NIDA Mentored Outreach Award in Substance Use Disorders (SUD) Treatment Dissemination

Supported by the National Institute on Drug Abuse (NIDA) from the National Institutes of Health (NIH) in partnership with the PA Foundation

Step 1: Review the 2022 NIDA Mentored Outreach Award overview and requirements document.

Step 2: Fill out form below and upload all required supporting materials.

Application Deadline: October 13, 2022

Applicant and Mentor Information

Applicant First/Last Name: *

Applicant AAPA ID: * 🛈

Applicant Street Address: *

Address Line 2:

City: *

State: *

Zip Code: *

E-mail: *

Phone Number: *

Applicant Employer: *

Applicant Job Title: *

Name of Project: *

Mentor First/Last Name: *

Mentor Employer: *

Mentor Job Title: *

Are you proposing more than one mentor? *

Yes

No

Second Mentor's First/Last Name: *

Second Mentor's Employer: *

Second Mentor's Job Title: *

Attestations

Candidates cannot have had previous or simultaneous funding from the National Institutes of Health (NIH) or research funding sources. Eligible candidates may not have a training award. Please check the following statements to confirm you meet the eligibility criteria. *

I have not had previous or simultaneous funding from the National Institutes of Health (NIH) or research funding sources.

I have not had a training award from NIDA.

Have you previously received funding for a project on the topic of substance use disorder? *

Yes

No

If so, how many SUD projects have you received funding for?

Funder:

Funding amount:

Project title:

Brief description of project:

Upload publication or poster presentation related to project, if applicable.

Funder for 2nd project (if applicable):

Funding amount:

Project title:

Brief description of project:

Upload publication or poster presentation related to project, if applicable.

Please check the box next to each statement to indicate your acknowledgment/agreement. *

I attest that the contents of this grant application are true and accurate. I agree that if awarded a grant, information about this project and my photograph may be published in AAPA and PA Foundation publications and news releases.

I attest that the individuals and organizations applying for this grant do not advocate, support, or engage in discrimination in the provision of healthcare on the basis of age, color, disability, ethnicity, gender identity or expression, national origin, union membership, political affiliation, race, size, religious affiliation, sex, sexual orientation, or socioeconomic or veteran status.

I understand that this funding cannot be used to support new, free-standing pilot studies, clinical trials, or clinical research studies.

I understand that if selected to receive an outreach award, I will be required to submit a 6-month narrative progress report and a final narrative report at the end of the performance period; attend and present a poster at the 2024 AAPA Annual Conference on May 18-22, 2024, in Houston, TX; and attend the NIDA Clinical Trials Network Meeting on April 19-21, 2023 (tentative).

I have read and acknowledge the NIH Guiding Principles for Ethical Research.

Abstract

Abstract/Brief Description of Project (250 word maximum)
Provide a brief summary of the project proposal and any associated activities. Include rationale, specific aims, and significance. *

0/250 words

Supporting Documents/Uploads

Attach written project proposal/plan, to include objectives, background information, and method or proposed activities (maximum 8 pages). See pages 3-4 of the requirements document for specific questions/items to address. Include literature citations in your proposal. * 🛈

Attach project timeline. Describe how the award year will be structured, and include major goals and objectives (indicate how they will be achieved). *

Attach detailed project budget and budget justification. * 🛈

Attach current biosketch/CV. *

Attach mentor's biosketch/CV. (If proposing two mentors, provide CV for each.) *

Attach letter of support from proposed mentor. (If proposing two mentors, provide letter of support from each.) *

Attach description of facilities available for project (to include any available computer access or statistical support). *

IF APPLICABLE: Letter of support if the proposed project uses facilities not routinely available to or directly under the supervision of the sponsoring organization.