Grantwriting: The Basics ASMHTP Preconference Workshop 09

1. Grantwriting: The Basics ASMHTP Preconference Workshop09/22/09

2. Presenters Mary Ganikos, PhDChief, Education BranchDivision of Transplantation Mary Ker, PhDOwner, Optimal Research and Evaluation Carolyn Johnson, PhDProfessorTulane University School of Public Health & Tropical Medicine

3. What is DoT? The primary federal entity with responsibility for: Organ Donation and Transplantation Program National Marrow/Blood Stem Cell/Cord Blood Donor Program (FDA is responsible for tissue.)

4. Where Does DoT Fit Within the Federal Government? US Department of Health & Human Services(CDC, CMS, NIH, FDA, SAMHSA, AOA, HRSA �) Health Resources & Services Administration Healthcare Systems Bureau Division of Transplantation Public/Professional Education Branch

5. What Does DoT Do? Division of Transplantation�s Organ Responsibilities Provide support & oversight of the transplant system: Organ Procurement & Transplantation Network Scientific Registry of Transplant Recipients Increase Organ Donation Public & Professional Education Branch Grants Contracts Special Projects

6. DoT Grant Programs Social and Behavioral Interventions to Increase Solid Organ Donation Clinical Interventions to Increase Organ Procurement Media Based Outreach Efforts to Increase Minority Donation Public Education Efforts to Increase Solid Organ Donation State Donor Registry Support Program National Living Donor Subsistence Reimbursement Program

7. Covering the Donation Continuumfrom Outreach to Transplant Social & Behavioral: Identify successful strategies for increasing individual and family consent Public Ed: Replicate them in other areas and, Minority: With special populations Registry: Improve donation infrastructure do donation declarations can be reliably stored and retrieved. Clinical: Identify methods to maintain organ viability. Subsistence: Remove financial disincentives from living donation.

8. 2010 Grant Programs Social and Behavioral Interventions for Increasing Solid Organ Donation Public Education Efforts to Increase Solid Organ Donation

9. Today�s Focus:Social & Behavioral Research Program Grantsmanship skills are very versatile Learn on one program, apply to others

10. A Little Background on the Program Begun in 1999 Funded 84 grants More than $65M 50 articles in peer reviewed journals

11. Minority Populations Targeted

12. Foci Worksites Schools/Universities Dialysis Patients & Centers Hair Stylists Requestor Training Mothers of Donors Paid Actors

13. Foci, cont�d Media & Community Campaigns Registries Funeral Directors Estate Planning Attorneys Clergy/Chaplains Hospital Development

14. Foci, cont�d Primary Care Centers Living Donation Donation after Cardiac Death First Person Consent Early Referral Kiosks

15. Foci, cont�d Tribal Colleges Flea Markets Bereavement Counseling Hospital Chaplains In-House Coordinators Presumptivity

16. Where to Start? The Guidance Every grant program will have a document telling you: Its purpose: what the source is interested in accomplishing through the grant program Who is eligible to apply What you need to do to qualify for funding For HRSA, it�s called a Guidance. Today, we will focus on the guidance for the Social and Behavioral Research Program.

17. Purpose of the S&B Program Support applied research to increase organ donation. Three types of allowable projects Pilot Replication Extension 20% time and budget for intervention development Address one of three performance measures: Increase individual designation with family notification for areas that do not practice first person consent Increase family consent at time of death Increase knowledge of opportunities for and the process, benefits, and risks of living donation (educate; do not encourage)

18. The Basics Eligibility: Organizations: Private not-for �profit; public Staff required: Principal Investigator, Principal Researcher/Evaluator Time: Up to 3 years Funding: $250,000-350,000 per year Electronic submissions Due date: March 3, 2010, 8:00 PM, non-negotiable

19. The Heart of Your Application: The Narrative Introduction and Purpose Needs Assessment Methodology� sink or swim here Resolution of Challenges Evaluation and Technical Support Capacity Organizational Information

20. Budget You want us to give you how much? For what?

21. Review CriteriaDirectly Related to Narrative � No Surprises Need: 10 pts Response: 20 pts Evaluative Measures: 25 pts Impact: 20 pts Resources/Capabilities: 15 pts Support Requested: 10 pts

22. Funding Priorities Funding Priority: Extra points provided for certain things Early years, funding priority for projects focusing on consent or minorities 2010: consortium

23. So, is a DoT grant in your future? What being involved in the grant program has meant to one OPOer. Stacy Underwood

24. Outline for today Getting started Writing the sections of the narrative: Need Response Evaluation Impact Budget Misc A message from previous grant reviewers One on one with a researcher

25.  Getting Started You need to Know: Your Funding Agency PrioritiesYour Own PrioritiesYour Research Problem

26. Disclaimers: You Don�t Have to Do It All! We are not trying to turn you into a researcher! That�s why we require a team that includes a researcher�so that the researcher can do the research stuff! The rest of your team will become clear as you choose your idea. We�re not trying to steal your ideas! Keep �em covered up!

