Foreign entities are not eligible to compete for, or receive, awards made under this announcement. Faith-based and community organizations that meet the eligibility requirements are eligible to receive awards under this funding opportunity announcement.
The Spinal Cord Injury Model Systems (SCIMS) program was designed in the early 1970s to provide a multidisciplinary system of rehabilitation care specifically to meet the needs of individuals with SCI.
The system of rehabilitation care that was developed through this program encompasses a continuum of services that include emergency medical services, acute care services, acute medical rehabilitation services, and post-acute services. Since its origin 51 years ago the program has evolved into a national network of SCI clinical centers that collaborate on multi-site research efforts and longitudinally track the experiences and outcomes of people with spinal cord injury. A clinical center’s comprehensive SCI service delivery system is now a prerequisite for receiving a SCIMS Center grant to conduct high-quality research that can be used to improve services and outcomes for people with spinal cord injury. For purposes of this program, SCI is defined as a clinically discernible degree of neurologic impairment of the spinal cord following a traumatic event. The NIDILRR currently supports 14 SCIMS centers through this program.
The SCIMS program is the largest network of research centers devoted to SCI in the world. This network creates opportunities for critical collaboration between SCI clinicians and researchers from around the U.S. and allows investigators to generate sample sizes that are adequate for the development and testing of a wide variety of interventions. The SCIMS Centers conduct research that fits under at least one of the outcome domains outlined in NIDILRR’s Long-Range Plan (NIDILRR, 2019). These domains are: (1) health and function, (2) community living and participation, and (3) employment.
There is an ongoing need for research that can be used to improve services and outcomes for people with SCI in each of these interrelated domains. There are approximately 294,000 people living with SCI in the United States. While SCI remains a low-incidence condition (estimates are that 17,810 people acquire new SCI in the U.S. each year) (NSCISC, 2020), the number of people surviving SCI continues to grow as a result of improved emergency and acute care. Increased survival rates and aging of people with SCI have created the need for new research-based information that can be used to improve clinical services, community supports, and a wide variety of health, employment, and community living outcomes for this population.
Since 1973, the SCIMS centers have collected and contributed information on common data elements for a centralized SCI database, referred to as the SCIMS database. This database is maintained through a NIDILRR-funded grant for a National Spinal Cord Injury Statistical Center (NSCISC). A total of 49,743 people with SCI have been enrolled in the SCIMS database, of whom 29,164 had one or more follow-up records. The data that these and other database participants have contributed provides invaluable information about the life course of people with spinal cord injury and about trends in their experiences and outcomes. The database now includes information from people who have been contributing data for 45 years. Further information about the SCIMS database, including inclusion criteria, can be found at the following website: https://www.nscisc.uab.edu/Public_Pages/Database
In 2019, NIDILRR co-sponsored an interagency meeting entitled “SCI 2020: Launching a Decade of Disruption in Spinal Cord Injury Research” (Morse et al., 2020). During this meeting, SCI researchers and people living with SCI identified multiple priorities for future research and categorized them into six broad areas. NIDILRR’s SCIMS program grantees have historically participated in research and contributed to the science in each of these six areas. Three of the areas discussed during the meeting had particular resonance with NIDILRR’s past, present, and future approach to SCI Research. The “health and secondary health effects of chronic SCI” portion of the meeting resonates strongly with SCIMS research in the NIDILRR health and function domain. The “technological facilitation, prosthetic and robotic interventions and therapies” area reflects NIDILRR’s ongoing emphasis on technologies that can facilitate positive health, function, employment, and community living outcomes. And the “with us, not for us: community activity and priorities” area reflects NIDILRR’s long-standing commitment to participatory action research, and the inclusion of people with disabilities as partners in the research enterprise (NIDILRR, 2019).
Morse, L. R., Field-Fote, E. C., Contreras-Vidal, J., Noble-Haeusslein, L. J., Rodreick, M., SCI 2020 Working Group, ... & Zanca, J. M. (2021). Meeting Proceedings for SCI 2020: Launching a Decade of Disruption in Spinal Cord Injury Research. Journal of Neurotrauma. 12(22)1-16.
NIDILRR (2019). National Institute on Disability, Independent Living, and Rehabilitation Research: 2018-2023 Long-Range Plan. https://acl.gov/news-and-events/announcements/new-nidilrr-long-range-pl…
National Spinal Cord Injury Statistical Center (2020). Facts and Figures at a Glance. Birmingham, AL: University of Alabama at Birmingham.
Priority: Spinal Cord Injury Model Systems:
The Administrator of the Administration for Community Living establishes a priority for the funding of Spinal Cord Injury Model Systems (SCIMS) centers (SCIMS Centers). The SCIMS Centers must provide comprehensive, multidisciplinary services to people with spinal cord injury (SCI) as a prerequisite and basis for conducting research that contributes to evidence-based rehabilitation interventions and clinical and practice guidelines. For purposes of this priority, SCI is defined as a clinically discernible degree of neurologic impairment of the spinal cord following a traumatic event. The SCIMS program is designed to generate new knowledge that can be used to improve outcomes of people with SCI in one or more domains identified in NIDILRR’s Long Range Plan (Plan): health and function, community living and participation, and employment. Each SCIMS Center must contribute to this outcome by--
(a) Continuing the assessment of long-term outcomes of people with SCI by enrolling at least 30 participants per year into the SCIMS database, following established protocols for the collection of enrollment and follow-up data on participants (found at nscisc.uab.edu);
(b) Proposing and conducting one site-specific research project to test innovative approaches to improving outcomes of people with SCI or to assessing outcomes of people with SCI in one or more domains identified in the Plan: health and function, community living and participation, and employment. The proposed site-specific research project may contribute to the advancement of the science at any stage of research. The stage(s) of research of the proposed work should be appropriate to the state of the science for the topic under study;
Note: Applicants who propose more than one site-specific research project will be disqualified.
