The NIH Almanac
The mission of the National Institute of Nursing Research (NINR) is to promote and improve the health of individuals, families, and populations. NINR supports and conducts clinical and basic research and research training on health and illness across the lifespan to build the scientific foundation for clinical practice, prevent disease and disability, manage and eliminate symptoms caused by illness, and improve palliative and end-of-life care.
In focusing on this vision, NINR supports clinical and basic, extramural and intramural research to:
- Explore the mechanisms underlying symptoms and develop personalized treatments that address these mechanisms through symptom science research;
- Enhance wellness in diverse groups through culturally-appropriate interventions designed to prevent illness and promote health;
- Engage individuals as active participants in their own health, especially those with chronic illnesses and conditions through self-management;
- Improve quality of life for patients with advanced and life-limiting illness, as well as their caregivers and families, through evidence-based palliative and end-of-life care; and
- Develop new technologies that facilitate self-management, improve clinical care, and lead to better communication, care coordination, and clinical practice.
NINR also places great emphasis on research training to cultivate the next generation of nurse scientists. NINR-supported opportunities for research training are available for students beginning their research careers, as well as for scientists seeking to expand their research expertise. Among these opportunities, NINR provides support for trainees from underrepresented and disadvantaged backgrounds.
NINR fosters collaborations with many other disciplines in areas of mutual interest such as long-term care for older adults, the special needs of women across the lifespan, genetics and genomics, biobehavioral aspects of the prevention and treatment of infectious diseases, and the impact of environmental influences on risk factors for chronic illnesses, among many others. NINR also supports interdisciplinary team science initiatives through its involvement with the NIH Clinical and Translational Science Awards (CTSA) program.
The NINR Strategic Plan: An Overview
Released in October 2011, Bringing Science to Life: NINR Strategic Plan, describes NINR’s approach for advancing the "science of health." It seeks to leverage 25 years of nursing science accomplishments to pave the way for future discoveries in scientific areas that have the greatest potential to impact the health of the nation. Developed with the input of scientists, clinicians, experts in health care and public policy, members of the public, and other stakeholders, the plan also provides a vision for the next quarter century of nursing science achievements. NINR’s research supports the science of health, which encompasses the investigation of multiple health determinants — including psychological, physiological, genomic, environmental, familial, societal, and cultural factors. This focus is based on the premise that individuals would benefit from being actively involved in maintaining their own health through the prevention of disease and self- management of illness.
To advance the science of health, NINR supports research to:
- Enhance health promotion and disease prevention
- Improve quality of life by managing symptoms of acute and chronic illness
- Improve palliative and end-of-life care
- Enhance innovation in science and practice
- Develop the next generation of nurse scientists
NINR’s Innovative Questions Initiative:
In fall 2013, NINR launched the Innovative Questions (IQ) Initiative, the next step in implementing NINR’s Strategic Plan. IQ was an interactive, collaborative initiative designed to stimulate a dialogue among the scientific community, professional organizations, and the public. NINR gathered thoughts and ideas that would encourage new thinking and creativity in nursing science, explore unanswered questions, promote results-oriented research, and guide the science over the next 5 to 10 years.
The initiative consists of two components: NINR’s IQ Workshops and the IQ Website. The IQ Workshop series brings together leading scientists to identify innovative questions that could stimulate novel research in nursing science. On the IQ Website, members of the scientific community and the general public can contribute their own innovative questions.
The questions developed through the IQ initiative have been released to the scientific community through the NINR website. NINR hopes that these questions will serve as a valuable resource to the entire nurse scientist community, from experienced investigators to trainees, in considering future directions for their own programs of research. These questions will also serve to provide the larger community with a better understanding of the potential and importance of nursing science.
Important Events in NINR History
November 10, 1985 — Public Law 99-158, the Health Research Extension Act of 1985, became law. Among other provisions, the law authorized the National Center for Nursing Research (NCNR) to support research and training related to patient care at NIH.
April 18, 1986 — The U.S. Department of Health and Human Services (HHS) Secretary announced the establishment of NCNR at NIH.
April 1986–June 1987 — Dr. Dorris Merritt, Special Assistant to the NIH Director, appointed Acting Director of NCNR. NCNR’s initial budget was $16 million.
December 3, 1986 — The HHS Secretary appointed the first members of the NCNR Advisory Council.
February 17, 1987 — The NCNR Advisory Council held its inaugural meeting.
June 1987–June 1994 — Dr. Ada Sue Hinshaw was appointed the first Director of NCNR.
May 30, 1988 — The NCNR Advisory Council was renamed the National Advisory Council for Nursing Research.
1992 — NINR-funded researcher Dr. David Olds established that visits from home nurses significantly lowered mothers' high blood pressure during pregnancy, resulted in better timing of subsequent pregnancies, and reduced abuse and neglect of children.
June 10, 1993 — P.L. 103-43, the NIH Revitalization Act of 1993, became law. Among other provisions, it elevated NCNR to a NIH Institute. As such, NCNR was re-designated the National Institute of Nursing Research (NINR).
June 14, 1993 — The HHS Secretary signed the Federal Register notice establishing the National Institute of Nursing Research (NINR).
July 1994–April 1995 — Dr. Suzanne Hurd served as Acting Director of NINR.
