Award Mechanism	Eligibility	Key Mechanism Elements	Funding
Clinical Trial Award	Extramural applicants only Investigators at the level of Assistant Professor and above (or equivalent)	Supports the rapid implementation of clinical trials with the potential to have a significant impact on psychological health conditions and/or TBI through clinical applications, including healthcare products, technologies, and/or practice guidelines. Funding Level 1 Early Career Investigator Partnering Option available. Different funding levels, based on the scope of research, are available. It is the responsibility of the PI to select the funding level that is most appropriate for the research proposed. The funding level should be selected based on the scope of the research project, rather than the amount of the budget. The following are general descriptions, although not all-inclusive, of the scope of research projects that would be appropriate to propose under each funding level: Research Level 1: Proof-of-principle pilot trials, correlative studies, and other innovative, exploratory clinical trials. Research Level 2: Clinical trials for promising treatments or interventions that have already demonstrated acceptable safety in human subjects. Research Level 3: Large-scale clinical trials to demonstrate efficacy in relevant patient populations. Submission of a preproposal is required; application submission is by invitation only	Research Level 1 Maximum funding of $500,000 for direct costs (plus indirect costs). Maximum period of performance is 3 years. Research Level 2 Maximum funding of $2,000,000 for direct costs (plus indirect costs). Maximum period of performance is 4 years. Research Level 3 Maximum funding of $4,000,000 for direct costs (plus indirect costs). Maximum period of performance is 4 years.
Focused Program Award	Investigators at the level of Full Professor and above (or equivalent)	Supports the development of a synergistic, multidisciplinary research program with the potential to have a significant impact on TBI and/or PH. Projects should work together to answer critical questions, resolve differing hypotheses, and translate laboratory findings to clinical applications. Projects may range from exploratory to hypothesis-developing through small-scale clinical trials that together address the overarching goal/question. A research team of highly qualified, multidisciplinary project leaders should be led by a PI with demonstrated success in directing large, focused projects. Submission of a preproposal is required; application submission is by invitation only	Maximum funding of $5,000,000 for direct costs (plus indirect costs) Maximum period of performance is 4 years.
Health Services Research Award	Investigators at the level of Assistant Professor and above (or equivalent)	Bridges the gap between research, practice, and policy by building a knowledge base on how interventions and clinical practices/guidelines and policies can be deployed to targeted populations at the appropriate time at the point of need. Clinical research/clinical trials are allowed but trials for new treatments are not allowed. Submission of a Letter of Intent is required prior to full application submission.	Maximum funding of $2,500,000 for direct costs (plus indirect costs) Maximum period of performance is 4 years.
Translational Research Award	Investigators at the level of Assistant Professor and above (or equivalent)	Supports the conversion of research findings in psychological health and/or TBI into clinical applications, including health care products, technologies, and/or clinical practice guidelines. Preclinical and clinical research/trials are allowed. Research Level 2 Early Career Investigator Partnering Option available. NEW FOR FY24: Different funding levels, based on the scope of research, are available. It is the responsibility of the PI to select the funding level that is most appropriate for the research proposed. The funding level should be selected based on the scope of the research project, rather than the amount of the budget. The following are general descriptions, although not all-inclusive, of the scope of research projects that would be appropriate to propose under each funding level: Research Level 1: Supports smaller, less complex preclinical and/or clinical research. Pilot clinical trials are allowed. Research Level 2: Research Level 2 is intended to support larger, more complex preclinical and/or clinical research. Pilot clinical trials are allowed. NEW FOR FY24: Submission of a preproposal is required; application submission is by invitation only.	Research Level 1 Maximum funding of $500,000 for direct costs (plus indirect costs). Maximum period of performance is 3 years. Research Level 2 Maximum funding of $1,000,000 for direct costs (plus indirect costs). Maximum period of performance is 4 years.
New for FY24: Emerging Research Award	Investigators at the level of Assistant Professor and above (or equivalent)	Advances research in emerging topics in in traumatic brain injury and/or psychological health. Unique set of topic areas aligned with TBIPHRP goals (see below) Preclinical and clinical research/trials are allowed. The Early Career Investigator Partnering Option is available for Funding Level 2. Different funding levels, based on the scope of research, are available. It is the responsibility of the PI to select the funding level that is most appropriate for the research proposed. The funding level should be selected based on the scope of the research project, rather than the amount of the budget. The following are general descriptions, although not all-inclusive, of the scope of research projects that would be appropriate to propose under each funding level: Research Level 1: Supports smaller, less complex preclinical and/or clinical research. Pilot clinical trials are allowed. Research Level 2: Research Level 2 is intended to support larger, more complex preclinical and/or clinical research. Pilot clinical trials are allowed. Submission of a preproposal is required; application submission is by invitation only.	Research Level 1 Maximum funding of $700,000 for direct costs (plus indirect costs). Maximum period of performance is 3 years. Research Level 2 Maximum funding of $1,500,000 for direct costs (plus indirect costs). Maximum period of performance is 4 years.

