FY 2024 Annual Performance Plan and Report - Strategic Goal 4: Objective 4.2

Fiscal Year 2024
Released March, 2023

Topics on this page: Objective 4.2: Invest in the research enterprise and the scientific workforce to maintain leadership in the development of innovations that broaden our understanding of disease, healthcare, public health, and human services resulting in more effective interventions, treatments, and programs | Objective 4.2 Table of Related Performance Measures

Objective 4.2: Invest in the research enterprise and the scientific workforce to maintain leadership in the development of innovations that broaden our understanding of disease, healthcare, public health, and human services resulting in more effective interventions, treatments, and programs

HHS is investing in strategies to support the research enterprise and the scientific workforce. HHS works to build public trust by upholding scientific integrity and quality. HHS is also working to recruit, retain, and develop a diverse and inclusive scientific workforce to conduct basic and applied research in disease, healthcare, public health, and human services. HHS supports innovation in how research is supported, conducted, and translated into interventions that improve health and well-being.

The Office of the Secretary leads this objective. The following divisions are responsible for implementing programs under this strategic objective: AHRQ, ASPE, ASPR, CDC, FDA, HRSA, NIH, OASH, OCR, and OGA. In consultation with OMB, HHS has determined that performance toward this objective is progressing. The narrative below provides a brief summary of progress made and achievements or challenges, as well as plans to improve or maintain performance.

Objective 4.2 Table of Related Performance Measures

Preventing the initiation of substance use and minimizing the risks of harmful consequences of substance use are essential parts of addressing SUD. NIH’s prevention research portfolio encompasses a broad range of research on how biological, social, and environmental factors operate to enhance or lessen an individual’s propensity to begin substance use, or to escalate from use to misuse to SUD. This line of research, along with rapidly growing knowledge about substance use and addiction (including tobacco, alcohol, illicit, and nonmedical prescription drug use), is helping to inform the development of evidence-based prevention strategies.

Vaping continues to be the predominant method of nicotine consumption among youth, and early nicotine use is associated with subsequent drug use and dependence. In FY 2022, NIH-funded researchers conducted two studies to test the effectiveness of prevention interventions focused on electronic nicotine delivery systems in schools, via social media and electronic cigarette advertising restrictions. In the first study, the researchers have been evaluating the effectiveness of culturally-tailored, anti-vaping social media messages for sexual and gender minority (SGM) youth ages 13-18. Available data indicate that SGM youth are more likely to initiate and continue vaping than non-SGM youth. This study, along with related NIH-funded studies, is building an evidence base to inform efforts to reduce vaping-related health disparities in this vulnerable population. In the interim, the researchers have called for a more nuanced approach to discussions about vaping: They pointed out in a scientific commentary that (1) discussions that lump the scientific/public health community into “supporters” and “opponents” of e-cigarettes are not productive because they ignore the areas of agreement, and (2) that discussions of potential harms and benefits of e-cigarettes need to be grounded in the characteristics of the products themselves, which are quite variable. In the second study, the researchers have been identifying features of e-cigarette advertisements that influence young adults' susceptibility toward vaping and to determine if restricting those features impacts attitudes, initiation, and continued use of vaping products. Their recent findings highlight the importance of advertisement source messaging – specifically, expert messaging, compared with peer messaging, was seen by young adults as more credible and was associated with increased perceptions of e-cigarette harm. As the FDA has the authority to regulate e-cigarette advertisement features, these results may inform real-world policy decisions aimed at vaping prevention.

In FY 2023, NIH will launch 1-2 clinical trials to test approaches to prevent opioid and other substance misuse by intervening on social determinants of health. (Social determinants of health refer to the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.) In FY 2024, NIH will launch 1-2 pilot studies to develop novel strategies to prevent substance use among youth and young adults informed by epidemiological research.

A critical part of the NIH mission is the education and training of the next generation of biomedical, behavioral, and clinical scientists. The overall goal of the NIH research training program is to maintain a population of scientists that is well educated, highly trained, and dedicated to meeting the Nation’s future health-related research needs. Success of NIH predoctoral research training programs can be measured, in part, by the number of trainees and fellows that go on to apply for and receive subsequent NIH career development and research awards. Subsequent support is an indicator of retention success in the research arena and reflects the impact of NIH-funded training on the ability of trainees and fellows to be competitive and sustain a research career with independent funding.

Each year, NIH assesses the degree to which predoctoral trainees and fellows who received NIH-funded training through a National Research Service Award (NRSA) are more likely to remain in research careers and successfully compete for NIH funding after the completion of their degrees. A 2001 assessment of the early progress of NRSA predoctoral trainees and fellows showed that the percentage of NRSA-funded individuals who applied for funding from NIH or the National Science Foundation was typically 10 percentage points higher than those who graduated from NIH-funded training institutions but who were not direct recipients of NRSA predoctoral funding. As part of the current assessment, NIH determines the difference in percentage points of receiving a research project grant mentored career development award between NRSA-funded individuals and other doctoral students at the same institutions who did not receive NRSA support. Tracking this measure annually serves as an indicator of the impact of NRSA support on ability of trainees and fellows to remain competitive and sustain a research career with independent funding.