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28. The HRSA Guidance is your friend.

29. Let the Guidance Help You Read through the guidance several times Does it match your type of work? Do the goals of the grantmaking organization match the goals of your organization? 80 pages total, 25 pages of narrative

30. What is a fundable project? At DoT, for the Social & Behavioral Program, they received 24 applications and funded 4 grants (16% success) Funded projects : Address an important need Contribute in a new/novel way to the field Can practically be done in 3 years .

31. Does your project address an important need? Will it address a specific NEED in some population, or address a specific need for some piece of information? Know what your granting agency wants you to find out or accomplish. For DoT, it is to increase donors or registrants or knowledge of living donation, and the more, the better!

32. Group Brainstorming: Important Projects Can the proposed project decrease the organ shortage? By how much? Can the proposed project be applicable to other regions and populations? Will this inform policy? Will this contribute to knowledge, practice and future research?

33. What is a Novel Project? Contributes new information Needs further study A new approach to solving a problem Extends an established approach in a new population or group Different racial groups Different regions of the country Combines multiple approaches Applies new technologies (e.g., social media) to a problem

34. How Do You Know It�s Novel? Know what has already been done! Talk to your peers Find an expert and ask him or her! Review the literature and popular press Determine what �Best Practices� are commonly known Look for gaps and listen for new approaches

35. Group Brainstorming: Novel Projects What would help you or others be more successful in your job? What is not known in your field? What problems do you encounter that you would like to eliminate? What could you add to what others have done? How could other�s work be adapted to your target group or region? Where should your field go next?

36. Get Practical: What is Feasible? What can you accomplish in 3 years? Assume 1st year start-up time What can you accomplish with $250K-$350K per year Can anyone donate services or staff time to allow you to do more?

37. Get Practical: Strong Project Team Political buy-in Access to the group of people you will be intervening with Enough team members to implement the study Researcher Technical expertise Previous grant-winning experience

38. Get Practical: Accessible Target Group Will you target: Providers? Community members? Families, organ donors, recipients? Who to include? Exclude? Do you have access to many members of your target group Need multiple sites? Do I need permission to survey them? (HIPAA, IRB)

39. Identify the focus of your project � the research question Intervention study: To try to improve something or fix a problem. Project also can have descriptive components: To learn something. The purpose of my project is to : intervene to try to change or improve Y. learn about Y.

40. The Need Section of The Guidance

41. Writing the Need Section: An Overview

42. Writing the Need Section:An Example  We need more kidneys for transplant Currently there are over 80,000 ESRD patients on the waiting list (UNOS, 2009) Last year, over 6,000 patients died waiting for a kidney (UNOS, 2009) Living donor kidneys are optimal kidneys Living donor kidneys last longer than deceased donor kidneys (UNOS, 2001) Dialysis centers have poor transplant education programs Waterman et al. (in review) found only 29% of providers reported having a formal transplant education program

43. Writing the Need Section:An Example  Dialysis patients are scared to pursue living donation and not knowledgeable about it 73% of dialysis patients were concerned a living donor would have health problems due to donating (Waterman et al., 2006) 72% of patients did not know how long living donor transplants lasted compared to deceased donor transplants (Waterman et al., 2006) Compared to Whites, African-Americans are less likely to be educated about transplant or receive living donor transplants (Eckoff et al., 2007; Navaneethan & Singh, 2006)

44. Writing the Need Section:An Example  Many dialysis patients, some with potential living donors, never pursue transplant We need dialysis patients and their families to make informed choices about living donation Therefore, the purpose of the study is to conduct a randomized controlled trial of a health education program to increase informed decision-making of dialysis patients

45. Reviewing Others� Need Sections  What worked? What didn�t? Questions?

46. Intervention PlanningImplementation Strategies

47. What can help in this process?

48. Questions to Ask Who is my target group and where will I access them (setting)? How will I gain access to the target group? How will I recruit them for the program? Who will be eligible�and who will not be eligible? What incentives will I give and for what?

