Innovative Health Care Models for Persons with Multiple Chronic Conditions from Populations That Experience Health Disparities

Council Date: September 10, 2021

Objective

This initiative will support innovative, collaborative, and multidisciplinary research designed to study the effective integration and implementation of recommended guidelines of care and their impact on health outcomes of persons with multiple chronic conditions (MCCs) from populations that experience health/health care disparities. Projects would be expected to involve more than one component and/or more than one level of influence—based on NIMHD Research Framework—within existing health care models or through newly proposed health care models. Download full concept paper

Description of Initiative

As stated in the objective, this initiative seeks to study the integration of guidelines of care for MCCs through interventions in existing or newly proposed health care models, and its impact on health outcomes in persons with MCCs from populations that experience health/health care disparities. This initiative in part parallels an active FOA presented to the NIMHD Council in February 2020 on Comprehensive Care for Adults with Type 2 Diabetes Mellitus from Populations with Health Disparities (NOT-MD-20-026 and PA-21-232).

For the purposes of this concept, chronic diseases of interest are those with the highest prevalence and/or greatest burden of morbidity, disability, and/or mortality in populations that experience health disparities. These include:

• Obesity
• Diabetes and its complications
• Cardiovascular diseases (including coronary artery disease, heart failure, peripheral vascular disease, and stroke)
• Cardiovascular or cardiometabolic disease risk factors (e.g., hypertension, hypercholesterolemia/dyslipidemia, smoking, prediabetes)
• Cancer and its complications
• Chronic respiratory diseases—especially chronic obstructive pulmonary disease and asthma—sleep disordered breathing
• Cognitive decline (including Alzheimer’s disease and related dementias)
• Chronic liver disease and cirrhosis
• Chronic kidney disease (including end-stage kidney disease)
• Substance use disorders
• Osteoarthritis
• Systemic lupus erythematosus and its associated complications
• Mental health conditions (including anxiety and depression)

Although most studies on MCCs have focused on adults, some studies have highlighted the emerging needs of children with chronic diseases. Therefore, projects focused on children are also of interest.

The initiative will support:

• Interventions (especially multi-component or multi-level interventions).
• Clinical trials (including cluster-randomized trials, pragmatic trials).
• Quasi-experimental studies.
• Natural experiments (e.g., impact of policy).
• Mixed-methods.
• Evaluation of proposed strategies or health care models.

Page updated Feb. 27, 2024