidisciplinary perspectives and focus on interactions among individual, family, group, and community factors in either the general population or defined subpopulations with special needs such as the very young, the elderly, minority groups, and those at risk for drug and alcohol abuse and transmission of HIV, TB, HBV, and HCV. Studies may include factors which influence temporal trends, such as economic conditions and beliefs of historic cohorts, and may address the etiologies and consequences of behaviors, physical, mental, and substance abuse problems and the aging process as they vary across individuals, families, generation, age, sex, and populations with different predisposing or protective factors and co-morbid conditions.

I. Multi-level, multi-contextual studies. Includes studies of development, health, risk, resilience, disease, and risky behaviors embedded within the context of biological, psychological, social, environmental, and cultural factors. Examples include, but are not limited to studies of interactive effects of risk and protective factors within the individual, family, neighborhood, and environment on physical, psychiatric and/or substance use disorders, recovery, and/or sustained health. Studies may focus simultaneously on multiple levels, pathways, and causes of normal and problem behaviors. Studies may examine the cumulative impact of multiple interacting factors affecting different stages of human development, clinical course, or range of outcomes to identify factors that appear to exert influence and to examine direct and mediating factors. Studies may focus on aspects of normal development and competencies; effects of technological change on health and human functioning; precocious and delayed development as functions of biologic, environmental and experiential factors; and emerging issues.

II. Behavioral genetic studies. Includes studies of the heritability, familial/kinship, parental, social, and environmental influences on the phenotypic expression of genotypes. Studies include population based or clinically ascertained family, twin, adoption studies that incorporate environmental risk factor identification and measurement.

III. Behavioral epidemiology. Includes descriptive, analytic, and genetic epidemiology in both general and specific population groups and international cross-cultural studies. Surveys, surveillance, and related behavioral and social studies are included which are informative of trends and emerging health-related problems and issues.

IV. Natural catastrophies and traumatic events. Includes studies of individual, familial, group, and community factors and dynamics which may predispose and/or result from natural catastrophies and traumatic events affecting a population or region (e.g., fire, hurricane, terrorism, violence, and crime). Studies may nest in-depth studies of individuals, community characteristics, expectations, trauma from prior experience, decision-making, group process, short and long term consequences and develop theoretical models of the impact of such events.

This study section reviews applications related to population processes, composition and distribution, their antecedents and consequences, and their inter-relationships with social, cultural, economic, behavioral, developmental and biomedical factors and processes. This includes studies of migration, mortality and health, residential distribution, reproduction, sexual health, population aging, labor force and retirement, household and family structure, intergenerational relations, and biodemography in the U.S. and other countries. It also includes the development and validation of methodologies for population research, including estimation and projection, formal and mathematical demography, modeling and simulation, qualitative and ethnographic methods, and measurement, design, and statistical analysis. Studies of gender, race and ethnicity as they relate to population processes are included.

I. Migration, emigration and immigration. Movement of people within and across national boundaries; social, cultural, economic, behavioral, and health factors and processes associated with population movement; processes related to migration (e.g., acculturation, adaptation); interstate, intercity, local migration and residential distribution; refugee movements.

II. Family and household. Living arrangements, intergenerational relations, co-residence, marriage, cohabitation, divorce, single-parent families, child care, sexual unions, roles of men, women and children within households and families, including parental and family investments in children and child well-being.

III. Population aging. Studies of the aging of the population, including interrelationships with demographic and social processes, household and family structure, economic status and inequality, health status, intergenerational exchanges and bequests, and impacts on public programs. Economics of aging.

IV. Fertility. Studies of conception, pregnancy, birth, and pregnancy outcomes; contraceptive use and sexual behavior; infertility; birth spacing and timing; birth intentions; value of children; interrelationships with the status and roles of women and men, health, union formation and dissolution, and other social, cultural, economic, behavioral, and biological processes.

V. Mortality, health, functioning and disability. Differentials, trends and projections for individuals, groups and populations, including studies of perinatal, infants, child, adult and elderly health and mortality including interrelationships with demographic, social, economic, behavioral, and biobehavioral processes; health economics.

VI. Biodemography. Interrelationships of biological, genetic, evolutionary, and ecological factors with life history patterns and population processes, composition and distribution. Comparison of life histories and population processes, composition and distribution between humans and other species.

VII. Sexual health. Population-based studies of sexually-transmitted diseases, sexual risk taking and prevention behaviors, sexual networks, and sexual partnerships including studies of social, biosocial, cultural, economic, and behavioral aspects in individuals, groups and society.