49. More Questions What will be the specific components of my program? Will the focus of my program be Education/outreach? Media? Mobilization of community resources Training of peer leaders? Environmental change? Advocacy/policy change?� Array of activities?

50. Levels of Intervention Do I intend to effect changes at one level or multiple levels? Individual Organizational (school, church, workplace, hospital) Community/village Some larger venue such as governmental policy or law (local, state/province, national)

51. Target Group & Setting Thoroughly describe target group As much as you know about the group before you begin the study Additional demographic information obtained with measurement Thoroughly describe setting, i.e. where access to target group will take place & when As much as you know about the setting before you begin the study Formative research either before or after study begins

52. Education & Outreach Training? Who, how, what? Structured classes with a curriculum? Printed media (pamphlets/brochures)? Audio/visual media? Individual/family/group? �

53. Media Is relevant literature already available? Will develop new printed media? Will you purchase traffic reports or other tv spots? Are TV spots a cost/benefit option? Can you use�Public Service Announcements (PSAs) or public radio for free spots? Internet and other kinds of Social Media? What other methods of communication could be used in the intervention?

54. Advocacy/Policy Change Are there policies or restrictions at the organizational level that can be modified to support behavior change? At the community level, are there partners that can be recruited to participate and/or maintain the program? Are there committees with representation from the community that you need to put into place? �

55. Implementation What? When? Where? How? By whom? Be as specific as possible

56. The Use of Objectives Goal represents overall purpose of program. Stated objectives provide the blueprint by which the goal will be achieved. Each intervention activity states how the objectives will be accomplished. All activities relate to one (or more) objective(s). Each activity leads to a set of tasks by which the activity will be accomplished.

57. Direction of Development

58. Direction of Implementation

59. Developing a Goal Not so good Increase registrations in Southern Florida Better Increase registrations�among African Americans age 18�to 35 in zip codes >> in Snowball, Florida.

60. Developing�Objectives The objectives accomplish the goal. � Increase organ donation knowledge among the target group. Promote positive attitudes and beliefs about organ donation among the target group. Dispell myths that are barriers to registration for organ donation.

61. Developing Implementation�Strategies Training DMV clerks �Distributing printed materials �Offering incentives �Media in the DMVs

63. Problems? Potential problems Anticipated facilitators: What already exists that will facilitate your program �

64. Planning Sequence Goal Overarching goal of program Does the goal fit with the mission statement of the agency you are representing? Objectives (Strategies) What are the main objectives/strategies of my program? What do I want to accomplish? Which risk factors will I target? Activities Develop the activities for each objective What is it that you are actually going to do? Tasks What are all of the nitty-gritty things that I have to do to create an activity? Answer the questions: What? When? How? Where? By whom? Timeline Summary of above questions in chart or table format

65. Planning Sequence (Cont�d) Initially, in planning stage, list the activities and tasks and explain by answering the questions: what, where, when, by whom, how The above format should be used if there are separate activities that feed into each objective

66. If you have activities that contribute to more than one objective, once objectives are listed, in separate section explain activities and tasks.

67. Response DO�S Do detail plans sufficiently that no assumptions are necessary regarding your experience or expertise. Do demonstrate that the project will have all the necessary parts to achieve the goals, from a methodological viewpoint. Ex: details on training, maintaining fidelity, pilot tests, instrument testing, steps in procedures, etc.

68. More Response DO�S If your project depends on someone cooperating, DO describe how you will ensure you will have their cooperation. � If your project depends on an organization cooperating, DO include a letter from�each organization on agency letterhead,�confirming its participation and role. DO describe how you would reduce barriers, including use of�incentives and presenters similar to target�group.� �

69. EVALUATIVE MEASURES

70. Threats to Validity What else could changes be due to? History (something else happening in the world) that caused the effect Maturation (the changes happened just because the sample aged) Instrumentation (changes in measurement cause the difference) Selection of subjects (comparison groups may be different to start with) Attrition (loss of subjects�those remaining in the study may be different in some way) John Henry effect (improved performance because a person is in a study and aware of it.) So how do you make sure the threats to validity don�t destroy the usefulness of your study?

71. �Put together a team! Big Mistake: not including an evaluator in the planning of the project from Day 1. The evaluation will partially drive how you can design your project. Second Big Mistake: getting the WRONG TYPE of evaluator.