1994 — NINR-funded researcher Dr. Loretta Sweet Jemmott tested several gender-appropriate, culturally sensitive interventions on hard-to-reach vulnerable populations and significantly reduced sexual risk behaviors for HIV. Her "Be Proud! Be Responsible!" intervention became the Centers for Disease Control and Prevention's model curricula.
April 3, 1995 — Dr. Patricia A. Grady was appointed Director of NINR.
1997 — The NIH Director designated NINR as the lead NIH institute to coordinate collaborative research on end-of-life care.
1998 — Building on research that showed risk for cardiovascular disease can begin at an early age, NINR-funded researcher Dr. Joanne Harrell demonstrated that a specially designed classroom educational program for elementary school children could significantly lower their cholesterol levels in just eight weeks. NINR-funded researcher Dr. Nancy Bergstrom, in a multi-site study, tested the Braden scale for risk of pressure sores and found its predictive capability accurate. The scale is now widely used in nursing homes and hospitals.
1999 — NINR-funded researcher Dr. Mary Naylor demonstrated that transitional care from hospital to home could significantly improve the health of older adult patients and substantially reduce patient days in hospitals, hospital readmissions, and health care costs. NINR-funded researcher Dr. Jon Levine established that gender plays a key role in pain relief, where women obtained satisfactory relief from kappa-opioids while men received little benefit.
Summer 2000 — NINR held the first Summer Genetics Institute.
2002 — NINR funded researcher Dr. Linda Aiken demonstrated that hospital working conditions and adequacy of nurse staffing per patient can affect patients' recovery and that in hospitals where nurses have lower patient workloads, patients have substantially lower mortality rates.
April 2002 — NINR launched a free online training, "Developing Nurse Scientists" for students interested in the nursing research field.
2003 — NINR Director Dr. Patricia A. Grady named co-chair of the Interdisciplinary Research component of the NIH Roadmap for Medical Research and co-chair of the NIH Pain Consortium.
2003 — NINR-funded researcher Dr. Martha Hill found that interventions conducted at the community level by a multidisciplinary health care team reduced high blood pressure in young inner city African-American males, who are typically underserved by the health care system. The study illustratied that culturally sensitive, successful interventions can be conducted for vulnerable populations and can help reduce health care disparities.
2004 — NINR Director Dr. Grady named co-chair of NIH Public Trust Initiative.
2004 — NINR launched a new pilot training project, the Graduate Partnerships Program (GPP) in Biobehavioral Research.
December 2004 — NINR co-sponsored the NIH State of the Science conference, Improving End-of-Life Care, bringing together almost 1,000 health care practitioners from around the world.
2005–6 — NINR celebrated its 20th anniversary at NIH.
2006 — NINR-funded researcher Dr. Bernadette Melnyk demonstrated that her Creating Opportunities for Parent Empowerment (COPE) program, which aims to support the parents of premature infants, resulted in improved knowledge and parenting behaviors, decreased parental stress, and shortened length of NICU stays by about four days, reducing health care costs associated with premature births by about $4,800 per infant. COPE has been adopted by hospitals and insurers throughout the United States.
2007 — NINR-funded researcher Dr. J. Randall Curtis and collaborators reported that an intervention to improve communication between ICU clinicians and family members of dying patients significantly reduced feelings of stress, anxiety, depression, and other symptoms of post-traumatic stress disorder in the family members for up to three months after the loss of their loved one.
2008 — NINR Director, Dr. Grady, named co-chair of the Science of Behavior Change NIH Roadmap/Common Fund Initiative.
2008 — First two NINR Graduate Partnerships Program fellows graduated.
2009 — NINR published an award-winning patient information brochure, “Palliative Care: The Relief You Need When You’re Experiencing the Symptoms of Serious Illness.”
2009 — NINR-funded researcher Dr. Pamela Mitchell reported that a behavioral intervention called Living Well with Stroke reduced the incidence of depression in stroke survivors, both immediately after treatment for stroke and at a one-year follow up.
2009 — Using the unprecedented additional funding made available through the American Recovery and Reinvestment Act (ARRA), NINR supported an additional $36 million in research in fiscal year 2009-2010. Projects supported under ARRA included a new research cooperative for palliative care science and multiple training opportunities to build the scientific workforce. Approximately 73 additional research grants were supported, along with multiple research and training supplements.
2010 — NINR intramural researcher Dr. Taura Barr identified a gene panel useful for stroke diagnostics and outcome prediction as well as other neurological conditions such as traumatic brain injury. Her work may lead to the development of bedside tests for assessment of the extent of brain injury and to guide individualized therapeutics. NINR intramural researcher Dr. Wendy Henderson developed a devise for collecting patient-reported outcomes related to pain called the "Gastrointestinal Pain Pointer" (GIPP), enabling a patient to describe the location, intensity, and subjective components of their pain on a graphic interface. These data were then captured electronically for quantification and comparison to later reports of pain.
2010 — NINR held the first Methodologies Boot Camp, which focused on pain research.
2010 — First NINR history book released: NINR: Bringing Science to Life.
2010 — U.S. Senate resolution, S. Res. 642, congratulated NINR on a quarter century of achievement in science and public service. The resolution was introduced by Senator Daniel Inouye (D-Hawaii) and co-sponsored by Senator Susan Collins (R-Maine).
