Medical Colleges). Funding announcements are mailed to members of these organizations. Funds for the projects are provided by the CIOs and are administered by CDC’s Public Health Practice Program Office (PHPPO).

Investigator-Initiated Research at CDC In the investigator-initiated approach to research, applicants propose research in topic areas of their choosing or under broad topic areas provided by the CIOs. The Extramural Prevention Research Program (also known as the Prevention Research Initiative [PRI]) is one of the largest investigator-initiated research efforts at CDC and is administered by PHPPO. In 1999, with a budget of $12.5 million, CDC began the PRI and funded 50 research service endeavors at academic health centers, research centers, and university-affiliated programs. The average grant was approximately $250,000, and most service endeavors were funded for 3 years. Awards covered a range of subjects and included prevention of specific diseases (e.g., asthma and sexually transmitted diseases) and injury prevention (Sattin, 2001).

All grants and cooperative agreements in this program are externally peer reviewed and are administered by the scientifically appropriate CIOs. Plans for 2002 called for emphasizing investigator-initiated research grants in topic areas that cross-cut diseases, injuries, and conditions and that address gaps in individual CIO agendas. Awards are to be for larger amounts to allow evaluation of service endeavors targeting large populations or the subgroups at highest risk (Doll et al., 2001). A major problem, however, is the lack of a central, organized focus for investigator-initiated research. There is no defined unit to which applications are submitted, and there is no single source of information on the availability of grants.

All applications submitted to CDC requesting research funding are subject to review. CDC uses two approaches to review applications: (1) objective review and (2) external peer review. Objective review is a process that includes an independent assessment of the technical or scientific merit of research by panels composed of federal reviewers only, predominantly from CDC. The peer review process includes an independent assessment of the technical or scientific merit of research by predominantly nonfederal reviewers, scientists with knowledge and expertise equal to that of the researchers whose work they review (Sattin, 2001).

Although CDC has been active and is a leader in prevention research, there are several barriers to maximizing its investigator-initiated prevention research. First, although CDC has recently funded increased numbers of investigator-initiated research projects, this remains a relatively small endeavor that is too dependent on CIO-specific programs. Another barrier relates to the fact that CDC staff frequently play a more directive role than is acceptable for academic research. Additionally, project funding is often for too short a time, and indirect cost allowances (which are based on the



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