72. What is the RIGHT type of Evaluator/Researcher? They must have social/behavioral research expertise. � Test your judgment: ? Ph.D. in English literature ? A registered nurse ? A practicing clinical psychologist ? A transplant surgeon ? A psychologist or sociologist

73. Are they a GOOD Evaluator/Researcher? ?Do they have experience with organ donation? (nice but not necessary) ? Do they have publications in scientific journals reflecting research experience? ? Have they worked on grants before? ? Do they have good references?

74. How do you find such a paragon? ? DoT can recommend researchers. ? Your local university may have appropriate researchers. ? Studies in journals are often by researchers who are happy to be involved in another grant.

75. Don�t Be Shyabout asking a researcher to work with you Remember, you are offering them an opportunity to do research! To make money! To get published! Basically, everything they live for!

76. What should your evaluator do for you? � Design the research to recognize and specifically address threats to internal and external validity, such as cross contamination of samples. These threats prevent you from attributing your findings to your project.��� � Don�t be surprised if your researcher wants a control group�that�s the only sure way to avoid a host of validity problems.

77. Evaluator tasks (Cont�d) ?Determine the right sample size�neither too big nor too small.� The researcher can determine your sample size (how many people you need to reach) by doing a power analysis.

78. Evaluator tasks (Cont�d)

79. More Evaluator Tasks: ?The evaluator can integrate the theory into the project and the evaluation, and demonstrate how that was done. No �window-dressing� theories. ? The evaluator can help you devise your goals and objectives. ? �The evaluator provide enough detail on the statistical tests to demonstrate the necessary expertise. ? The evaluator should provide ongoing feedback on the conduct of the project. ? The evaluator can help you in determining whether your project has met its goals and objectives.

80. What should you do for your evaluator? Integrate them into the planning process. Provide accurate feedback on the impact of the evaluation on the project. Notify them immediately of any changes to the project.

81. IMPACT This is where you show us just how valuable your project will be.

82. Impact Do�s & Don�ts Do assess the cost effectiveness of the project relative to its impact. Don�t present a hugely expensive project that will only impact a handful of people. Do ask DOT to help with this if you need it.

83. More Impact Do�s & Don�ts

84. RESOURCES/CAPABILITIES This is where you� 

85. What is the Goal of This Section? To convince the reviewers that your team and your consortium agencies have what it takes to get the job done� to implement a successful project. � Key to success: provide a convincing argument, i.e. sufficient, relevant information.

86. Where Do You Start? Things Office space and equipment Financial management� Project oversight and administration Study site commitment and participation� Materials development Intervention implementation Access to the target population Data collection instrument Research design and implementation Data analysis

87. What & who do you need to accomplish the project? What Auto manufacturing plants Kiosks Visibility: Signage Supplies: Lemons, juicer, Lemonade Mixers, ice, cups, sugar, vodka, etc. Materials: Donation Brochures Money for change Evaluation plan

88. Put it Into Writing Prove you have: Appropriately qualified staff. Demonstrate that your team collectively has all the various skill sets, knowledge, experience, and expertise to perform all the various tasks needed to succeed. Provide biographical sketches, resumes, or CVs, but relevant information only. Indicate who will do what, and be sure major tasks are covered by someone with relevant expertise. Include a staffing chart. For consortium members or other participants, include letters showing willingness and role. For to-be-hired key staff, describe the qualifications you will seek. Make sure staff size is appropriate to project scope. �

89. Writing the Section (Cont�d) Prove you have: A capable and willing applicant institution/organization. Describe the capability of the applicant institution to provide the facilities, accounting mechanism, office space, etc. to support the project. Access to the target population: Provide letters from key gatekeepers to the target population indicating their intent to provide access. Acceptability to the target population. Show that your implementation staff will be acceptable and credible to the target population, especially if working with special groups such as minorities, youth, older people, auto workers.

90. Other Things to Consider Letters of support. On agency letterhead. No copy-cat letters. Use consultants to if your team is lacking some area of expertise or doing something for the first time. Provide sufficient information to enable reviewers to assess the qualifications of your staff for the tasks they will perform. Indicate successful prior experiences, for example, if: your team has worked together on projects before you have done work with the target institutions your staff has had prior experience with similar populations

91. Remember � If you have done a good job writing up your narrative and recruiting consortium partners and staff, this section should flow easily. This is a relatively easy section. Just be complete and concise.