2010-11 — NINR celebrated its 25th anniversary at NIH with a series of scientific events.
2011 — NINR launched a new NINR Director's Lecture series, designed to bring the nation’s top nurse scientists to the NIH campus to share their work and interests with a transdisciplinary audience. Dr. Bernadette Melnyk presented the inaugural lecture on “COPE: Improving Outcomes for Premature Infants and Parents.”
January 2011 — NINR established a YouTube channel, “NINR News,” to post videos highlighting its events and trainings.
August 11–12, 2011 — NINR convened a national summit on “The Science of Compassion: Future Directions in End-of-Life and Palliative Care,” attended by nearly 1,000 scientists, health care professionals, and public advocates.
October 13, 2011 — Bringing Science to Life: NINR Strategic Plan released at NINR's 25th Anniversary Concluding Symposium.
November 2011 — NINR published the Spanish-language public education brochure: Cuidados Paliativos: El alivio que necesita cuando tiene síntomas de una enfermedad grave (Palliative Care: The Relief You Need When You're Experiencing the Symptoms of Serious Illness).
January 2012 — Dr. Elaine Larson delivered the 2nd NINR Director's Lecture on “Infection Prevention: An Interdisciplinary Team Approach.”
March 2012 — NINR launched the Video Grantsmanship Workshop series, designed to help pre- and post-doctoral students and early career nurse scientists learn the basics of grantsmanship, on its YouTube channel and website.
April 2012 — NINR-supported researcher Dr. Marilyn Rantz found that, in a trial of an early warning sensor system that alerts nurses to declining health, long-term care residents participating in the intervention demonstrated better functional measures (e.g., hand-grip; gait) than did residents receiving usual care.
October 2012 — Dr. Jessica Gill joined NINR as one of the first Lasker Clinical Research Scholars, the premier clinical intramural training program at NIH. She has developed a novel line of research on the mechanisms underlying differential responses to combat trauma and traumatic brain injury (TBI).
April 2013 — NINR Twitter account launched.
May 2013 — Dr. Mary Woo delivered the 3rd NINR Director's Lecture on “It's All in the Mind: Heart Failure and the Brain.”
August 2013 — NINR published “Building Momentum: The Science of End-of-Life and Palliative Care: A Review of Research Trends and Findings, 1997-2010.”
November 2013 — Dr. Ann Cashion appointed Scientific Director for the NINR Division of Intramural Research.
December 2013 — NINR launched its Innovative Questions Initiative, the next step in the implementation of NINR’s Strategic Plan. The IQ initiative consisted of two components, a series of workshops, and a public website.
The workshops, which began in November of 2013 and continued through June of 2014, focused on wellness and personalized health strategies, self-management for individuals with chronic illness, end-of-life and palliative care, and technology in health. The workshops brought together leading scientists and interdisciplinary experts to identify and refine innovative research questions for each topic through a consensus-building, discussion format.
On NINR’s IQ website, members of the scientific community, professional organizations, and the general public were given the opportunity submit innovative research questions directly to NINR, and to comment on questions submitted by others. /p>
December 2013 — Dr. Jessica Gill, a Lasker Clinical Research Scholar and NINR intramural investigator, and Dr. Ida Spruill, an NINR-supported extramural scientist, were selected to receive the Presidential Early Career Award for Scientists and Engineers (PECASE). The PECASE is the highest honor bestowed by the United States Government on science and engineering professionals in the early stages of their independent research careers.
The Office of End of Life and Palliative Care Research (OEPCR) was established in December 2013 to support NINR’s leadership role in end-of-life and palliative care (EOLPC) research. As the lead NIH Institute for end-of-life research, NINR supports research that explores interventions to manage the symptoms of advanced illness and in planning for end-of-life decisions.
January 2014 — NINR launched the Palliative Care: Conversations Matter® campaign, which aims to increase the use of palliative care for children living with a serious illness. The campaign was initiated to raise awareness of and improve communication about pediatric palliative care.
March 2014 - NINR, lead institute for end-of-life research at NIH, developed a new web resource aimed at helping people address a sensitive subject — the end of life. The 13-chapter End of Life module was added to NIHSeniorHealth.gov, a health and wellness website for older adults.
May 2014 — Dr. Barbara J. Drew delivered the 4th NINR Director’s Lecture on “Electrocardiographic Monitoring: Two Decades of Discovery.”
September 2014 — C-SPAN’s Washington Journal interviewed NINR Director Dr. Patricia A. Grady, NIH Director Dr. Francis Collins, and NIDDK Director Dr. Griffin Rodgers, about important and groundbreaking research taking place across the NIH.
September 16, 2014 — Dr. Barbara Medoff-Cooper delivered the 5th NINR Director’s Lecture on “Innovations in High-Risk Infant Care: Creating New Pathways.”
October 2014 — NINR-supported scientist Dr. Linda Aiken received the prestigious Gustav O. Lienhard Award from the Institute of Medicine. View Image.
NINR Legislative Chronology
November 10, 1985 — Public Law 99-158, the Health and Research Extension Act of 1985, became law. Among other provisions, the law authorized the National Center for Nursing Research (NCNR) to support research and research training related to patient care at NIH.
