Pragmatic Trials Conducted in Health Care Systems
🏛 National Institutes of Health (HHS-NIH11)
✓ Free, no account · Source: Grants.gov · Last verified Jul 16, 2026
Can you apply?
This grant is for large-scale pragmatic and implementation trials conducted within health care settings. Eligible applicants typically include research institutions, universities, and health care systems with capacity to design and execute multi-site clinical trials. Trials must test intervention effectiveness in routine clinical practice and directly inform decision-makers about comparative benefits and risks. Applicants are encouraged to include diverse health system types and assess adaptation across regions.
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Key dates
- Apr 29, 2026 Applications open
- Feb 23, 2027 Application deadline in 221 days
- Dec 1, 2027 Award announced
- Dec 1, 2027 Project start
Program description
The National Institutes of Health intends to publish a Notice of Funding Opportunity (NOFO), Pragmatic and Implementation Trials Conducted in Health Care Settings
This funding opportunity will support large-scale pragmatic trials that test intervention effectiveness in routine clinical care and/or implementation trials that evaluate strategies for delivering interventions within health care settings. These trials are intended to directly inform decision-makers (e.g., patients, clinicians, administrators, policymakers, and payers) about the comparative benefits, burdens, and risks of biomedical or behavioral interventions.
To enhance real-world relevance and generalizability, applicants are encouraged to:
1) Select care settings where the target condition is commonly seen (e.g., emergency departments, primary care, public health clinics).
2) Include multiple health system types (e.g., academic centers, federally qualified health centers, integrated networks, VA Medical Centers).
3) Assess adaptation across systems and regions to ensure intervention effectiveness and implementation feasibility.
Interventions under study should be embedded in routine care. Trials may integrate one or more interventions with established efficacy into appropriate health care settings or implement system-level changes to improve health outcomes.
This phased award will use a milestone-driven cooperative agreement mechanism, supporting a planning phase and a phase for full trial execution.
Applications are not being solicited at this time. Notice is being provided to allow potential applicants sufficient time to develop meaningful collaborations and responsive projects. Investigators with expertise and insights into this area are encouraged to begin to consider applying for this NOFO.
Who can apply
Eligible applicants
How to apply
Application links
Key dates & requirements
Required documents
- SF-424 (or equivalent NIH application form)
- Project Narrative/Research Plan
- Budget and Budget Justification
- Institutional Commitment Letters (from partner health systems)
- Biographical Sketches (key personnel)
- Letters of Support from clinical partners
Program contact
- 👤 NCCIH Division of Extramural Research Program Officer
- 📧 NCCIHDERFunding@nih.gov
- 📞 Please contact via e-mail.
Funding track record
Recent awards under CFDA 93.213 from the last 3 years — real organizations that won funding through this same program.
Top 10 Largest Recent Awards
-
$22,367,527
-
$21,646,919
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$19,236,131
-
$17,730,528
-
$15,036,701
-
$14,473,882
-
$12,748,932
-
$11,956,053
-
$11,225,697
-
$10,919,780
Top States by Funding
- CA 13 awards $83.5M
- MA 13 awards $80.2M
- WA 8 awards $69.9M
- NC 7 awards $53.8M
- NY 6 awards $40.0M
Source: USAspending.gov — federal spending transparency. Data covers last 3 years.
Funding history
Annual funding for this program — Federal obligations (CFDA 93.213). How funding has trended year over year.
| 2024 | $240,178,154 | |
| 2025 | $232,899,116 | |
| 2026 est. | $2,655,626 |
FAQ
What types of interventions are eligible?
Interventions should be embedded in routine care with established efficacy. Both biomedical and behavioral interventions are eligible.
What is the timeline for applications?
Applications are not being solicited at this time. The deadline is February 23, 2027. Investigators should begin developing collaborations now.
What makes a competitive application?
Include multiple diverse health system types, select real-world care settings, and demonstrate adaptation strategies across systems and regions.
Is this a single-phase award?
No. This phased award uses a milestone-driven cooperative agreement with planning and full trial execution phases.
Who should be involved in the research team?
Assemble researchers, clinicians, and administrators from diverse health systems with expertise in pragmatic trial design and implementation science.
💡 Tips for applicants
- Partner with multiple health system types early (academic centers, FQHCs, integrated networks, VA facilities) to strengthen real-world relevance.
- Design trials in settings where the target condition is commonly encountered to ensure clinical meaningfulness.
- Plan milestone-driven deliverables clearly since this is a cooperative agreement requiring active NIH collaboration.
- Anticipate implementation challenges across different systems and build adaptation strategies into your study design.
- Start building collaborations and partnerships immediately; this advance notice is meant to allow adequate planning time.
⚠️ Common mistakes
Proposing interventions without clear efficacy evidence or without embedding them into routine clinical practice. Failing to include diverse health system partners or demonstrating generalizability across regions and settings. Underestimating the coordination complexity of pragmatic trials across multiple sites and the milestone-driven reporting requirements.
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