(c) Proposing one module research project on SCI rehabilitation and participating in at least one module research project. Module projects are research collaborations between two or more SCIMS Centers on topics of mutual interest and expertise. The proposed module project may contribute to the advancement of the science at any stage of research. The stage(s) of research of the proposed work should be appropriate to the state of the science for the topic under study. At the first SCIMS Project Directors’ meeting following the announcement of new awards under this priority, SCIMS Project Directors will review, discuss, and choose module projects to be implemented during the 2021-2026 SCIMS grant cycle, from among the module projects that were proposed by the successful applicants. NIDILRR staff will facilitate this post-award discussion and negotiation among new SCIMS grantees. Each SCIMS Center must participate in at least one of the module projects that are selected for implementation;
Note: Applicants who propose more than one module research project will be disqualified.
(d) Demonstrating, in its original application, that people with SCI from racial and ethnic minority backgrounds will be included in study samples in sufficient numbers to generate knowledge and products that are relevant to the racial and ethnic diversity of the population of people with SCI in its clinical catchment area. The SCIMS Center must describe and justify, in its original application, the racial and ethnic distribution of people with SCI who will participate in the proposed research activities.
(e) Coordinating with the NIDILRR-funded Model Systems Knowledge Translation Center (MSKTC) (http://www.msktc.org) to provide scientific results and information for dissemination to stakeholders. Stakeholders may include but are not limited to people with SCI and their families, researchers, clinicians, policymakers, and the ACL-funded National Paralysis Resource Center. Grantees may use a variety of dissemination mechanisms that could include state-of-the-science meetings, webinars, websites, and other approaches; and
(f) Ensuring that the input of people with SCI is used to shape SCIMS research.
Each applicant under this priority must--
(1) Demonstrate, in its application, its capacity to successfully engage in multi-site collaborative research. This capacity includes access to research participants, the ability to maintain data quality, and the ability to adhere to research protocols;
(2) Propose to spend at least 15 percent of its annual budget on module project participation, as described in paragraph (c) of this priority;
(3) Ensure that its Project Director participates in two annual face-to-face SCIMS Project Directors’ meetings in the greater Washington, D.C. area;
(4) Identify and justify the stage or stages of research of the projects that they are proposing as site-specific and module research projects. If the applicant proposes to conduct research that can be categorized under more than one stage, including research that progresses from one stage to another, those stages must be clearly specified.
These stages, exploration and discovery, intervention development, intervention efficacy, and scale-up evaluation, are defined in this section of the funding opportunity announcement.
Definition: Stages of Research
(a) Exploration and discovery means the stage of research that generates hypotheses or theories by conducting new and refined analyses of data, producing observational findings, and creating other sources of research-based information. This research stage may include identifying or describing the barriers to and facilitators of improved outcomes of individuals with disabilities, as well as identifying or describing existing practices, programs, or policies that are associated with important aspects of the lives of individuals with disabilities. Results achieved under this stage of research may inform the development of interventions or lead to evaluations of interventions or policies. The results of the exploration and discovery stage of research may also be used to inform decisions or priorities.
(b) Intervention development means the stage of research that focuses on generating and testing interventions that have the potential to improve outcomes for individuals with disabilities. Intervention development involves determining the active components of possible interventions, developing measures that would be required to illustrate outcomes, specifying target populations, conducting field tests, and assessing the feasibility of conducting a well-designed interventions study. Results from this stage of research may be used to inform the design of a study to test the efficacy of an intervention.
(c) Intervention efficacy means the stage of research during which a project evaluates and tests whether an intervention is feasible, practical, and has the potential to yield positive outcomes for individuals with disabilities. Efficacy research may assess the strength of the relationships between an intervention and outcomes and may identify factors or individual characteristics that affect the relationship between the intervention and outcomes. Efficacy research can inform decisions about whether there is sufficient evidence to support “scaling-up” an intervention to other sites and contexts. This stage of research can include assessing the training needed for wide-scale implementation of the intervention and approaches to evaluation of the intervention in real world applications.
(d) Scale-up evaluation means the stage of research during which a project analyzes whether an intervention is effective in producing improved outcomes for individuals with disabilities when implemented in a real-world setting. During this stage of research, a project tests the outcomes of an evidence-based intervention in different settings. It examines the challenges to successful replication of the intervention and the circumstances and activities that contribute to successful adoption of the intervention in real-world settings. This stage of research may also include well-designed studies of an intervention that has been widely adopted in practice, but that lacks a sufficient evidence-base to demonstrate its effectiveness.