1986 — A series of continuing resolutions (P.L. 99-500, P.L. 99-599) established NCNR as a separate NIH appropriation.
June 10, 1993 — P.L. 103-43, the NIH Revitalization Act of 1993, became law. Among other provisions, it elevated NCNR to a NIH Institute. As such, NCNR was re-designated the National Institute of Nursing Research (NINR).
2010 — U.S. Senate resolution, S. Res. 642, congratulated NINR on a quarter century of achievement in science and public service. The resolution was introduced by Senator Daniel Inouye (D-Hawaii) and cosponsored by Senator Susan Collins (R-Maine).
Biographical Sketch of NINR Director Patricia A. Grady, Ph.D., R.N.
Dr. Patricia A. Grady was appointed Director, NINR, on April 3, 1995. She earned her undergraduate degree in nursing from Georgetown University in Washington, DC. She pursued her graduate education at the University of Maryland, receiving a master's degree from the School of Nursing and a doctorate in physiology from the School of Medicine.
An internationally recognized researcher, Dr. Grady's scientific focus has primarily been in stroke, with emphasis on arterial stenosis and cerebral ischemia. She was elected to the Institute of Medicine in 1999 and is a member of several scientific organizations, including the Society for Neuroscience, the American Academy of Nursing, and the American Neurological Association. She is also a fellow of the American Stroke Association.
In 1988, Dr. Grady joined NIH as an extramural research program administrator in the National Institute of Neurological Disorders and Stroke (NINDS) in the areas of stroke and brain imaging. Two years later, she served on the NIH Task Force for Medical Rehabilitation Research, which established the first long-range research agenda for the field of medical rehabilitation research. In 1992, she assumed the responsibilities of NINDS Assistant Director. From 1993 to 1995, she was Deputy Director and Acting Director of NINDS. Dr. Grady served as a charter member of the NIH Warren Grant Magnuson Clinical Center Board of Governors.
Before coming to NIH, Dr. Grady held several academic positions and served concurrently on the faculties of the University of Maryland School of Nursing and School of Medicine.
Dr. Grady has authored or co-authored numerous articles and papers on hypertension, cerebrovascular permeability, vascular stress, and cerebral edema. She is an editorial board member of the major stroke journals. Dr. Grady lectures and speaks on a wide range of topics, including future directions in nursing research, developments in the neurological sciences, and federal research opportunities.
Dr. Grady has been recognized with several prestigious honors and awards for her leadership and scientific accomplishments, including the first award of the Centennial Achievement Medal from Georgetown University School of Nursing and Health Sciences, being named the inaugural Rozella M. Schlotfeld distinguished lecturer at the Frances Payne Bolton School of Nursing at Case Western Reserve University, and receiving the honorary degree of Doctor of Public Service from the University of Maryland. Dr. Grady was named the Excellence in Nursing Lecturer by the Council on Cardiovascular Nurses of the American Heart Association. In 2005, Dr. Grady received Doctor of Science, Honoris Causa degrees from the Medical University of South Carolina and Thomas Jefferson University. Additionally, Columbia University School of Nursing honored her with its prestigious Second Century Award for Excellence in Health Care. In 2008, Dr. Grady received a Doctor of Science, Honoris Causa degree from the State University of New York Downstate Medical Center. View Image.
In 2011 and 2013, Dr. Grady was named one of the 100 Most Powerful Women in Washington by Washingtonian Magazine and received Arizona State University's College of Nursing and Health Innovation’s Discover Award, which honors those who are dedicated to improving the health of the American public and who “pursue big dreams, lead innovative changes, and achieve their goals.” This was followed in 2012 by the University of California-Los Angeles School of Nursing’s Sterling Award, presented in recognition of “superior achievement in science and health” by those who have taken “great strides in promoting and improving health across the nation through scientific research and leadership in health communities.”
Dr. Grady is also a past recipient of the NIH Merit Award and received the Public Health Service Superior Service Award for her exceptional leadership.
|Name||In Office from||To|
|Doris H. Merritt (Acting)||April 18, 1986||June 1987|
|Ada Sue Hinshaw||June 6, 1987||June 30, 1994|
|Suzanne S. Hurd (Acting)||July 1, 1994||April 2, 1995|
|Patricia A. Grady||April 3, 1995||Present|
Division of Extramural Science Programs (formerly Division of Extramural Activities)
The Division of Extramural Science Programs (DESP) leads NINR’s extramural program functions, grants management, and scientific review. DESP staff recommend priorities for new science initiatives; coordinate review of research training and career development awards; conducts analyses of the nursing science reviewed through the Center for Scientific Review; makes recommendations to the NINR Director regarding science priorities; and manages the non-programmatic areas of grants administration (e.g., second level review by the National Advisory Council for Nursing Research). The staff of DESP maintain awareness of critical advances in nursing science, emergent scientific areas of emphasis, and research activities throughout the NIH, across the nation, and internationally.
