Understanding Expectancies in Cancer Symptom Management (R01 Clinical Trial Required) | PAR 25 254

Opportunity Information: Apply for PAR 25 254

The National Institutes of Health (NIH) is soliciting R01 grant applications under PAR-25-254, titled "Understanding Expectancies in Cancer Symptom Management (R01 Clinical Trial Required)." The opportunity funds mechanistic, hypothesis-driven research that digs into how expectancies are formed and how they shape real-world cancer symptom experiences and outcomes. In this context, "expectancies" means beliefs about what will happen in the future, including beliefs about how a person will respond to cancer itself or to cancer treatment. The core idea behind the NOFO is that these beliefs are not just attitudes or opinions; they can meaningfully influence cognitive, behavioral, and biological processes that affect symptom burden and symptom management, and those effects may be shaped by who holds the expectancy (patients, clinicians, caregivers, or social networks) and the context in which care occurs.

A central focus of the NOFO is to identify the factors that generate expectancies and to measure how those factors influence both the expectancies themselves and downstream symptom management outcomes. The NIH is specifically interested in research that explains the "how and why" of expectancy effects in cancer, not only whether they exist. That means proposed studies should aim to clarify underlying mechanisms, such as the psychological pathways (for example, attention, learning, threat appraisal, coping), behavioral pathways (for example, adherence, self-management behaviors, help-seeking), and biological pathways (for example, stress physiology, neuroimmune signaling) through which expectancies may alter symptom trajectories. Applications are also expected to examine moderators, meaning the conditions or characteristics that strengthen, weaken, or otherwise change expectancy effects. Moderators could include patient-level factors (age, culture, prior treatment experiences, health literacy), symptom-level factors (pain, fatigue, nausea, sleep disturbance), cancer type or site, treatment modality, clinical setting, or broader social and systemic influences.

The NOFO emphasizes that expectancies can be evoked by social, psychological, environmental, and systemic factors. Practically, this can include how clinicians communicate about side effects and prognosis, how information is framed, what patients observe in peers, caregiver messaging, institutional norms, media exposure, and the broader health care environment. It also recognizes that expectancy effects can arise not only from the patient but from clinicians, family members, caregivers, and dyadic or social networks. This opens the door for studies that examine interpersonal or team-based dynamics in symptom management, such as how clinician expectations influence patient expectations, or how caregiver beliefs shape patient coping and symptom reporting.

This is an R01 mechanism and a clinical trial is required, signaling that the NIH expects rigorous prospective testing in humans where an intervention or experimental manipulation is used to evaluate effects on outcomes. While the NOFO is centered on mechanistic understanding, the framing makes clear that the long-term goal is to identify the patients, symptoms, cancer sites, and care contexts where expectancy effects can be intentionally leveraged to improve cancer outcomes, particularly in symptom management. In other words, the program is looking for research that can ultimately inform better clinical strategies for communication, supportive care, and symptom control by understanding when and how expectancy can be a therapeutic lever.

The funding opportunity is categorized as discretionary and uses the NIH grant funding instrument. The activity area is Education and Health and it is associated with CFDA number 93.399. The original closing date listed is 2026-05-07, and the record creation date is 2024-11-21. An award ceiling is not specified in the provided source data, and the expected number of awards is not listed.

Eligibility is broad and includes many types of domestic applicants such as 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; tribal organizations other than federally recognized tribal governments; public housing authorities/Indian housing authorities; nonprofits with or without 501(c)(3) status (outside of higher education); for-profit organizations (other than small businesses); and small businesses. The NOFO also explicitly calls out additional eligible applicant categories, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, eligible federal agencies, regional organizations, U.S. territories or possessions, Indian/Native American tribal governments other than federally recognized entities, and non-U.S. (foreign) organizations.

A major stated priority is inclusion: the program is particularly interested in applications that enroll individuals and groups from populations that have been historically underrepresented or excluded from biomedical and behavioral research. This indicates that applications with thoughtful recruitment, retention, and engagement plans for underserved or underrepresented communities, and studies designed to test whether expectancy mechanisms and effects differ across populations and contexts, are likely to align well with NIH interests under this NOFO.

• The National Institutes of Health in the education, health sector is offering a public funding opportunity titled "Understanding Expectancies in Cancer Symptom Management (R01 Clinical Trial Required)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.399.
• This funding opportunity was created on 2024-11-21.
• Applicants must submit their applications by 2026-05-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• 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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