In FY 2022, NIH-funded predoctoral trainees and fellows were 9.8 percentage points more likely to remain active in biomedical research than non-NIH trainees and fellows. This number falls just short of meeting the annual target of equal to or greater than 10 percentage points set in 2001. In recent years, early career researchers have been experiencing a highly dynamic and uncertain research environment. For example, the lingering impact of COVID-19 has added uncertainty to the already changing funding landscape for early career investigators. Increasingly, recent trends indicate that an investigator’s first or initial NIH award tends to be a mentored career development (K) or fellowship (F) award rather than an NIH research project grant. NIH has evaluated this recent pattern and will update its methodology to better reflect the current funding landscape and opportunities (e.g., incorporating research training fellowships in NIH’s analysis criteria). With proposed update in analysis methodology, as mentioned above, NIH will maintain the current target in FY 2023 and FY 2024 and continue to assess differences between NIH-funded and non-NIH trainees and fellows as an indicator of programmatic impact.

NIH is committed to diversifying the Nation’s biomedical research workforce. It funds numerous programs – at the undergraduate, graduate, postdoctoral, and faculty levels – that foster research training and the development of a strong and diverse workforce. The National Institute of General Medical Sciences, a component of NIH, develops and manages many of these programs. A key focus of the Institute is to provide trainees with mentored research training and career development experiences that help them acquire important knowledge and skills to drive scientific discovery and innovation.

This measure highlights a critical component – career development experiences – in the development of trainees from underrepresented backgrounds and tracks that data across different career stages. Underrepresented backgrounds include historically underrepresented racial/ethnic minorities (e.g., Blacks or African Americans, Hispanics or Latinos, American Indians or Alaska Natives, Native Hawaiians, and other Pacific Islanders), individuals with disabilities, and individuals from disadvantaged backgrounds (through the undergraduate stage). In FY 2022, the Institute supported 3,972 career development experiences across all career stages for trainees from diverse backgrounds. In FY 2023 and FY 2024, the Institute aims to support 3,550 and 3,600 career development experiences across all career stages for trainees from diverse background.

Established by Congress in 1993, the goal of the Institutional Development Award (IDeA) program is to broaden the geographic distribution of NIH funding. The program supports faculty development and institutional research infrastructure enhancement in states that have historically received low levels of support from NIH. The purpose of the IDeA Networks of Biomedical Research Excellence (INBRE) is to augment and strengthen the biomedical research capacity of IDeA-eligible states. The INBRE represents a collaborative effort to sponsor research between research-intensive institutions and primarily undergraduate institutions (PUIs), community colleges, and tribally controlled colleges and universities (TCCUs).

A primary goal of the INBRE is to provide research opportunities for students from PUIs, community colleges, and TCCUs, and to serve as a "pipeline" for these students to continue in biomedical research careers within IDeA states. Offering these students mentored research experiences is crucial in developing their foundation in biomedical research and their interest in pursuing health research careers. Different types of mentored research experiences are available to these students. Examples include participating in INBRE-supported internship programs that provide hands-on research experience; attending research seminars, laboratory meetings, and journal clubs; and preparing oral or poster presentations of individual research projects and presenting them to the scientific community during the state’s annual summer research conference. In FY 2022, an estimated 1,490 undergraduate students participated in mentored research experiences, consistent with the FY 2021 level. In future years, NIH aims to sustain the number of undergraduate mentored research experiences at the same level as previous years.

To support the Department’s mission and FDA’s scientific expertise, FDA is launching a new FDA Traineeship Program while continuing other Fellowship programs. This performance goal focuses on FDA’s efforts to retain a targeted percentage of the scientists who complete these programs. Additionally, it is important to realize that whether “graduates” from these programs continue to work for FDA or choose to work in positions in related industry and academic fields, they are trained in using an FDA-presented understanding of the complex scientific issues in emerging technologies and innovation, which furthers the purpose of this strategic objective. FDA reset the retention target to 20% in FY 2021 to reflect the new expanded program's expected baseline. Although the Traineeship program has not yet been fully implemented, and additional programs will come online over the next few years, FDA has met the initial target of 20% in FY 2022. FDA will continue to monitor and adjust the target for retention moving forward as necessary. For now, the target will remain at 20% in FY 2023 and 2024.

HHRSA’s Federal Office of Rural Health Policy (FORHP) has a statutory charge to advise the HHS Secretary on rural health and telehealth policy issues across the Department, including interactions with the Medicare and Medicaid programs, and support policy-relevant research on rural health issues, consistent with HRSA’s broader focus on access and underserved populations.  HRSA provides funding for the only Federal research programs specifically designed to provide publicly available, policy relevant research on rural health issues.  The Rural Health Research Center (RHRC) Program funds eight core research centers to conduct policy-oriented health services research to assist providers and decision/policymakers at the federal, state, and local levels to better understand the healthcare-related challenges faced by rural communities and provide information that can be applied in ways that improve health care access and population health.  HRSA supports four research projects per RHRC per year.  The RHRCs produce policy briefs and peer-reviewed journal manuscripts based on their funded research projects.  These publications are made available through the HRSA-funded Rural Health Research Gateway (www.ruralhealthresearch.org).  The Rural Health Research Gateway disseminates and promotes the work of the RHRCs to rural health stakeholders with the goal of informing and raising awareness of key policy issues important to rural communities.  HRSA has repositioned the program to develop more robust technical research products vs. the shorter research briefs; HRSA anticipates that this adjustment will result in a decrease in the total number of research products.

Endnotes

³⁹  FORHP has repositioned the RHRC to develop more fulsome, technical research products vs. the shorter research briefs completed prior to FY22. As such, FORHP anticipates the total number of research products will decrease from the previous trends.