Getting Funded Cornelia Beck

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Getting FundedCornelia Beck

• Originally Presented
• March 7-9, 2001
• Houston, Texas

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I get by with a little help from my friends

• I get high (ie funded)
• with a LOT of help from my friends.

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Issues in developing a research focus

• Estimating the research priority in your setting
• Articulating research goals
• Accepting rejection (the Pink Slip Syndrome)

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Why try to add research to your already busy
life?

• To contribute to betterment of patient care
• To fulfill your creative instinct
• To have fun

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Many people think that research is a
supernatural gift of the Gods.It is simply an
idea from a troubled mind, an inspiration
followed by infinitely painstaking work and
perspiration. Sir Frederick Banting
1891-1941
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Traits of a successful grant writer

• Good research skills
• Salesmanship skills
• Good communication skills
• Ingenuity and flexibility

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• Administrative skills
• Interpersonal skills
• Persistence, dedication, patience, hard work
• Political awareness
• Integrity

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Tips for keeping focused

• Practice saying No
• Remember that every opportunity does not have to
  be taken
• Dont be taken in by
• But youre the best one to do it
• Its six months away
• I dont know who else will do it

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• Choose a specific focus
• Get to know the experts
• Be opportunistic
• Schedule a set time each week
• Discuss ideas with colleagues
• Build synergistic dyads or groups

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• Start small
• Know when to go big
• Dont expect to be the expert in every field,
  especially statistics
• Cherish your critics
• Target a specific date

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Getting started

• Engage Employer/Chair
• Buy-in
• Release Time
• Negotiate Resources
• Do
• Task List
• Time Plan

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• Read one or more recent proposals in your field
• Have a funded proposal at your side
• Make a detailed outline before you begin to write
• Have two or three colleagues critique at multiple
  stages
• Simulate the review group

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Grant application process planning tool

• Preliminary development
• 6-8 months prior to grant submission
• Proposal development and review
• 3-4 months prior to grant submission
• (Crain, H.C. Broome, M.E. (2000). Tool for
  planning the grant application process. Nursing
  Outlook, 48(6), 288-293.)

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Know your audience
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• Who are reviewers?
• Your audience
• Busy people
• Agencys
• Priorities
• Funding history

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Review criteria

• Significance
• Approach
• Innovation
• Investigator
• Environment

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Be Sure You Care Enough Be Sure That A
Funder Will Care Enough
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General principle

• Science2 Marketing
• Art x pilot data
• Your end product must
• be important
• be unique
• contribute significantly to the field!

Grantmanship
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What do you intend to do? Specific Aims
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Why is the work important?Background and
significance
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What have you already done?Preliminary work
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How are you going to do this work?Research
design and methods
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How will you know what you know?

• Data analysis

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Specific Aims
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Sources of ideas

• Calls for proposals
• State of the Science
• Reports to Congress
• Integrated reviews
• Research reports
• What we found (did not ask/find)
• What it means (is there a hole)
• Implications for future research

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• Anecdotal literature
• Case studies
• Clinical journals
• Clinical experiences
• Concerns
• Frustrations

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The biggest Fatal Flaw

• Bad Idea

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Good ideas

• Yours
• Passes the passion test
• You have capacity/resources to do it
• time, sites, institutional support
• Potential funder/s
• priority
• fit with portfolio/mission

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Important ideas

• Timely/Relevant
• New/Innovative/Unique/Creative
• Corroborative
• Contributive

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Doable ideas

• Realistic
• Affordable
• Resources required
• Time
• Money
• Availability of
• Sample
• Instruments
• Equipment
• Team/Consultants

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Ideas that sell

• Focused sequence of studies that build on one
  another
• Studies that
• are hypothesis-based
• provide useful info regardless of outcome
• info from one study sets stage for others
• have contingency plans if they dont work
• Questions
• What will be learned?
• Why is it important?

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There are no ways to make a bad idea look good,
but there are a lot of ways to disguise a good
idea
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Purpose

• Aim for precision and simplicity
• What are you planning to do?
• Fit with aims of science (describe, explain,
  predict/control)
• The purpose of this study is to.. (what
  concepts? What relationships?)

