Linking the Provider Recommendation to Adolescent HPV Vaccine Uptake (R21 Clinical Trial Optional) | PAR 18 019

Opportunity Information: Apply for PAR 18 019

Linking the Provider Recommendation to Adolescent HPV Vaccine Uptake (R21 Clinical Trial Optional) is a National Institutes of Health (NIH) discretionary grant opportunity (FOA number PAR 18-019) focused on improving adolescent uptake of the human papillomavirus (HPV) vaccine by studying one of the most influential drivers of vaccination: the healthcare provider's recommendation. The central idea is that a recommendation alone is not always enough; the way healthcare is organized and delivered can either strengthen that recommendation and turn it into real vaccine uptake, or it can weaken it through delays, missed opportunities, workflow problems, communication gaps, access barriers, or inconsistent follow-through. This announcement invites research that clarifies how and why those system factors matter, and what can be changed to make provider recommendations reliably translate into completed vaccination.

The FOA emphasizes that HPV vaccine uptake is shaped by a mix of influences that interact with each other. Provider characteristics can include training, confidence in discussing HPV vaccination, communication style, time constraints, personal attitudes, familiarity with guidelines, and how strongly and consistently they recommend the vaccine at the appropriate ages. Parent and patient characteristics can include beliefs about vaccine safety and necessity, knowledge about HPV and cancer prevention, trust in clinicians and the healthcare system, cultural norms, logistical constraints, and readiness to accept vaccination during routine visits. Clinical setting characteristics may include whether the clinic has reminder and recall systems, standing orders, prompts in the electronic health record, team-based workflows, vaccine stock and storage reliability, appointment availability, policies for same-day vaccination, and how billing, insurance, and consent processes are handled. The research encouraged here is meant to connect these real-world conditions to measurable outcomes, particularly whether a provider recommendation actually results in the adolescent starting and continuing the HPV vaccine series.

Because the topic sits at the intersection of prevention and service delivery, the FOA calls for multidisciplinary expertise. Competitive projects are expected to draw from cancer prevention, behavioral science related to adult and child decision-making, immunization promotion strategies, and healthcare delivery or implementation research. The "R21" mechanism signals exploratory and developmental work, meaning applicants can propose innovative, early-stage studies that generate actionable evidence, test new approaches, or build the foundation for larger trials and broader-scale implementation projects. The listing notes "Clinical Trial Optional," which means applicants may propose either studies that do not meet the NIH definition of a clinical trial or, if appropriate, a clinical trial design aimed at improving vaccine uptake, depending on the research questions and methods.

The funding instrument is a grant, with an award ceiling of $200,000. The opportunity is tied to CFDA numbers 93.393 and 93.395, reflecting NIH program areas related to cancer and prevention research. The original closing date shown is July 16, 2019, and the FOA creation date is November 8, 2017, which is useful context for understanding the timeframe of the posted announcement.

Eligibility is broad and includes many types of U.S.-based organizations and governments. Eligible applicants listed include state, county, and city or township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; Native American tribal governments (federally recognized); tribal organizations that are not federally recognized; public housing authorities/Indian housing authorities; nonprofits with or without 501(c)(3) status (excluding institutions of higher education where relevant); for-profit organizations other than small businesses; small businesses; and other eligible entities. The FOA also explicitly highlights additional eligible applicant categories such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), historically black colleges and universities (HBCUs), Hispanic-serving institutions, tribally controlled colleges and universities (TCCUs), faith-based or community-based organizations, regional organizations, eligible federal agencies, Indian/Native American tribal governments that are not federally recognized, and U.S. territories or possessions. At the same time, it clearly restricts foreign involvement: non-domestic (non-U.S.) entities and foreign institutions are not eligible to apply, non-domestic components of U.S. organizations are not eligible, and foreign components as defined by the NIH Grants Policy Statement are not allowed.

Overall, this FOA is designed for projects that move beyond simply saying "provider recommendation matters" and instead dig into the practical reasons recommendations succeed or fail in everyday healthcare. The goal is to produce evidence that helps clinics and health systems design processes, communication strategies, and delivery supports that make strong recommendations more consistent, reduce missed vaccination opportunities, and ultimately increase adolescent HPV vaccination uptake as a cancer prevention measure.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Linking the Provider Recommendation to Adolescent HPV Vaccine Uptake (R21 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.393, 93.395.
• This funding opportunity was created on 2017-11-08.
• Applicants must submit their applications by 2019-07-16. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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