DESP is comprised of three offices:
- Office of Extramural Programs
- Office of End of Life and Palliative Care Research
- Office of Extramural Research Administration
The Office of Extramural Programs (OEP) is divided into four branches that reflect the scientific themes that flow from NINR’s strategic plan:
- Symptom Science: Promoting Personalized Health Strategies
- Wellness: Promoting Health and Preventing Illness
- Self-Management: Improving Quality of Life for Individuals with Chronic Illness
- Promoting Innovation: Technology to Improve Health and 21st Century Nurse Scientists: Innovative Strategies for Research Careers
The Office of End of Life and Palliative Care Research (OEPCR) was established to support NINR’s leadership role in end-of-life and palliative care (EOLPC) research. As the lead NIH Institute for end-of-life research, NINR supports science to assist individuals, families, and health care professionals in managing the symptoms of life limiting conditions and planning for end-of-life decisions.
OEPCR is unique in that it encompasses both science and policy functions. Ongoing NINR efforts in end-of-life and palliative care (EOLPC) science include:
- Stimulation of EOLPC research initiatives;
- Creation of opportunities for collaborative activities;
- Facilitation of interdisciplinary EOLPC science;
- Identification of opportunities for science to inform policy and practice; and
- Coordination of the development, implementation, and evaluation of EOLPC research in direct collaboration with other NIH Institutes and Centers, federal research agencies, and outside constituencies.
To learn more about the Institute’s history in this area prior to the establishment of the OEPCR, see “NINR’s Leadership on End-of-Life Research and Palliative Care” below.
The Office of Extramural Research Administration (OERA) is divided into four branches:
- Scientific Review Branch - Responsible for coordinating the NINR standing study section that reviews training and career development awards. Responsibilities of this branch Include:
- Meeting management and issuing of summary statements.
- Coordinating the special emphasis panels to review applications submitted in response to NINR-sponsored funding opportunities such as Requests for Applications (RFAs) and some Program Announcements (PARs).
- Grants Management Branch - Responsible for all business-related activities associated with the negotiation, award, and administration of grants and cooperative agreements for NINR. This branch works with grantee business officials, principal investigators, NIH staff, and NINR program staff to:
- Review, negotiate, and administer NINR-funded grants.
- Work closely with NINR program staff to interpret grant policies as they pertain to the grants award process.
- Council Operations Branch - Responsible for coordinating logistics for meetings of the National Advisory Council for Nursing Research (NACNR) and other meetings hosted by NINR.
- Research Policy and Analysis Branch - Responsible for supporting DESP with program functions and policy implementation and for using databases to analyze portfolios. Example activities include:
- Monitoring the Guide Publication System (GPS) for funding announcements published by other Institutes and Centers that may be of interest to NINR
- Executing policy changes that have been approved through the Extramural Program Management Committee (EPMC).
Research Centers Program
The OEP maintains oversight of the nationwide Research Centers program. The Research Centers program is designed to increase research capability and expand the science of investigators working on multiple projects by promoting collaboration between groups and across institutions, through the use of shared resources and expertise. These settings promote the development of skilled new investigators dedicated to interdisciplinary research. The collaborative approach to research typified in Centers has been found to be valuable in producing results that become the evidence base for practice. NINR funded Centers bring together scientists, students, and other colleagues with similar interests to focus on a common area of investigation, such as symptom management in chronic diseases, nursing outcomes, or end-of-life care. They also serve to advance the NINR goals of building research infrastructure, expanding research capacity, and increasing training opportunities. The focus of currently funded centers includes Building the Science of Self-Management, End-of-Life Transition Research, Pain Studies, Evidence-based Practice in the Underserved, Sleep Disturbances, and Promotion of Cardiovascular Health.
The Research Centers represent a continuum of institutional research programs at different stages of development, each with unique needs and potential. They are funded through three grant mechanisms:
- Exploratory Center (P20) grants target schools of nursing with emerging research programs, helping them to expand their early research efforts, centralize resources, strengthen research capabilities, and increase productivity to generate new research.
- Core or Center of Excellence (P30) grants, designed for institutions with several years of demonstrated research success, support interdisciplinary collaborative research programs among established investigators in specific areas of basic and/or clinical research of strategic interest to NINR.
Extramural Research Training and Career Development
NINR offers a range of extramural training awards and opportunities.
The Ruth L. Kirschstein National Research Service Awards (NRSA) are given to individual fellowship applicants selected for award as a result of national competition for research training in specified health-related areas. The National Institutes of Health (NIH) awards NRSA individual postdoctoral fellowships (F32) to the most promising applicants to support full-time research training related to the mission of the NIH awarding components. Some specialized individual predoctoral fellowships (F31) and senior fellowships (F33) are also provided. The NINR T32 Award Program enables institutions with schools of nursing to make NRSA awards to individuals for pre-and postdoctoral research training in acute and chronic illness across the lifespan, focusing on health promotion, disease prevention, health disparities, HIV/ AIDS, aging, caregiving, management of symptoms, self-management, and care at the end of life.
Career Development Awards
NINR supports several career development awards funded through the K01, K23, K24, and K99 mechanisms.