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Purpose

• The purpose of the proposed investigation is to
  test the efficacy of a family model of primary
  and secondary prevention for families identified
  as being at high risk for early coronary artery
  disease. Primary prevention is defined as the
  reduction of the incidence of the disease while
  secondary prevention includes early detection and
  treatment of the disease. Coronary artery
  disease is classified as early when it occurs in
  males before the age of 45 and females before the
  age of 55.

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Specific aims

• Briefly describe the problem your research will
  solve
• Clarify the long-term goals
• State the purpose of the study
• Clearly state the aims of the research
• Research questions/hypotheses
• Present the theoretical basis for your approach
• Briefly explain how you will go about it

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• Provide a preview
• Start the compelling story

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Carefully specify outcomes

• Specify the effects that you expect to
  demonstrate. Do you want to
• demonstrate effects at the mean?
• demonstrate effects at the individual level?
• show the numbers of person affected?
• show the chances of a person being affected?
• State how clinical significance will be determined

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Research questions/hypotheses

• The relationships among the specific constructs
  in your conceptual framework are the basis for
  the research questions or hypotheses

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Research questions/hypothesis

• Aim for relevance
• simple/complex number of variables
• directional/nondirectional
• more/less - difference
• anticipated relationships
• statistical (null) no difference

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Early Experiments in Transportation
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Common weaknessesof specific aims

• The problem is not important enough
• Research will not produce any new or useful
  information
• Research is not testable
• Research aim is unclear
• Systematic constructs are not developed

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• The description of the research and of its
  significance leaves the proposal nebulous and
  diffuse and without clear research aim
• The hypotheses are ill-defined, lacking, faulty,
  diffuse, unwarranted, unimportant, or
  unimaginative

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• The problem fails to fall clearly within
  health-related research
• The problem is scientifically premature and
  warrants only a pilot study
• The research is overly involved with too many
  elements under simultaneous Investigation

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• Hypotheses rest on insufficient, doubtful, or
  unsound evidence
• The problem is more complex than the investigator
  appears to realize
• The problem has only local significance
• The problem is one of production or control

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• It is unrealistic that the intervention proposed
  would ever be adopted in routine practice
• A descriptive study is proposed when the field is
  ready for an intervention study
• Cost issues have not been considered

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Background significance
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Background significance

• Write this section first
• Convince readers that the research is important
• Provide a theoretical rationale for the research
• Clearly and explicitly state the hypotheses,
  variables and measures, and how the data analysis
  will confirm or disconfirm the hypotheses

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Background significance

• What has already been done in the field?
• Why is this work important?
• What gaps will project fill?
• Why is this research important?

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Background significance

• This is an important project
• That your agency should fund
• Background of present application
• Demonstrate knowledge of literature
• Critical evaluation of existing knowledge

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Background significance

• Your chance to show that your work is important,
  how it is important, and how it fits into the
  larger picture.
• Evidence presented in this section should include
  a critical analysis of the literature.

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Framework

• Makes sense of concepts relationships
• Conceptual framework
• Theoretical model

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Conceptual framework

• Clearly specify the conceptual domains
• Clearly identify the specific constructs in each
  domain
• Pay particular attention to the conceptualization
  and operational definitions
• Adequately identify the manifestations of
  constructs in your research

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To justify relationships among constructs use

• Previous research
• Deductive logic of the conceptual framework
• Literature review

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Questions about conceptual issues

• Why did you choose these particular concepts and
  why are these concepts important as opposed to
  other concepts?
• What is the justification for specific
  hypothesized relationships among constructs in
  the proposed investigation?

