Notice of Special Interest (NOSI): Interventions to promote mental well-being in populations that experience health disparities through social, cultural, and environmental connectedness

Overview

The Office of Disease Prevention (ODP) and participating National Institutes of Health (NIH) Institutes, Centers, and Offices (ICOs) are soliciting intervention projects to promote mental well-being and/or prevent mental health problems by fostering social, cultural, or environmental connectedness in one or more populations that experience health disparities. Mental health or mental wellness may be the primary outcome of the intervention and/or an intermediate factor to improve other health outcomes.

In 2021, the NIH Office of Disease Prevention (ODP) established ADVANCE (Advancing Prevention Research for Health Equity), an initiative with the objective of strengthening NIH-funded research focused on reducing health disparities through disease prevention. Mental well-being is a key priority for ADVANCE, and in collaboration with other NIH Institutes, Centers, and Offices, ADVANCE issued a Request for Information (RFI), NOT-OD-23-030, which solicited information on “innovative approaches to prevent mental health problems and promote mental wellness in populations that experience health disparities.” A key theme that emerged from the RFI responses centered around the need to foster a greater sense of belonging, meaning, and purpose by increasing connectedness (with people, culture, and activities) and decreasing isolation and loneliness. This theme is consistent with the 2023 U.S. Surgeon General’s Advisory on the Health Effects of Social Connection and Community, which calls for research to understand root causes of social disconnection and evaluate interventions to promote social connection.

Research Objectives

In response to the identified need, this ADVANCE NOSI encourages research aimed at developing, refining, and/or testing interventions and programs that promote mental well-being and/or prevent mental health problems by fostering connectedness in one or more populations that experience health disparities. The proposed research should test approaches that are both scalable and sustainable in real world contexts, either in person or online, where individuals, groups, or communities are likely to establish and maintain connections. Connectedness may take many forms, including but not limited to the examples mentioned below.

Social connectedness, or a sense of belonging, companionship, comfort, psychological safety, and mutual support in the company of other people, including family, friends, coworkers, neighbors, etc. Examples of activities to promote social connectedness include, but are not limited to, family mealtime, block parties, book clubs, peer support groups, school gender and sexuality alliances, team sports, and volunteering.

Cultural connectedness, or a sense of engagement in activities that reflect a person’s values and interests. Examples of activities to promote cultural connectedness include, but are not limited to, traditional or contemporary cultural activities, customs, or celebrations; hobbies; creative or performing arts; spiritual or religious activities; involvement in local or school government; and neighborhood associations.

Environmental connectedness, or a sense of being attuned to or immersed in the natural world or physical environment. Examples of activities to promote environmental connectedness include, but are not limited to, outdoor exercise or recreational activities; cultivating plants or animals; hunting, fishing, or foraging; environmental conservation activities; restoring or creating green spaces; and community revitalization or cleanup efforts.

While projects may involve individual-level components to foster connectedness (e.g., education, training, experiential learning, or skill building), it is expected that interventions will also address relevant interpersonal, organizational, or community-level factors to make connections possible and sustainable (e.g., an intervention to connect youth to nature may require providing transportation to existing green spaces or development of neighborhood green spaces).

Mental well-being may be the primary outcome (e.g., an environmental connectedness intervention that aims to improve mental well-being) or an intermediate factor that is hypothesized to improve other physical or mental health outcomes (e.g., an intervention that seeks to improve mental well-being [proximal outcome] with the goal of reducing risk for the development of cardiovascular disease [distal outcome]). Projects may test new or adapted interventions, novel combinations of multiple interventions, and/or new strategies to implement evidence-based interventions.

Interventions done in collaboration with community-based organizations (e.g., patient or consumer advocacy organizations, professional societies, faith-based organizations, or neighborhood associations) or local governmental service sectors (e.g., health, public health, education, housing, labor, social services, child welfare, transportation, parks and recreation, commerce, justice, environmental protection, etc.) are strongly encouraged.

Intervention projects are expected to have the following features:

• Develop and/or evaluate interventions that address factors at multiple socioecological levels (individual, interpersonal, organizational, and/or community) to promote and sustain connectedness.
• Include a theoretically informed conceptual model that specifies the hypothesized pathways between connectedness, mental well-being, and/or other distal health outcomes.
• Include appropriate measurement and analytic plans designed to evaluate hypothesized pathways and the impact of multi-level or higher-level (i.e., interpersonal, organizational, community, or societal) mechanisms of action on outcomes as appropriate.
• Be adequately powered to identify intervention effects for the HD population(s) of focus and/or the impact of the intervention on reducing or eliminating disparities in mental well-being and/or other distal health outcomes. Intervention development projects (e.g., R21, R34) that are not examining intervention efficacy or effectiveness should include sufficient samples to evaluate intervention feasibility and acceptability in the proposed HD population(s).
• Use appropriate study designs that allow for a rigorous evaluation of the intervention’s impact on the proposed outcomes, such as randomized clinical trials (e.g., individual, cluster-randomized, stepped wedge), quasi-experimental designs (e.g., regression discontinuity, interrupted time-series), or a rigorous alternative that includes a comparison condition or site.  Methods consistent with plans for the assignment of participants, delivery of interventions, and sample size calculations should be documented in the application. Additional information is available at  https://researchmethodsresources.nih.gov/.

Projects are strongly encouraged to include Social Determinants of Health (SDOH) measures from the Core and Specialty collections that are available in the SDOH Collection of the PhenX Toolkit as relevant (www.phenxtoolkit.org). Inclusion of a common set of measures across studies facilitates future use of datasets for secondary analyses and a cumulative science base, consistent with the goals of the NIH Data Management and Sharing Policy. Other unique measures may also be included, as appropriate for the experimental questions and hypotheses.

Applicants must select the IC and associated NOFO to use for submission of an application in response to the NOSI. For submission to an IC-specific NOFO, the application must align with the IC requirements and responsiveness criteria listed in that NOFO to be considered responsive. Non-responsive applications will be withdrawn from consideration for this initiative. In addition, applicants using NIH Parent announcements will be assigned to participating ICs on this NOSI that have indicated those NOFOs are acceptable based on usual application-IC assignment practices.

Investigators are strongly encouraged to reach out to the Scientific/Research Contact(s) listed in the Inquiries section of this NOSI to determine which NOFO and activity code are appropriate for their proposed research. Participating NIH Offices may consider co-funding meritorious applications depending on the alignment with office-specific missions and priorities and the availability of funds. The following ICs will accept applications to the NOFOs below or their subsequent reissued equivalents: