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

Frequently Asked Questions (FAQs)

What is this NIH funding opportunity about?

This NIH funding opportunity (RFA-MH-22-150; CFDA 93.242) supports research to strengthen established adolescent mental health treatments by adding Just-in-Time Adaptive Interventions (JITAIs). The idea is to enhance treatments that already have evidence (such as well-supported psychotherapies or structured behavioral interventions) by providing adaptive, real-time support to adolescents in the moments it is most needed.

What does "layering in JITAIs" mean in this context?

Layering in JITAIs means taking an existing adolescent mental health treatment and integrating a technology-delivered component that can adapt to context and timing. Rather than replacing the original treatment, the JITAI provides brief, personalized supports between sessions or in real-world settings (for example, school, home, peer interactions, or online contexts) to improve engagement, skill practice, and outcomes.

What is a JITAI (Just-in-Time Adaptive Intervention)?

In this announcement, a JITAI is an intervention approach that uses near-ubiquitous device access (such as smartphones or wearables) to deliver intervention content in a way that is personalized and context-sensitive. JITAIs can use sensors or self-report check-ins to detect risk states, tailor messages or micro-interventions to current needs and preferences, and provide immediate feedback, reinforcement, or coaching.

Why is adolescence a focus for this funding opportunity?

The scientific rationale emphasizes adolescence as a strategic window because many mental disorders first appear or worsen during this period, engagement and retention in traditional face-to-face care can be difficult, and day-to-day technology use is extremely high. The FOA aims to use real-time supports to reduce common gaps such as missed appointments, limited between-session practice, low motivation, and mismatch between clinic learning and real-world challenges.

What problems in adolescent mental health care is this FOA trying to address?

The FOA highlights gaps that JITAIs may help close, including missed appointments, limited practice of skills between sessions, low motivation or engagement, and the disconnect between what is taught in therapy and what happens in real-life contexts (school, home, peers, or online). The goal is to make support more timely and relevant as challenges arise.

Does this opportunity support replacing existing therapy with an app or digital tool?

No. The opportunity is framed around optimizing and strengthening established adolescent mental health treatments, not replacing them. The JITAI component is intended to extend and enhance what is already evidence-based by delivering personalized support in day-to-day life.

What kinds of established treatments are intended to be enhanced?

The FOA describes established treatments as those with evidence behind them, including well-supported psychotherapies or structured behavioral interventions. The focus is on enhancing a treatment approach that is already supported by evidence, then adding JITAI components to make it more potent, timely, and engaging for adolescents.

What kinds of functions can the JITAI component serve?

The FOA describes several functions, including: prompting brief skills practice in ecologically valid settings (not just in the clinic), adapting the intensity or type of support from moment to moment, detecting risk states via sensors or self-report check-ins, and providing real-time scaffolding such as immediate feedback, reinforcement, or coaching to reduce impairment as challenges arise.

How should applicants think about theory and developmental appropriateness?

NIH signals that proposals should be developmentally informed and theoretically grounded. That means the application should clearly explain the behavioral or clinical theory behind what the JITAI delivers, when it delivers it, and why the timing and content should improve outcomes for adolescents.

Is a clinical trial required under this announcement?

Yes. This is a clinical trial required announcement, meaning applicants are expected to propose and carry out a clinical trial as part of the project.

What is the R61/R33 mechanism and how does it work here?

This opportunity uses an R61/R33 phased innovation award mechanism. It includes an initial developmental/feasibility phase (R61) and the possibility of transitioning to a larger, more confirmatory phase (R33) if predefined milestones are met.

What determines whether a project can transition from the R61 phase to the R33 phase?

Transition is based on meeting predefined milestones. The source summary indicates that milestone expectations are tied to the R61/R33 transition, and applicants would typically look to the full FOA for the specific budget structure, milestone details, and related review criteria.

What makes this an "emerging area" according to the FOA?

The FOA notes an 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. NIH is positioning this as intervention science meant to push the field forward rather than incremental work in a mature evidence base.

What outcomes might be evaluated in the supported research?

The FOA describes generating clinical trial evidence on whether JITAI enhancements improve engagement, skill use, symptoms, functioning, or other meaningful outcomes. The overall focus is on testing whether adding JITAIs to established treatments improves real-world impact for adolescents.

What technologies or data sources are envisioned for delivering JITAIs?

The FOA points to advances in mobile computing, wearables, and digital phenotyping as enabling these designs. In practice, JITAIs may use device platforms adolescents find motivating and can incorporate sensors or self-report check-ins to detect risk states and tailor support.

Who is the funding agency and what type of grant is this?

This is a discretionary grant from the National Institutes of Health (NIH).

What are the opportunity identifiers listed in the source information?

The source information lists RFA-MH-22-150 and CFDA 93.242.

What is the closing date and when was the record created?

The closing date listed in the source data is 2023-01-13, and the opportunity record was created 2021-11-15.

Which organizations are eligible to apply?

A wide range of 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.

Are specific types of institutions explicitly called out as eligible?

Yes. The FOA 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 non-U.S. (foreign) organizations and regional organizations.

Are foreign or non-U.S. organizations eligible to apply?

Yes. The source information states that non-U.S. (foreign) organizations and regional organizations are eligible.

Is the award ceiling or the expected number of awards provided?

No. The award ceiling and expected number of awards are not specified in the provided source fields. Applicants would typically consult the full FOA text for budget structure and other details.

What kinds of teams is this opportunity aimed at?

The opportunity is aimed at teams that can combine clinical expertise in adolescent mental health, strong grounding in behavior change or clinical theory, rigorous experimental methods, and the technical ability to build and evaluate adaptive, real-time digital supports.

What is the overall goal of the funded research?

The overall goal is to optimize established adolescent mental health treatments by extending support into adolescents' daily lives, increasing timely skill delivery and practice, improving engagement and retention, and improving outcomes through personalized, in-the-moment intervention components tested within a clinical trial framework.