Opportunity Information: Apply for RFA HS 23 002
The grant opportunity titled "Dissemination and Implementation of Equity-Focused Evidence-Based Interventions in Healthcare Delivery Systems (R18)" (Funding Opportunity Number RFA-HS-23-002) is a discretionary grant program offered by the Agency for Health Care Research and Quality (AHRQ) under CFDA 93.226. It supports applied health services research that moves beyond identifying effective clinical or organizational approaches and instead focuses on how to successfully put proven, equity-focused interventions into real-world healthcare delivery settings. The central aim is to fund innovative studies that test, refine, and implement evidence-based interventions designed to reduce inequities in care and outcomes, while also generating practical knowledge about what makes implementation succeed or fail across diverse systems and populations.
A defining feature of this NOFO is its emphasis on pairing implementation work with rigorous evaluation. Funded projects are expected to integrate implementation evaluation (for example, assessing adoption, fidelity, reach, feasibility, sustainability, and context) alongside outcome or impact evaluation (for example, changes in quality of care, access, patient experience, safety, utilization, or health outcomes). In other words, applicants are being asked to not only deploy an intervention, but also to measure both the "how" of implementation within healthcare delivery systems and the "so what" of whether the intervention measurably improves equity-relevant outcomes. The intent is to produce actionable evidence that healthcare organizations and policymakers can use to scale effective approaches and avoid strategies that do not translate well outside controlled research environments.
The eligible applicant pool is broad and includes many types of public, private, and community-based entities capable of conducting health services research in partnership with healthcare delivery organizations. Eligible applicants include state, county, city or township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; Native American tribal organizations other than federally recognized tribal governments; public housing authorities/Indian housing authorities; nonprofits with or without IRS 501(c)(3) status (other than institutions of higher education); for-profit organizations other than small businesses; and small businesses. The NOFO also explicitly highlights additional eligible applicant categories such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), eligible agencies of the federal government, faith-based or community-based organizations, regional organizations, U.S. territories or possessions, and Indian/Native American Tribal Governments (other than federally recognized). This breadth signals an interest in funding projects that are grounded in the realities of different care settings and that can authentically engage communities disproportionately affected by inequities.
There are clear restrictions related to foreign participation. While the source text lists "Non-domestic (non-U.S.) Entities (Foreign Organizations)" in a way that can look confusing, the eligibility statement clarifies that non-domestic (non-U.S.) entities and foreign institutions are not eligible to apply, and non-domestic components of U.S. organizations are also not eligible. Practically, that means applicants should be U.S.-based and propose work carried out by domestic components, which aligns with AHRQ's mission to improve healthcare quality, safety, access, and equity in the United States.
In terms of basic award details, the funding instrument is a grant and the activity category is health. The posted award ceiling is $2,500,000, indicating the program is designed for substantial, multi-component implementation and evaluation efforts rather than small pilot projects. The opportunity was created on February 15, 2023, with an original closing date of April 22, 2023. The expected number of awards is not specified in the provided source data, which often means final award counts depend on available appropriations, application volume and quality, and programmatic priorities.
Overall, this R18 opportunity is best understood as an implementation-oriented equity grant: it seeks projects that take interventions with existing evidence and do the hard work of embedding them into healthcare delivery systems, while producing credible evaluation findings about both implementation performance and equity-related outcomes. Applicants that are well-positioned to compete are typically those with strong partnerships with healthcare delivery organizations, the ability to recruit and retain populations experiencing disparities, a clear plan to measure implementation processes and outcomes, and a practical strategy for dissemination and scaling within real operational constraints.Apply for RFA HS 23 002
- The Agency for Health Care Research and Quality in the health sector is offering a public funding opportunity titled "Dissemination and Implementation of Equity-Focused Evidence-Based Interventions in Healthcare Delivery Systems (R18)" and is now available to receive applicants.
- Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.226.
- This funding opportunity was created on 2023-02-15.
- Applicants must submit their applications by 2023-04-22. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
- Each selected applicant is eligible to receive up to $2,500,000.00 in funding.
- Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.
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Frequently Asked Questions (FAQs)
1) What is the full title of this grant opportunity?
The opportunity is titled "Dissemination and Implementation of Equity-Focused Evidence-Based Interventions in Healthcare Delivery Systems (R18)."
2) What is the Funding Opportunity Number (NOFO number)?
The Funding Opportunity Number is RFA-HS-23-002.
3) Which federal agency is offering this grant?
This is a discretionary grant program offered by the Agency for Health Care Research and Quality (AHRQ).
4) What CFDA/Assistance Listing number is associated with this program?
The program is listed under CFDA 93.226.
5) What type of funding instrument is used?
The funding instrument is a grant.
6) What is the activity category for this opportunity?
The activity category is Health.
7) What is this grant designed to fund (in plain terms)?
This opportunity supports applied health services research focused on how to successfully put proven, equity-focused interventions into real-world healthcare delivery systems. It is aimed at moving beyond identifying what works and instead studying how to implement what works in operational settings, especially in ways that reduce inequities in care and outcomes.
8) What does AHRQ mean here by "equity-focused evidence-based interventions"?
Based on the description provided, the interventions should already have evidence supporting their effectiveness and should be designed to reduce inequities in care and outcomes. The emphasis is on interventions that are both evidence-based and explicitly oriented toward improving equity-relevant results across diverse populations.