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Evaluation ofconceptual framework

• How well you articulate justify the conceptual
  framework
• How well you use this framework to formulate
  specific hypotheses, design the research study,
  choose measures, and specify a data analysis plan

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Presentation ofconceptual framework

• Verbal Account
• Path Diagrams
• Venn Diagrams
• Regression Equations
• Structural Equation Models

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Partnership Approach to Improving Quality of Care
in Nursing Homes
Organizational Environment
Social Factors
Organizing Arrangements
Physical Setting
Technology
Involve All Partners
Organizational Outcomes
Organizational Performance
Partnership Behaviors
Action
Action
Research
Research
Process
Process
Quality Care
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Aspects of Care for Psychiatric Disorders
Predictors of Use
Use of Care
Process of Care
Outcomes of Care
Patient Predisposing Factors Enabling
Factors Need Factors
Appropriate Treatment Inappropriate Treatment No
Treatment
Disease-Specific Outcomes Symptom
Severity Generic Outcomes Functional Status
Amount of Use No Use
Service Substitution
Service System
Modifying Factors
ACCESS Availability Accessibility Accommodation Af
fordability Acceptability
Disease-Specific Prognostic Factors Generic
Prognostic Factors
Costs of Care
Direct Costs Indirect Costs
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Conceptual framework Factors in the etiology of
pressure sores
Mobility
Activity
Pressure
SensoryPerception
Pressure SoreDevelopment
Extrinsic Factors
Tissue Tolerance
Intrinsic Factors
Adapted from Bergstrom et al.4
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Literature review

• Research literature vs. narrative/anecdotal
  literature
• Convincing the reader
• Logical grouping of material
• Visible flow of material

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Literature review

• Prepare to discuss all critical literature
• Demonstrate a full command of the literature
• You cannot include everything, be selective
• Be sure to identify and include critical
  references
• Do be current
• Review must be organized
• When good reviews or summaries exist, use them

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CRISP - Computerized Retrieval of Information on
Scientific Projects

• Extramural programs of
• NIH ( intramural)
• CDC
• FDA (intramural)
• HRSA
• AHRQ
• http//www-common.cit.nih.gov/crisp/

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Give reader a road map

• In this section, we review (1) the epidemiology
  of cocaine-associated presentations in the ED
  (2) the pathophysiology of cocaine-associated
  chest pain (3) other medical consequences of
  cocaine use (4) the clinical treatment of
  cocaine-associated chest pain (5) the clinical
  course of ED chest pain presentations with recent
  cocaine use and (6) treatment-seeking and
  service by drug or cocaine users.

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• Saturation Synthesis
• Concepts/relationships guide review
• What is known unknown
• Include
• Seminal articles
• Teams work
• Reviewers research

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• A review of literature should be logically
  organized and, more importantly, should include a
  discussion of the major variables that are
  measured or manipulated in the research. A ROL
  is a critical analysis and synthesis of related
  research. It is not a simple listing of research
  findings. (R-W, 1992)

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Organizing the Background and Significance

• Around the Specific Aims
• Around the major concepte

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Common weaknessesof conceptual framework

• Not clearly specified
• Too many constructs
• Overly simple
• No specific relationships among constructs

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• Failure to consider alternative explanations
• Failure to discuss temporal relationships
• Literature not well integrated
• The conceptual framework does not direct any of
  the hypotheses

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I know you think you understand what you thought
I said but what you fail to realize is that what
I said is not what I meant
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Review criteria

• Significance
• Innovation

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Preliminary studies
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Preliminary studies

• What has lead up to this project
• Why your team should get the money
• Your previous work
• Establish your credibility
• I have done
• Our team has...

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Preliminary studies

• Your chance to show that you have the experience
  necessary to proceed competently on the proposed
  program of research
• You may discuss your own work--and that of your
  collaborators-- on reasonably related projects

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Preliminary studies

• Convince reviewers that you can achieve your
  research goals
• Provide enough detail of prior studies to
  convince reviewers of your technical competence
• Include any other information that will help
  establish your competence

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Pilot testing

• Single most important thing you can do
• A required investment
• Pre-test
• Instruments
• Procedures
• Case Acquisition
• Data Collection
• Analysis/Conclusion
• Answers the question Is this do-able?

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Collect pilot datawhen you

• Modify a standard instrument to increase its face
  validity or to get information more relevant to
  your research questions
• Modify procedures to use the instrument with a
  different population or in different
  circumstances than originally planned for the
  instrument

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Collect pilot data when you

• Use an instrument on groups who either were not
  in the norming group on which the psychometric
  adequacy of the instrument was assessed or were
  under-represented in the norming group
• Construct your own assessment instrument for one
  or more key constructs in your research

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Preliminary studies

• Dont just list your findings
• Explain their importance
• What did you learn in the process?
• How did they prepare you to conduct current work?
• What pitfalls are you now aware of?