92. More Resources/Capabilities Do�s & Don�ts Do make sure you have a reasonable timeline for the project�not too long, not too short.

93. Budget Used to assess the amount of funds that will be awarded. Key: your requested expenses are reasonable and necessary. Ask for what you need to make the project happen. Most budgets are approved as requested. You don�t need to pad it in order to get what you need. In fact, that is a quick way to get your budget slashed as well as getting a low score on this criterion. The last components of your grant application that we will discuss are the budget and budget justification, aka narrative. As you can see in the guidance, the amount available to each project falls within a range. The amount awarded is based on the amount requested in the budget. The KEY is that your request is reasonable and necessary. You want to ask for what you need to make the project happen. Make sure that you consider all possible expenses so that you are not in a position where you come to the end of the project and you have gone over budget or cannot complete the tasks you have proposed. The review committee and the granting agency have the ability to reduce the budget if they feel that it is excessive, there are expenses that are not justified or there are expenses listed that are not allowable. BUT do not pad your budget. This is not a good way to get what you need. It is obvious to the reviewers and staff that the budget has been padded and this is a quick way to get the budget slashed. You may not get what you need if this happens. Consider carefully what you need as you create your budget. The last components of your grant application that we will discuss are the budget and budget justification, aka narrative. As you can see in the guidance, the amount available to each project falls within a range. The amount awarded is based on the amount requested in the budget. The KEY is that your request is reasonable and necessary. You want to ask for what you need to make the project happen. Make sure that you consider all possible expenses so that you are not in a position where you come to the end of the project and you have gone over budget or cannot complete the tasks you have proposed. The review committee and the granting agency have the ability to reduce the budget if they feel that it is excessive, there are expenses that are not justified or there are expenses listed that are not allowable. BUT do not pad your budget. This is not a good way to get what you need. It is obvious to the reviewers and staff that the budget has been padded and this is a quick way to get the budget slashed. You may not get what you need if this happens. Consider carefully what you need as you create your budget.

94. Budget Justification Each line item in the budget should clearly connect back to the proposed activities. Used to show how the line items relate to the proposed activities. Do not assume you only need to justify the major players�even clerical staff needs to appear justified. If it appears in the budget, make sure it appears in the justification! Double check! Make sure everything fits with the goals and objectives. See sample budget justification The budget justification is used to see how the budget is related to the proposed project (AKA budget narrative). Each item on the budget should be clearly related to project tasks and this should be thoroughly described in the justification. This is one place that people often lose points because they simply write in the budget numbers instead of a clear description. Another thing to keep in mind is that each staff member�s role in the project should be described. This includes al clerical staff, graduate or undergraduate research staff. If it appears in the budget it must appear in the budget justification. The budget justification is used to see how the budget is related to the proposed project (AKA budget narrative). Each item on the budget should be clearly related to project tasks and this should be thoroughly described in the justification. This is one place that people often lose points because they simply write in the budget numbers instead of a clear description. Another thing to keep in mind is that each staff member�s role in the project should be described. This includes al clerical staff, graduate or undergraduate research staff. If it appears in the budget it must appear in the budget justification.

95. Other tips for writing your application Contact the agency with questions Check right away for requirements that may take time and need to be done prior to submission (ex. DUNS number) Adhere to guidelines (page numbers, margin size) Use standard fonts, font sizes Use professional headings and language Have someone else review your application PROOF READ! Submit the application at least 3 days early!! Check that your application was accepted

96. Before you begin writing Make an outline based on the guidance

97. When you finish writing

98. The Rest of the Application Make a checklist Include each requirement Check your checklist. Did you include every requirement?

99. Some Requirements Healthy People 2010 Cultural and Linguistic Competence Technical Assistance Workshops for Grantees

100. For Example 2009 Social and Behavioral Grant Guidance, Performance Measures section (pg. 3-4) which has several bullet points: �Applications must provide discussion and justification supporting the performance measure selected. Applications that address more than one performance measure should clearly differentiate project components, effects, and outcomes relevant to specific performance measures.�

101. Sample Checklist

102. Sources for Funding Federal Agencies Grants.gov State and Local Government Agencies Private Foundations Foundationcenter.org

103. Contact us Mary Ganikos mganikos@hrsa.gov Mary Ker maryker@comcast.net Carolyn Johnson cjohnso5@tulane.edu Rita Maldonado rmaldonado@hrsa.gov Amy Waterman awaterma@dom.wustl.edu

104. Good Luck!