The lecture series is actually looking at understanding the positioning of a proposal within national priorities and science fields. So basically looking at how you write a grant and how you make these ideas fit with what the people who have the money in making the decisions on who gets the grant funding are in line with. So the other way to look at it is can I ever find a home for my research ideas? And anybody who's written a couple grants who've gotten those grants back rejected can often feel like that. And I know myself, I had one grant project where I had actually submitted it six or eight times and I had said I'd finally come to the conclusion that nobody was going to fund that particular topic. And then you are able to and successfully revise it into a package that is a home for your research ideas, which is really exciting. So the objective of this talk is to understand funding priorities and also understand current avenues of funding through the NIH. So we'll discuss a little bit about how to approach applying for your own extramural grant funding and to talk a little bit about pathways of institutional grants and how to harness some of the institutional grants to help you and other avenues of funding. And then we'll very briefly talk about tailoring significance and innovation sections to sell your ideas a little bit more. So in 2003, which is actually getting 10 years ago now, the Institutes of Medicine released priority areas for national action. And the book that was released was called Transforming Healthcare Quality. And within this book, they talked about extending research to encompass this full spectrum of healthcare. So to look at keeping people well, to focus on living with illness and chronic disability, and cutting across the system interventions that will help bring people together. And within this document, they set 20 top health priorities for the Department of Health and Human Services. And so one way to look at this as a urogynecologist is to be a little bit depressed, unfortunately, because you don't see major gynecologic needs in this top 20 list of healthcare priorities. But then when you start thinking about your own research, there are avenues where you could really maximize some things with patients' health and pelvic floor disorders. And some of those could come through care coordination or health literacy, end-of-life planning, frailty, medication management, so multiple medications, interactions of medications, side effects. Pregnancy and childbirth is in there, although it's sometimes hard to sell our pelvic floor disorders. But it's really taking a step back, a gigantic step back, and seeing where are the major priorities for funding going. I was kind of combing all over the NIH websites and institutes of medicine prior to this talk. And in 2009, when they had the American Recovery and Reinvestment Act, they were looking for this comparative effectiveness research. Now, I think the funding for the comparative effectiveness research is not quite there anymore. But if you look at these top, there's a list of the top 100 priorities for comparative effectiveness research. And even though urinary incontinence is not a bullet point in that research, you can start taking a step back at what you're doing and seeing how does this fit into what people are recommending as important research topics and priorities. Another way to really, really stay up to date with what's important and what the NIH is funding is to know what RFAs and funding announcements are coming back, coming out. And so there's actually a website on the NIH called the Weekly NIH Funding Opportunities and Notice. And that is the actual web address for that section. When I wrote this talk, it was September 20th, but it's updated every week and it's updated on Fridays. And it's a good idea to pay attention to these things because you'll be surprised at what comes across. You can actually sign up for this and so you'll get this as an email once every Friday. Another way of paying attention to what the NIH is interested in is just to kind of look around on their website. And there's actually an NIH director's blog where the director of the NIH talks about things that he's finding fascinating at the moment. And not that everything that's on the blog I find fascinating, but it is nice to understand kind of the directions that the NIH is going in and thinking about. Another thing that I thought was kind of neat or funny is that you can follow the NIH director on Twitter. And so there are ways in terms of social media to, if you're a person who tweets, to kind of understand what's going on with those priorities. The NIH director is a PR rep and so he is going out and he is talking to the lay media and trying to sell that, hey, this is a good, we are representing the public's interest and we are trying to look at things that impact the public. And so I forget what month it was. I think it was either August or September. He was on a talk show circuit and so he's on the Daily Show and other talk shows talking about how the NIH is invested in understanding the brain. Well, that doesn't necessarily apply to the public floor, but how do you make your research apply in something that is in line with the funding priorities of the NIH? And it's just important to kind of start paying attention to those things. And so one of the things that's really, really important to understand before you start going after too many grants is to understand the type of grant that you're going after. The big ones for people who are starting out are the R grants and the K grants. The K grants are the career development awards. And so K grants are mostly for salary support and protected research time. They're not necessarily giving you a lot of funds unless they're a very specialized type of K grant for actually the research itself, so hiring a research assistant, setting up your lab, equipment, those types of things. But if you go to this NIH website, you can read about all of the different types of grants and sometimes there's different nuances about different funding priorities that's really an important distinction. And the other thing that's interesting is, especially if you're looking at K grants, K grants come from the institution, the institute at the NIH and not outside of the institute. And so K grants do vary, at least in my limited understanding of the NIH, by the institute. And so you will have different requirements of your K grants in different institutes, at least that's my understanding, because the NIDDK K grants, I'm under the understanding that you can have a career development award with 50% protected research time, whereas a lot of the other K grants looking for career development awards, you are mostly required to 75% protected research time. There are specific K grants at different institutes that will be very specific and tailored and may have extra research funds. And so there's a K08 or a Beeson award out of the NIA that has extra research funds as a part of that grant. And so there are some particular things on these research grants and awards that you may be able to start exploring at the NIH on the website. And the other important thing is to try to start talking to people at your institution and seeing what they're getting and what they're able to achieve and how they're able to support you. You know, I have talked to other people who really, really were excited about writing a K grant, went through and wrote a K grant, and by the time they were going to get their chair's letter of support, and this is just an awful story anyway, there wasn't that support for their K grant. You know, there wasn't that, no, I can write you a letter, because the institution they were at couldn't support a K but may have been more supportive for other different types of research grants. And so you want to really, really think about what type of grant you're going after. If I haven't defined it before, and I know I might be going through this really quickly, the K grants are the career development awards. The K grants are for salary support. Some of the K grants are individual grants, so you apply directly to the NIH to get the K grants. There's a lot of amazing researchers in OGS and other organizations who have got K23 grants, which are individual grants to support their own career development for up to five years. There's also institutional K grants. So if you're at an academic medical center, they may have a K12 grant, and the K12 grant is a grant that's given to the institution. So Women and Infants Hospital, Yale University, were her grants that are K12 grants, and so these are career development awards given to the institution, and then the institution gets to decide who at their institution gets that grant. The difference between the two is if you leave that institution, if it's an institutional grant, it won't follow you. If it's your grant, you can apply and ask the NIH if they'll allow you to transfer the grant. So it's just a little nuance. It's also interesting if you talk to different people across the country. Sometimes the K23s or those individual grants are much more competitive, and then at some institutions, some of those internal grant awards are so competitive that if you go outside the internal process, sometimes you're able to be more successful. So just because there is one pathway and it's not working for you doesn't mean another pathway couldn't work in the future. Another great tool to try to begin to start figuring out what the NIH is doing or what the specific institute is doing is to look up on what's happening on the NIH Reporter. And so this is the NIH Reporter website, and basically this is a public disclosure website. And so the NIH funds research studies with public money, and so they are obligated to show the public what that research is. And so you can look up a grant on this website on a bunch of different ways there are to look up the grant. But you can specifically look up the grant, and then you will be able to read the abstract for the grant. Why this is important is sometimes it's nice to go through and read other people's abstracts and see what's successful. How are they selling their grant so that the people at the NIH are sitting down and reading it and really excited and want to fund that research? The other thing is that it also shows you what the NIH is valuing, what type of research they're investing in. And it also shows you is there another project out there at the NIH that is exactly the same as my project, and do I need to revise my project to make sure that I'm different and unique or asking an interesting question that's going to be advancing the field. So the NIH Reporter is a good tool if you haven't explored it before. One of the most important things about, and I'm just in the early parts of my research career, but what I found is it is critical and important to look around at your institution where you're at and see what is your institution good at and what resources it has. And one of the very, very interesting and great things to become a part of if you found this at your institution, definitely look at it as CTSA sites. So CTSA sites are designated sites where the NIH has given that institution monies to support research and to support career development. And so look around at your institution. Is there a CTSA? What type of things do they offer? Do they offer just statistical support? Is there a director of the CTSA so that if you go and you put your grant process together, you can get a letter of support saying that this person is invested in your career and invested in a successful project and being invested in supporting this project so it can be successful. That's very powerful and very, very helpful for when you're looking for funding. Even if your institution doesn't have a CTSA, it doesn't mean that there's not resources there. And it's really, really critical to harness the power of whatever is available to you in your institution. And what's really cool is it can take you in directions that you never thought you would go with your research, but it can give you a completely new perspective on how to look at some problems that we see in our own field. And for my career, when I started out just as a junior faculty member, just out of fellowship at Yale, I looked around. And Yale had an incredibly powerful section of geriatrics, nationally renowned section of geriatrics. And that really helped me because I went and I got mentorship from that section. And not only were they wonderful and supportive, but they have a history of prior grant funding and being successful with these grants. And so that helped harness kind of my careers in different directions, although I never would have dreamed that I would be collaborating with geriatricians. As a surgeon, it worked out perfectly and it's actually been very successful for me. But that doesn't mean that you need to go out and find a section of geriatrics. It means look at what your institution has. Is it a neurologist? Is it a urologist? Is it a cancer doctor? What does your institution have and how can you collaborate to make that something really exciting, new, different, that will help advance our field? This is another interesting slide. The NIH and research in general has been pushing towards a concept of translational research. And the translational research that I was very used to in my first exposures or what I first had heard about translational research was the bench to bedside, so translating the laboratory discoveries to patients, which is the first step in translational research. But there's two steps in translational research and there's bedside to population. And so going from the patient to how do we translate that to really impact how healthcare is delivered in communities. And so there's a lot of aspects to translational research. So the only thing that I wanted to get across in this slide is don't undersell yourself and don't think that you don't have translational research if you're not in the laboratory. So translational is all about collaboration across disciplines. And translational can also take many forms. So it doesn't just have to be the bench to the bedside. It can also be from the bedside to the population. Now I'm going to talk about kind of figuring out where the research priorities are that aren't the NIH research priorities. And I'd say for us in urogynecology, the very first thing to do is to read this document. OGS was amazing and when the OGS meeting was in Long Beach, California, they had this research summit where they had experts in the field talk about what our knowledge was in the field and where our knowledge gaps are. Reading through this document is a beautiful way of saying, hey, this is what we know in urogynecology and this is the next step. This is what the next people need to ask to advance our field. And so I would highly recommend if you're thinking about a grant project or submitting a grant proposal or if you're looking at that specific aims page and it just doesn't seem right, taking a nice step back and taking a read. But it's not just OGS that has the money and it's not just OGS that has the research priorities. So other people have money and research priorities as well. And I just went through and thought of a couple. You know, every once in a while, not always, I wish I was a cancer surgeon. And the reason why is cancer people have a lot of money. And so they have different avenues to get their research funded than we may not necessarily have trying to go after female pelvic floor disorders. But there are definitely avenues that you could reach out and kind of collaborate with some of your cancer surgeons or think of in different ways that may be interesting and may be one direction you want your research to go in. Another is looking at urology. So urology has set their research agenda. They have it as a PDF published on the web. And so the AUA Foundation has their own roadmap for what are we looking for in those types of diseases. And it definitely overlaps with a lot of what we're doing and so worth taking a read. Another place, like I said, from my own experience, I do a lot of crossover into the geriatric world. And one of the things I found was the research agenda for surgical and medical specialties that actually Dr. Richter collaborated on. And especially they had specific sections both on geriatric surgery and geriatric gynecology. And these research priorities were critical because I could cite this document as this document said that this was a research priority and I'm trying to answer this question. So just go ahead and look because there's definitely things out there. It's always hard to find money. But there's lots of different organizations where your question may fit into those priorities of that organization. IUGA also has research money available and they have their own research priorities. So it's another place to look. Another place to look is the International Society for the Study of Vulvovaginal Diseases. They have both research agendas and research grants that members of IUGA have won in the past as well. So just kind of thinking outside of the box in terms of where am I going to get money, how do I sell this project, and how can these things be tailored to fit where I'm trying to go and how I'm trying to advance the field. Very briefly, I'm going to talk about the significant section and the innovation section of your grants and I'm just going to share a couple lines that I had written from one of my grants that was successfully funded. The significant section should justify the need for what you're proposing. It's all about telling a story and does the project address an important problem or critical barrier to progress in the field. Your goal of your significant section is to explain the importance of a project and explain how the project will improve scientific knowledge or methods in a broader context, not just within your field. So this is just an example that I had that I was successfully funded on and it said research on frailty with a specific focus on maximizing function was named as one of the top 20 research priorities to improve the quality of health care proposed by the Institutes of Medicine. In 2004, the Geriatrics Society Research Agenda Setting Project identified defining the natural history of incontinence in older adults as a key research question. Since these challenges are an understanding of the impact of frailty on the aging process, the dynamic and reversible nature of frailty states and the importance of measuring frailty to predict post-operative outcomes after physical stressors, including surgery and or hospitalization has increased dramatically. So somehow putting what you're asking into the context of what is going on with different research agendas or priorities. Innovation sections should be able to outline what is new. And so does this application challenge and seek to shift current research or clinical practice paradigms by using novel concepts, approaches, methodologies, instrumentations, or interventions? Do you want to explain how the application seeks to shift a current research or clinical practice, describe the novel concept or approach, and refine the concept or approaches? And so this is just an example of an innovation section where I said older adults are less likely to participate in research. Efforts to encourage their participation and methods to facilitate their participation are therefore desirable. Our proposed pilot study will investigate methods for including older women in incontinence research through the development of a web-based, user-friendly, self-administered questionnaire. This is an innovative approach to facilitate the inclusion of older adults into research, and the implications of our research go well beyond the scope of this project with useful applications for other researchers because we can have this web-based tool that older adults feel comfortable using. And so that's just another example of specifically saying why you're innovative. And I'm definitely in my early stages of trying to figure out how to write grants and where to get funding. But those are just a couple of thoughts that I wanted to share with everybody in terms of what to look for, kind of being creative, looking outside the box, finding where your resources are, who can help you, and especially within your institution, and how can you make these relationships across different specialties that can really address our field. Because it's amazing how different specialties look at disease and patients just in a different way. And from that perspective, I always find resources that can really help. Thank you. Thank you.

grant proposals

funding priorities

NIH

career development awards

research priorities

leveraging resources