Opportunity Information: Apply for RFA AG 17 013
The National Institutes of Health (NIH) grant opportunity titled "Encouraging Appropriate Care Using Behavioral Economics through Electronic Health Records (R21/R33)" (Funding Opportunity Number RFA-AG-17-013) supports research that uses behavioral economics to improve how clinicians follow evidence-based treatment guidelines by embedding well-designed prompts, defaults, nudges, and other decision supports directly into electronic health record (EHR) systems. The basic idea is to take insights about how people actually make decisions in busy, real-world settings and apply them to clinical workflows, so that the "easy" or "default" path aligns more often with recommended care. By improving guideline adherence, the FOA aims to raise quality of care, improve health outcomes, and help reduce health disparities that can arise when recommended treatments are not delivered consistently across patient groups or settings.
This FOA uses a phased R21/R33 mechanism. The first phase (R21) is intended for early-stage, pilot work that focuses on feasibility: designing EHR-integrated interventions based on behavioral economics principles, implementing them in a realistic care environment, and testing whether they can be deployed, adopted, and used as intended. The R21 phase is meant to help applicants work through practical issues such as integration with existing EHR platforms, provider workflow constraints, acceptability to clinicians and patients, data capture, and the operational steps needed to run the intervention reliably. If the pilot results are strong and the intervention appears workable and promising, projects can transition to the second phase (R33), which is intended to support larger-scale implementation and evaluation through pragmatic trials. In other words, the program is structured to help teams move from a workable prototype and feasibility evidence to rigorous real-world testing at scale.
The funding announcement is categorized as discretionary funding and uses a grant funding instrument, with activity areas in education and health. It is associated with CFDA numbers 93.279 and 93.866. The listed award ceiling in the provided data is $200,000, and the original closing date for applications was 2017-01-30 (with a creation date of 2016-09-16), indicating this was a time-bound solicitation rather than an always-open program.
A wide range of applicant organizations are eligible. Eligible applicants include state, county, and local governments (including cities or townships), special district governments, independent school districts, federally recognized Native American tribal governments, public housing authorities and Indian housing authorities, and other Native American tribal organizations that are not federally recognized tribal governments. The FOA also allows public and state-controlled institutions of higher education, private institutions of higher education, nonprofit organizations with or without 501(c)(3) status (as long as they are not higher education institutions in those categories), for-profit organizations other than small businesses, and small businesses. The opportunity explicitly highlights additional eligible applicant types such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, and Indian/Native American tribal governments that are not federally recognized.
At the same time, the announcement places clear restrictions on foreign involvement. Non-domestic (non-U.S.) entities and foreign institutions are not eligible to apply. Non-domestic components of U.S. organizations are not eligible to apply, and foreign components (as defined by the NIH Grants Policy Statement) are not allowed. These constraints mean applicants must keep the proposing institution and project components within eligible U.S.-based organizational structures and locations.
In practical terms, the FOA is aimed at research teams that can combine clinical expertise, health services research, behavioral economics, and health IT/EHR implementation skills. Competitive proposals would be expected to show a strong plan for embedding behavioral economics-informed interventions into the EHR in a way that fits clinical workflows, is measurable using EHR data, and is positioned to scale into a pragmatic trial if early feasibility benchmarks are met. The overall emphasis is not just on designing clever nudges, but on testing whether those interventions can be integrated into real care delivery settings and meaningfully improve compliance with recommended treatment guidelines, especially in ways that could narrow inequities in care.Apply for RFA AG 17 013
- The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Encouraging Appropriate Care Using Behavioral Economics through Electronic Health Records (R21/R33)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.279, 93.866.
- This funding opportunity was created on 2016-09-16.
- Applicants must submit their applications by 2017-01-30. (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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FAQs: Encouraging Appropriate Care Using Behavioral Economics through Electronic Health Records (R21/R33) (RFA-AG-17-013)
What is this NIH funding opportunity?
This is a National Institutes of Health (NIH) grant opportunity titled "Encouraging Appropriate Care Using Behavioral Economics through Electronic Health Records (R21/R33)" under Funding Opportunity Number (FON) RFA-AG-17-013. It supports research that uses behavioral economics concepts implemented directly within electronic health record (EHR) systems to encourage clinicians to deliver evidence-based care more consistently.
What problem is the FOA trying to solve?
The FOA focuses on improving adherence to evidence-based treatment guidelines in real clinical settings. The goal is to reduce gaps between recommended care and the care patients actually receive by shaping decision-making within busy clinical workflows, where time pressure and cognitive load can lead to missed opportunities or inconsistent practice.
What kinds of approaches does the FOA encourage?
The FOA encourages EHR-integrated interventions grounded in behavioral economics, such as well-designed prompts, defaults, nudges, and other decision supports. The emphasis is on making the recommended action the easy or default path inside the EHR workflow.
Where are the interventions expected to be implemented?
Interventions are expected to be embedded directly into electronic health record (EHR) systems and tested in realistic care environments, where clinicians are making real decisions and where workflow fit, adoption, and data capture can be observed in practice.
How is this opportunity structured (R21/R33)?
