UNITE 2022 Request for Information Report

UNITE

2022 REQUEST FOR INFORMATION REPORT

Comments and Suggestions to Advance and Strengthen Racial Equity,

Diversity, and Inclusion in the Biomedical Research Workforce and

Advance Health Disparities and Health Equity Research

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CONTENTS

Acknowledgments .............................................................................................................. 4

Executive Summary

............................................................................................................ 5

Summary of Comments by Topic Area

............................................................................... 5

Grants Process

............................................................................................................. 5

Student-to-Workforce and Career Pathways

.................................................................. 6

Biomedical Research Workforce

.................................................................................... 6

Health Disparities and Health Equity Research

............................................................... 6

Community Partnerships and Outreach

.......................................................................... 6

Cross-Cutting Themes

.................................................................................................. 7

Introduction

........................................................................................................................ 8

Methods

............................................................................................................................. 9

Three-Phase Analysis........................................................................................................ 9

Phase 1: Data Preparation, Preliminary Review, and Codebook Development

............... 10

Phase 2: RFI Tool Coding

............................................................................................ 10

Phase 3: RFI Tool Analysis and Identiﬁcation of Key Topic Areas and Themes

............... 10

Summary Of Comments By Topic Area

.............................................................................12

Grants Process

............................................................................................................... 12

Grant Application Process

........................................................................................... 13

Grant Review Process

................................................................................................. 14

Grant Review Criteria and Criterion Scores

.................................................................. 14

Diversity of Grant Review Panels

................................................................................. 14

Funding Priorities and Selection of Grants

.................................................................... 15

Student-to-Workforce and Career Pathways

.................................................................... 16

Pre-Graduate Curricula and Exposure to STEM

............................................................ 18

Financing Undergraduate and Graduate Training

......................................................... 18

Research Training and Infrastructure

............................................................................ 19

Barriers to Career Development

................................................................................... 20

Mentorship and Academic Networks

........................................................................... 21

Biomedical Research Workforce

...................................................................................... 24

Recruitment, Hiring, Promotion, and Retention

............................................................. 24

Diversity in Leadership and Hiring Committees

............................................................. 27

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Health Disparities and Health Equity Research ................................................................. 28

Prioritization and Support of Health Disparities and Health Equity Research

.................. 28

Community Partnerships and Outreach

........................................................................... 29

Building Community Partnerships

................................................................................ 30

Cross-Cutting Themes

......................................................................................................31

Expand the Scope of Inclusion

.................................................................................... 31

Implement DEI Initiatives

............................................................................................. 32

Operationalize Diversity Metrics

................................................................................... 32

Enhance and Expand DEI Training

............................................................................... 33

Improve Communication and Outreach

........................................................................ 33

Acknowledge Structural Racism and Its Impact

............................................................ 33

Discussion

.........................................................................................................................34

Appendix 1: Glossary

........................................................................................................35

Appendix 2: Summary of Recommendations

....................................................................41

Appendix 3: Table of Acronyms

........................................................................................45

References

........................................................................................................................46

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Acknowledgments

We would like to thank the following staff from across NIH for their dedication and efforts to UNITE, in addition

to supporting data analysis, writing, and review of this report.

Courtney Aklin (IMOD/OD), Melissa Antman (IMOD/OD), Shelli Avenevoli (NIMH), Dexter Collins (FIC), Laura

Cooper (NIAMS), Kevin Davis (CIT), Teresa Estrada (NCI), Cara Finley (IMOD/OD), Jamie Gulin (NHLBI), Kelly

Ten Hagen (NIDCR), Monica Webb Hooper (NIMHD), Shadab Hussain (NCATS), Doug Joubert (NLM), Melissa

Laitner (IMOD/OD), Charlene Le Fauve (COSWD/OD), Leslie Littlejohn (NIAMS), Mia Rochelle Lowden (NINR),

Vanessa Marshall (NIMHD), Troy Muhammad (NCI), Ian Myles (NIAID), Roland Owens (OIR/OD), Kamilah Rashid

(IMOD/OD), Ryan Richardson (OD), Anu Sharman (NCI), Brian Trent (NEI), Della White (NCCIH)

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EXECUTIVE SUMMARY

In 2021, the National Institutes of Health (NIH) launched theUNITEinitiative,

an agency-wide effort committed

to ending structural racism and advancing racial equity and inclusion practices to positively inﬂuence the

biomedical research enterprise. As part of this initiative, the U Committee, a subcomponent of the UNITE

initiative, was charged with listening and learning to understand perceptions of diversity, equity, and

inclusion (DEI) issues in the biomedical research workforce. With the goal of understanding through listening and

learning, the U Committee published a Request for Information (RFI)

in March 2021 that invited respondents

to provide feedback on approaches NIH can take to advance racial equity within all facets of the biomedical

research workforce and expand research to eliminate or lessen health disparities and health inequities. In this

report, the U Committee summarizes the comments received in response to the RFI, including ﬁve key topic

areas that emerged, and six cross-cutting themes that underscore changes NIH can consider to improve DEI

within NIH and across the biomedical research enterprise. This feedback represents the opinions of the RFI

respondents and is summarized in this report to help inform NIH’s future plans and approaches.

SUMMARY OF COMMENTS BY TOPIC AREA

The UNITE RFI resulted in more than 1,100 responses from individuals and organizations across the biomed-

ical research community, with respondents representing groups including academia, health care profession-

als, NIH staff, other Federal staff, nonproﬁts and professional societies, researchers, trainees, and students.

The responses encompassed a wide range of feedback that were grouped into ﬁve key topic areas, which

include 1) Grants Process, 2) Student-to-Workforce and Career Pathways, 3) Biomedical Research Workforce,

4) Health Disparities and Health Equity Research, and 5) Community Partnerships and Outreach (Figure 1).

Key Topic Areas of Feedback

Grants Process

Student-to-

Workforce and

Career Pathways

Biomedical

Research

Workforce

Health Disparities

and Health Equity

Research

Community

Partnerships

and Outreach

Figure 1: Key Topic Areas of Feedback

Grants Process

The grants process was the most common topic across responses and respondent types. Overall, the

NIH grant review process and lack of diversity in review panels were identiﬁed as signiﬁcant drivers of bias

and funding gaps across individuals underrepresented in science. Several responses indicated that the grant

application process and submission requirements are burdensome, difﬁcult, and not always well understood.

Funding policies and priorities were also mentioned as major contributors to gaps in funding in response

to the question about existing policies, procedures, and practices that perpetuate disparities and bias.

There were additional suggestions related to expanding the pool of funded investigators through select

pay procedures and grant caps for highly funded investigators. Respondents focused on aspects of the grants

process that they commented disadvantage early-career researchers, researchers from racial and/or ethnic

minority groups, individuals underrepresented in science more broadly, and lower-resourced research

institutions.

Recommendations to address these gaps included greater support for the application and

submission process, revising grant review criteria, anonymizing the grant review process, increasing diversity

of review panels, and requiring DEI training for those involved in grant review.

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Student-to-Workforce and Career Pathways

Barriers to training and lack of access to educational opportunities, persisting from early childhood through

early career, were highlighted as signiﬁcant challenges for groups underrepresented in science. Respondents

noted that racial and ethnic minority students often do not have exposure to science, technology, engineering,

and math (STEM) during K-12 education, which impacts overall career trajectories. These respondents provided

recommendations on how NIH can best foster student engagement and interest in STEM from kindergarten

through undergraduate years. Moreover, responses suggested that ﬁnancing training and education is a key

barrier for students from groups underrepresented in science who hope to pursue a career in biomedical

research. Mentorship and strong academic networks were also noted as crucial to career success. However,

respondents reported struggling to ﬁnd strong mentorship, with some experiencing isolation and ‘othering’

within the predominantly White, male-dominated world of academia.

Biomedical Research Workforce

Respondents described how implicit and explicit biases affect hiring and promotion decisions within the

NIH workforce and the broader biomedical research ecosystem. Respondents asserted that diversifying NIH

leadership and hiring committees would bring more members of racial and ethnic minority groups into the

workforce and into supervisory positions, ultimately helping the NIH workforce to be more representative of

the U.S. population. Respondents acknowledged that overall diversiﬁcation of NIH and the broader biomedical

workforce will require prioritization and diversiﬁcation of recruitment, hiring, promotion, and retention strategies

that eliminate barriers faced by groups underrepresented in the workforce. Respondents also encouraged NIH

to support career advancement by providing targeted mentoring, outreach, and training opportunities for racial

and ethnic minority staff members.

Health Disparities and Health Equity Research

A lack of adequate funding prioritization within NIH and limited knowledge among reviewers about health

disparities and health equity research methods were cited as key barriers to expanding and advancing health

disparities and health equity research. Respondents urged NIH to prioritize these research areas across Insti-

tutes and Centers (ICs) and to increase resources and support for the National Institute on Minority Health and

Health Disparities (NIMHD). Many comments discussed the need for cross-culturally appropriate, inclusive

study designs. Comments also discussed data disaggregation and cohort studies to better understand the

impact of research ﬁndings on underrepresented communities.

Community Partnerships and Outreach

Respondents commented on how meaningful partnerships with community organizations can eliminate

or remove barriers that negatively impact groups underrepresented in the biomedical research workforce.

Respondents highlighted that partnerships also support community-engaged research designed to address

or reduce health disparities. While some respondents noted that current NIH efforts to build and enhance

partnerships and outreach are well-designed, others highlighted that NIH could better incentivize researchers

to incorporate community-based approaches. Respondents emphasized that community partnerships require

trust and collaboration and that more can be done to enhance NIH-funded research by integrating community

members at every stage of the grant process.

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Cross-Cutting Themes

Along with the ﬁve key topic areas that emerged from the data, six cross-cutting themes were identiﬁed from

respondents’ comments that captured common messages across all topic areas. These themes are 1) Expand

the Scope of Inclusion, 2) Implement DEI Initiatives, 3) Operationalize Diversity Metrics, 4) Enhance and Expand

DEI Training, 5) Improve Communication and Outreach, and 6) Acknowledge Structural Racism and Its Impact.

These themes are presented in Figure 2. They emerged independent of RFI topic area, respondent type, or

response focus. Three themes were related to the overall concepts of structural racism and DEI: broad requests

to expand NIH’s deﬁnition of DEI; concern that NIH’s focus on structural racism, as represented in this RFI,

will not be followed by signiﬁcant, tangible action; and disagreement regarding the existence or implications

of structural racism in the biomedical workforce. Three additional themes were raised as recommendations

frequently across topic areas. Respondents called upon NIH to expand reporting and transparency of DEI met-

rics within the grant application and review process, across the NIH workforce, and as relevant to NIH-funded

intramural and extramural research. Similarly, respondents encouraged NIH to strengthen and mandate DEI

training for various internal and external NIH groups, including NIH staff, grant reviewers, and principal inves-

tigators supported under grant awards. Finally, improved communication was highlighted as a fundamental

way to improve NIH institutional partnerships, community engagement, the grant submission process, and

relationships with current or potential NIH trainees and staff.

Cross-Cutting Themes

Expand the

Scope of

Inclusion

Implement DEI

Initiatives

Operationalize

Diversity

Metrics

Enhance and

Expand DEI

Training

Improve

Communication

and Outreach

Acknowledge

Structural Racism

and Its Impact

Figure 2: Cross-Cutting Themes

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INTRODUCTION

Recen

t national discourse and research regarding social justice and structural racism underscore ongoing

inequities in biomedical research and healthcare. The 2011 report by Ginther et al.

highlighted signiﬁcant

racial gaps in the NIH-supported research workforce and disparities in success rates and funding for racial

and ethnic minority researchers that still exist, though to a lesser degree, more than a decade later. Peer-

reviewed research provides evidence of historical and structural disparities that have inﬂuenced NIH grant

funding supporting Black researchers on topics that impact underserved communities.

As articulated by the

recent Executive Order (EO) 14035,

Diversity, Equity, Inclusion, and Accessibility (DEIA) aims to ensure that the

Federal Government, the nation’s largest employer, acts as a model for DEIA practices in the workplace and

provides a space where all employees are treated with dignity and respect. NIH strives to foster a biomedical

research community and internal workplace free from hostility and discrimination grounded in race, religion,

sex (including sexual and gender minority status), disabilities, and all other federally protected characteristics.

The ability for NIH to remain at the forefront of biomedical research requires fostering diversity across skill sets,

viewpoints, and backgrounds.

The UNITE initiative was established by the National Institutes of Health (NIH) in February 2021. The goal

of the initiative is to identify and address structural racism within the NIH-supported and greater biomedical

research community. On March 1, 2021, NIH released theRequest for Information (RFI): Inviting Comments

and Suggestions to Advance and Strengthen Racial Equity, Diversity, and Inclusion in the Biomedical research

Workforce and Advance Health Disparities and Health Equity Research.² The intent of the RFI was to seek

input from scientiﬁc associations, academia, advocacy groups, health professionals, the broader biomedical

research community, NIH staff, non-scientiﬁc communities, and the general public to inform the development

of plans and approaches for promoting and advancing racial equity, diversity, and inclusion; and to support a

more robust health disparities and health equity research portfolio. The topics and sub-topics presented for

comment are summarized in Table 1.

Table 1: RFI Main Topics and Sub-Topics

RFI Main Topics and Sub-Topics

All Aspects of the Biomedical Workforce

• Perception and reputation of NIH as an organization

• New or existing inﬂuence, partnerships, or collaborations

• Factors that present obstacles to training, mentoring, or career path

• Barriers inhibiting recruitment and hiring, promotion,retention,and tenure

• Successful actions NIH and other institutions and organizations are currently taking

Policies and Partnerships

• Existing NIH policies, procedures, or practices

• Best practices or proven approaches to build new or enhance existing partnerships

and collaborations

Research Areas

• Signiﬁcant research gaps or barriers to expanding and advancing the science of health

disparities/health inequities research and proposed approaches to address them

Further Ideas

• Additional ideas for bold, innovative initiatives, processes, or data-driven approaches

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The RFI received more than 1,100 responses and closed on April 23, 2021. This report summarizes feedback

provided in response to the RFI, providing a broad overview of the analytic approach, topics, and themes of the

responses, and recommendations proposed by respondents. Speciﬁc examples, including de-identiﬁed quotes

from RFI respondents, are included, as appropriate, to expand upon broad concepts or to provide speciﬁc

recommendations that address concerns raised by respondents. This report reﬂects perceptions that may be

unique to or frequently raised by certain categories of respondents (e.g., NIH staff, advocacy organizations,

and academic institutions).

This report aims to capture, organize, and provide a summation of the responses to the RFI. As a result,

some of the issues and recommendations raised may not be within NIH’s purview as a Federal agency with

a primary goal of funding biomedical research. To the extent possible, the report attempts to clarify recommen-

dations that are speciﬁc or applicable to NIH and its partners within the biomedical workforce (e.g., academic

institutions, industry employers). In addition, some proposed actions may already be under consideration or in

motion at NIH or within the broader biomedical community.

Terminology within the report reﬂects respondents’ language to the greatest extent possible to avoid inaccurate

interpretation or overinterpretation of respondent comments. Frequently used terms are deﬁned in Appendix 1

and linked within the text, and clariﬁcation is provided when respondent terminology may differ from standard

NIH deﬁnitions. The feedback summarized in this report represents the opinions of the RFI respondents and is

intended to help inform NIH’s future plans and approaches.

METHODS

NIH encouraged individuals and organizations from multiple sectors to submit responses to the RFI between

March 1 and April 23, 2021. Organizations were asked to submit a single response reﬂective of the organiza-

tion’s views or the views of the organization’s membership. Responses were submitted via online portal or email

and could focus on any or all RFI topics. The RFI was posted publicly to the NIH UNITE website and was shared

through multiple channels, including email and social media channels, in order to reach a broad audience.

THREE-PHASE ANALYSIS

The RFI analysis consisted of three phases designed to examine the responses and identify emerging themes

and topics: Phase 1 Data Preparation, Preliminary Review, and Codebook Development; Phase 2 RFI Tool

Coding; and Phase 3 RFI Tool Analysis and Identiﬁcation of Key Topic Areas and Themes (Figure 3). Phase

1 focused on an open-ended review of the responses to develop codes and emerging themes. In Phase 2,

codes from Phase 1 were used to categorize and analyze all RFI responses using the NIH Ofﬁce of Portfolio

Analysis RFI Tool

(“RFI Tool”). Phase 3 included an analysis of the data from the RFI Tool coding, combined with

Phase 1 themes, to provide a ﬁnal analysis and report of the data.

a. The RFI Tool simpliﬁes and streamlines coding and analysis of responses received from RFIs and other text collections.

It is available exclusively to NIH staff.

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Phase 1:

Data Preparation,

Preliminary Review, and

Codebook Development

Phase 2:

RFI Tool Coding

Phase 3:

RFI Tool Analysis

and Identiﬁcation

of Key Topic Areas

and Themes

Figure 3: Phases of RFI Data Coding and Analysis

Phase 1: Data Preparation, Preliminary Review, and Codebook Development

RFI responses submitted via an online portal or email were merged into one dataset for analysis. During Phase

1, analysts utilized an open coding approach,

which consisted of reading the RFI data and identifying poten-

tial codes. Coders frequently met to discuss responses, ask questions, and reach a consensus as needed.

A preliminary data review provided information on emerging themes and topics within RFI responses. At the

end of this phase, coders compiled and recommended codes for inclusion in the codebook for use in Phase 2.

The codebook included working deﬁnitions for each code.

Phase 2: RFI Tool Coding

After ﬁnalizing the codebook, coders utilized the RFI Tool to code all responses. Analysts frequently met to

discuss speciﬁc responses, challenges, or operational deﬁnitions of codes. Responses to the RFI were coded

deductively, using unique topic codes and high-level codes that were uniform across RFI topics. Where evident,

responses to the ﬁrst question were coded as having a positive or negative perception of NIH. The coding

scheme for individual topics was broken into subcategories, where appropriate, to provide additional depth

and insights speciﬁc to the topic. Respondent type (e.g., NIH staff, academia, nonproﬁt) was an optional,

self-reported single response selection at the time of RFI submission.

b. Respondent afﬁliations from historically black colleges and universities (HBCUs) were coded using the HBCU list from the

U.S. Department of Education. https://sites.ed.gov/whhbcu/one-hundred-and-ﬁve-historically-black-colleges-and-universities/

Phase 3: RFI Tool Analysis and Identification of Key Topic Areas and Themes

Analysts used features within the RFI Tool to query codes and expand upon and identify key topic areas and

cross-cutting themes. Analysts used the most frequent codes to guide deeper analysis within those topics,

which included re-reading responses to develop a complete understanding of the topic. The RFI Tool also

allowed for analysis by respondent type, providing for a segmented examination of the data. Codes within the

RFI Tool were analyzed by respondent type. Speciﬁc respondent types are mentioned if a particular person’s

response differed from or added additional perspective to the overall collective view. Where it was evident,

coders also tagged responses by the groups that were discussed (e.g., early-stage investigators, students).

The analysis team discussed these preliminary themes for accuracy and insights before the ﬁnal reporting of

the data and analysis.

Represented among respondents were members of academia, advocacy groups, community partners, health

professionals, industry representatives, professional societies, post-doctoral researchers, students, NIH staff,

and members of the public (Figure 4). They provided valuable insights across ﬁve key topic areas. Each of these

topics, as well as six cross-cutting themes, are discussed in their corresponding sections.

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Distribution of Respondent Types

46%

Academic

(Includes 2% HBCUs)

13%

NIH Staff

11%

Health

Professional

Nonproﬁt/

Professional

Society

Student/

Postdoc

Researcher

16%

Other

(e.g., Advocacy

Organizations, Members

of the Public, and more)

Figure 4: Distribution of Respondent Types

Each section of this report outlines the main topics that emerged from the analysis and relevant sub-topics. For

each key topic area, the text begins with a short description of the overarching thoughts of respondents and

a summary table of their recommendations. These are followed by more detailed descriptions that arose from

the RFI responses, as well as salient quotes from respondents. The organization of the report is intentionally

centered on the respondents’ thoughts, ideas, and words.

Key Topic Areas of Feedback

Grants Process

Student-to-

Workforce and

Career Pathways

Biomedical

Research

Workforce

Health Disparities

and Health Equity

Research

Community

Partnerships

and Outreach

Cross-Cutting Themes

Expand the

Scope of

Inclusion

Implement DEI

Initiatives

Operationalize

Diversity

Metrics

Enhance and

Expand DEI

Training

Improve

Communication

and Outreach

Acknowledge

Structural Racism

and Its Impact

Figure 5: Key Topics and Cross-Cutting Themes

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SUMMARY OF COMMENTS BY TOPIC AREA

This report aims to summarize the responses to the RFI. As a result, some of the issues and recommendations

raised may not be within NIH’s purview as a Federal agency with a primary goal of funding biomedical research.

Terminology within the report reﬂects respondents’ language to the greatest extent possible to avoid inaccurate

interpretation or overinterpretation of respondent comments. The summary tables are not an exhaustive list

of all recommendations received, but rather the most commonly suggested. Speciﬁc respondent types are

mentioned if their responses differed from or added additional perspective to the overall collective view.

GRANTS PROCESS

The grants process, in its entirety, was the most common topic mentioned across respondent types. This key

topic area encompasses grant procedures and policies deﬁned and administered by NIH. This includes many

things that impact the extramural research workforce

such as understanding funding opportunity announce-

ments (FOAs), preparing applications, submitting applications, completing application r

eview, and disbursing

grant funding. Most responses discussed grants speciﬁcally, although some of the responses could be gener-

alizable to other funding mechanisms. Respondents noted that despite the 2011 article by Ginther et al.

high-

lighting the signiﬁcant gaps in funding and success rates for Asian and Black or African American investigators,

the gaps remain more than a decade later, though to a lesser degree. Respondents further described aspects

of the grants process that they believe lead to these gaps in funding and make it less likely for researchers

from racial or ethnic minority groups to receive awards compared to their White peers. This funding gap, which

respondents cited was demonstrated again by Hoppe et al. in 2019,

ultimately contributes to a lack of diversity

within the extramural research workforce. Responses also indicated concerns regarding funding gaps related

to research topics, areas, and methodologies. Numerous improvements were recommended to stages of the

NIH grant process, from funding opportunities to preparing and submitting applications, through application

review, and ﬁnally for grant priorities and funding.

A summation of respondents’ grant process recommendations is detailed in Table 2.

Table 2: Summary of Recommendations for Grants Process

Topic Recommendations

Grant Application

Process

• Provide more outreach from NIH, especially to researchers and trainees from

racial and ethnic minority groups and lower-resourced institutions, to support

grant application and submission efforts

• Clarify and simplify application and submission instructions and requirements

• Offer workshops and institutional grants to provide support for application

submissions and grant administration

• Expand time frames between publication and submission deadlines for FOAs

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Topic Recommendations

Grant Review

Process

• Change or remove the environment and investigator criteria

• Anonymize review

• Add review criteria on diversity and mentorship, including the Principal

Investigator (PI) and team, the commitment of the institution and the PI,

and the relevance to health disparities research

• Diversify review panels

• Require DEI training for reviewers and Scientiﬁc Review Ofﬁcers (SROs)

Funding Priorities

and Selection of

Grants

• Utilize select pay or expanded paylines for applicants who are

underrepresented in science and for applications proposing health

disparities and health equity research

•

Increase transparency and standardize select pay policies across NIH

• Institute random selection lotteries for meritorious applications

• Cap funding for higher-resourced investigators and institutions

Grant Application Process

The grant application process and submission requirements were reported as burdensome, difﬁcult, and not

always well understood. These challenges were described as particularly concerning for ﬁrst-time applicants,

members of racial or ethnic minority groups, lower-resourced institutions, and community-based groups.