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Common weaknesses in preliminary work

• The investigator has inadequate experience or
  training for this research
• The investigator's previously-published work in
  this field does not inspire confidence
• The investigator relies too heavily on an
  insufficiently-experienced associate
• The investigator lacks skilled collaborators

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Remember

• The quality of presentation of your pilot work is
  seen as a measure of your ability to present data
  from your proposed work

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• . the best predictor of what you will do
  tomorrow is what you did yesterday..

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Review criteria

• Investigator
• Environment

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Schematic of Trial Design
Determination of Treatment Response
Physical Therapyand Placebo
Interventions continuedat maintenance intensity
UsualCare
Yes
No
Fluoxetine andFriendly Visit
Yes
No
Physical Therapyand Fluoxetine
Yes
No
Friendly Visitand Placebo
Yes
No
Usual Care
12
9
3
3
0
Usual Care
Maintenance Phase
RandomizedControlled Trial
MONTHS
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Common weaknesses of setting sample

• Inadequate institutional setting
• Restricted access to patient populations
• Sampling technique not adequately specified
• Sample too heterogeneous to yield desired results
• Size inadequate, unrealistic or unattainable

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Common weaknesses of setting sample

• Inappropriate composition, number, or
  characteristics of sample
• Criteria for subject selection not justified
• Subject selection bias and attrition not addressed

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Common weaknesses of setting sample

• No assurance of ability to recruit adequate
  numbers of subjects
• No projected dropout rate based on previous
  experience
• Experimental and control groups not comparable

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Intervention

• 1. Description of protocol
• Replicability
• 2. Pilot testing
• Feasibility

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Intervention

• Tx Fidelity/ Adherence
• Dose response
• Practicality
• Interventionist
• Resources needed

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Common weaknesses of intervention

• Not adequately described
• Not adequately supported by literature
• No theoretical underpinnings
• Not practical

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• Is the conceptual link between the intervention
  and the outcome variable logical?
• To what extent is the outcome variable amenable
  to change?
• Is the content validity of the outcome measures
  adequate for detecting the effect of the proposed
  intervention?
• Does the instrument used to measure the attribute
  have a potential distribution of scores that will
  allow detection of change?
• Stewart, B. Archbold, P. 1992

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Beware of threats to validity

• Threats to internal validity
• Selection
• History
• Maturation
• Mortality
• Testing
• Diffusion of Tx
• Regression to the mean

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Threats to the statistical conclusion

• Low power
• Violated assumptions
• Fishing
• Reliability to measures
• Reliability of Tx

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Threats to external validy

• Interaction between Tx and selection
• Interaction between setting and Tx
• Hawthorne effect
• Experimenter effect

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Common weaknesses of methods

• Design flaws
• missing control groups
• control groups are the wrong ones
• Insufficient statistical power
• Imprecise measures (dependent variables)
• Cannot recruit the needed population
• Lack of face validity

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Common weaknesses of methods

• Studies lack cohesiveness
• Sequence of experiments is not logical
• Results of a study leads to a dead end
• Subsequent studies rely too much on previous
  experiment
• Contingency plans either not stated or ill
  conceived and are not feasible

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Common weaknesses of variables

• Confounding variables not controlled sufficiently
• Controls are either inadequately conceived or
  inadequately described
• Tool development insufficiently conceptualized
  underestimation of difficulty

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Common weaknessesin measurement plan

• Measures not linked to constructs in conceptual
  framework
• Key constructs inadequately measured
• Tools not clearly specified too ambiguous to
  obtain data needed

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Common weaknessesin measurement plan

• Tools inappropriate for variables as developed
• Need multiple measures of some constructs
• No mention of test-retest gains

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Seriously consider respondent burden

• Respondent burden will differ in accord with the
  respondents status and other obligations
• In many studies, research subjects should be
  paid marginal costs may be small
• What will the research subject need to be told
  and who is going to do the telling

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Table 1 Proposed Measures
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Common weaknesses of procedures

