Advancing Research to Develop Improved Measures and Methods for Understanding Multimorbidity (R01 Clinical Trial Optional) | PAR 20 179

Opportunity Information: Apply for PAR 20 179

The National Institutes of Health (NIH) funding opportunity "Advancing Research to Develop Improved Measures and Methods for Understanding Multimorbidity (R01 Clinical Trial Optional)" (PAR-20-179) supports research aimed at strengthening how multimorbidity, also described as multiple chronic conditions (MCCs), is measured, captured, and analyzed. The central focus is not on testing new interventions, but on improving the underlying data resources, measurement tools, and analytic methods that researchers and health systems rely on to understand how chronic conditions cluster, evolve, and affect patients over time. The FOA is designed to push the field beyond simple condition counts and toward approaches that better represent the real-world complexity of people living with multiple chronic diseases across different ages, backgrounds, and care settings.

A major priority is developing, discovering, and evaluating measures or tools that reflect the longitudinal nature of multimorbidity and the life course diversity of how MCCs develop. That includes work that tracks how disease combinations emerge, change, and interact across years rather than at a single time point. The FOA encourages approaches that can capture timing, sequencing, severity, and trajectories of conditions, recognizing that multimorbidity is often dynamic and shaped by factors such as aging, social context, and access to care. In practice, this could involve creating new indices, phenotyping strategies, algorithms, or measurement frameworks that better represent the lived and clinical reality of co-occurring chronic illnesses.

The announcement also highlights the value of tools that can support basic and translational discovery related to shared MCC pathways. This includes, for example, measures or methods that help researchers use animal models of MCCs to explore mechanisms that might drive multiple conditions at once, or to identify shared biological "signatures" across conditions. The FOA calls for the identification and early-stage biological, analytical, and clinical evaluation of these shared signatures, meaning work that helps establish whether proposed markers or patterns are meaningful, reproducible, and useful for understanding multimorbidity. The intent is to strengthen the scientific foundation for later mechanistic or interventional work by improving the quality of the measures and methods used to define and study MCCs in the first place.

Patient-focused measurement is another core theme. The FOA explicitly seeks studies that incorporate patient reports and related constructs such as functional limitations and quality of life. This reflects a recognition that multimorbidity is not adequately described by diagnoses alone, and that patient-centered outcomes can be essential for understanding burden, day-to-day impact, and heterogeneity across populations. Projects may focus on developing or validating instruments, improving how patient-reported data are collected or interpreted in multimorbidity contexts, or integrating patient-reported outcomes with clinical data to create more complete MCC measures.

On the methods side, the FOA encourages analytic approaches that are well-matched to multimorbidity data and the populations being studied. Multimorbidity presents distinctive challenges, such as high dimensionality (many conditions and combinations), confounding by indication and care patterns, changing risk over time, and differences in coding and documentation across settings. This initiative supports methodological work that improves the rigor and interpretability of multimorbidity research, including approaches tailored to different groups, health care environments, and data types. A related emphasis is making better use of electronic health record (EHR) data, including strategies that fully harness the volume and richness of EHR systems while addressing their limitations, such as missingness, measurement error, variable follow-up, and differences in clinical practice.

The FOA allows researchers to use existing data sources and to link datasets to explore new questions about co-occurring chronic conditions. That means strong applications can be built around secondary analyses, new linkages across clinical and non-clinical data, or enhanced measurement using already collected information, as long as the project materially advances MCC measurement or analytic capability. The overall goal is to produce tools and methods that increase the availability, quality, and utility of multimorbidity data, so that downstream studies across many diseases and populations can be more accurate, comparable, and clinically meaningful.

This is an NIH R01 grant mechanism with clinical trials listed as optional, meaning applicants may propose clinical trial elements if they are appropriate to the measurement or methods goals, but a clinical trial is not required. The FOA also notes that applicants whose primary interests are in identifying shared mechanisms or developing innovative interventions to address MCCs should consider a separate NIH announcement (referenced as PAR-XX-XXX), signaling that this opportunity is more squarely aimed at measurement and methodological advancement rather than intervention development.

Eligibility is broad and includes many U.S.-based organizations and governmental entities, such as state, county, and local governments; public and private institutions of higher education; independent school districts; special district governments; federally recognized tribal governments and other tribal organizations; public housing authorities/Indian housing authorities; nonprofits (with or without 501(c)(3) status); for-profit organizations (other than small businesses) as well as small businesses; and other eligible entities. The FOA also highlights interest in applications from a range of institution types, including Alaska Native and Native Hawaiian Serving Institutions, AANAPISIs, 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-domestic (non-U.S.) entities and foreign institutions are not eligible to apply, and non-domestic components of U.S. organizations are not eligible; however, foreign components, as defined under NIH policy, may be included when scientifically justified.

Key administrative details provided include the opportunity number PAR-20-179, the agency (NIH), the grant instrument type (grant), and activity categories related to education and health. The original closing date listed is 2024-01-07. The FOA description does not specify an award ceiling or the expected number of awards in the provided excerpt, indicating that applicants would need to consult the full FOA and NIH institute-specific guidance for budget expectations, project period norms, and any institute-participation details tied to the CFDA listings (93.121, 93.173, 93.213, 93.399, 93.866).

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Advancing Research to Develop Improved Measures and Methods for Understanding Multimorbidity (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): 93.121, 93.173, 93.213, 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.

Apply for PAR 20 179

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