Using Just-in-Time Adaptive Interventions to Optimize Established Adolescent Mental Health Treatments (R61/R33 Clinical Trial Required) | RFA MH 22 150

Opportunity Information: Apply for RFA MH 22 150

This NIH funding opportunity (RFA-MH-22-150; CFDA 93.242) supports research that strengthens established adolescent mental health treatments by layering in Just-in-Time Adaptive Interventions (JITAIs). The core idea is to take treatments that already have evidence behind them (for example, well-supported psychotherapies or structured behavioral interventions) and make them more potent, timely, and engaging for teenagers by delivering adaptive support in the moments it is most needed. The mechanism is an R61/R33 phased innovation award and it is a clinical trial required announcement, meaning applicants are expected to propose and carry out a clinical trial as part of the project, with an initial developmental/feasibility phase (R61) that can transition to a larger, more confirmatory phase (R33) if predefined milestones are met.

The scientific rationale is grounded in why adolescence is such a strategic window for this work. Adolescence is a period when many mental disorders first appear or worsen, when engagement and retention in traditional face-to-face care can be difficult, and when day-to-day technology use is extremely high. The FOA is essentially betting that real-time, technology-delivered supports can help close common gaps in adolescent care: missed appointments, limited between-session practice, low motivation, and the mismatch between what is taught in session and what happens in real-world contexts like school, home, peer situations, or online spaces. By focusing on developmentally informed and theoretically grounded approaches, NIH is signaling that proposals should not just be tech-forward, but should clearly explain the behavioral or clinical theory behind what the JITAI delivers, when it delivers it, and why that should improve outcomes.

JITAIs, as described here, are meant to capitalize on near-ubiquitous device access to deliver intervention content through platforms adolescents may find intrinsically motivating, and to do so in a way that is context-sensitive and personalized. In practice, that can include prompting brief skills practice in the situations where symptoms show up, using sensors or self-report check-ins to detect risk states, tailoring messages or micro-interventions to the adolescents current needs and preferences, and providing immediate feedback, reinforcement, or coaching. The FOA highlights several functions these systems can serve: helping adolescents practice skills in ecologically valid settings (not just in the clinic), adapting intensity or type of support moment-to-moment, and offering real-time scaffolding to reduce impairment as challenges arise. It also reflects the view that recent advances in mobile computing, wearables, and digital phenotyping make these designs more feasible than they were even a few years ago.

A notable point in the announcement is the stated evidence gap: despite promising results for JITAIs in other areas such as general health behavior change and addiction, there were no published studies of JITAIs for adolescent mental disorders at the time of the FOA description. That gap is part of what NIH is trying to address, positioning this as an emerging area of intervention science rather than an incremental improvement on an already mature evidence base. In other words, applications are expected to push the field forward by demonstrating how JITAIs can be integrated with established adolescent treatments and by generating clinical trial evidence on whether those enhancements improve engagement, skill use, symptoms, functioning, or other meaningful outcomes.

In terms of logistics and eligibility, this is a discretionary grant from the National Institutes of Health. The closing date listed in the source data is 2023-01-13, and the opportunity record was created 2021-11-15. A wide range of applicant organizations are eligible, including state, county, city, and special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized tribal governments and other tribal organizations; public housing authorities/Indian housing authorities; nonprofits with or without 501(c)(3) status; for-profit organizations (other than small businesses) and small businesses; and other entities. The FOA also explicitly calls out additional eligible applicants such as Alaska Native and Native Hawaiian Serving Institutions, AANAPISIs, Hispanic-serving Institutions, HBCUs, Tribally Controlled Colleges and Universities, faith-based or community-based organizations, certain tribal governments that are not federally recognized, U.S. territories or possessions, and even non-U.S. (foreign) organizations and regional organizations. The award ceiling and expected number of awards are not specified in the provided source fields, so applicants would typically need to consult the full FOA text for budget structure, milestone expectations, and review criteria tied to the R61/R33 transition.

Overall, the opportunity is aimed at teams that can combine clinical expertise in adolescent mental health, strong grounding in behavior change or clinical theory, and rigorous experimental methods with the technical ability to build and evaluate adaptive, real-time digital supports. The goal is not to replace established treatments, but to optimize them by extending their reach into the daily lives of adolescents, increasing timely skill delivery and practice, and improving outcomes through personalized, in-the-moment intervention components tested within a clinical trial framework.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Using Just-in-Time Adaptive Interventions to Optimize Established Adolescent Mental Health Treatments (R61/R33 Clinical Trial Required)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.242.
• This funding opportunity was created on 2021-11-15.
• Applicants must submit their applications by 2023-01-13. (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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