Implementation Research for Multi-morbidity Management in the Context of Non-communicable Diseases in Low- and Middle-Income Countries and US Tribal Populations (R61/R33 Clinical Trial Required) | PAR 25 223

Opportunity Information: Apply for PAR 25 223

The NIH is planning a grant opportunity (PAR-25-223) that supports implementation research focused on improving how noncommunicable diseases (NCDs) are managed when people are living with more than one chronic condition at the same time (multi-morbidity). The program is being developed in collaboration with the Global Alliance for Chronic Diseases (GACD), and it is aimed at generating practical, real-world evidence on what strategies actually work to deliver better NCD care in settings that often face major resource, access, and equity barriers. A key emphasis is on studies that move beyond describing the problem and instead test and evaluate scalable approaches to deliver integrated, coordinated care for people with multiple chronic diseases.

This opportunity specifically targets two priority contexts: (1) World Bank-defined low- and middle-income countries (LMICs), and (2) American Indian and Alaska Native (AI/AN) Tribal Nation populations in the United States. In both contexts, NCDs are a growing driver of illness and early death, and multi-morbidity can make standard single-disease programs less effective. The intent is to support research that evaluates implementation strategies in the places where care is delivered, such as community clinics, primary care settings, health systems serving Tribal communities, and other local health delivery structures. Because the announcement is a "Clinical Trial Required" FOA, projects are expected to include a clinical trial component, meaning investigators should be prepared to test an intervention or implementation strategy using a prospective, structured research design.

The funding mechanism is an R61/R33 phased innovation award, which generally supports a two-stage approach. The early phase (R61) is designed for launching and refining the approach, addressing feasibility milestones, and ensuring the intervention and implementation plan are ready for a more definitive test. The later phase (R33) supports the expanded study and more rigorous evaluation once predefined milestones are met. This phased structure is meant to reduce risk and encourage teams to build strong partnerships, finalize delivery workflows, and confirm that recruitment, measurement, and implementation processes will work in the intended settings before moving into the larger trial phase.

Eligibility is broad, reflecting the program's focus on partnerships and community-relevant research. In addition to typical eligible entities (state, county, and city governments; public and private institutions of higher education; nonprofits with or without 501(c)(3) status; for-profit organizations other than small businesses; and small businesses), the opportunity explicitly highlights organizations that serve or are led by populations of interest. This includes Tribal governments (federally recognized) and other Tribal organizations, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), faith-based or community-based organizations, U.S. territories or possessions, and non-U.S. entities and regional organizations. The practical takeaway is that applicants are not limited to traditional academic medical centers; community-rooted and Tribal-serving organizations can be central applicants or key partners, which fits the goal of designing interventions that are feasible and acceptable in real service environments.

From a funding and timing perspective, the opportunity is listed as a discretionary NIH grant in the health category, with multiple CFDA program numbers associated with participating NIH Institutes and Centers (93.233, 93.242, 93.313, 93.837, 93.838, 93.839, 93.840, 93.989). The listed award ceiling is $500,000, and the original closing date shown is January 7, 2026. The notice was created October 25, 2024. While the summary does not specify the number of expected awards, applicants should plan for a competitive process typical of NIH funding, and for budgets and timelines that align with a phased clinical trial-oriented implementation research plan.

Overall, the program is looking for teams that can combine implementation science with practical chronic disease care improvement, with a clear focus on multi-morbidity management rather than isolated single-condition solutions. Strong applications will typically make a convincing case that the proposed approach is responsive to local context (LMIC health systems or AI/AN Tribal health settings), includes meaningful stakeholder engagement, and is designed to produce evidence that can be adopted, sustained, and potentially scaled to improve health outcomes and reduce inequities in chronic disease care.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Implementation Research for Multi-morbidity Management in the Context of Non-communicable Diseases in Low- and Middle-Income Countries and US Tribal Populations (R61/R33 Clinical Trial Required)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.233, 93.242, 93.313, 93.837, 93.838, 93.839, 93.840, 93.989.
• This funding opportunity was created on 2024-10-25.
• Applicants must submit their applications by 2026-01-07. (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 $500,000.00 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.

Apply for PAR 25 223

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