Topic Areas for the FY24 TBIPHRP Emerging Research Award

1. Blast/Impulse Exposure and Psychological/Cognitive Health: There have been recent emphasis placed on the unseen wounds of war and brain health deficits seen in Warfighters returning from combat zones, but with no diagnosable conditions.^7,8 These Service Members are not experiencing the classical symptoms of traumatic brain injury nor the symptoms necessary for a posttraumatic stress disorder (PTSD) diagnosis. If clinical providers probe further, there are clear deficiencies that coincide with chronic impulse exposure and insults to the head, but without a named disorder, it is very difficult to build an effective treatment regimen. There is a need for increased research to understand the mechanisms of how these exposures are affecting the brain physically and increased etiological considerations for how the physical blows manifest to cognitive deficits and psychiatric episodes outside of the International Classification of Diseases (ICD) paradigm.
   
   Focus areas under this topic include:
• Understand the physiological/biological/physical mechanisms of hazardous impulse/impact/blast exposures that result in adverse effects on the brain.
• Understand changes in cognitive performance and psychological status associated with brain exposure(s).
• Develop and/or validate safe and effective countermeasures to protect or restore brain health (cognition; psychological health) in the event of exposure(s).


2. Diagnosis and Treatment of Anger: Large survey studies of U.S. (Army STARRS⁵, Millennium Cohort Study⁶) and Australian military personnel have found that problematic anger is prevalent among Service Members and Veterans.^9,10 Anger is frequently comorbid with PTSD, and a history of anger attacks is predictive of persistent PTSD and of new onset depression, anxiety, substance use, and suicidality.¹¹ While anger is listed as a factor to consider in the Department of Veterans Affairs/Department of Defense (VA/DOD) Clinical Practice Guidelines for the Assessment and Management of Patients at Risk of Suicide, there are no known guidelines for treating anger and aggression in Service Members and Veterans.¹² A current systematic review of treatments for anger in military populations with PTSD found that PTSD-focused and mind-body treatments were largely ineffective in addressing anger.¹³ Given the prevalence and negative impact of problematic anger among military personnel, as well as its association with new onset psychological health issues, more research is needed.
   
   Focus areas under this topic include:
• Developing and evaluating screening and early intervention strategies.
• Systematizing the measurement and assessment of anger symptoms.
• Treatment approaches that directly address anger, especially in individuals who have sustained a traumatic brain injury where the experience/expression of anger or aggression/impulsivity may be related, in part, to the biological dysregulation secondary to brain injury.


3. Define risk and protective factors for harmful behaviors at the interpersonal and organizational levels: Risk and protective factors for harmful behaviors¹⁴ at the interpersonal and organizational level of the social-ecological model¹⁵ need to be further understood in a military context; most research to date has been contextualized at the individual level. There is a need to better understand protective factors and risk factors that are shared across multiple forms of harmful behaviors. Defining these factors beyond the individual level that align with a military setting and with recommendation 2.3a (implementation of prevention strategies at organizational and community levels) of the Independent Review Commission on Sexual Assault in the Military¹⁶ will set the stage for future studies to identify change over time and program evaluation efforts (focused on modifying those factors) to decrease harmful behaviors.
   
   Focus areas under this topic include:
   • Understanding protective and protective factors beyond the individual level that are shared across multiple forms of harmful behaviors.¹⁴
   • Research involving collective efficacy is of interest. Community collective efficacy, in which a group perceives an ability to work together to agree on mutually valued goals, is associated with reduced rates of child maltreatment and intimate partner violence.^17,18,19
   • Research involving alcohol outlet density and other community- and societal level risk factors are of interest. Community-level factors such as alcohol outlet density, neighborhood disorder, and firearm availability and accessibility increase risk for harmful behaviors. Examples of societal level risk factors include gender stereotypes and institutionalized racism.²⁰
   
   
4. Relationship Between Social Media and Mental Health: Growing concerns about the relationship between problematic social media use (PSMU) and negative mental health outcomes is gaining public awareness. Calls for action for more research on social media’s harms and potential benefits on mental health have been issued by the White House²¹ and the U.S. Surgeon General’s Office.²² In a recently conducted systematic review, the Psychological Health Center of Excellence found a longitudinal association between PSMU and depression, sleep disturbances, and other mental health outcomes in predominantly healthy populations²³; however, we found no research on social media use or social media addiction in active-duty Service Members. The DOD has similarly prioritized understanding Service Members’ activities and prevention needs within the cyber environment to include use of social media platforms and online “information cocoons” (i.e., when a person’s cyber experience is shaped by a reflection of the person’s own views).²⁴
   
   Focus areas under this topic include:
• Understanding social media use impacts (e.g., prevalence of “information cocoons” and problematic social media use) and whether and how engagement on social media contributes to harmful behaviors¹⁴ and adverse mental health outcomes among Service Members.
• Examining the role of risk factors and modifiable targets in social media addiction to develop preventive interventions and identifying interventions to treat social media addiction.

A pre-application is required and must be submitted through the Biomedical Research Application Portal (eBRAP) prior to the pre-application deadline. All applications must conform to the final funding opportunity announcements that will be available for downloading from the Grants.gov website. The application package containing the required forms for each award mechanism will also be found on Grants.gov. A listing of all CDMRP and other USAMRDC extramural funding opportunities can be obtained on the Grants.gov website by performing a basic search using CFDA Number 12.420.

Submission deadlines are not available until the funding opportunity announcements are released. For email notification when announcements are released, subscribe to program-specific news and updates under “Email Subscriptions” on the eBRAP homepage. For more information about the TBIPHRP or other CDMRP-administered programs, please visit the CDMRP website (https://cdmrp.health.mil).

References:

¹Crosscutting prevention approaches refer to strategies that enhance protective factors and reduce risk factors at multiple socio-ecological levels (e.g., individual, relationship, and community). https://www.sapr.mil/sites/default/files/PPoA_2.0.pdf

²Military readiness is the ability of military forces to fight and meet the demands of assigned missions. Family readiness is the state of being prepared to effectively navigate the challenges of daily living experienced in the unique context of military service. https://www.tradoc.army.mil/wp-content/uploads/2020/10/AD1029823-DOD-Dictionary-of-Military-and-Associated-Terms-2017.pdf

³Intervention repurposing is the identification of novel indication(s) for an FDA-approved intervention.

⁴For the TBIPHRP, “postvention” is defined the response to and care for individuals affected in the aftermath of a sexual assault, suicide event, or other trauma” (adapted from U.S. Department of Health and Human Services Office of the Surgeon General and National Action Alliance for Suicide Prevention, 2010, p. 141).

⁵https://starrs-ls.org/

⁶https://www.millenniumcohort.org/

⁷https://www.nytimes.com/2023/11/26/us/military-brain-injury-rocket-launcher.html

⁸https://www.nytimes.com/2023/11/05/us/us-army-marines-artillery-isis-pentagon.html

⁹Adler AB, LeardMann CA, Roenfeldt KA, et al., and Millennium Cohort Study Team. 2020. Magnitude of problematic anger and its predictors in the Millennium Cohort. BMC Public Health 20, 1-11.

