E4A currently only funds school-based research if the participating school(s) is already engaged in the project. Applicants working with schools MUST submit letters of support from participating school(s) at the full proposal stage.
Racial equity refers to the conditions in which race or ethnicity no longer predicts a person’s ability to live a healthy life. It requires that society be free of systems and structures that unfairly disadvantage people of color (Black, Latino/a/x, Indigenous, Asian, Pacific Islander, and other racial and ethnic minorities), compared to white people.
Conducting research using a racial equity lens means that research topics center the health priorities of people or communities that have been impacted by structural racism; that problems and solutions being studied are motivated and/or validated by people who are directly impacted; and that the research process engages stakeholders at appropriate stages of the project. Moreover, E4A-funded studies should be designed so that positive, negative, or null findings can all be informative for policy or programmatic decision-making.
The United States has a deep history of structural racism, manifested in discriminatory policies and practices embedded across every sector and realm of society. These policies and practices have systematically excluded and marginalized people based on race and/or ethnicity, creating patterns of segregation, disinvestment, and unfair treatment of people and communities of color, with lasting impacts across many social determinants of health (e.g., housing, education, built environment, economic opportunity, law enforcement, and others). Racism also intersects with other forms of marginalization, such as having low income, being an immigrant, having a disability, or identifying as LGBTQ+ or a gender minority, compounding the challenges faced by people of color who belong to one or more of these groups. We cannot achieve a Culture of Health without attention to racial equity.
E4A funding is dedicated for research projects that will advance racial equity. We anticipate that most of the funding will support evaluations of social interventions, such as programs, policies, and/or practices, that are designed to assess the causal impact(s) of the intervention on health and racial equity outcomes. Research must be rigorously and equitably designed and implemented, and findings must have immediate real-world implications and actionability.
We recognize that there are approaches to disrupting racism that are in early stages of development or trial, so we will also consider other types of research that can inform action to advance racial equity. Such projects might include research to identify viable policy or programmatic responses to community needs and priorities, pilot projects to test the feasibility of novel initiatives, development and validation of racial equity measures, etc.
At E4A, our definition of intervention is quite broad. An intervention is anything that may change outcomes for those who are exposed to or experience it. This may include, but is not limited to, systems, structures, laws, policies, norms, programs and practices that determine the distribution of resources and opportunities, which in turn influence individuals’ options and behaviors. We are interested in interventions that target "upstream" causes of health inequities, NOT individual behavior-change interventions (e.g., programs that encourage individuals to modify their personal behavior in the absence of greater environmental or structural changes). For examples of interventions that have been a good fit, we recommend reviewing the Funded Projects page.
A variety of research designs can help improve the evidence base to advance health and racial equity. These may include randomized trials, quasi- or natural experiments, secondary analyses of existing data, grounded theory approaches, case studies, network or systems analyses, Indigenous methodologies, or other study designs and methods.
Regardless of the specific design, RWJF views evaluation as a tool to advance racial equity by applying principles of the Equitable Evaluation Framework, which stresses the importance of attention to historical and structural contexts; differential effects on subgroups; and effects on the underlying drivers of inequity. Moreover, evaluative work should be designed and implemented to reflect multi-cultural validity and participant ownership. Research that is a good fit for E4A will integrate these principles into the research approach and activities.
For evaluations of interventions, we strongly prefer designs that attempt to assess causal relationships between interventions and health outcomes. In most cases, this requires an appropriate control or comparison group (e.g., a similar group that does not receive the intervention). While randomized controlled trials (RCTs) are often considered the gold standard for drawing causal inference, we recognize that RCTs are not always feasible. Other methods of comparison such as a wait list control or various matching techniques may also be acceptable. In some cases, qualitative or mixed-methods approaches may be appropriate - for example, to better define the contexts under which an intervention does or does not work.
A wider range of approaches may be suitable for non-evaluative research that is explicitly focused on dismantling racism. For example, we will consider implementation or pilot studies, case studies, or development of new measures needed to monitor and support progress toward racial equity. For these studies, we will consider a variety of research designs and methods, including quantitative, qualitative, and mixed-methods approaches, as long as corresponding standards of methodological rigor are applied.
We encourage community participation and ownership in the research design and implementation process, and therefore endorse CBPR approaches. While we do not typically fund the early stages of the CBPR process (e.g., when community members are still determining priorities), we would fund all research-related aspects of a community participatory/action-oriented approach once a specific research question has been agreed upon.
We are most interested in outcomes that indicate community and population health. Sometimes this may be captured by aggregating individual responses or outcomes; other times, it may be best measured using community-level indicators of health or equity.
In limited cases, E4A will consider funding the development or evaluation of training programs when the training is situated within the context of broader systems or policy level change and when the training co-occurs with or follows a systems-level change. The review committee will also consider the likelihood that the training can reach beyond an individual clinic/agency/organization to influence operations, practices, procedures, and policies more broadly.
When evaluating training programs, it is important to consider the health and racial equity outcomes not just for the trainees (e.g., care providers, educators, etc.), but for those they serve.
Heterogeneous treatment effects (HTEs) are different effects that an intervention may have on different types of individuals. Evaluating whether effects of an intervention differ for subsets of the population is important to E4A because it helps us understand whether the intervention remediates or exacerbates health disparities; anticipate the likely effectiveness of an intervention beyond the study population; focus on a specific population of interest; or determine who is most likely to accrue the greatest benefits of an intervention. This information allows policymakers, practitioners, and other stakeholders to make better decisions about allocating, prioritizing and targeting resources. To learn more about HTEs, read our E4A blog post and associated Methods Note.
Social determinants include any conditions that impact health risks and outcomes. These conditions include, but are not limited to, early childhood factors, education access and quality, social and community cohesion, employment and economic opportunities, discrimination, poverty, civic participation, law enforcement, food security and food systems, housing, physical and built environments, transportation, healthcare access, and health literacy.
To learn more about RWJF's focus on Social Determinants of Health, visit https://www.rwjf.org/en/our-focus-areas/topics/social-determinants-of-health.html.
When we refer to "community" or "communities," we are not referring solely to a place-based concept. We use the term(s) broadly to refer to any group of individuals that share a common history or common social, economic, and political interests, regardless of physical proximity to one another.
Applicants should be specific and intentional about who they envision interpreting, using, and applying the research findings. This might include elected officials, public agencies, program administrators, community groups, etc. These individuals or groups don't necessarily need to be formally affiliated with the research team, but ideally the researchers will have relationships with relevant end-users before starting the research project, to ensure that their research questions, approach, outcomes of interest, and other project components align with the type of information that end-users will find useful.
Applicants should demonstrate whether and what level of conversations and collaboration have taken place when responding to the LOI application questions about the context under which the research question and study were developed. This could include anything from a community-led prioritization process and vetting the initial research question(s), to formation of an advisory committee.
As a research funding program, E4A does not fund activities associated with implementing or carrying out interventions or general organizational operations. We have also identified some examples of research that are not a good fit with the program objectives: projects that focus on describing the existence and/or scope of a problem or disparity; literature reviews; development and validation of screening tools; basic biomedical inquiry; drug therapy or device research; and animal or plant science. Finally, research concerning interventions that are focused on changing individual behaviors - without acknowledging or addressing greater environmental or structural changes - is not a good fit.
The following are expectations of all E4A-funded grantees: