Opportunity Information: Apply for PAR 19 044
End-of-Life and Palliative Care Approaches to Advanced Signs and Symptoms (R21 - Clinical Trial Optional) is a National Institutes of Health (NIH) discretionary grant opportunity (Funding Opportunity Number PAR 19 044; CFDA 93.361) designed to push forward early-stage, exploratory research focused on the complicated, often overlapping signs and symptoms that occur in the last phase of life. The central aim is to stimulate studies that dig into the multi-dimensional foundations of these advanced symptoms, how patients and caregivers experience them in real-world settings, and how clinicians and care teams can better assess and manage them. In practical terms, the opportunity is geared toward improving understanding and care for people nearing the end of life by encouraging innovative approaches to symptom science and palliative care, including work that can clarify why certain symptom clusters emerge, how they change over time, and what strategies meaningfully reduce distress and improve quality of life.
A key feature of the FOA is its emphasis on the complexity of end-of-life symptom burden. Rather than treating symptoms in isolation, it encourages research that considers the full picture: physical symptoms (such as pain, breathlessness, fatigue, nausea, constipation, delirium, or agitation), psychological and emotional distress (including anxiety, depression, fear, or existential suffering), social impacts (family strain, caregiver burden, communication challenges), and other contextual factors that shape how symptoms are perceived and managed. The wording highlights "multi-dimensional foundations, experiences and management," which signals interest not only in biological mechanisms and clinical trajectories, but also in patient-centered outcomes, lived experience, and care delivery realities across settings like hospitals, hospices, nursing facilities, and home-based care.
The mechanism is an R21, which generally supports exploratory and developmental research. That typically means projects can be relatively high-risk/high-reward, aimed at generating new insights, pilot data, proof-of-concept findings, or novel methods that could later be scaled up under larger grant mechanisms. The FOA is labeled "Clinical Trial Optional," meaning applicants may propose a clinical trial if it makes sense for the research question, but they are not required to do so. This makes the opportunity flexible for teams pursuing observational studies, measurement development, symptom monitoring approaches, intervention development, feasibility testing, or early efficacy assessments, as long as the work is focused on advanced symptom issues in end-of-life and palliative care contexts.
Funding details provided in the source data indicate an award ceiling of $200,000. The original closing date listed is 2022-01-07, and the opportunity was created on 2018-10-31. Even though this specific closing date has passed, the FOA summary is still useful for understanding the NIH research priorities it represents, and similar or reissued announcements sometimes appear over time under updated numbers or related programs. The activity categories tied to this opportunity are Education and Health, reflecting the broader public health and health services relevance of improving end-of-life symptom care.
Eligibility is broad and includes many types of applicants across the public, nonprofit, academic, and private sectors. Eligible entities listed include state, county, and city/township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; tribal organizations other than federally recognized tribal governments; public housing authorities/Indian housing authorities; nonprofits with or without 501(c)(3) status (excluding higher education institutions when specified in those categories); for-profit organizations other than small businesses; and small businesses. In addition, the FOA explicitly calls out other eligible applicants 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, non-domestic (non-U.S.) entities (foreign organizations), Indian/Native American tribal governments other than federally recognized, and U.S. territories or possessions. This wide eligibility range reflects an intent to attract diverse perspectives and settings, including organizations that serve populations often underrepresented in research or disproportionately affected by gaps in serious-illness and end-of-life care.
Taken together, this grant opportunity is essentially about improving the science and practice of managing severe, complex symptom burdens near the end of life. It encourages projects that move beyond simple symptom checklists toward deeper understanding of symptom mechanisms, patient and caregiver experiences, and practical strategies for relief. The R21 structure supports creative, early-stage work that can open new directions in palliative care research, with the broader goal of reducing suffering and improving quality of life for people with advanced illness and those who care for them.Apply for PAR 19 044
- The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "End-of-Life and Palliative Care Approaches to Advanced Signs and Symptoms (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): 93.361.
- This funding opportunity was created on 2018-10-31.
- Applicants must submit their applications by 2022-01-07. (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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FAQs: End-of-Life and Palliative Care Approaches to Advanced Signs and Symptoms (R21 - Clinical Trial Optional)
What is the name of this grant opportunity?
The opportunity is titled End-of-Life and Palliative Care Approaches to Advanced Signs and Symptoms (R21 - Clinical Trial Optional).
Which agency is offering this funding opportunity?
This is a National Institutes of Health (NIH) discretionary grant opportunity.
What is the Funding Opportunity Number (FON) and CFDA number?
The Funding Opportunity Number is PAR 19 044, and the CFDA number is 93.361.
What is the main goal of the funding opportunity?
The central goal is to stimulate early-stage, exploratory research on the complex and often overlapping signs and symptoms that occur in the last phase of life, with emphasis on their multi-dimensional foundations, real-world experiences of patients and caregivers, and improved assessment and management by clinicians and care teams.