This FOA uses a phased R21/R33 mechanism. The first phase (R21) supports early-stage feasibility and pilot work. If the project meets feasibility and promise milestones, it can transition to the second phase (R33), which supports larger-scale implementation and evaluation, including pragmatic trials.
What is the purpose of the R21 phase in this FOA?
The R21 phase is intended for designing and piloting a behavioral economics-informed intervention within an EHR and testing whether it can realistically be implemented and used as intended. The R21 work is meant to address practical feasibility issues like EHR integration, workflow constraints, acceptability to clinicians and patients, operational reliability, and whether needed data can be captured through the EHR.
What is the purpose of the R33 phase in this FOA?
The R33 phase is intended for larger-scale implementation and evaluation after feasibility is demonstrated in the R21 phase. It supports more rigorous real-world testing, including pragmatic trials, to evaluate whether the EHR-embedded behavioral economics intervention meaningfully improves guideline adherence and related outcomes at scale.
What makes a project suitable to transition from R21 to R33?
Based on the FOA description, projects are positioned to transition when pilot results are strong and the intervention appears workable and promising in a real care environment. The overall idea is to move from a feasible prototype with early evidence to a larger pragmatic evaluation.
What outcomes is the FOA aiming to improve?
By improving adherence to evidence-based treatment guidelines, the FOA aims to raise quality of care, improve health outcomes, and help reduce health disparities that can occur when recommended treatments are not delivered consistently across patient groups or settings.
Why does the FOA emphasize behavioral economics?
The FOA is built on the idea that clinicians (like all people) make decisions under time pressure and real-world constraints. Behavioral economics offers tools for designing decision environments so that the default or easiest action aligns more often with recommended care.
Does the FOA focus only on designing nudges, or also on testing them?
It emphasizes both. The FOA is not just about designing clever prompts or nudges; it is about testing whether those interventions can be integrated into real care delivery settings and whether they measurably improve compliance with recommended treatment guidelines.
What kinds of teams are a good fit for this opportunity?
The FOA is aimed at research teams that can combine clinical expertise, health services research, behavioral economics, and health IT/EHR implementation skills. Competitive efforts would be expected to show a strong plan for EHR embedding, measurement using EHR data, and a pathway to scaling into a pragmatic trial if feasibility benchmarks are met.
What funding instrument and funding type does this opportunity use?
The announcement is categorized as discretionary funding and uses a grant funding instrument.
What are the activity areas for this funding opportunity?
The listed activity areas are education and health.
What CFDA numbers are associated with this opportunity?
This opportunity is associated with CFDA numbers 93.279 and 93.866.
What is the award ceiling listed for this opportunity?
The provided data lists an award ceiling of $200,000.
When was the application closing date for this FOA?
The original closing date for applications was 2017-01-30.
When was this opportunity created?
The creation date listed for the opportunity is 2016-09-16.
Is this an always-open program?
No. The provided information indicates it was a time-bound solicitation with a specific closing date, rather than an always-open program.
Who is eligible to apply?
A wide range of U.S.-based organizations are eligible, including state, county, and local governments (including cities or townships); special district governments; independent school districts; federally recognized Native American tribal governments; public housing authorities and Indian housing authorities; and other Native American tribal organizations that are not federally recognized tribal governments.
Are colleges and universities eligible?
Yes. Eligible applicants include public and state-controlled institutions of higher education and private institutions of higher education. The FOA also explicitly highlights eligibility for several institution categories such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISIs, Hispanic-serving Institutions, HBCUs, and TCCUs.
Are nonprofits eligible to apply?
Yes. The FOA allows nonprofit organizations with or without 501(c)(3) status, as long as they are not higher education institutions in those categories.
Are for-profit organizations eligible?
Yes. For-profit organizations other than small businesses are eligible, and small businesses are also eligible.
Are faith-based or community-based organizations eligible?
Yes. The FOA explicitly highlights faith-based or community-based organizations among eligible applicant types.
Are federal agencies eligible?
Yes. The FOA notes that eligible federal agencies can apply.
Are U.S. territories or possessions eligible?
Yes. The FOA explicitly includes U.S. territories or possessions among eligible applicant types.
Are foreign organizations eligible to apply?
No. Non-domestic (non-U.S.) entities and foreign institutions are not eligible to apply under the restrictions described.
Can a U.S. organization include a foreign component or conduct part of the project outside the U.S.?
No. Non-domestic components of U.S. organizations are not eligible to apply, and foreign components (as defined by the NIH Grants Policy Statement) are not allowed.
What does the FOA mean by focusing on disparities?
The FOA notes that disparities can arise when recommended treatments are not delivered consistently across patient groups or settings. By improving guideline adherence through EHR-embedded decision supports, the FOA aims to help reduce inequities in care delivery and outcomes.
How are projects expected to measure whether the intervention is working?
The FOA emphasizes interventions that are measurable using EHR data. Proposals would be expected to address data capture and the ability to measure adoption, use, and impacts on guideline adherence within the EHR-enabled environment.
What practical implementation issues should applicants be ready to address in the R21 phase?
The FOA highlights practical issues such as integration with existing EHR platforms, provider workflow constraints, acceptability to clinicians and patients, data capture, and the operational steps needed to run the intervention reliably in real care settings.
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