Identifying Innovative Mechanisms or Interventions that Target Multimorbidity and Its Consequences (R01 Clinical Trial Optional) | PAR 20 180

Opportunity Information: Apply for PAR 20 180

The NIH funding opportunity "Identifying Innovative Mechanisms or Interventions that Target Multimorbidity and Its Consequences (R01 Clinical Trial Optional)" (PAR-20-180) supports research aimed at reducing the burden of multimorbidity, meaning the presence of multiple chronic conditions (also called MCCs). The main goal is to move beyond studying single diseases in isolation and instead focus on shared biological, behavioral, and contextual mechanisms that lead to clusters of chronic illnesses, along with practical interventions that can prevent, slow, or better manage MCCs and the downstream consequences for patients, families, and health systems.

A central emphasis of this FOA is intervention-oriented research that investigates why and how multiple chronic conditions develop together, and what can be done to interrupt those pathways. Projects are encouraged to study mechanisms or pathways that could prevent MCCs in the first place, including work to identify early biomarkers, map behavioral pathways, and clarify how individual-level risk factors (such as genetics, physiology, behavior, or mental health) interact with contextual risk factors (such as social determinants of health, environment, health care access, neighborhood conditions, or structural factors). This includes research that looks at interactions among risks and potential intervention points, rather than treating each condition as independent. Studies can focus on different stages of life and are expected to be relevant to diverse populations, recognizing that multimorbidity patterns, causes, and outcomes can differ across age groups, communities, and care settings.

The FOA also highlights the development and testing of targeted therapies and management approaches for people who already have multimorbidity. This can include clinical and behavioral interventions designed to delay disease progression, prevent additional chronic conditions from emerging, reduce symptom burden, and improve day-to-day functioning and quality of life. Self-management is explicitly included, meaning proposals can address strategies that help patients manage multiple conditions more effectively (for example, improving medication adherence across complex regimens, coordinating lifestyle changes that impact multiple diseases at once, or addressing fatigue, pain, sleep, mobility, cognition, depression, or other cross-cutting problems). The intent is to support interventions that are deliberately designed for MCC complexity, including approaches that target shared therapeutic pathways relevant to co-occurring conditions, rather than simply stacking single-disease treatments.

Another major area of interest is innovative health care partnership models for managing or treating multimorbidity. This points to care delivery and system-level interventions, such as new models of coordination between primary care, specialty care, behavioral health, community organizations, social services, and public health partners. Applications can propose ways to improve integrated care, align incentives, reduce fragmentation, and address real-world barriers that commonly affect people with multiple chronic conditions. The FOA encourages research that evaluates how partnerships and delivery models influence outcomes like disease control, function, patient experience, caregiver burden, utilization, and inequities.

Methodologically, the announcement encourages creative designs that can capture complexity, including studies that examine shared mechanisms and test how risk factors and interventions interact. Innovative technologies are specifically welcomed, both for measuring risk factors and pathways (such as digital phenotyping, remote monitoring, wearables, or other technology-enabled assessments) and for delivering interventions (such as telehealth, mobile health tools, adaptive interventions, or technology-supported care coordination). The FOA also allows and encourages the use of existing data sources and data linkages to ask new questions, including analyses that help disentangle how mechanisms operate alone versus in combination. Clinical trials are optional under this R01, meaning applicants can propose either clinical trial or non-trial research, as long as the project fits NIH definitions and requirements.

In terms of fit, the FOA is especially focused on interventions that can prevent and treat multiple chronic health conditions simultaneously, including studies that investigate therapeutic targets aimed at preventing co-occurring conditions. At the same time, it draws a boundary around certain measurement and methods work: applicants whose primary focus is on developing improved measures, tools, or methods for understanding multimorbidity (for example, creating new multimorbidity indices, novel measurement platforms, or foundational tools for mechanistic signature discovery and initial evaluation) are directed to a different opportunity (referenced as PAR-XX-XXX in the text), suggesting this FOA is more squarely aimed at mechanism-informed interventions and actionable pathways.

Eligibility is broad and includes many U.S.-based organization types: state, county, and local governments; special districts; independent school districts; public and private institutions of higher education; federally recognized tribal governments and other tribal organizations; public housing authorities; nonprofits with and without 501(c)(3) status; for-profit organizations (other than small businesses) and small businesses; and other eligible entities. The FOA also explicitly calls out additional eligible applicants such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISISs, 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. Non-U.S. (non-domestic) entities and non-U.S. components of U.S. organizations are not eligible to apply as applicant organizations, but foreign components (as defined by NIH policy) may be included when justified.

Key administrative details from the source include that the agency is the National Institutes of Health, the mechanism is an R01 grant with clinical trial optional, and the opportunity number is PAR-20-180. The original closing date listed is 2024-01-07. The CFDA program numbers associated with the announcement include 93.173, 93.213, 93.242, 93.279, 93.307, 93.361, 93.399, and 93.866. The posting indicates an award ceiling was not specified in the excerpt provided, and the expected number of awards was not listed in the provided fields.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Identifying Innovative Mechanisms or Interventions that Target Multimorbidity and Its Consequences (R01 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.173, 93.213, 93.242, 93.279, 93.307, 93.361, 93.399, 93.866.
• This funding opportunity was created on 2020-04-30.
• Applicants must submit their applications by 2024-01-07. (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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