These applicants are less likely to have access to the administrative infrastructure to support application and

submission requirements. Furthermore, early-career investigators from groups underrepresented in science

and from lower-resourced institutions often lack experienced mentors to help navigate the application process.

Responses suggested that these challenges perpetuate gaps in funding and success rates for racial and ethnic

minority researchers. Recommendations were made to simplify application and submission instructions and to

eliminate preliminary data requirements to increase the success of ﬁrst-time applicants.

Another issue raised was the short period between the publication

date and application due date for FOAs. Investigators at institutions

that lack administrative infrastructure have difﬁculty preparing com-

petitive applications within such a short time frame. Relatedly, it was

suggested that NIH expand outreach to investigators and adminis-

trators on how best to navigate the grant application system. Such

outreach could include workshops for staff in administrative support

ofﬁces (e.g., ofﬁces of sponsored research) to provide education on

application procedures and to assist in submitting applications. Anoth-

er recommendation suggested that direct support from mentors and

outreach from NIH staff, particularly Program Ofﬁcials (POs), could

reduce some of the application and submission challenges investiga-

tors face. The respondents speciﬁcally mentioned a desire for guid-

ance on grant writing and application and submission requirements,

as well as encouragement to resubmit applications.

“Low-resourced institutions

often lack an effective ofﬁce

of research and sponsored

programs, and junior faculty

often need extensive support

in preparing and submitting

successful proposals.

Institutional grants to

support such ofﬁces, which

in turn assist the faculty in

preparation and submission

of successful grant proposals,

would have a great impact.”

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Grant Review Process

The grant review process was most frequently cited as a major contributor to bias and funding gaps for racial

and ethnic minority researchers and other individuals underrepresented in science. This feedback was

consistent across respondent types and RFI topics. Respondents with negative perceptions of NIH expressed

that the current state of the review process—in particular, the lack of diversity in review panels—contributed

to those perceptions; however, this feedback also extended to other items relevant to grant review, including

grant review criteria.

Grant Review Criteria and Criterion Scores

Grant review criteria were perceived as biased, and respondents expressed beliefs that these criteria con-

tributed to identiﬁed funding gaps for racial and ethnic minority researchers.

The primary criteria considered

and scored during the review of an application include signiﬁcance, investigator(s), innovation, approach, and

environment.

Many respondents identiﬁed the investigator and environment criteria as speciﬁc sources of bias.

Investigator scores were perceived to affect women and racial and ethnic minority applicants negatively. The

environment criterion was viewed as negatively impacting applications from lower-resourced institutions that

often lack research infrastructure to compete with applications from well-funded, higher-resourced institutions.

Respondents suggested changing the investigator and environment criteria by de-emphasizing, removing, or

rating them only as acceptable/not acceptable to enable reviewers to focus solely on the merits of the proposal

at hand.

Several responses also recommended anonymizing the review process

to help reduce bias that inadvertently leads to better scores for appli-

cations from well-known and well-funded investigators compared to

those from less well-known investigators. An anonymized review would

require removing identifying information on investigators and institutions

from grant applications. Respondents also note that more experienced

PIs, the distribution of which skews White and male, appear to receive

better scores based on name recognition and reputation. An anonymized peer-review process, such as that

piloted in the Transformative R01 program,

was listed as an example of a way to enable reviewers to judge

proposals more adequately on the merits of the science and research plan and focus on signiﬁcance, innova-

tion, and approach.

Suggestions to revise the grant review criteria to reﬂect support for DEI among investigators and in the

research topic area were made by respondents. A common suggestion was to consider diversity as a score-

driving criterion during grant review. The score could reﬂect the diversity of the research team, the Principal

Investigator’s and institution’s commitments to diversity, and the project’s relevance to health disparities and

health equity research. Another suggestion was to integrate mentorship of students and trainees into the

scored review criteria. This score could incorporate mentoring history and mentoring activities.

“Make history of mentoring

students from under-

represented groups

a score-driving criteria.”

Diversity of Grant Review Panels

Comments often noted concerns regarding how the lack of diversity on NIH review panels perpetuates bias.

Respondents reported that low funding rates for health disparities and health equity research are partly due

to low rates of diversity in training and/or background among reviewers. Responses noted that panels typi-

cally do not include strong representation from members of racial and ethnic minority groups or early-career

researchers and often lack diversity in areas of research expertise. Respondents noted that reviewers often do

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not understand or value qualitative approaches, mixed

methods, or community-based approaches. Identifying

grant reviewers who are well-versed and have adequate

expertise and perspective to evaluate health disparities

and health equity research was suggested. A recommen-

dation was made to diversify review panels by expanding

the pool of potential reviewers beyond those who have

received R01 or other substantial funding.

Respondents recommended that providing grant review

training opportunities to early-career researchers,

researchers from racial and ethnic minority groups, and

researchers from lower-resourced institutions without

signiﬁcant funding would help prepare them for service

on review panels, and ultimately improve panel diversi-

ty. Respondents advocated that study sections should

reﬂect the diversity of the applicant pool, if not the gen-

eral population. Proposed recommendations included

allowing investigators to self-nominate for consideration

on review panels and limiting terms of service for study

section members to allow for higher turnover. This term

limit would increase the opportunities to include a great-

er diversity of reviewers and perspectives.

“The composition of study sections

being comprised only of people who have

been awarded NIH grants is important

because these people understand the

grant application and review process

best. However, this becomes a systemic

problem when the vast majority of

investigators funded by NIH (in some

ﬁelds more than others) are of the majority

(i.e., White males). It is not too difﬁcult

to see that if there is a panel comprised

mostly of White males who were mentored

by White males, if they review applications

produced by other White males who had

similar training then these reviewers may

view these applications more favorably.”

Respondents suggested that reviewers are inﬂuenced by implicit biases, including afﬁnity bias, in which individ-

uals demonstrate an unconscious tendency to prefer others similar to themselves. This bias can lead reviewers

to give better scores to investigators with demographics and areas of expertise similar to their own. There

were suggestions that NIH should enhance fairness

in the grant review process through education and

monitoring. One recommendation was to provide edu-

cation and training in implicit bias and other aspects

of DEI for those participating in the grant review pro-

cess, including grant reviewers and Scientiﬁc Review

Ofﬁcers. Another recurring recommendation was reg-

ular evaluation of grant reviewers and summary state-

ments for quality and biases.

“[NIH should require] evidence-based

training in DEI and implicit bias for all peer

reviewers, study section chairs, and NIH

staff involved in grant review. Efforts should

be made to measure the effectiveness of

bias training once implemented.”

Funding Priorities and Selection of Grants

Respondents called on NIH to diversify the extramural research workforce through grant funding procedures.

Several factors were identiﬁed as current barriers to funding, including the use of paylines and select pay

procedures by NIH. Paylines are Institute or Center (IC)-speciﬁc funding cutoff points for grant applications,

and select pay is used to fund outside of these cutoff points to ensure balance across the pool of grants

and expand the breadth of topics and approaches to funded research. A perceived lack of transparency

surrounding select pay processes and the research priorities of individual ICs may also contribute to funding

gaps. Moreover, IC funding policies and funding priorities were perceived as major contributors to the lack of

funding diversity. The responses stated that the select pay process is biased, particularly regarding how POs

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choose applications to recommend for select pay. Repeated funding to support the same investigators and

research institutions was also an identiﬁed issue. Some responses cited Taffe and Gilpin’s article highlighting

racial disparities in NIH funding, which suggested that meritorious grant applications from Black PIs that score

above the payline have a lower likelihood of receiving funding compared to similarly scored applications from

White PIs.

Recommendations to mitigate and reduce funding gaps for researchers from groups underrepresented in

science included increasing transparency and standardizing the select pay process across NIH. Another

recommendation included expanding paylines, akin to the approach taken with early-stage investigators,

and providing select pay for meritorious applications from racial and ethnic minority groups and for health

disparities and health equity research. Respondents also suggested instituting random selection lotteries for

meritorious applications and implementing grant caps for highly funded investigators and institutions to free up

funding for others.

STUDENT-TO-WORKFORCE AND CAREER PATHWAYS

Respondents asserted that access to education and exposure to research training is critical for groups

underrepresented in science, from early childhood through early career. Diversiﬁcation of the biomedical

research workforce requires identifying and bridging gaps in the student-to-workforce pathway,

which is

deﬁned as the path students take to explore, identify, and pursue a career in biomedicine. Research and

policy work in this area frequently attempt to address “leaky” student-to-workforce pathway issues where-

in students leave the pathway by choosing majors or career paths outside of science, technology, engineering,

and math (STEM). Students from underrepresented racial and ethnic groups, particularly those from low-in-

come backgrounds with limited ﬁnancial support, often do not have exposure to STEM early in life and face

signiﬁcant ﬁnancial and educational barriers in pursuit of research careers.

Respondents discussed the leaky

student-to-workforce pathway and the signiﬁcant challenges students, trainees, individuals underrepresented

in science, and early-career researchers face that slow or halt progress and potentially lead to long-term reten-

tion issues within the biomedical research workforce. For this report, the biomedical research workforce refers

to the collective of individuals who comprise the internal NIH research workforce and the extramural biomedical

research workforce.

A summation of respondents’ recommendations for strengthening the student-to-workforce pathway and

addressing issues related to career pathways in the biomedical research ﬁeld is detailed in Table 3.

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Table 3: Summary of Recommendations for Student-to-Workforce and Career Pathways

Topic Recommendations

Pre-Graduate Curricula

and Exposure to STEM

• Develop and fund improved pre-graduate STEM education aimed at

diverse groups of scholars

• Increase outreach to pre-graduate students by members of the

biomedical research community

• Support diversity bridge programs and opportunities to engage in

research

Financing Undergraduate

and Graduate Training

• Address disparities in student loans and repayment programs

• Support graduate students through fast-track programs and

connections to post-doctoral positions

• Increase funding to current NIH training programs that support diverse

trainees

Research Training

• Invest in research infrastructure to support training programs at lower-

resourced institutions

• Make institutional training grants accessible

• Expand diversity funding mechanisms to better support early-career

researchers

Barriers to Career

Development

• Increase salaries of graduate students and research trainees

• Increase or expand beneﬁts for graduate students, post-doctoral

trainees, and early-career researchers

• Improve opportunities for work-life integration through workplace

ﬂexibilities

• Create protected time for and reward academic and scientiﬁc service

Mentorship and

Academic Networks

• Support mentorship initiatives for the intramural NIH and extramural

research workforce

• Add mentoring requirements to grant criteria

• Incentivize institutions and faculty to support and expand mentorship

programs

• Create partnerships between lower-resourced and high-resourced

institutions for mentoring and collaborations

• Maintain and add funds to effective mentoring programs

• Improve training, evaluation, and oversight for mentors

• Offer recognition and reward to strong mentors

• Expand networking and collaboration opportunities for trainees and

early-career researchers

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Pre-Graduate Curricula and Exposure to STEM

Respondents encouraged creation of funding opportunities that support pre-graduate students in STEM

education and/or focus on diversifying the biomedical research student-to-workforce pathway, as early

exposure to STEM is critical in fostering interest in STEM topics and encouraging more students to pursue

STEM careers. Several recommendations included suggestions for both extramural and NIH intramural

researchers to increase outreach to pre-graduate students. There were also suggestions for improved support

for programs that allow pre-graduate, racial and ethnic minority students to engage in research and participate

in NIH activities (e.g., research camps or summer programs). Expanded partnerships between government

agencies, community colleges, minority serving institutions (MSIs), and lower-resourced institutions were

suggested to improve students’ exposure to scientiﬁc opportunities. The NIH Science Education Partnership

Awards (SEPA)

was listed as one example of an effective partnership program that supports researchers and

K-12 schools.

