The National Institutes of Health (NIH) has recently launched a groundbreaking initiative, the Communities Advancing Research Equity for Health – or CARE for Health program, signaling a significant investment in primary care research. This $30 million pilot program, funded over fiscal years 2024 and 2025, is designed to test the feasibility of a national primary care research network that seamlessly integrates clinical research into everyday primary care settings. But What Programs Do The Nih Have That Involve Primary Care beyond this new initiative? This article delves into CARE for Health and explores the broader landscape of NIH’s commitment to advancing primary care through research.
The CARE for Health program is particularly focused on improving health outcomes by enhancing access to clinical research, especially for communities that have been historically underrepresented in research or underserved by the healthcare system. These communities, often facing significant health disparities, stand to benefit greatly from research tailored to their specific needs. Dr. Monica M. Bertagnolli, the NIH Director, emphasizes this vision in a recent Science Editorial, highlighting the urgency to adapt research to be more inclusive and responsive to the diverse needs of all communities.
“Despite tremendous scientific progress, the health of important segments of the U.S. population is getting worse, not better,” Dr. Bertagnolli stated. She further elaborated on the multifaceted nature of health, acknowledging the significant influence of environmental and societal factors, and the unique characteristics of each community. The CARE for Health program directly addresses these complexities by aiming to empower primary care providers and their patients to actively participate in knowledge generation, ensuring that research findings are directly translated into improved patient care within their communities.
Supported by the NIH Common Fund, CARE for Health will initially build upon existing NIH-funded clinical research networks and community partnerships. This strategic approach will establish the necessary infrastructure to support research activities within selected primary care sites. The initial funding awards are specifically targeted towards organizations serving rural communities and are anticipated to be granted in the fall of 2024. This focus on rural areas underscores NIH’s commitment to addressing geographical disparities in healthcare access and research participation.
Illustration describes the CARE for Health program
Infographic illustrating the NIH CARE for Health program, highlighting its community-centered approach to primary care research and health equity.
HHS Secretary Xavier Becerra highlighted the importance of inclusivity in clinical research, stating, “Health research should be accessible to all populations. Clinical trials should reflect the diversity of Americans – because we know that delivers the best results.” He emphasized that CARE for Health represents a significant stride towards ensuring that historically underrepresented communities are fully included in research and benefit from the most advanced scientific findings. This inclusivity is crucial for generating research outcomes that are broadly applicable and effective for all segments of the population.
A key feature of the CARE for Health program is its flexibility and community-driven approach. Participating clinical sites will have the autonomy to select research studies based on the most pressing health issues within their communities. This ensures that research is directly relevant to the needs of the population being served. Moreover, patients will be active contributors to the research process, with their data directly informing findings that are clinically meaningful to them. The program is committed to transparency, with final study findings and aggregate results being shared directly with research participants, fostering trust and engagement.
CARE for Health is strategically designed to broaden the reach of NIH-funded research studies, actively engaging individuals from communities that have historically faced barriers to healthcare and clinical research. This includes racial and ethnic minorities, older adults, rural populations, and individuals with lower socioeconomic status or educational attainment. The research undertaken within the CARE for Health network will address prevalent health concerns and prioritize disease prevention strategies, aiming to improve overall community well-being.
Dr. Bertagnolli further emphasized the vital role of community-oriented primary care in building trust, particularly among populations who may have reservations about conventional medical care or scientific research. She noted that “greater availability of primary care services in communities is associated with fewer disparities in health outcomes and lower mortality.” By integrating research into these trusted primary care settings, CARE for Health aims to bridge the gap between scientific advancement and community health needs.
Looking ahead, the CARE for Health program is envisioned to expand its scope, launching new studies across the network and further developing study sites, training programs, data management systems, and enhanced data interoperability. This expansion will foster a dynamic ecosystem where research data seamlessly integrates with clinical practice, and clinical data enriches research studies. This integrated approach will facilitate the adoption of innovative practices and trial designs, minimizing the burden of research participation for both primary care providers and patients.
Dr. Tara A. Schwetz, NIH Deputy Director for Program Coordination, Planning, and Strategic Initiatives, articulated the ultimate vision for CARE for Health as creating a “learning health system in which research informs clinical practice and clinical data informs research.” As the program evolves, participating sites and their communities will play a central role in shaping new clinical studies that directly address their specific health priorities, ensuring that research findings are directly translated into improved care within those communities.
In addition to CARE for Health, the NIH supports a wide array of programs that involve primary care research across its various institutes and centers. While CARE for Health is a cross-cutting initiative through the Common Fund, individual institutes like the National Institute of General Medical Sciences (NIGMS) and the National Heart, Lung, and Blood Institute (NHLBI), among others, also fund significant primary care related research. These programs often focus on specific disease areas or populations within the primary care setting. Exploring the NIH website (www.nih.gov ) provides a deeper understanding of the diverse portfolio of primary care research initiatives supported by the agency.
The NIH’s commitment to primary care research, exemplified by the CARE for Health program and its broader portfolio, underscores the agency’s dedication to improving health outcomes for all Americans. By prioritizing community engagement, inclusivity, and the integration of research into clinical practice, NIH programs are paving the way for a more equitable and effective healthcare system.