For postdoctoral and established investigators, the K01 Mentored Research Scientist Development Award provides for a period of additional mentored research experience with an expert sponsor as a way to gain expertise in an area new to the candidate or would demonstrably enhance the candidate’s scientific career. NINR also supports research career awards that offer mentored research experiences for trainees from underrepresented and disadvantaged backgrounds. Also funded by the K01 training mechanism, investigators have addressed issues such as serious developmental problems in Mexican migrant infants; culturally appropriate community-level suicide prevention programs for American Indian rural youth; improvement of awareness of prostate cancer screening among African American men; and ways to identify triggers or markers for increased risk for sudden death in Asian heart failure patients.
NINR participates in the NIH Pathway to Independence (PI) Award, which offers another excellent opportunity for highly promising, postdoctoral research scientists. This award uses the combination K99/R00 funding mechanism and is designed to facilitate receipt of an R01 award earlier in an investigator's research career. The PI Award provides up to 5 years of support consisting of 2 phases: 1-2 years of mentored support, followed by up to 3 years of independent support for career transition, contingent on securing an independent research position. Previously funded NINR topics range from interventions to improve cognitive impairment in older adults with heart failure; discovering biomarkers of pulmonary infection in the critically ill, to understanding access to hospice care. Award recipients are expected to compete successfully for independent R01 support from NIH during the career transition period.
Other career development awards offered by NINR’s OEP include the Mentored Patient-oriented Research Career Development Award (K23); the Translational Scholar Career Award in Pharmaco-genomics and Personalized Medicine (K23); and the Midcareer Investigator Award in Patient-Oriented Research (K24).
For students considering a research career, NINR offers a CD-ROM program titled "Discover Nursing Research." This program presents interviews with nurse scientists and their doctoral students as a way to improve understanding of the scope of nursing science and recruit nurses into research careers. Copies are available upon request.
NINR also offers a video-based grantsmanship workshop via its YouTube channel and the NINR website. The workshop’s seven modules are geared to pre- and post-doctoral students and early career nurse scientists.
Division of Intramural Research
NINR maintains a robust intramural program on the NIH campus in Bethesda, Maryland, dedicated to conducting basic and clinical research on the interactions among molecular mechanisms underlying a single symptom or cluster of symptoms and environmental influences on individual health outcomes. The Division of Intramural Research (DIR) program encompasses the individual variability inherent in symptoms associated with digestive disorders, cancer-related fatigue, traumatic brain injury, cardiovascular-related disorders, congenital muscle disease, and post-traumatic stress disorders as well as clinical interventions to alleviate these symptoms.
NINR's laboratories leverage the benefits of the highly collaborative research environment of the NIH intramural research community, where scientific partnerships are readily established and the nursing science community can take full advantage of resources, infrastructure, and mentoring opportunities available at NIH. The Division of Intramural Research (DIR) consists of the Office of the Scientific Director and three branches: Tissue Injury, Symptom Management, and Biobehavioral.
Tissue Injury Branch
The Tissue Injury Branch conducts clinical and laboratory-based studies on the mechanisms of tissue injury. These studies include the identification of molecular targets and pathways activated in response to cellular damage, the provision of greater understanding of the pathophysiology associated with tissue injury and identifying novel targets for therapeutic intervention.
The Tissue Injury Branch currently consists of three units: Brain Injury, Vascular Biology, and Neuromuscular Symptoms.
- The Brain Injury Unit examines the risks for post-concussive syndrome and post-traumatic stress disorder (PTSD) following a traumatic brain injury (TBI). This unit’s research seeks to design screening methods to approximate psychological and neurological risks following TBI and interventions to mitigate risks and treat early symptoms.
- The Vascular Biology Unit focuses on dietary factors and nutrients that are associated with the development of cardiovascular disease and symptoms, the role of nutrition interventions, and personalized nutrition based on individual genomic profiles.
- The Neuromuscular Symptoms Unit focuses on the measurement and treatment of symptoms associated with various forms of congenital muscle disease, including Collagen 6 Related Myopathy, LAMA2 Related Muscular Dystrophy, and RYR1 Congenital Myopathy. The measures will then be implemented in interventional trials in an effort to find treatments for patients with congenital muscle disease.
Symptom Management Branch
The Symptom Management Branch is dedicated to improving the understanding of the underlying biological mechanisms of a range of symptoms, their effect on patients, and the biological and behavioral basis for how patients respond to interventions.
The Symptom Management Branch consists of three units: Genomic and Clinical Biomarkers, Symptom Biology, and Cardiovascular Symptoms.
- The Genomic and Clinical Biomarkers Unit conducts research to discover biomarkers, within an environmental and clinical context and predicts patient outcomes and guide therapies specifically in solid organ transplant recipients. This unit will eventually expand to encompass other diseases/disorders and patient populations.
- The Symptom Biology Unit examines the nature and causes of fatigue in association with cancer treatments and pain associated with fibromyalgia.
- The Cardiovascular Symptoms Unit focuses on vasculoprotective nutritional interventions that may improve the lipid profile in hyperlipidemia and decrease high blood pressure in hypertension.
The Biobehavioral Branch supports research into the interplay of behavioral, biological, and environmental determinants of health and wellness across populations. The Biobehavioral Branch consists of the Digestive Disorders Unit.
- The Digestive Disorders Unit seeks to understand the mechanisms involved in symptom distress related to digestive disorders, specifically the biobehavioral relationships between inflammation and patient symptoms, in order to identify genetic or other biologic/physiologic factors that predict patient-related clinical outcomes.