“The Science Education Partnership Awards (SEPA), which create partnerships between

researchers and K-12 schools, is an example of an effective partnership that often reaches

teachers and students who are underrepresented in biomedical research. As a grantee for 30

years, [I have] seen the beneﬁts of this program in practice, bringing teachers from across

the country into the laboratories of working scientists where they had the opportunity to

gain ﬁrst-hand experience working on a research project.”

Financing Undergraduate and Graduate Training

As students enter their undergraduate years and aspire to graduate-level STEM education, a primary

concern cited was the difﬁculty of ﬁnancing education in the U.S. and the long-term burden of student loan

repayment. Respondents commented that removing ﬁnancial barriers associated with expensive and

lengthy degree pursuits will allow more individuals from underrepresented racial and ethnic communities to

enter and sustain scientiﬁc careers without taking on a lifetime of ﬁnancial burden. Respondents speciﬁcally

highlighted how students from low-income families face ﬁnancial difﬁculties pursuing science degrees.

Rising student loan rates contribute to wealth inequity,

contributing to a lack of diversity within the ﬁeld. Many

respondents, therefore, suggested the U.S. government pay down student debt and address disparities in

student loans and student loan repayment opportunities. While NIH may have limited ability to relieve the

burden of student loans, respondents encouraged NIH to consider additional ﬁnancial support for students,

trainees, and early-career researchers.

“[T]he prospect of remaining ﬁnancially

unviable for 8 years after undergraduate

heavily favors those able to take ﬁnancial

risk, persons with signiﬁcant familial or

spousal wealth, persons without dependents

or persons with limited debt or ﬁnancial

obligations to family in-country or abroad.

This is not a recipe for diversity and cannot

be maintained in academia.”

Additionally, respondents called on NIH to expand

funding opportunities to a broader pool of investigators

by expanding programs that support early-career

researchers and to make training and career devel-

opment mechanisms more easily accessible to train-

ees without extensive publications, presentations, or

previous funding history. Respondents recommended

devoting additional funds to existing initiatives and/

or implementing these programs more broadly across

NIH. Programs that reduce the effort required to apply

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to training opportunities or allow trainees to streamline or reduce total time spent in training were highlighted.

These programs would enable trainees to enter their chosen ﬁelds earlier and receive greater ﬁnancial support

earlier in their careers.

Several types of programs at NIH and academic institutions were frequently cited as beneﬁcial, including

those that connect trainees to peers at other research training programs; those that provide opportunities for

collaboration; those that provide hands-on experience; and those that provide mentorship experiences. The

NIH Distinguished Scholars program

is an example of a cohort-based model that improves trainees’ sense of

community and belonging. Respondents commented that these programs may provide particular advantages

for trainees at lower-resourced institutions, who may not have access to opportunities, research infrastructure,

or connections that increase competitiveness when applying to graduate school, post-doctoral positions, or

full-time research positions. To improve experiences within existing programs, respondents encouraged NIH

to address bias and cultural issues that may cause trainees from groups underrepresented in science to feel

unsupported or out of place, leading to less-than-optimal outcomes for these individuals.

Research Training and Infrastructure

All training programs do not lead to equal opportunities

for students who stay in the student-to-workforce path-

way. Most responses expressed challenges faced at low-

er-resourced institutions, which they noted might include

MSIs, R2 universities (i.e., less intensive research envi-

ronments than R1-designated universities, which have

the highest level of research activity), and community col-

leges. Respondents from Historically Black Colleges and

Universities (HBCUs) expressed this concern and urged

NIH to invest in HBCU researchers and provide funding to strengthen research environments. Respondents

noted that adequate research infrastructure—the facilities, materials, and resources needed to conduct scien-

tiﬁc research—is necessary to support strong training programs.

“[We need] NIH funding opportunities

for improving infrastructure (purchase

of scientiﬁc equipment) at academic

institutions that have shown a historical

commitment to educating students from

underrepresented groups.”

Partnerships between lower- and higher-resourced institutions were highlighted as a method of helping

lower-resourced institutions improve research infrastructure and training programs. For example, respondents

suggested the creation of funding initiatives for collaborative grants between institutions, which could allow

researchers at under-resourced institutions to beneﬁt from stronger research infrastructure at potential partner

programs.

Additionally, incentivizing higher-resourced institutions to partner with under-resourced centers could allow

for resource sharing and collaboration. Some encouraged NIH to create a database of researchers who are

interested in and available to collaborate with researchers at other institutions and to create a mechanism to

incentivize higher-resourced institutions to collaborate with lower-resourced institutions. The National Human

Genome Research Institute’s Genome Research Experiences to Attract Talented Undergraduates into the

Genomics Field to Promote Diversity (the GREAT Program)

was highlighted as a current NIH program that

requires research-intensive applicant institutions to partner with under-resourced institutions, providing trainees

opportunities to pursue further training via institutional partnerships. The creation of sustainability plans for

cross-institute engagement was highlighted as a practical approach to building enduring partnerships and

facilitating long-term resource sharing.

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Barriers to Career Development

As highlighted by respondents, many students and trainees face signiﬁcant ﬁnancial barriers at the beginning of

their careers. Unfortunately, the low salaries and lack of tangible beneﬁts (e.g., affordable insurance, childcare,

and housing) associated with biomedical research training may exacerbate this problem. Those who continue

in biomedical research careers may face additional challenges that affect career advancement, including a

lack of value placed on the extensive work they do outside their individual research programs, which may

include committee work related to DEI issues, community outreach and engagement, and mentorship of

students and trainees.

Salary

Recommendations to address ﬁnancial instability among

graduate students and post-doctoral trainees most frequent-

ly included the need to increase salaries. Respondents noted

instances in which researchers from racial and ethnic minori-

ty groups declined opportunities due to a lack of appropriate

compensation despite achieving academic excellence in their

chosen ﬁelds. Poorly compensated opportunities advantage

more privileged candidates, creating disparities in career trajec-

tories. Respondents encouraged NIH to increase the salaries of

graduate students and research trainees to set an example for

academic training programs across the nation.

“If you want to strengthen DEI

in science, you need to provide

stability and support to those

coming from less-advantaged

backgrounds so they can develop

without the grinding fear of no

money/no job every year.”

Benefits and Work-Life Integration

Respondents felt that graduate students and post-doctoral trainees also require access to beneﬁts, includ-

ing relocation funds, retirement packages, health insurance, caregiving support (e.g., elder and childcare),

and housing and transportation beneﬁts. These beneﬁts are not always available as part of compensation in

biomedical research careers, which exacerbates ﬁnancial challenges. Given these ﬁnancial considerations,

respondents suggested that better beneﬁts and tangible support could attract greater numbers of scientists

from lower-resourced communities, especially when considering employment opportunities in areas with a

higher cost of living.

Responses also described the biomedical research ﬁeld

as demanding and not conducive to work-life integration.

Respondents expressed a desire for improved workplace

ﬂexibility, noting that trainees and early-career researchers

are particularly vulnerable to being derailed by a lack of

workplace support. Workplace ﬂexibility was speciﬁcally

highlighted as important for members of multi-generational

households and individuals who are caregivers. Tribal com-

munities were described as particularly affected by these

concerns, as respondents suggested grant timelines and

the demands of biomedical research do not always align

with community obligations and cultural activities.

“A work/life balance is different for

everyone and different within cultures.

The typical timeframe for starting

a family overlaps with the typical

timeframe for growing a career.

There is a cumulative disadvantage

throughout one’s career if a research

step is missed early. NIH should

consider differing timelines for early-

stage investigators.”

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Valuation of Academic and Scientific Service

Many respondents reported that contributions to the research community, such as mentoring and communi-

ty outreach, which do not support individual research programs, are signiﬁcantly undervalued. Further, staff

from underrepresented racial and ethnic groups are frequently encouraged or tasked to participate in and

lead DEI-related activities, a phenomenon referred to as the “minority tax.” These individuals are also often

in high demand as mentors to support students from similar racial and ethnic backgrounds. These activities

may take them away from research and academic responsibilities without signiﬁcant acknowledgment from

supervisors or institutional leadership, thus impeding career advancement. Respondents emphasized that staff

from underrepresented racial and ethnic groups should not be obligated or expected to carry the burden

of culture change. However, mentorship and participating in DEI-related activities should be adequately

valued. Recommendations to address these challenges included creating protected time for academic and

scientiﬁc service and directly rewarding these contributions when considering promotions, tenure decisions,

and grant applications.

“Service requests are often much higher for faculty of color than for faculty from the majority

culture. These requests often involve serving on search committees and other institutional

committees to address diversity requirements and being [asked] to provide presentations or

serving on panels for students to see role models of scientists of color. These requests can

add up and take signiﬁcant time away from research, publishing, grant writing, etc. It would be

helpful to acknowledge these contributions ofﬁcially in [promotion and tenure] instead of credit

being predominantly focused on [publications] and grants. In fact, if our institutions are really

committed to growing URM [underrepresented minorities] lines and making them successful,

then institutionally funded, protected time to serve on committees, provide role model seminars,

mentor URM students, etc. should be considered, as well as [promotion and tenure] credit.”

Mentorship and Academic Networks

Respondents noted that for undergraduate students, graduate students, and post-doctoral trainees, men-

torship and academic networks are crucial components to success in biomedical research. Mentorship was

cited as providing guidance and resources, both tangible and intangible, that are critical for ensuring continued

educational progress and career development. Academic networks were highlighted as offering opportunities

for collaboration, peer support, and a sense of belonging. Many respondents emphasized how difﬁcult it is

for individuals from racial and ethnic minority groups to advance in their careers without consistent mentor

relationships and robust academic networks.

Mentor Availability and Prioritization

Respondents identiﬁed a variety of barriers that prevent trainees, especially those from underrepresented

racial and ethnic backgrounds and those training at MSIs, from ﬁnding inﬂuential mentors. Respondents stated

that most well-known and successful biomedical researchers are White men, many of whom were trained by

White men. Mentees were cited as often preferring to seek out mentors of a similar demographic background.

Because the biomedical research workforce currently lacks diversity, respondents noted, trainees struggle to

ﬁnd mentors who can share in the experience of being both a member of a group underrepresented in science

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d a researcher in their ﬁeld. While respondents recognized that this exclusion may not always be intentional,

it can perpetuate the lack of diversity in the workforce. In their comments, some current mentors acknowledged

that they were not effectively mentored themselves and therefore did not feel prepared to mentor their students.

Recommendations from respondents included improved training, evaluation, and oversight for mentors and

rewarding or otherwise incentivizing strong and supportive mentors. In addition, respondents stated that NIH

should create and expand programs that facilitate partnerships to pair students and trainees from lower-re-

sourced research institutions with mentors from higher-resourced institutions and/or create co-advising fellow-

ships. These fellowships would enable students attending lower-resourced institutions to be co-mentored by

a researcher at their current site and a researcher from a higher-resourced institution. Moreover, respondents

highlighted existing NIH programs that aim to expand mentorship opportunities for trainees and called for these

initiatives to be expanded. These programs included cohort-based mentoring programs such as the Research

Initiative for Scientiﬁc Enhancement (RISE),

the Initiative for Maximizing Student Development (IMSD),

Maximizing Access to Research Careers (MARC),

and the National Research Mentoring Network (NRMN).

“High quality mentoring is essential to success in graduate studies and independent

research, and mentorship can help underrepresented scientists continue into research-

track careers. Studies show that these scientists have unique mentoring needs and may

beneﬁt from a culturally sensitive mentor who can help guide them with challenges unique

to their background. The implementation of a mentoring requirement for all grants that

support research trainees, regardless of funding mechanism, can boldly reinforce the

importance of mentorship at all stages, as well as draw attention to the unique mentoring

needs of underrepresented individuals.”

Valuation of Mentorship

Mentorships are critical to career success in the biomedical research ﬁeld. Respondents noted that most

mentors do not receive training, incentives, additional funding, or even additional time to foster positive men-

torships. Many highlighted the need for mentors to receive DEI training to help them engage with mentees in

a cross-culturally informed way and with cultural humility. When the only mentors available for students from

racial and ethnic minority groups are themselves members of underrepresented groups, there is an undue

burden on those mentors, particularly when such activities are not a valued criterion for consideration in men-

tors’ career advancement. This cycle also leads to smaller networks of mentors and mentees, which can impact

future career success.

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“One cannot separate mentorship from science. We cannot excuse people who are perceived

‘brilliant,’ yet treat the trainees in their laboratories as dispensable labor. A careful evaluation

by institutions of their faculty’s mentorship, not based on number of trainees and number who

attain faculty positions, but rather peer-and trainee-evaluations, as is often done in liberal arts

setting, will hopefully substantiate this as a review criterion for promotion. We likely know of

many mentors, and are likely the product of some of them, who create special environments

where scientists can thrive in a positive and rewarding environment. We need to ‘quantify’

this in some way in order to proactively reward these environments. They will lead to happier

trainees regardless of the type of scientiﬁc career they go on to pursue.”

Academic Networks and Networking Opportunities

Despite the importance of building academic networks, many students and trainees report challenges and

limited networking opportunities. These challenges can be exacerbated when students and trainees attend

smaller schools or MSIs, or do not work with highly prestigious or well-published mentors. Some described

experiencing unfriendly and even hostile academic networks, which were seen as a contributor to stu-

dent-to-workforce pathway barriers. Responses indicated continued implicit and explicit bias toward indi-

viduals from racial and ethnic minority groups and individuals underrepresented in science, both within NIH

and the extramural research workforce. Reported racist comments, microaggressions, and “othering” create

environments in which individuals from racial and ethnic minority groups feel unwelcome and face numerous

obstacles to success. These experiences can lead students and researchers to leave the biomedical research

workforce earlier and at higher rates. Respondents encouraged NIH to expand networking and collaboration

opportunities for trainees and early-career researchers.

Some respondents suggested that NIH host more sci-

entiﬁc forums to provide networking opportunities.

Respondents also recommended that NIH take a more

direct approach and expand visiting scholars, exchange,

or shadowing programs that foster collaboration. Other

recommendations included mitigating the ﬁnancial and

geographic barriers to researchers interacting with the

larger research community through free or low-cost

NIH-sponsored events that utilize virtual platforms and

other technologies designed to promote networking and

collaborations.

“Continued feelings of tokenism,

alienation, and a lack of support

persist…. Peer networks are often found

to be unwelcoming, which can prevent

development of crucial relationships that

lead to collaboration and advancement.”

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BIOMEDICAL RESEARCH WORKFORCE

As noted by respondents, supporting DEI across the biomedical workforce requires participation from individ-

uals and institutions at every level. For this report, the biomedical research workforce refers to the collective

of individuals who comprise the internal NIH research workforce (primarily intramural researchers) and the

extramural biomedical research workforce (NIH-funded researchers and trainees). Appendix 1 further delin-

eates these categories. The internal NIH workforce includes both research and non-research staff. Respon-

dents commented about DEI issues within the biomedical research workforce, including recruitment, hiring,

promotion, and retention within biomedical research and the importance of diversity in leadership and hiring

committees. Responses were categorized to indicate whether they were related to the NIH internal workforce,

extramural research workforce, or the entire biomedical research workforce.

A summation of respondents’ recommendations related to the biomedical research workforce is detailed in

Table 4.

Table 4: Summary of Recommendations for Biomedical Research Workforce

Topic Recommendations

Recruitment, Hiring,

Promotion,

and Retention

• Advance researchers from underrepresented groups across all scientiﬁc

career stages at NIH through improved recruitment, hiring, promotion,

and retention practices

• Diversify NIH staff to be more representative of the U.S. population

• Provide more outreach and assistance with the NIH job application

and submission process

• Review the USAJOBS process to reduce bias and improve equity

• Encourage or require the extramural research community to diversify

staff and build a more diverse student-to-workforce pathway

• Rethink and reimagine the range of staff across skillsets, degrees,

and backgrounds that can positively contribute to biomedical research

• Make training more accessible to a wide range of educational degrees

and levels

• Work with research institutions to support long-term mentoring

Recruitment, Hiring, Promotion, and Retention

In general, responses indicated the perception that NIH is committed to cultivating a diverse internal

workforce and is leading the biomedical research workforce overall toward greater equity and representation.

Some respondents viewed NIH positively for its long-term and growing efforts to support diversity across the

biomedical research community, with some applauding the UNITE initiative as an example of this commitment.

However, other respondents criticized NIH’s lack of progress toward actionable solutions to its stated DEI

goals. They recommended NIH implement, evaluate, and report on appropriate initiatives and policy changes

that could help eradicate DEI issues in the biomedical research workforce.

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Internal NIH Workforce

Respondents called on NIH to ensure that its internal workforce is

representative of the demographics of the U.S. population and asked

NIH to serve as a role model for the extramural research community

in this commitment. Responses from NIH staff and those within aca-

demia described the NIH recruitment and hiring processes as barriers

to employment at NIH for job seekers from groups underrepresented

in the workforce. Respondents expressed concern that beginning

with USAJOBS,

the Federal Government’s ofﬁcial employment site that connects job seekers with Federal

employment opportunities, applicants from groups underrepresented in the workforce are often disadvantaged

due to challenges in meeting certiﬁcations and developing a resume that leads to an ofﬁcial offer from NIH.

“These gate keeping

processes are locking people

like me out of NIH and pretty

much ensuring that my career

will fail.”

Respondents encouraged expanding outreach via in-person and virtual workshops and job fairs for sharing

information on the NIH job application and submission processes. Moreover, suggestions indicated that these

efforts would be particularly beneﬁcial for individuals from groups underrepresented in the workforce and those

training or employed at MSIs. Though outside NIH’s purview, respondents suggested an overall review of the

USAJOBS process to ensure that all applicants receive fair and unbiased chances to work within the Federal

Government.

Respondents also reported a lack of career advancement opportunities for some members of the internal NIH

workforce. For example, respondents observed a lack of successful transitions between NIH post-doctoral

trainees and full-time NIH positions, particularly for members of groups underrepresented in science.

Extramural Biomedical Research Workforce

Several concerns about the extramural biomedical research workforce were noted, including overall lack of

diversity within the workforce and persistent barriers to success for members of groups underrepresented

in science. Comments addressed the unique challenges of researchers at lower-resourced institutions and

described the pressure felt by researchers from racial and ethnic minority populations. Respondents from

academic research settings indicated that academia still feels like an “old boys club” due to a lack of diversity,

encompassing race, ethnicity, gender, and other demographic characteristics. There was a perception that

success is determined by how well one is connected. Although there have been efforts to diversify grad-

uate and post-doctoral pools, respondents reported comparatively fewer resources to support individuals

from underrepresented racial and ethnic groups in obtaining faculty and leadership positions in the extramural

research workforce.

Common suggestions were for NIH to prioritize and build a more diverse student-to-workforce pathway and

encourage and/or require, where possible, the diversiﬁcation of the extramural research workforce. One speciﬁc

suggestion was for NIH to support researchers from racial and ethnic minority groups by working with academic

research institutions to improve their hiring practices and long-term mentoring. Moreover, lower-resourced MSIs

reported challenges retaining highly productive researchers. Speciﬁcally, successful, well-published researchers

from underrepresented racial and ethnic groups who are employed at lower-resourced MSIs are often recruited

by higher-resourced institutions that can offer higher pay and/or less intensive teaching demands. This pattern

creates a continuous cycle in which lower-resourced institutions repeatedly invest in and train new researchers

in a way that ultimately may limit long-term institutional growth.

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The extramural biomedical research community was

encouraged to rethink and reimagine the range of staff

that can positively contribute to biomedical research.

Speciﬁc suggestions were made to expand and diversify

the biomedical research community by welcoming inter-

disciplinary professionals into the ﬁeld, such as experts

in health communication, policy, law, public health, and

community-based partnerships. Recommendations to

support diversity of background also included increas-

ing access to various educational degrees or training

programs by creating free or low-cost certiﬁcations or

open access online courses that would lower barriers

and expenses for research training.

“Minoritized faculty are more likely to

mentor and train students from minoritized

groups. Yet, mentoring is not considered to

be a core element in the retention,

promotion, and tenure (RTP) process at

colleges and universities. Until universities

are encouraged or required to value

mentoring as part of the RTP process, it

will always disadvantage faculty from

minoritized groups, who will continue to

mentor students from BIPOC groups.”

Internal NIH and Extramural Biomedical

Research Workforce

Several factors were reported as impacting both the internal NIH workforce and the workforce at extramural

research institutions. Commonly cited issues included barriers affecting members of groups underrepresented

in science across hiring, promotion, retention, and tenure practices. Respondents noted that workplace discrim-

ination causes individuals to leave academia or stagnate in their careers as they are passed over for promotion

and opportunities. Work environments are sometimes isolating and hostile for researchers from groups under-

represented in science, respondents observed, which may lead to adverse personal and professional effects.

Several respondents alleged continual implicit and explicit bias

toward members of racial and ethnic minority communities

within NIH and the extramural research workforce. They noted

that issues should be able to be raised without fear of retalia-

tion, such as missed opportunities and promotions.

“An unwelcoming environment

is indescribable, but deeply felt,

especially among underrepresented

faculty and students.”

According to respondents, retention of diverse staff at NIH and

within academia is critically important and may require a cul-

ture shift. Respondents noted that due to lower salaries, lack of beneﬁts and work-life integration, and explicit

or implicit bias directed toward members of racial and ethnic minority groups, talented scientists are drawn to

non-STEM careers or non-academic biomedical careers. Respondents delineated several barriers to promotion

and tenure within NIH and across academic research institutions. Several respondents described an over-em-

phasis on publications and grant funding required for promotion and tenure, which can limit individuals who

are trained or employed at lower-resourced institutions. As previously discussed in the Student-to-Workforce

and Career Pathways section, efforts spent on academic and scientiﬁc service are often not considered in

promotion and tenure decisions. Respondents reported that this practice signals that DEI-related activities are

not prioritized or valued.

Academic respondents, including respondents from HBCUs, suggested that limited academic networks

and a lack of strong mentor relationships impede applicants from groups underrepresented in science when

searching for employment at NIH and academic institutions. Nepotism and cronyism—situations where family

and friends are given unfair advantages—were commonly discussed by respondents, particularly concerning

hiring practices. Afﬁnity bias was often noted, where individuals have an unconscious tendency to prefer others

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like them, leading to preference in hiring, mentorship,

promotion, and selection to participate in commit-

tees. Some stated that when underrepresented racial

or ethnic minority staff are invited or selected for

coveted roles and positions, they perceive a sense of

tokenism, wherein their presence is solely due to the

need to fulﬁll diversity requirements rather than their

talent and expertise. Furthermore, HBCU respon-

dents described a sense of self doubt that when they

obtain roles, it may not have been due to their merits

and achievements (or conversely, that others perceive it was not due to their merits). Taken as a whole, these

impacts create signiﬁcant barriers for the career paths for individuals from groups underrepresented in science

in their pursuit of careers in the biomedical research workforce.

“Imposter syndrome/difﬁculty in asking for

help - minority faculty may be dealing with

racism on their campuses or from their

colleagues and this can make it more difﬁcult

for them to ask for help since they are afraid

that people will judge them poorly for

needing help.”

Diversity in Leadership and Hiring Committees

Diversity in leadership and hiring committees was highlighted as playing an important role in improving diver-

sity within the biomedical research workforce. Many respondents noted that groups underrepresented in

science are underrepresented in leadership and hiring committees. Comments also noted that while Asian

Americans are overrepresented in the STEM workforce, this group remains underrepresented in leadership and

administrative positions. Comments highlighted that women, particularly those who are members of racial or

ethnic minority groups, are also underrepresented in these positions.

Most of the discussion related to this topic focused on the internal NIH workforce. However, some comments

also applied to the extramural biomedical research workforce. Several respondents indicated that diversifying

the NIH internal workforce begins with diverse hiring committees and NIH leadership. They described how the

mentality of hiring an individual based on a perception of a “good

ﬁt” can lead to biases and barriers, often leading decision-makers

to prioritize similarity over diversity. Respondents also reported a

perception that some NIH job postings are not open to diverse

and qualiﬁed candidates because preferred or known candidates

have already been identiﬁed prior to the publication of the job

announcement. Additionally, respondents emphasized that lead-

ers must set the tone and expectations around the importance of

diversity and empower staff to openly discuss DEI-related issues in

the workplace.

“[M]any of the hiring and

selection managers aren’t from

diverse backgrounds and lean

toward hiring people who look

like them.”

A lack of diversity in leadership and hiring committees across the biomedical research workforce is believed

to result in hiring, promotion, and retention bias within NIH and the extramural research workforce. Targeted

mentoring and training are viewed as necessary for underrepresented racial or ethnic minority researchers to

succeed in the biomedical research workforce. Furthermore, ongoing implicit bias training for investigators

and leadership at NIH was deemed essential for advancing DEI. Responses noted the importance of diver-

sity in leadership teams, grant review panels, hiring committees, and individuals in decision-making or gate-

keeping roles.

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HEALTH DISPARITIES AND HEALTH EQUITY RESEARCH

As identiﬁed by respondents, research on health disparities and health equity offers pathways to ensure all

communities can obtain equitable health outcomes and can access necessary health care resources. Respon-

dents reported that health disparities research was less valued or supported by NIH, which respondents stated

contributes to inequities in funding and lack of diversity in the workforce.

A summation of respondents’ recommendations related to health disparities and health equity research is

detailed in Table 5.

Table 5: Summary of Recommendations for Health Disparities and Health Equity Research

Topic Recommendations

Prioritization and

Support of Health

Disparities and Health

Equity Research

• Improve prioritization and funding of health disparities and health

equity research

• Increase resources and funding for NIMHD

• Ensure all NIH ICs support health disparities and health equity research

• Emphasize the value of qualitative, mixed methods, social science,

translational, community-based, community-engaged, and multi-

disciplinary research models

• Support culturally sensitive and inclusive study designs

• Prioritize research on underrepresented populations and consider data

disaggregation techniques and/or cohort studies that would examine

the needs of individuals from underrepresented groups

• Increase funding opportunities that address the health effects of bias,

racism, and xenophobia

• Focus on disease areas with signiﬁcant disparities across underserved

communities

Prioritization and Support of Health Disparities and Health Equity Research

“Collaboration of NIH institutes

with NIMHD on addressing health

disparities/inequities needs to be

heightened to increase the funding

of studies on health inequities

throughout NIH. While this has

increased in the last few years, this

has to be taken to a greater scale to

result in meaningful advancement of

our understanding of health.”

Respondents urged NIH to prioritize health disparities and health

equity research to better understand the health needs of pop-

ulations that experience health disparities. Many respondents

also emphasized the importance of adequate funding for this

research, noting that a failure to support health disparities and

health equity research will lead to limited advancements and

inadequate strategies to improve health disparities and out-

comes. Respondents, predominantly those from academia, per-

ceived that the devaluing of health disparities and health equity

research is partially due to biases in the grant review process

that impact funding opportunities. There were calls for NIH to

expand resources for NIMHD that will enable the Institute to

increase funding for extramural research and stafﬁng. Respon-

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dents also emphasized the need for all NIH ICs to increase funding and prioritize health disparities and health

equity research. Respondents stressed that this research is crucial across ICs and should not be the sole

purview of NIMHD.

Comments highlighted how speciﬁc groups—including women; Asian Americans, Native Hawaiians, and Pacif-

ic Islanders (AANHPI); individuals from Tribal communities; members of sexual and gender minority groups

(SGM); and members of the disabled community—remain largely overlooked, even in considering recent health

disparities and health equity research. Responses encouraged disaggregation of data within these groups, use

of cohort studies to examine the needs of subgroups, and more consideration of intersectionality. Respondents

also proposed speciﬁc funding opportunities that would address health care needs in these communities, as

well as continued research investment on the health effects of bias, racism, and xenophobia.

Respondents noted that there are many researchers from groups underrepresented in science interested in

studying health disparities and health equity, yet respondents assert there are biases that prevent certain types

of research from receiving NIH funding. Respondents suggested NIH emphasize the value of qualitative, mixed

methods, social science, translational, community-based, and multi-disciplinary research models. They per-

ceived these research approaches as valuable for assessing the magnitude and nuances of health disparities.

Respondents also highlighted the importance of culturally sensitive and inclusive study designs, which are

essential for understanding population interests and recruiting diverse patient populations.

COMMUNITY PARTNERSHIPS AND OUTREACH

Complementary to the responses discussed above, respondents noted that NIH should support and encour-

age community-engaged research to address health disparities and health equity. Respondents identiﬁed that

when a speciﬁc underserved community or population is the focus of a research study, guidance from com-

munity members in the development of study design and execution can ensure the methods and interventions

appropriately reﬂect the needs of communities.

Many responses emphasized the value of developing relationships with community-based organizations

and community members. Some comments highlighted organizations in speciﬁc communities (e.g., Tribal

communities) and others referred to organizations more broadly (e.g., local health organizations). NIH was

encouraged to improve community outreach to build or strengthen partnerships with community groups.

Respondents noted that community partnerships involve biomedical researchers and community members

working together toward common goals, with each partner bringing resources and strengths, resulting in

stronger research studies and more relevant health outcome measures.

A summation of respondents’ recommendations for improved community partnerships and outreach is

detailed in Table 6.

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Table 6: Summary of Recommendations for Community Partnerships and Outreach

Topic Recommendations

Building Community

Partnerships

• Build community partnerships to encourage community participation

in the development of programs and initiatives, understanding of, and

participation in NIH research studies

• Require or incentivize applicants to incorporate community-based

approaches into their research

• Invite community members to serve as investigators, participate in

the grant review process, and serve as an intermediary between

investigators and study participants

• Build partnerships upon trust and in a collaborative manner

Building Community Partnerships

Respondents highlighted that partnerships between communities and researchers can contribute to the

sustainability of effective interventions and support participation by groups underrepresented in science.

There was an emphasis among respondents on the value of developing relationships with community-based

organizations, with many encouraging NIH outreach to build and strengthen partnerships with these groups.

Respondents suggested more active leveraging of community networks, including developing community-

based recruitment centers to increase participation in biomedical research.

Respondents indicated that community engagement is critical to ensuring that research reﬂects the needs

and outcomes of the community of interest. Respondents highlighted the signiﬁcance of partnerships and

engagement that promote community participation. Responses noted that it is vital to include community

voices in program development and grant review to build trust and provide critical insights. They recommended

NIH increase funding for community partnerships. Responses recognized that increasing interest in commu-

nity-based partnerships and addressing barriers, such as associated costs, will take time. Several policy-lev-

el recommendations were offered, such as requiring or incentivizing applicants and grantees to incorporate

community-based approaches into their research. Other recommendations included expanding the grant time

frame to allow for community-engaged research and providing funding to community partners that includes

the administrative and delivery costs of participating in research projects. Respondents described the impor-

tance of partnerships with Tribal communities and Tribal

Colleges and Universities (TCUs) that are built upon

trust. These responses noted that building trust begins

with understanding and asking communities about the

research areas that are paramount to their communities,

working collaboratively, and reporting the results to the

communities and participants. Respondents expressed

a desire for more outreach and collaboration with TCUs,

including investment in American Indian and Alaska

Native students to support the biomedical research

workforce pathway.

“Encourage study co-design with

community stakeholders from the

beginning, which can both provide

critical insights and build trust. This

should include racial and ethnic

minorities, leaders from poor

geographical communities, small rural

county governmental representatives,

representatives from multiple

sectors, etc.”

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CROSS-CUTTING THEMES

A collection of concepts emerged throughout responses that were not unique to any one RFI topic area,

respondent type, or response focus. These areas were identiﬁed from respondents’ comments as cross-

cutting themes that span all aspects of DEI planning at NIH and the biomedical research workforce. Col-

lectively, these cross-cutting themes may help to inform actions in support of DEI across the biomedical

research workforce.

Cross-Cutting Themes

Expand the

Scope of

Inclusion

Implement DEI

Initiatives

Operationalize

Diversity

Metrics

Enhance and

Expand DEI

Training

Improve

Communication

and Outreach

Acknowledge

Structural Racism

and Its Impact

EXPAND THE SCOPE OF INCLUSION

There were requests to expand NIH’s deﬁnition of DEI. Often, responses suggested NIH has ignored groups that

may be viewed as “less” marginalized. Respondents encouraged NIH to expand its focus to consider factors

beyond race and ethnicity and include attention to demographic factors such as SGM status, age, geography,

and disability status. These respondents frequently highlighted inclusion and accessibility concerns for many

underrepresented populations and brought attention to how intersectionality may further impact opportunities

for members of racial and ethnic minority groups.

Some responses also highlighted the fact that the NIH deﬁnition for underrepresented scientists does not

include Asian Americans; however, respondents noted that individuals from Asian American subgroups (e.g.,

Hmong, Vietnamese, Filipino, Laotian, Cambodian Americans) are vastly underrepresented in STEM ﬁelds.

Respondents stated their perception that some diversity-oriented NIH training opportunities are inaccessible

to Asian American researchers.

Respondents also noted that grouping diverse communities into single categories does not appropriately

account for the heterogeneity within communities and may inadvertently mask the challenges experienced by

individuals. For example, subgroups within the AANHPI population show evidence of signiﬁcant health dispar-

ities in areas of diabetes, cancer, and mental and behavioral health disorders.

However, these disparities are

often difﬁcult to assess when data is presented for the entire AANHPI population without examining differences

across subgroups. Some respondents called for the disaggregation of racial and ethnic data when reporting

NIH internal and biomedical research workforce data, as well as when reporting data on the demographics

of participants in NIH-funded research, particularly when considering AANHPI, Hispanic/Latino, and Middle

Eastern and North African populations.

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“While this RFI and the response here is primarily focused on racial equity, we note

the importance of intersectionality in properly addressing structural racism and

discrimination and hope the agency will consider in its work all groups facing inequities

in the biomedical research workforce, including racial and ethnic minorities, women,

persons with disabilities, LGBTQ individuals, and ﬁrst-generation college students as

well as other individuals from diverse backgrounds.”

IMPLEMENT DEI INITIATIVES

There were concerns that NIH’s focus on structural

racism, as represented in this RFI, would not be fol-

lowed by signiﬁcant, tangible action or implementa-

tion. Although some respondents indicated positive

perceptions of NIH’s recent acknowledgment of

structural racism, many stated that further action

is needed. Responses indicated that although NIH

has had longstanding awareness of the lack of diver-

sity in funded research and the biomedical research

workforce, NIH could do more to implement concrete

actions aimed at eliminating bias and advancing DEI.

Moreover, some respondents stated they could not identify any DEI programming or initiatives at NIH, while

others noted they could not identify examples of successful programs. They called on NIH to implement action-

able solutions and continuously report on the progress of DEI initiatives.

“The recent announcement that NIH

acknowledges the existence of structural

racism and disparities was a good start

but it must be followed by brave action,

in the knowledge that attempts to move

towards equity will come under attack

from privileged groups protecting their

favorable position.”