What types of research does this FOA encourage?
The FOA encourages innovative, exploratory work that improves understanding of advanced symptom burden near the end of life. This includes studies that clarify why symptom clusters emerge, how they evolve over time, and what strategies reduce distress and improve quality of life.
Is this opportunity focused on single symptoms or multiple symptoms at once?
It emphasizes the complexity of end-of-life symptom burden and encourages research that considers symptoms as a full picture rather than in isolation, including overlapping symptoms and symptom clusters.
What kinds of symptoms and issues are in scope?
The scope includes physical symptoms (for example pain, breathlessness, fatigue, nausea, constipation, delirium, or agitation), psychological and emotional distress (such as anxiety, depression, fear, or existential suffering), and social impacts (including family strain, caregiver burden, and communication challenges), along with other contextual factors that influence symptom perception and management.
Does the FOA consider caregiver experience and social context?
Yes. The description highlights patient and caregiver experiences in real-world settings and explicitly includes social impacts like caregiver burden and family strain as part of the multi-dimensional symptom context.
What does "multi-dimensional foundations, experiences and management" mean in practice?
It signals interest in more than biology alone. The FOA points to research that can include biological mechanisms and clinical trajectories, as well as patient-centered outcomes, lived experience, and care delivery realities across different care settings.
What is the grant mechanism for this opportunity?
The mechanism is R21, which typically supports exploratory and developmental research.
What kind of projects are a good fit for an R21 in this area?
Projects are generally expected to be early-stage and may be high-risk/high-reward, aimed at generating new insights, pilot data, proof-of-concept findings, or novel methods that could later be expanded under larger mechanisms.
Are clinical trials required under this FOA?
No. The FOA is labeled Clinical Trial Optional, meaning a clinical trial may be proposed if appropriate, but it is not required.
What types of study designs could fit if a clinical trial is not proposed?
Based on the description, suitable approaches may include observational studies, measurement development, symptom monitoring approaches, intervention development, feasibility testing, or early efficacy assessments, as long as the focus remains on advanced signs and symptoms in end-of-life and palliative care contexts.
What settings are relevant for the research?
The FOA references real-world care delivery across settings such as hospitals, hospices, nursing facilities, and home-based care.
What is the maximum award amount mentioned for this opportunity?
The source information indicates an award ceiling of $200,000.
When was this funding opportunity created?
The opportunity was created on 2018-10-31.
What was the listed closing date?
The original closing date listed is 2022-01-07.
Does the passed closing date mean the topic is no longer relevant?
The closing date has passed for this specific listing, but the summary remains useful as a signal of NIH research priorities, and similar or reissued announcements may appear over time under updated numbers or related programs.
What activity categories are associated with this opportunity?
The activity categories tied to this opportunity are Education and Health.
Who is eligible to apply?
Eligibility is broad. Eligible applicants include a wide range of government entities, higher education institutions, nonprofits, for-profits (including small businesses), tribal entities and organizations, public housing authorities/Indian housing authorities, eligible federal agencies, regional organizations, non-U.S. entities (foreign organizations), and U.S. territories or possessions.
Are state and local governments eligible?
Yes. Eligibility includes state governments, as well as county and city/township governments, and special district governments.
Are schools and universities eligible?
Yes. Eligible entities include independent school districts, public and state-controlled institutions of higher education, and private institutions of higher education.
Are nonprofits eligible, including those without 501(c)(3) status?
Yes. The eligibility list includes nonprofits with 501(c)(3) status and nonprofits without 501(c)(3) status (as categorized in the source information).
Are for-profit organizations and small businesses eligible?
Yes. The eligibility list includes for-profit organizations other than small businesses and small businesses.
Are tribal governments and tribal organizations eligible?
Yes. Eligibility includes federally recognized Native American tribal governments, tribal organizations other than federally recognized tribal governments, and it also calls out Indian/Native American tribal governments other than federally recognized.
Are organizations serving specific communities (HSIs, HBCUs, TCCUs, etc.) explicitly included?
Yes. The FOA explicitly calls out eligible applicants such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISIs, Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), and Tribally Controlled Colleges and Universities (TCCUs).
Are faith-based or community-based organizations eligible?
Yes. The FOA explicitly includes faith-based or community-based organizations among eligible applicants.
Are non-U.S. (foreign) organizations eligible to apply?
Yes. The FOA explicitly includes non-domestic (non-U.S.) entities (foreign organizations).
Are U.S. territories or possessions eligible?
Yes. The eligibility list includes U.S. territories or possessions.
What is the larger purpose or impact this FOA is aiming for?
Overall, it aims to improve the science and practice of managing severe, complex symptom burdens near the end of life, supporting work that reduces suffering and meaningfully improves quality of life for people with advanced illness and those who care for them.
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