¹⁰Varker T, Cowlishaw S, Baur J, et al. 2022. Problem anger in veterans and military personnel: Prevalence, predictors, and associated harms of suicide and violence. Journal of Psychiatric Research 151, 57-64.

¹¹Metcalf O, Finlayson-Short L, Forbes D, et al. 2023. A systematic review of treatments for problem anger in veteran and military populations with PTSD. Aggression and Violent Behavior 101837.

¹²Department of Veterans Affairs/Department of Defense. 2019. VA/DoD Clinical Practice Guidelines for the Assessment and Management of Patients at Risk of Suicide. https://www.healthquality.va.gov/guidelines/MH/srb/VADoDSuicideRiskFullCPGFinal5088212019.pdf

¹³Smith DM, Meruelo A, Campbell-Sills L, et al. 2021. Pre-enlistment anger attacks and postenlistment mental disorders and suicidality among US Army soldiers. JAMA Network Open 4(9), e2126626-e2126626.

¹⁴Harmful behaviors include adverse outcomes such as sexual assault, suicide, and interpersonal violence (including intimate partner and family violence). https://www.armyresilience.army.mil/ard/images/pdf/Policy/PPOA%202.O.pdf

¹⁵https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html

¹⁶Independent Review Commission on Sexual Assault in the Military. 2021. Hard truths and the duty to change: Recommendations from the Independent Review Commission on Sexual Assault in the Military. Independent Review Commission on Sexual Assault in the Military. https://media.defense.gov/2021/Jul/02/2002755437/-1/-1/0/IRC-FULLREPORT-FINAL-1923-7-1-21.PDF

¹⁷Capaldi DM, Knoble NB, Shortt JW, et al. 2012. A systematic review of risk factors for intimate partner violence. Partner Abuse 3(2), 231-280. https://doi.org/10.1891/1946-6560.3.2.231

¹⁸Lippy C, DeGue S. 2016. Exploring alcohol policy approaches to prevent sexual violence perpetration. Trauma Violence Abuse 17(1), 26-42. https://doi.org/10.1177/1524838014557291

¹⁹Sanchez C, Jaguan D, Shaikh S, et al. 2020. A systematic review of the causes and prevention strategies in reducing gun violence in the United States. American Journal of Emergency Medicine 38(10), 2169-2178. https://doi/10.1016/j.ajem.2020.06.062

²⁰Armstead TL, Wilkins N, and Doreson A. 2018. Indicators for evaluating community- and societal-level risk and protective factors for violence prevention: Findings from a review of the literature. Journal of Public Health Management Practice 24, S42-S50. https://doi/10.1097/phh.0000000000000681

²¹The White House. (February 2023). White House Report on Mental Health Research Priorities. Retrieved October 27, 2023, from https://www.whitehouse.gov/wp-content/uploads/2023/02/White-House-Report-on-Mental-Health-Research-Priorities.pdf

²²U.S. Department of Health and Human Services. 2023. Surgeon General Issues New Advisory About Effects Social Media Use Has on Youth Mental Health. https://www.hhs.gov/about/news/2023/05/23/surgeon-general-issues-new-advisory-about-effects-social-media-use-has-youth-mental-health.html

²³Bellanti DM, Boyd C, Smolenski DJ, et al. 2023. Problematic social media use and mental health: A systematic review of longitudinal studies. [Manuscript submitted for publication].

²⁴Office of the Under Secretary of Defense (Personnel and Readiness). 2022. FY23 Integrated Prevention Research Agenda. Retrieved on October 27, 2023, from https://www.prevention.mil/Portals/130/Documents/2023%20Integrated%20Prevention%20Research%20Agenda.pdf?ver=5nWUoNuEExzzlw9Y0GczGA%3D%3D

Point of Contact:

CDMRP Public Affairs
301-619-9783
usarmy.detrick.medcom-cdmrp.mbx.cdmrp-public-affairs@health.mil