Intramural Research Training and Career Development
NINR is committed to developing the next generation of nurse scientists and provides research training through several mechanisms. Post-baccalaureate training positions are available that allow BSN-prepared nurses interested in exploring a career in nursing research to spend a year engaged in biomedical investigation in the Division of Intramural Research (DIR) laboratories. Pre- and postdoctoral fellowship positions, including summer internships, are also available.
NINR also offers mentored research support to post-doctoral intramural investigators via the K99 mechanism. Known as the Pathway to Independence Award, it is designed to facilitate receipt of an R01 award earlier in an investigator's research career.
The DIR also supports the Graduate Partnerships Program (GPP). The NINR GPP is a doctoral fellowship training program that coordinates training and funding for PhD students attending a school of nursing. The program combines the academic environment of a university with the breadth and depth of research resources available at NIH. The goal is to encourage and support the training of nursing doctoral students who are motivated to undertake careers in basic or clinical research. Students complete all required coursework at their academic institution. Their dissertation research is then conducted up to 3 years within the Intramural Research Programs of the NIH in Bethesda, Maryland.
Through the DIR, NINR sponsors the Summer Genetics Institute (SGI), an intensive research training program held at NIH and administered by the Foundation for Advanced Education in the Sciences (FAES) as one of its Biotechnology Specialty programs. The SGI provides a foundation in molecular genetics for use in research and clinical practice and features both lecture and hands-on laboratory training. The purpose of the SGI is to increase the research capability among nursing graduate students and faculty, and develop and expand the basis for clinical practice in genetics among clinicians. The program awards eight hours of graduate-level college credit. SGI graduates are making a difference in their communities in many ways. They are successfully building programs of research in genetics related to nursing (e.g., genetic components involved in organ transplantation outcomes, gene-to-gene and gene-environment interactions in childhood asthma); disseminating findings through publications and scientific conference presentations; and integrating genetics content into nursing school curricula across the country.
The NINR Symptom Research Methodologies Series is a one-week intensive research training “boot camp” at the National Institutes of Health (NIH) in Bethesda, Maryland. Sponsored by NINR and also administered by FAES, NINR’s “Boot Camp” has focused on topics on topics including pain, fatigue, sleep, and Big data.
NINR also co-sponsors nursing students in the Minority Faculty Student Partnership, which is also conducted by the FAES. The program is a one-week training program in targeted areas of molecular to third or fourth year science majors along with their mentors from Historically Black Colleges and Universities, Hispanic or Native American Institutions.
The NINR DIR also participates in the NIH Lasker Clinical Research Scholar program. The Lasker Scholar program supports a small number of exceptional clinical researchers in the early stages of their careers to promote their development to fully independent scientists. The program combines a period of research experience as a tenure-track Principal Investigator in the DIR with an opportunity for additional years of independent financial support, either within the DIR or at an extramural research institution.
The flyer “NINR Training Opportunities” provides an overview of both the extramural and intramural training programs offered by NINR. NINR also offers a video-based grantsmanship workshop via its YouTube channel and the NINR website. The workshop's seven modules are geared to pre- and post-doctoral students and early career nurse scientists.
NINR Leadership in End-of-Life Research and Palliative Care
In recent years, many factors have converged to increase public and professional interest in issues surrounding the end of life.
The 1997 report from the Institute of Medicine (IOM), Approaching Death: Improving Care at the End of Life, found widespread dissatisfaction with end-of-life care and many gaps in our scientific knowledge of this phase of life. In response, NINR sponsored a workshop on the symptoms of terminal illness. Later that year, the NIH Director designated NINR as the lead Institute within NIH for end-of-life research. In continuation of recommendations from the 2014 IOM report, Dying in America, NINR studies the management of pain and other symptoms, family decision-making, caregiving, advance planning, and quality of care for the elderly and critically ill provided an important base of knowledge on which to build. NINR has sponsored several community events to gather input on concerns related to end-of-life issues.
In December 2004, NINR co-sponsored the NIH State of the Science conference, Improving End-of-Life Care, bringing together almost 1,000 health care practitioners from around the world. This conference served to evaluate the current state of the science in end-of-life care and to determine future directions for research. It also highlighted the interactions among patients, caregivers, and the health system, and their effects on outcomes. The consensus statement from this conference is available here.
NINR recognizes palliative care as a critical component of high-quality, evidence-based health care that improves the quality of life for those suffering from the symptoms of serious illness. In 2009, NINR released a patient information brochure entitled: "Palliative Care: The Relief You Need When You're Experiencing the Symptoms of Serious Illness."(PDF-15.5 MB) In 2011, it released the Spanish version: “Cuidados Paliativos: El alivio que necesita cuando tiene síntomas de una enfermedad grave.” Both brochures are copyright free and may be downloaded and reproduced without charge from NINR's Publications webpage. To order print copies or printer files to produce larger quantities, please email email@example.com, or call 301-496-0207.
The Palliative Care Research Cooperative (PCRC) was established in 2010, with foundational support through a cooperative agreement from the NINR and ARRA funding in January 2011 (UC4NR012584). The PCRC focuses on developing palliative care research capacity nationally; supporting the conduct, analysis, and dissemination of high-quality research in palliative care; and, training and mentoring next/ future clinician scientists committed to advancing palliative care research. Through use of the existing PCRC infrastructure of over 50 member sites and core resources, this funding will support high-quality, leading-edge research in end-of-life and palliative care.