OPERATIONALIZE DIVERSITY METRICS

Respondents called on NIH to collect, assess, track,

and report data on diversity and the outcomes of relat-

ed policies, procedures, and processes. Respondents

urged NIH to increase accountability by measuring the

progress and impact of the UNITE initiative and other

DEI-related programming. Other recommendations for

improved accountability included sharing and publishing

demographic data on both the NIH and biomedical research workforces, sharing and publishing information on

the diversity of grant reviewers, and publicly reporting the outcomes of the grant review process (e.g., score

distribution). Additionally, responses encouraged NIH to expand reporting and transparency regarding DEI met-

rics, particularly within the grant application and review process. Respondents encouraged NIH to implement a

data-driven strategy to build a more inclusive workforce and meet the UNITE initiative’s broader goals.

“Tangible goals are essential. NIH must

set measurable objectives… The broader

ecosystem of accountability, recognition,

and rewards is the future.”

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ENHANCE AND EXPAND DEI TRAINING

Improvements to DEI training, mandating training for speciﬁc groups, and increasing training volume and

frequency, both at NIH and across the biomedical research workforce, were frequently suggested. Implement-

ing mandatory training was recommended for grant reviewers, internal NIH staff, PIs supported by NIH grants,

academic and research mentors, early-stage investigators, trainees, and fellows. Respondents frequently

encouraged NIH to transition beyond simple implicit bias training to a more comprehensive evidence-based

training.

IMPROVE COMMUNICATION AND OUTREACH

Improved communication was highlighted as a fundamental way to enhance NIH institutional partnerships,

community engagement, the grant application process, and relationships with current or potential NIH trainees

and staff. Many submissions called for NIH to increase and improve internal and external communication to

support DEI. Respondents drew particular attention to the need for better communication with underrepre-

sented communities and lower-resourced institutions.

A few suggested communication priorities included

simplifying NIH communication to avoid language

barriers; expanding targeted outreach to administra-

tive support staff and investigators at MSIs and low-

er-resourced institutions; and improving outreach to

students, trainees, and early-career researchers from

groups underrepresented in science. Some requested

outreach formats included hosted discussions, listen-

ing sessions, seminars, and trainings and workshops.

“Communication will be key to the success

of these efforts and visuals/words must be

weighed carefully…. If there is an end goal

for these current efforts… then I suggest

that should be conveyed clearly and with

assurances [that UNITE] is not a one and

done.”

ACKNOWLEDGE STRUCTURAL RACISM AND ITS IMPACT

While most RFI respondents agreed with the hypothesis that structural racism presents obstacles for mem-

bers of racial and ethnic minority groups in the biomedical research workforce, some denied the existence of

structural racism. There was disagreement regarding the existence or implications of structural racism in the

biomedical workforce amongst respondents. Some indicated that they did not feel there was a lack of diversity

or evidence of structural racism at NIH or in the biomedical workforce, while some respondents described their

perception of what they referred to as “reverse discrimination.” These subsets of respondents often expressed

that career advancement and grant funding decisions should be strictly merit-based and without regard to

diversity, equity, or inclusion considerations. These comments highlighted a belief that science is strongest

when it is purely merit-based.

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DISCUSSION 

Analysis of responses suggested signiﬁcant interest in the above-discussed topics on behalf of many types

of respondents. Forty-six percent of responses came from members of academia, including 2% from HBCUs,

although respondents spanned a variety of categories, including NIH staff, health professionals, and non-proﬁt

and/or professional societies. Most respondents indicated agreement with the ideas put forward in the RFI,

i.e., that NIH carries a signiﬁcant responsibility to address the systemic challenges and barriers affecting the

NIH workforce and NIH-supported biomedical research community and that enhancing workforce diversity

and equity across the biomedical enterprise are critical steps to achieving progress in these areas. However, a

portion of respondents did not perceive or denied concerns related to structural racism or other forms of bias,

inequitable treatment, or discrimination within NIH or the greater biomedical workforce.

Overall perceptions of NIH’s attempts to address structural racism and inequities prior to the release of the

RFI were mixed. Many respondents described NIH as supportive of workforce diversity but noted a lack of

implementation and little tangible evidence of change. Many respondents described their perceptions of NIH

as a predominantly White, male organization, especially at the leadership and senior levels. This perceived lack

of diversity was also extended to the larger biomedical workforce.

Responses and recommendations for NIH spanned a broad array of topics. The grant process was most

frequently cited by respondents, who asserted that review policies and lack of diversity on review panels are

some of the most signiﬁcant contributors to racial and ethnic funding gaps among extramural researchers.

Relatedly, many respondents indicated that health disparities and health equity research is not adequately or

equitably prioritized across all NIH ICs. Many comments noted grant reviewers often are not well trained to

consider research designs and methodologies frequently used in health disparities research, including commu-

nity-appropriate approaches, qualitative designs, and projects that focus on social or structural determinants

of health, which further perpetuates lack of funding for health disparities research.

Training and mentorship; hiring, promotion, and retention; and community outreach and engagement were

also areas of frequent focus. Respondents highlighted speciﬁc concerns across these topics and provided

recommendations for NIH to address these challenges. Some recommendations were outside NIH’s purview.

Other recommendations were appropriate for NIH to consider and could also be applied by other employers,

organizations, or partners across the biomedical workforce. Many respondents called upon NIH to lead by

example to build trust in the biomedical community. They called for NIH to do this via increased outreach,

engagement, and communications surrounding structural racism, diversity, equity, and inclusion.

Responses to this RFI highlighted the need to assess biases and barriers to DEI in policies, practices, and

procedures at NIH and external research institutions. This RFI represents one of the earliest efforts of the

NIH UNITE initiative and one of the broadest attempts to gather input on this important topic from NIH part-

ners, collaborators, and the public. NIH appreciates the exceptional number of detailed, thoughtful responses

from respondents who represent many facets of the biomedical workforce and broader community. Practical

recommendations shared by respondents, summarized in this report, will assist NIH in identifying, developing,

and implementing strategies that will allow the biomedical enterprise to beneﬁt from a more diverse and

inclusive research workforce and a more robust portfolio of research to better understand and address

inequities in our existing system.

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APPENDIX 1: GLOSSARY

All deﬁnitions marked with † are from the NIH Glossary.

Deﬁnitions marked with * are deﬁned within this report.

Term Deﬁnition/Description

Accessibility

The design, construction, development, and maintenance of facilities, information

and communication technology

, programs, and services so that all people,

including people with disabilities, can fully and independently use them.

Accessibility includes the provision of accommodations and modiﬁcations to

ensure equal access to employment and participation in activities for people

with disabilities; the reduction or elimination of physical and attitudinal barriers to

equitable opportunities; a commitment to ensuring that people with disabilities

can independently access every outward-facing and internal activity or electronic

space; and the pursuit of best practices such as universal design.

Administrative

infrastructure

The support, tools, and capacity to manage the general business practices

that ar

e common to research administration, including the preparation and

submission of grant applications and post-funding administrative functions.

ﬁnity bias

The unconscious tendency by which individuals prefer others similar to

themselves.*

Bias

Attitudes, behaviors, and actions that are prejudiced in favor of or against one

person or gr

oup compared to another.*

Biomedical r

esearch

workforce

The collection of individuals who comprise the NIH internal research workforce

(primarily intramural) and the extramural biomedical r

esearch workforce (NIH-

funded investigators, researchers, trainees).

Black, Indigenous

and People of Color

(BIPOC)

This is a term speciﬁc to the United States and is intended to center the

experiences of Black and Indigenous gr

oups and demonstrate solidarity between

communities of color.

Community-engaged

research

The process of engaging the community to help develop research questions,

design a study

, and collect data with the goal to answer a scientiﬁc question or

meet a speciﬁc research need. Types of community-engaged research include

action research, community-based participatory research, and participatory action

research.

Community

engagement

The process of working collaboratively with and through groups of people

ﬁliated by geographic proximity, special interest, or similar situations to address

issues affecting the well-being of those people.

Cronyism

Bestowing of favors to friends, colleagues, and associates based on personal

elationships and connections rather than actual performance standards.

DEIA Executive

Order 14035

Aims to ensure that the Federal Government, the nation’s largest employer, is

a model for Diversity

, Equity, Inclusion, and Accessibility (DEIA) practices and a

place where all employees are treated with dignity and respect.

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Term Deﬁnition/Description

Diversity

The practice of including the many communities, identities, races, ethnicities,

backgrounds, abilities, cultures, and beliefs of the American people.

Early-career

researchers

Individuals in the early stages of their career, including pre-doctoral

researchers through early-stage investigators.*

Early-stage

investigators

Program Director / Principal Investigator (PD/PI) who has completed their

terminal research degree or is at the end of post-graduate clinical training within

the past 10 years, whichever date is later, and has not previously competed

successfully as PD/PI for a substantial NIH independent research award.†

Equity

The consistent and systematic fair, just, and impartial treatment of all

individuals, including individuals who belong to underserved communities that

have historically been denied such treatment.

Extramural research

workforce

Researchers external to NIH for whom NIH provides funding support.*

Grant review criteria

(scored)

Impact scores are based on grant reviewers’ assessment of 1) signiﬁcance,

2) investigator(s), 3) innovation, 4) approach, and 5) environment.

Grants process

Steps required for an application to proceed from planning and submission

through to award.

Groups

underrepresented

in science

Individuals from racial and ethnic groups that have been shown by the National

Science Foundation to be underrepresented in health-related sciences on a

national basis. The following racial and ethnic groups have been shown to be

underrepresented in biomedical research: Blacks and African Americans,

Hispanics or Latinos, American Indians or Alaska Natives, Native Hawaiians

and other Paciﬁc Islanders.

Health disparities

research

Research that focuses on differences in health outcomes for deﬁned

disadvantaged populations that are worse than the White reference

population.

Health disparity

A health difference that adversely affects disadvantaged populations, based on

one or more of the following health outcomes:

• Higher incidence and/or prevalence and earlier onset of disease

• Higher prevalence of risk factors, unhealthy behaviors, or clinical

measures in the causal pathway of a disease outcome

• Higher rates of condition-speciﬁc symptoms, reduced global daily

functioning, or self-reported health-related quality of life using

standardized measures

• Premature and/or excessive mortality from diseases where population

rates differ

• Greater global burden of disease using a standardized metric

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Term Deﬁnition/Description

Health equity

research

Research that interrogates the dynamic, cumulative, and interrelated structures of

power

, environmental conditions, and economic systems that produce inequities

in health between different populations. Health equity research also identiﬁes,

promotes, and leverages unique community-informed protective factors that are

traditionally undervalued and understudied.

Health inequity

Systematic differences in the opportunities that groups have to achieve

optimal health, leading to unfair and avoidable dif

ferences in health

outcomes.

Historically Black

College or University

(HBCU)

Any historically black college or university established prior to 1964 whose

principal mission was and is the education of Black Americans and is

accredited by a nationally recognized accrediting Agency or Association

determined by the Secretary of Education to be a reliable authority as to the

quality of training offered, or is, according to such an Agency or Association,

making reasonable progress toward accreditation.

†

Imposter syndr

ome

When high-achieving individuals who, despite their objective successes, fail to

inter

nalize their accomplishments and have persistent self-doubt and fear of being

exposed as a fraud or imposter.

Inclusion

The recognition, appreciation, and use of the talents and skills of employees of all

backgr

ounds.

Institute or

Center (IC)

The NIH organizational component responsible for a particular grant program or

set of activities.†

Inter

nal NIH

workforce

All NIH staff, research and non-research staff, Federal employees, and

contractors.*

Intramural r

esearch

workforce

NIH internal researchers and staff who conduct biomedical research within the

conﬁnes of NIH ICs.*

Lower

-resourced

institution

Institutions that are generally characterized as having insufﬁcient resources and

tend to serve large numbers of disadvantaged and/or low- income students.

Microaggression

Everyday verbal, nonverbal, and environmental slights, snubs, or insults—whether

intentional or unintentional—that communicate hostile, der

ogatory, or negative

messages to individuals based solely upon their marginalized group membership.

