Opportunity Information: Apply for RFA NR 23 001
The HEAL Initiative: Prevention and Management of Chronic Pain in Rural Populations (UG3/UH3, Clinical Trials Required) is a National Institutes of Health cooperative agreement funding opportunity (RFA-NR-23-001) aimed at speeding up the real-world adoption of effective, non-opioid approaches to chronic pain care in rural and remote communities. The program is designed for projects that move beyond tightly controlled efficacy studies and instead test how well proven interventions can be implemented in everyday care settings, with a strong emphasis on reducing inappropriate opioid use while improving pain outcomes and related functioning. The trials supported under this opportunity are expected to generate practical evidence that can be used by policymakers, payers, community partners, health system leaders, clinicians, and patients, especially in common rural points of care such as primary care clinics, emergency departments, hospitals, home health services, and dental settings.
This FOA uses the UG3/UH3 phased award structure, meaning applicants submit one combined application that covers both phases, but funding begins with a milestone-driven planning period (UG3) lasting 1 to 2 years. During UG3, the research team is expected to complete key start-up and feasibility activities and to hit clearly defined scientific and operational milestones that demonstrate the study is ready to launch at scale. Only projects that meet those milestones can transition to the second phase, UH3, which supports the full implementation and evaluation period for up to 4 additional years, for a total possible project length of about 5 years across both phases. Because this is a cooperative agreement, awardees should expect substantial NIH involvement during the project, typically including collaboration on study oversight, milestone tracking, and other aspects of execution that are common in cooperative mechanisms.
The kinds of studies encouraged here include pragmatic trials, implementation trials, and hybrid effectiveness-implementation designs, all with clinical trials required. The core idea is to take interventions that already have evidence of efficacy and determine how to implement them successfully in rural contexts where resources, staffing, geography, and access barriers can differ sharply from urban and academic settings. The FOA explicitly allows, and even anticipates, multi-component, bundled, or multi-level interventions, meaning projects can combine strategies at the patient, provider, clinic, and community levels as long as the intervention package is grounded in prior evidence. In practice, that could mean integrating non-opioid pain management options, care pathways, decision support, workforce training, referral networks, telehealth-enabled services, behavioral health components, physical or rehabilitative approaches, and other coordinated elements, provided the study is designed to test implementation in real clinical workflows.
Partnership requirements are central. Investigators must partner with one or more rural healthcare systems to plan and carry out the work, ensuring that the study is anchored in the realities of rural service delivery. In addition, during the UG3 planning phase, applicants must develop one or more community-based partnerships, reflecting the program goal of making interventions fit local needs and improving uptake, sustainability, and trust. These partnerships are not a minor add-on; they are part of the intended implementation strategy and are closely tied to the expectation that the resulting evidence will be relevant to community stakeholders and decision-makers.
Eligibility is broad across public and private sectors, including state, county, city or township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; nonprofits with or without 501(c)(3) status; for-profit organizations other than small businesses; small businesses; and several tribal entities (including federally recognized tribal governments and other Native American tribal organizations). The FOA also highlights additional eligible applicant types such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISI institutions, Hispanic-serving institutions, Historically Black Colleges and Universities, Tribally Controlled Colleges and Universities, faith-based or community-based organizations, regional organizations, eligible federal agencies, and U.S. territories or possessions. At the same time, it clearly excludes non-U.S. organizations and institutions from applying, prohibits non-domestic components of U.S. organizations, and does not allow foreign components under NIH policy, keeping the work fully domestic in scope.
Administratively, this opportunity falls under the broader HEAL initiative and is listed with multiple CFDA numbers (including 93.121, 93.213, 93.233, 93.273, 93.279, 93.307, 93.361, 93.393, 93.395, and others), reflecting the cross-institute nature of NIH participation in HEAL-related pain and opioid research. The original closing date listed for this FOA was November 21, 2022, and the award ceiling and expected number of awards were not specified in the provided source data. Overall, the opportunity is best understood as NIH support for teams that can combine rigorous trial methods with practical implementation planning, strong rural health system collaboration, and meaningful community partnership to expand access to non-opioid chronic pain care and reduce reliance on inappropriate opioid prescribing in rural America.Apply for RFA NR 23 001
- The National Institutes of Health in the education, health, income security and social services sector is offering a public funding opportunity titled "HEAL Initiative: Prevention and Management of Chronic Pain in Rural Populations (UG3/UH3, Clinical Trials Required)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.121, 93.213, 93.233, 93.273, 93.279, 93.307, 93.361, 93.393, 93.395, 93.837, 93.838, 93.839, 93.840, 93.846, 93.853, 93.865, 93.866.
- This funding opportunity was created on 2022-09-16.
- Applicants must submit their applications by 2022-11-21. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- 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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