Pan-Canadian Network to Improve Outcomes of Preterm Birth: Questions and answers from the webinar on Thursday 7th April, 2016

  1. Will the presentation be shared?
  2. Is there only 1 grant?
  3. Should the planned research involve all CIHR pillars?
  4. What outcomes are you looking for?
  5. Can the outcomes include non-clinical outcomes, e.g. parent/patient experience, resource utilization?
  6. Can the focus of the application be community-based clinical care improvement?
  7. So care can be across hospital to community?
  8. Should there be an emphasis on prevention of preterm birth?
  9. Should the application be from multiple sites or can a single site apply?
  10. Can you provide more details on parents in the Principal Applicant role?
  11. There are already Canadian networks: how will this network be positioned compared with these already existing groups?
  12. Is it possible to divide up the funding from CIHR at the start so that it isn’t funneled through one centre?
  13. Was there any consideration of having an LOI stage that would make the process smoother considering the need to submit a 22-page proposal with only one application funded? An LOI stage may also have helped catalyze discussions about joining applications together since the whole idea is to have a "network"?
  14. Is there an expectation for the network to include international linkages?
  15. Can I get some more examples of health systems improvement projects?

1. Will the presentation be shared?

Yes, the presentation has been sent to everyone who registered for the webinar. If you would like a copy of the presentation, please contact Ruth Warre, Associate, IHDCYH.

2. Is there only one grant?

Yes, only one grant will be awarded. There will not be multiple grants. The objective of the funding opportunity is to bring together researchers from all areas of research into clinical care for preterm birth (neonatal, obstetric, surgical, follow-up etc.) so that together as a group they can span the whole spectrum of care, think about preterm birth differently, and enlarge the vision that currently exists in terms of improving outcomes of preterm babies.

3. Should the planned research involve all CIHR pillars?

No, it doesn’t have to. The objective of the grant is to look at improving care and outcomes of preterm birth. This work could be totally clinical; if there are elements from other pillars that could improve the efforts made then they could be included but it’s not a requirement to address all four pillars. In particular, the basic sciences and discovery aspects of health research will likely be less relevant to this application.

4. What outcomes are you looking for?

Demonstrable improvement in the outcomes of preterm birth.

5. Can the outcomes include non-clinical outcomes, e.g. parent/patient experience, resource utilization?

Yes, this a flexible application in that it is up to you to define what the key outcomes are. Clinical outcomes are central to the objectives of the funding opportunity but patient experience, resource utilization, satisfaction, parental stress, etc. are also important.

6. Can the focus of the application be community-based clinical care improvement?

The focus of the grant is: how do we improve the outcomes of preterm babies? If your approach to this question includes some part of it being community-based, then that is acceptable. It’s up to the applicant team to define the scope of how they will approach the objectives of the grant. However, bear in mind that focusing solely on community-based care misses the other areas of care for preterm babies.

7. So care can be across hospital to community?

Yes.

8. Should there be an emphasis on prevention of preterm birth?

No. The objective of the funding opportunity is to support improving the outcomes of preterm birth through clinical care – not preventing preterm birth. IHDCYH is planning to mobilize a separate funding opportunity to support a national strategy to prevent preterm birth in the future.

9. Should the application be from multiple sites or can a single site apply?

The aim of the funding opportunity is to support a national team. It is OK if the application comes from one site, so long as you have a team that is nationally representative and you can do the work on a national level.

10. Can you provide more details on parents in the Principal Applicant role?

The objective of including one or more family/patient representatives in the network team as a Principal Applicant is to ensure that all the key stakeholders in the care of a preterm baby are included. One possible option for engaging parents is to have a parent advisory group representative as a Principal Applicant. This person would be able to provide input into parents’ perspectives, how to design projects, what outcomes are relevant to families, what kinds of delivery modes are most helpful, and so on.

11. There are already Canadian networks: how will this network be positioned compared to these already existing groups?

The opportunity is for the preterm birth research community to come up with an effective way of working together to address the funding opportunity objectives. One option is that the existing networks can come together to cover the whole spectrum of preterm birth with additional efforts to address any gaps that exist. It is also possible that a completely new network could be created. The key is to meet the objectives of the funding opportunity: that the network is national in scope, covers the whole spectrum of preterm birth care and outcomes, breaks down the current silos, and addresses any gaps that exist in the current infrastructure.

12. Is it possible to divide up the funding from CIHR at the start so that it isn’t funneled through one centre?

No. The system of funding from CIHR is that grant money is directed to the host institution of the Nominated Principal Applicant (NPA). In the case of a network, there will of course be expenditure of funds in other locations depending on the work that needs to be done. When this occurs it is up to the NPA’s institution to create subcontracts with other institutions where the work will be completed and to send funds to those institutions. This is the standard procedure and when it occurs, institutional participation in the Research Support Fund (which CIHR contributes to) ensures that support for indirect costs can be claimed by any institution receiving funding from a CIHR grant as part of a subcontract with the NPA’s institution. Further information on how all co-applicants on a grant can claim support for indirect costs can be found on the Research Support Fund website.

13. Was there any consideration of having an LOI stage that would make the process smoother considering the need to submit a 22-page proposal with only one application funded? An LOI stage may also have helped catalyze discussions about joining applications together since the whole idea is to have a "network"?

There is always the possibility of having an LOI stage, but IHDCYH did not think it would be necessary in this case. The objectives of the funding opportunity are clear and build on our prior consultation with the preterm birth research community through a workshop that many potential applicants attended. It is our hope that the community will be able to come together to form one network but this is still an open competition. With a small number of applications, the inclusion of an LOI stage causes extra work for everyone, both in terms of the application and peer review process. It is also possible that when the competition is completed, any unsuccessful groups can join the successful group and enrich it that way.

14. Is there an expectation for the network to include international linkages?

There is no requirement for applicant teams to include international linkages in their proposed network. If you feel that there is a good reason for or advantage to including international linkages in the proposed network, then by all means include international linkages.

15. Can I get some more examples of health systems improvement projects?

It is important to note that the objectives of the preterm birth network funding opportunity are about improving clinical care. There is the possibility that health systems improvements could be built into the network in an effort to improve clinical care, but IHDCYH is planning to mobilize a funding opportunity to support a national effort to address perinatal healthcare systems at a later date.

In terms of examples of perinatal health systems problems, currently a high percentage of high-risk babies are ‘outborn’ or not born in a facility with the appropriate level of care available. The question is: how can this be changed? In addition, when babies are outborn, 40% those transported to level 3 units arrive hypothermic. Regionalization in every province is also arranged differently and the transport systems are different. In British Columbia, for example, there is a single transport system that is provincially organized, whereas in Ontario there is one based at every hospital. Yet in British Columbia the outcomes of the transported patients are better than anywhere else in the country. Is that a reason to be concerned about having a decentralized transport system and how can we change that? These are only a few of the system-wide issues that could be investigated in the future but are not the primary focus of the preterm birth network funding opportunity.

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