Microaggressions repeat or afﬁrm stereotypes about a minority group, and they

tend to minimize the existence of discrimination or bias, intentional or not.

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Term Deﬁnition/Description

Minority serving

institution (MSI)

Institutions of higher education that serve minority populations, and strive to give

their constituents the social and educational skills needed to overcome racial

discrimination and limited economic opportunities.

Minority tax

Extra, ﬁnancially uncompensated duties and responsibilities that minorities are

asked to perform to increase diversity at their institutions, such as serving on a

search committee that would otherwise be all White.

Nepotism

Inappropriate action related to the appointment, employment, promotion, or

advancement of a relative, recommending that a relative receive an award, or the

advocacy of such actions for the beneﬁt of a relative.

NIH non-research

workforce

NIH staff (e.g., administration, human resources, budget, facilities, and logistics)

across the enterprise in non-research roles.*

Othering

The construction and identiﬁcation of the self or in-group and the other or out-

group in mutual, unequal opposition by attributing relative inferiority and/or radical

alienness to the other/out-group.

Outreach

Sending/receiving information or news, including targeted communication with

certain groups or institutions.*

Payline

A percentile-based funding cutoff point determined by balancing the projected

number of applications coming to an NIH Institute with the amount of funds

available. Set after the budget is determined, paylines are not mandatory, are not

made for all activity codes, and may be adjusted during the year.†

Pre-graduate

student

An individual receiving education in the grades Kindergarten through twelfth

grade, or undergraduate education.*

Principal

Investigator (PI)

An individual designated by the applicant organization to have the appropriate

level of authority and responsibility to direct the project or program supported

by an award. The PI is responsible and accountable to the recipient organization

or, as appropriate, to a collaborating organization, for the proper conduct of the

project or program, including the submission of all required reports.†

Program Ofﬁcial (PO)

NIH ofﬁcial who is responsible for the programmatic, scientiﬁc, and/or

technical aspects of a grant.†

R1 universities

Institutions that meet benchmarks across 10 indicators measured by the

Carnegie Classiﬁcation of Institutions of Higher Education indicating that the

university engages in “very high research activity.”

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Term Deﬁnition/Description

R2 universities

Institutions that meet benchmarks across 10 indicators measured by the

Carnegie Classiﬁcation of Institutions of Higher Education indicating that the

university engages in “high research activity.”

Racial and ethnic

minorities

NIH uses the racial and ethnic group classiﬁcations determined by OMB in the

Revisions to Directive 15, titled Standards for Maintaining, Collecting, and

Presenting Federal Data on Race and Ethnicity. The minority racial and ethnic

groups deﬁned by OMB are American Indian or Alaska Native, Asian, Black or

African American, and Native Hawaiian or other Paciﬁc Islander. The ethnicity

used is Latino or Hispanic.

Racial equity

A process of eliminating racial disparities and improving outcomes for everyone.

It is the intentional and continual practice of changing policies, practices, systems,

and structures by prioritizing measurable change in the lives of people of color.

Research

infrastructure

The resources and services for conducting research, including major equipment

or sets of instruments, knowledge-related facilities such as collections, archives

or scientiﬁc data infrastructures.*

Research project

grant (R01)

Provides support for health-related research and development based on the

mission of NIH, R01s can be investigator-initiated or can be solicited via a

Request for Applications. The R01 research plan proposed by the applicant must

be related to the stated program interests of one or more of the NIH Institutes and

Centers based on their missions.

Scientiﬁc Review

Ofﬁcer (SRO)

NIH ofﬁcial who serves as the designated Federal ofﬁcial and has legal

responsibility for managing the peer-review meeting, the procedures for evaluating

the applications assigned to the scientiﬁc review group, and the determinations

and management of conﬂicts of interest, as noted in 42 CFR 52(h).†

Select pay

The funding of a small number of programmatically important applications at the

margin of the payline as recommended by Council.†

Student-to-

workforce pathway

The path students take to explore, identify, and pursue a career in biomedical

research.*

Summary statement

A combination of the reviewers' written comments and the SRO's summary of

the members' discussion during the study section meeting. It includes the

recommendations of the study section, a recommended budget, and

administrative notes of special considerations.†

Trainees Pre-doctoral and post-doctoral researchers training in biomedical research.*

NATIONAL INSTITUTES OF HEALTH

Term Deﬁnition/Description

Undergraduate

student

An individual seeking one of two higher education degrees—an associate degree

or a bachelor’s degree.

Underrepresented

group

Group of individuals underrepresented in the biomedical, clinical, behavioral,

and social sciences, such as people with disabilities, people from disadvantaged

backgr

ounds, and certain racial and ethnic groups such as Blacks or African

Americans, Hispanics or Latinos, American Indians or Alaska Natives, and Native

Hawaiians and other Paciﬁc Islanders.

†

Underserved

communities

Populations that share a particular characteristic and/or geographic

communities that have been systematically denied the full opportunity to

participate in aspects of economic, social, and civic life. In the context of the

Federal workforce, this term includes individuals who belong to communities of

color, such as Black and African American, Hispanic and Latino, Native

American, Alaska Native and Indigenous, Asian American, Native Hawaiian

and Paciﬁc Islander, Middle Eastern, and North African persons. The term also

includes individuals who belong to communities that face discrimination based

on sex, sexual orientation, and gender identity (including lesbian, gay, bisexual,

transgender, queer, gender non-conforming, and non-binary (LGBTQ+) persons);

persons who face discrimination based on pregnancy or pregnancy-related

conditions; parents; and caregivers. It also includes individuals who belong to

communities that face discrimination based on their religion or disability;

ﬁrst-generation professionals or ﬁrst-generation college students; individuals with

limited English proﬁciency; immigrants; individuals who belong to communities

that may face employment barriers based on older age or former incarceration;

persons who live in rural areas; veterans and military spouses; and persons

otherwise adversely affected by persistent poverty, discrimination, or inequality.

Individuals may belong to more than one underserved community and face

intersecting barriers.

USAJOBS

The Federal Government’s ofﬁcial employment site (www.usajobs.gov) that

connects job seekers with Federal employment opportunities.

NATIONAL INSTITUTES OF HEALTH

APPENDIX 2: SUMMARY OF RECOMMENDATIONS

Topic: Grants Process Recommendations

Grant Application

Process

• Provide more outreach from NIH, especially to researchers and trainees

from racial and ethnic minority groups and lower-resourced institutions,

to support grant application and submission efforts

• Clarify and simplify application and submission instructions and

requirements

• Offer workshops and institutional grants to provide support for

application submissions and grant administration

• Expand time frames between publication and submission deadlines

for FOAs

Grant Review Process

• Change or remove the environment and investigator criteria

• Anonymize review

• Add review criteria on diversity and mentorship, including the Principal

Investigator (PI) and team, the commitment of the institution and the PI,

and the relevance to health disparities research

• Diversify review panels

• Require DEI training for reviewers and Scientiﬁc Review Ofﬁcers (SROs)

Funding Priorities and

Selection of Grant

• Utilize select pay or expanded paylines for applicants who are

underrepresented in science and for applications proposing health

disparities and health equity research

• Increase transparency and standardize pay policies across NIH

• Institute random selection lotteries for meritorious applications

• Cap funding for higher-resourced investigators and institutions

NATIONAL INSTITUTES OF HEALTH

Topic: Student-to-

Workforce and Career

Pathways

Recommendations

Pre-graduate Curricula

and Exposure to STEM

• Develop and fund improved pre-graduate STEM education aimed at

diverse groups of scholars

• Increase outreach to pre-graduate students by members of the

biomedical research community

• Support diversity bridge programs and opportunities to engage in

research

Financing Undergraduate

and Graduate Training

• Address disparities in student loans and repayment programs

• Support graduate students through fast-track programs and

connections to post-doctoral positions

• Increase funding to current NIH training programs that support diverse

trainees

Research Training

• Invest in research infrastructure to support training programs at

lower-resourced institutions

• Make institutional training grants accessible

• Expand diversity funding mechanisms to better support early-career

researchers

Barriers to Career

Development

• Increase salaries of graduate students and research trainees

• Increase or expand beneﬁts for graduate students, post-doctoral

trainees, and early-career researchers

• Improve opportunities for work-life integration through workplace

ﬂexibilities

• Create protected time for and reward academic and scientiﬁc service

NATIONAL INSTITUTES OF HEALTH

Topic: Student-to-

Workforce and Career

Pathways

Recommendations

Mentorship and

Academic Networks

• Support mentorship initiatives for the internal NIH and extramural

research workforce

• Add mentoring requirements to grant criteria

• Incentivize institutions and faculty to support and expand mentorship

programs

• Create partnerships between lower-resourced and high-resourced

institutions for mentoring and collaborations

• Maintain and add funds to effective mentoring programs

• Improve training, evaluation, and oversight for mentors

• Offer recognition and reward to strong mentors

• Expand networking and collaboration opportunities for trainees and

early-career researchers

Topic: Biomedical

Research Workforce

Recommendations

Recruitment, Hiring,

Promotion, 

and Retention

• Advance researchers from underrepresented groups across all

scientiﬁc career stages at NIH through improved recruitment, hiring,

promotion, and retention practices

• Diversify NIH staff to be more representative of the U.S. population

• Provide more outreach and assistance with the NIH job application

and submission process

• Review the USAJOBS process to reduce bias and improve equity

• Encourage or require the extramural research community to diversify

staff and build a more diverse student-to-workforce pathway

• Rethink and reimagine the scope of staff that can positively contribute

to biomedical research

• Make training more accessible to a wide range of educational degrees

and levels

• Work with research institutions to support long-term mentoring

NATIONAL INSTITUTES OF HEALTH

Topic: Health

Disparities and Health

Equity Research

Recommendations

Prioritization and

Support of Health

Disparities and Health

Equity Research

• Improve prioritization and funding of health disparities and health

equity research

• Increase resources and funding for NIMHD

• Ensure all NIH ICs support health disparities and health equity research

• Emphasize the value of qualitative, mixed methods, social science,

translational, community-based, community-engaged, and multi-

disciplinary research models

• Support culturally sensitive and inclusive study designs

• Prioritize research on underrepresented populations and consider data

disaggregation techniques and/or cohort studies that would examine

the needs of individuals from underrepresented groups

• Increase funding opportunities that address the health effects of bias,

racism, and xenophobia

• Focus on disease areas with signiﬁcant disparities across underserved

communities

Topic: Community

Partnerships and

Outreach

Recommendations

Building Community

Partnerships

• Build community partnerships to encourage community participation

in the development of programs and initiatives, understanding of, and

participation in NIH research studies

• Require or incentivize applicants to incorporate community-based

approaches into their research

• Invite community members to serve as investigators, participate in

the grant review process, and serve as an intermediary between

investigators and study participants

• Build partnerships upon trust and in a collaborative manner

NATIONAL INSTITUTES OF HEALTH

APPENDIX 3: TABLE OF ABBREVIATIONS

Abbreviation

AANHPI Asian American, Native Hawaiian, and Paciﬁc Islander

BIPOC Black, Indigenous and People of Color

DEI Diversity, Equity, and Inclusion

DEIA Diversity, Equity, Inclusion, and Accessibility

EO Executive Order

FOA Funding Opportunity Announcement

GREAT

Genome Research Experiences to Attract Talented Undergraduates

into the Genomics Field to Promote Diversity

HBCUs Historically Black Colleges and Universities

ICs Institutes and Centers

IMSD Initiative for Maximizing Student Development

MSI Minority Serving Institution

NIH National Institutes of Health

NIMHD National Institute on Minority Health and Health Disparities

PD Program Director

PI Principal Investigator

PO Program Ofﬁcial

RFI Request for Information

SGM Sexual and Gender Minority Groups

SRO Scientiﬁc Review Ofﬁcer

STEM Science, Technology, Engineering, and Math

TCU Tribal Colleges and Universities

NATIONAL INSTITUTES OF HEALTH

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