9) Is this opportunity more about discovery research or implementation in real settings?
It is implementation-oriented. The opportunity prioritizes studies that test, refine, and implement interventions inside real healthcare delivery settings, while producing practical knowledge about why implementation succeeds or fails.
10) What makes this NOFO distinctive compared to grants that only test interventions?
A defining feature is the expectation that projects pair implementation work with rigorous evaluation. Applicants are expected to deploy an intervention and measure both (1) implementation performance (the "how") and (2) outcome/impact (the "so what"), including equity-relevant results.
11) What is meant by "implementation evaluation" in this opportunity?
The description indicates implementation evaluation may include assessing adoption, fidelity, reach, feasibility, sustainability, and context. In other words, projects should study how the intervention is taken up, delivered as intended, who it reaches, whether it is workable in practice, whether it lasts, and what organizational or community factors influence results.
12) What is meant by "outcome or impact evaluation" in this opportunity?
The description indicates outcome/impact evaluation may include changes in quality of care, access, patient experience, safety, utilization, or health outcomes. The expectation is that projects measure whether implementing the intervention leads to meaningful improvements, particularly in equity-relevant outcomes.
13) Do applicants need to measure both implementation and outcomes?
Yes. The opportunity emphasizes integrating implementation evaluation alongside outcome or impact evaluation. Applicants are being asked to measure both the implementation process and the resulting effects.
14) What kinds of settings are projects expected to work in?
Projects are expected to be implemented within healthcare delivery systems and real-world healthcare delivery settings. The intent is to generate actionable evidence that translates outside controlled research environments.
15) Why does the NOFO emphasize "real-world" delivery systems?
The stated intent is to produce actionable evidence that healthcare organizations and policymakers can use to scale effective approaches and avoid strategies that do not translate well outside controlled research environments.
16) What is the primary goal related to equity?
The central aim is to test, refine, and implement evidence-based interventions designed to reduce inequities in care and outcomes, and to learn what drives success or failure across diverse systems and populations.
17) Who is eligible to apply?
The eligible applicant pool is broad and includes many public, private, and community-based entities capable of conducting health services research in partnership with healthcare delivery organizations. The listed eligible applicants include:
- State, county, city or township governments
- Special district governments
- Independent school districts
- Public and state-controlled institutions of higher education
- Private institutions of higher education
- Federally recognized Native American tribal governments
- Native American tribal organizations other than federally recognized tribal governments
- Public housing authorities/Indian housing authorities
- Nonprofits with or without IRS 501(c)(3) status (other than institutions of higher education)
- For-profit organizations other than small businesses
- Small businesses
18) Are specific institution types explicitly highlighted as eligible?
Yes. The NOFO explicitly highlights additional eligible applicant categories, including:
- Alaska Native and Native Hawaiian Serving Institutions
- Asian American Native American Pacific Islander Serving Institutions (AANAPISI)
- Hispanic-serving Institutions
- Historically Black Colleges and Universities (HBCUs)
- Tribally Controlled Colleges and Universities (TCCUs)
- Eligible agencies of the federal government
- Faith-based or community-based organizations
- Regional organizations
- U.S. territories or possessions
- Indian/Native American Tribal Governments (other than federally recognized)
19) Does the opportunity encourage community-connected or community-based applicants?
The breadth of eligible applicants and the explicit mention of faith-based or community-based organizations, tribal entities, and serving institutions signals interest in projects that can authentically engage communities disproportionately affected by inequities.
20) Are foreign organizations eligible to apply?
No. While the source text may appear confusing at a glance, the eligibility statement clarifies that non-domestic (non-U.S.) entities and foreign institutions are not eligible to apply.
21) Can a U.S. organization include a non-domestic (non-U.S.) component in the proposed work?
No. The eligibility statement also clarifies that non-domestic components of U.S. organizations are not eligible.
22) What is the maximum award amount (award ceiling)?
The posted award ceiling is $2,500,000.
23) What does the award ceiling suggest about the intended scope of projects?
The stated ceiling suggests the program is designed for substantial, potentially multi-component implementation and evaluation efforts rather than small pilot projects.
24) When was this opportunity created?
The opportunity was created on February 15, 2023.
25) What was the original closing date?
The original closing date was April 22, 2023.
26) How many awards will be made?
The expected number of awards is not specified in the provided source data.
27) If the number of awards is not listed, what might that imply?
Based on the information provided, it often means final award counts may depend on available appropriations, application volume and quality, and programmatic priorities.
28) What is the overarching purpose of requiring both implementation and outcome evaluation?
The purpose is to generate actionable evidence about (1) what it takes to implement equity-focused interventions successfully across diverse systems and populations and (2) whether those interventions produce measurable improvements in equity-relevant outcomes.
29) What kinds of implementation factors are applicants expected to learn about?
The description emphasizes producing practical knowledge about what makes implementation succeed or fail across diverse systems and populations, including factors such as context, feasibility, reach, fidelity, adoption, sustainability, and other real-world constraints.
30) What kinds of outcomes are considered relevant in this opportunity?
The description lists examples such as quality of care, access, patient experience, safety, utilization, and health outcomes, with a focus on equity-relevant improvements.
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