VIII. Employment, labor force and retirement. Social, cultural, economic and behavioral antecedents and consequences for working-age and dependent men and women, groups and society. Studies of interrelationships with health, migration, family and household structure, disability, functioning, social and economic status, impact of public and private programs such as social security on labor force transitions and income security of the elderly.

IX. Population size, composition, and structure. Race and ethnic composition. Population composition by age, sex, and nativity and other demographic characteristics.

X. Population and the environment. The interrelationship between population processes and the physical environment.

This study section reviews health services research studies that include multidisciplinary investigations of factors including access, organization, costs, quality, and financing of health services such as ambulatory care, inpatient care, subacute care, and long-term care. Studies can also focus on the antecedents and consequences of health services utilization.

I. Community, personnel, economic, technological, and management resources and support. Includes studies of community resources, including supply and areal market behaviors; health care provider characteristics; health insurance, reimbursement, and financing mechanisms; care management technology and assessment; delivery system characteristics.

II. Health needs and health services utilization. Includes studies of severity of illness; comorbidity; case mix and risk adjustment; psychosocial and economic antecedents; health care access; health services utilization and patterns.

III. Healthcare organizations, programs, and delivery of services. Includes studies of managed care organizations; integrated care delivery systems; disease management and modeling; continuous quality improvement; characteristics of the organization and patient outcomes; organizational performance and efficiency; cost-benefit analysis.

IV. Healthcare quality, effectiveness, outcomes. Includes studies of application and evaluation of practice guidelines; quality of health care; patient satisfaction; health status and outcomes assessment; evidence-based practice; health related quality of life; dissemination.

V. Voluntary health and social service organizations and programs. Includes studies of voluntary organizational programs for health advocacy, prevention and social support services; evaluation of public-private collaborative and inter-organizational network services delivery; intersection of formal and informal care provision.

SNEM-5

GENERAL STATEMENT

This study section reviews applications having a primary focus upon advancing techniques and technologies that address important statistical and mathematical problems, research design and methodological issues, and the modeling of phenomena relevant to biomedical, behavioral and scientific research. This study section encourages generic methodological research that can improve the validity, reliability, or precision of measures; the development of statistical theory and mathematical models to analyze data, clinical trial intervention studies, and nonbehavioral basic science; statistical research targeted at data structures developed in clinical trials; advanced ways of using computers and/or new testing technology, or computational modeling techniques with existing data sets; or applying techniques from other disciplines (e.g., genetics, neurology, computer science) to behavioral and social science topics, as well as other biomedical areas of research. The emphasis and main focus of applications should be upon the methods, statistics, or modeling techniques.

I. Data collection. Processes associated with self-reports; validity, reliability, precision of measurements; self-disclosure of stigmatized and illegal behaviors or rare phenomena; computer-assisted interviews and data collection; biomedical or biobehavioral measures, testing, and evaluations; physiological measures of behavioral phenomena (e.g., fatigue); and techniques for incorporating the collection of biological specimens in behavioral and social science as well as other areas of biomedical research.

II. Research design. Sample selection, completion, and bias estimation; research designs for complex interdisciplinary studies; novel clinical trials design, multiple substudies within clinical trials and cohort/longitudinal design; integration of qualitative, quantitative, clinical, and historical data collection.

III. Advanced statistical issues. Development of theory and models that might include new approaches in Bayesian methodology; regression artifacts; application of smoothing distributions; heteroskedasticity; statistical problems; statistical and methodological issues in clinical trials; medical signals, images, and statistical analyses.

IV. Analytic methods and modeling. Theoretical and methodological issues in meta analysis; modeling measurement error; generalized linear models; statistical issues for large data sets for missing observations or non-response; statistical models of the progression, transmission, and spread of diseases and conditions; demographic modeling; modeling of social networks and family tree and kin networks; connectionist/neural network models of social, psychological and biobehavioral processes; event history analysis; computer simulation; mathematical modeling; graphic information systems; and analytic methods and modeling of qualitative data. Software development.

This study section reviews applications for epidemiologic research dealing with (1) the description and detection of chronic and communicable diseases and of known risk factors for diseases (e.g., surveillance; morbidity and mortality rates and proportions; secular trends), (2) the etiology of diseases and assessment of new risk factors associated with diseases (e.g., genetic and environmental factors affecting health and quality of life; interaction effects; identification of confounders and effect modifiers), and (3) effective interventions for the prevention, treatment, and control of diseases and improvement of quality of life (including clinical trials). In addition, the study section reviews applications focusing on the development of new methods for design, data collection, and statistical analysis in epidemiologic research.