• Lack of attention to logistical realities of
  conducting study
• Role of PI as data collector raises concerns
  about bias

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Data analysis
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Data analysis

• Answers research questions
• Results will achieve aims
• Descriptive statistics first
• Look before you regress
• Hypothesis testing
• Other associations

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Common weaknesses of data analysis plan

• The statistical aspects of the approach have not
  gotten enough consideration
• The data analysis plan does not describe how
  specific hypotheses will be tested or analyzed
• The data analysis plan lacks congruence between
  data analysis procedures and aims of the study

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• The Investigator does not understand the
  proposal's complex statistical procedures
• The Investigator uses simple statistical
  procedures when more complex procedures are
  necessary or commonly used

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• The Investigator uses statistical procedures that
  are not state of the art
• Analysis inappropriate for the design of data
  collection methods
• Approach for handling missing data excluded

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• Failure to provide psychometric data for measures
• Failure to consider psychometric adequacy of
  measures
• Uncontrolled measurement biases

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Dont forget

• Limitations
• Dissemination plans

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Allow time to review your proposal

• Develop a proposal map schema to detect any gaps
  (e.g. unrelated parts) in your proposal
• Using your proposal map, have a colleague attempt
  to map your grant proposal

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Mapping your proposal

• Concepts
• Background
• Data
• Analysis
• Interpretation
• Budget

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The title is your work in a nutshell

• Descriptive
• Specific
• Appropriate

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The abstract

• May be the only part read by many voters
• The broad, long-term objectives of the proposal
  are.
• The specific aims are 1) , 2) , 3)
• The significance of this project is
• The research design is..

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Putting it together

• Remind reviewers of priorities how your
  proposal fits with priorities
• Indicate how you can save
• Use
• readable
• font

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Remember to

• Use grammar/spell check
• include reliability of variables power
  calculations
• Sell your idea
• Use headers
• Have someone else review

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• Follow rules
• Page limitations
• due by date
• Signatures
• Contents

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Most common reasons for disapproval

• Lack of new or original ideas
• Diffuse, superficial, or unfocused research plan
• Lack of knowledge of published relevant work
• Lack of experience in the essential methodology
• Uncertainty concerning the future directions

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• Questionable reasoning in experimental approach
• Absence of an acceptable scientific rationale
• Unrealistically large amount of work
• Lack of sufficient experimental detail
• Uncritical approach

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• The Investigator is spreading herself too thin
  she will be more productive if she concentrates
  on fewer projects
• The Investigator needs to communicate more with
  colleagues
• The past connections between the various
  investigators remain unclear

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Characteristics of fundable proposals

• A good research idea
• A well-focused, well-written research proposal
• A good Track Record and/or substantive
  preliminary results
• A substantial percent effort
• A stable work group
• An ample number of substantial, preferably
  peer-reviewed publications

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Take home messages

• Plan, Plan, Plan
• Allow enough time
• Importance of abstract

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Many people think that research is a
supernatural gift of the Gods.It is simply an
idea from a troubled mind, an inspiration
followed by infinitely painstaking work and
perspiration. Sir Frederick Banting
1891-1941
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I get by with a little help from my friends

• I get high (ie funded) with a LOT of help from
  my friends.

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General principle

• Science2 Marketing
• Art x pilot data
• Your end product must
• be important
• be unique
• contribute significantly to the field!

Grantmanship
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Some advice

• Be
• Proactive
• Persistent
• Patient

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Be careful what you ask for - You just might get
it
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Good Luck!
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Assemble a Research Team
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• Project management plan
• Roles/responsibilities of team members

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Who do you need on your team?
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Principal investigator

• Has original idea that stimulated project
• Has major responsibility for scientific integrity
  and financial status
• Typically has 25-40 on project

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Co-principal investigator

• Integral to development of project
• Takes a leadership role for implementing portion
  of project
• Typically 10-25 on project

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Co-investigator

• Has responsibility for smaller portion of project
• Typically 10-25 on project

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Consultant

• Has specialized area of expertise
• Up to 5 on project
• Limited or concentrated effort

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Project staff

• Work in specific roles
• 25-100 effort on project