In 2013, NINR published “Building Momentum: The Science of End-of-Life and Palliative Care: A Review of Research Trends and Funding, 1997-2010.” This report looked at the trends in EOLPC research publications over the past 14 years, including federal research awards, funding patterns, and the contributions of public and private investments in EOLPC science. The report’s focus addresses the 1997 Institute of Medicine recommendations for the scientific community to strengthen the research landscape, foster new evidence, and define and implement priorities for increasing the knowledge base for EOLPC. The key findings of the report not only summarized the state of EOLPC research, but also identified gaps that future research efforts could address. The publication is available online at http://www.ninr.nih.gov/eolspotlight.
The Office of End of Life and Palliative Care Research (OEPCR) was established in December 2013 to support NINR’s leadership role in end-of-life and palliative care research. As the lead NIH Institute for end-of-life research, NINR supports research that explores interventions to manage the symptoms of advanced illness and in planning for end-of-life decisions.
In 2014, NINR moved EOLPC forward in a variety of ways.
NINR launched its Palliative Care: Conversations Matter™ campaign to encourage early and ongoing conversations between families and health care providers about pediatric palliative care. The campaign emphasizes that palliative care works along with other treatments to enhance quality of life for children of any age living with a broad range of serious illnesses. It strives to break the common association between palliative care and hospice care, stressing that palliative care is appropriate throughout illness — not just at the end of life.
Campaign resources include materials and a website with information for health care providers, families, and caregivers. The materials consist of a series of video vignettes and a customizable tear-off pad (available in English and Spanish), which includes tips for health care providers, answers to common questions about palliative care, and customizable patient education sheets designed to guide the provider’s discussion with the patient and his/her parent or caregiver. The materials are free and can be downloaded or requested by e-mailing firstname.lastname@example.org.
NINR also launched a new public education resource, the End of Life module on the NIHSeniorHealth website, to address the common but sometimes sensitive issues faced by the dying and their caregivers. The module describes the physical, mental, and emotional needs of people nearing the end of life, and suggests ways to maintain their quality of life, such as hospice and home care. It also addresses the often complex practical concerns that can attend death, including financial issues, advance directives, caregiver support, and more. Information on pain management, types and places of EOL care, paying for EOL care, what to do when the end comes, coping with grief, and research efforts may also be found.
NINR and Trans-NIH Initiatives
NINR plays an active role in several trans-NIH initiatives, including the:
- NIH Pain Consortium
- NIH Neuroscience Blueprint
- NIH Science of Behavior Change Roadmap/Common Fund initiative
- NIH Basic Behavioral and Social Science Opportunity Network (OppNet)
- NIH Health Care Systems Research Collaboratory Work Group
- NIH Big Data to Knowledge (BD2K) initiative
NINR is a key member of the NIH Pain Consortium, for which Dr. Grady serves on the Executive Committee. The consortium promotes collaboration among the many NIH Institutes and Centers that conduct or fund pain research. NINR is also a member of the NIH Neuroscience Blueprint, which is designed to develop resources (i.e., people, tools, methods, knowledge bases) for the advancement of research in neuroscience. NINR’s involvement in these areas opens further avenues of research to NINR-supported investigators.
NINR is a co-sponsor of the Science of Behavior Change (SOBC) Roadmap/Common Fund initiative, and Dr. Grady serves as a co-chair of the SOBC initiatives working group. As one of the top priorities for NIH-wide research efforts, advancing the science of behavior change is focused on developing new and innovative approaches to enhance health-related behavior change.
In 2009, NIH launched the Basic Behavioral and Social Science Opportunity Network (OppNet), a trans-NIH initiative to expand the agency’s funding of basic behavioral and social sciences research (b-BSSR). Basic-BSSR studies mechanisms and processes that influence behavior at the individual, group, community and population level. Research results lead to new approaches for reducing risky behaviors and improving the adoption of healthy practices. All NIH Institutes and Centers (ICs) share the mission of supporting b-BSSR. Representatives for NINR are involved in the OppNet Steering Committee, the Executive and Coordinating Committees, and other working groups and initiatives. OppNet has developed a plan for focused multi-year programs across ICs to advance priority b-BSSR topics, such as the impact of culture on health and well-being and multisensory processing.
NINR is a member of the NIH Common Fund’s Health Care Systems Research Collaboratory (HSC), whose goal is to strengthen national capacity to implement cost-effective, large-scale research studies that engage health care delivery organizations as research partners. . One ofthe Collaboratory’s initiatives seeks to stimulate pragmatic clinical trials for multiple chronic conditions. NINR is participating with the National Institute on Aging in an NIH HSC UH2/UH3 pragmatic trial to evaluate the effectiveness of advance care planning video decision support tools in the nursing home setting across two large health care systems nationwide. This work has the potential to improve the palliative and end-of-life care provided to millions of older Americans in nursing homes and enable future pragmatic trials in this setting.
For more information about NINR, nursing science, and research training opportunities, please visit the NINR website at: www.ninr.nih.gov.