I. Cardiovascular Disease Epidemiology. Includes studies on the description, detection, etiology, prevention, treatment, and control of cardiovascular disease, coronary heart disease, arterial and venous disease, myocardial infarction, lipidemia, and other cardiovascular-related morbidity and mortality in different age, ethnic, and gender groups within the U.S. and internationally as well as in other groups of interest (e.g., as related to other diseases).

II. Reproductive and Perinatal Epidemiology. Includes studies on the description, detection, etiology, prevention, treatment, and control of reproductive diseases, pregnancy and fertility (including birthweight), child growth and development, and the menopause in appropriate age, ethnic, and gender groups within the U.S. and internationally as well as in other groups of interest (e.g., as related to other diseases).

III. Musculoskeletal Epidemiology. Includes studies on the description, detection, etiology, prevention, treatment, and control of musculoskeletal diseases, osteoporosis, falls and fractures, body composition, bone mineral content and density, frailty, and related areas in different age, ethnic, and gender groups within the U.S. and internationally as well as in other groups of interest (e.g., as related to other diseases).

IV. Arthritis, Lupus, and Rheumatoid Disease Epidemiology. Includes studies on the description, detection, etiology, prevention, treatment, and control of arthritis and rheumatoid diseases, lupus, and related conditions in different age, ethnic, and gender groups within the U.S. and internationally as well as in other groups of interest (e.g., as related to other diseases).

V. Diabetes, Digestive Disease, and Kidney Disease Epidemiology. Includes studies on the description, detection, etiology, prevention, treatment, and control of Type 1 diabetes mellitus (insulin dependent diabetes mellitus), Type 2 diabetes mellitus (non-insulin dependent diabetes mellitus), juvenile and other-onset diabetes, digestive diseases, and kidney diseases in appropriate age, ethnic, and gender groups within the U.S. and internationally as well as in other groups of interest (e.g., as related to other diseases).

VI. Obesity, Physical Activity, and Nutritional Epidemiology. Includes studies on the description, detection, etiology, prevention, treatment, and control of obesity as well as studies on the roles of physical activity and nutrition in the etiology, prevention, treatment, and control of diseases and of post-operative outcomes in different age, ethnic, and gender groups within the U.S. and internationally as well as in other groups of interest (e.g., as related to other diseases or factors).

VII. Methodological/Analytical Epidemiology. Includes studies focusing on new methods for the design of epidemiologic studies, for data collection, and for analysis in epidemiologic studies with different study designs (e.g., analysis of longitudinal versus retrospective data; new modeling methods; meta-analyses).

This study section reviews applications involving case-control studies, longitudinal (cohort) studies and natural history studies; community studies, clinical trials and surveillance studies; and epidemiologic studies including some supporting laboratory studies. Specific disease areas include: cancer, infectious diseases, environmental and occupational risk factors, pulmonary diseases, sleep disorders, and neurological disorders including the epidemiology of Alzheimer's Disease, dementias, stroke and epilepsy.

SPECIFIC AREAS INCLUDE BUT ARE NOT LIMITED TO:

I. Incidence and Prevalence Rates of Specific Disease Morbidity and Mortality: Studies examining the incidence and prevalence of morbidity and mortality related to the above disease areas.

II. Identification of Biologic and Genetic Risk Factors: Examination of genetic and biologic risk factors, alone and in conjunction with environmental factors, which put individuals at risk for the specific diseases listed above.

III. Development and Improvement of Research Designs and Methodologies: Development and application of improved research designs and methods addressing epidemiologic questions in the above mentioned disease areas.

IV. Use and Development of Biostatistical Methods in Epidemiology: Modification of or utilization of biostatistical methods and the development of new methods for the analysis of epidemiologic data pertaining to the above-mentioned diseases. The focus should be on the application of biostatistical methods to epidemiologic research methods and data, rather than theoretical statistics.

NURS

GENERAL STATEMENT

This Study Section reviews applications that directly or indirectly address clinical nursing practice or use nursing theories as conceptual frameworks, i.e., studies relevant to the nursing diagnosis and treatment of human responses to actual or potential health problems, and patient outcomes responsive to nursing interventions. As such, nursing research includes both scientific inquiry into nursing science as well as basic biomedical and behavioral processes relevant to nursing care and research relating to nursing interventions in patient care. Biological, psychological, social, and cultural perspectives are frequently employed in the design and conduct of nursing research as are multidisciplinary perspectives. The outcomes are for either short or long term improvements in patient outcomes. Nursing interventions are designed to enhance disease prevention, promote recover, and/or maintain health. Research addressing cost issues or systems issues should focus on the cost of nursing care or the environment in which nursing care is delivered.

[Referral & Review]