Catherine Sarkisian speaks on the topic of How to Write the “Specific Aims” Section of a Grant Application at the R Award Workshop on November 08, 2018 at UCLA.

1. How to write the "Specific Aims"
section of a grant application
Catherine A. Sarkisian, MD, MSHS
UCLA CTSI R Workshop
November 8, 2018

2. Specific Aims
• This is arguably the most important section of your application
• Write early and circulate
• Length: 1 page. Format can vary but suggest:
– Intro paragraph – capture attention (HOOK/GAP/Critical Need)
– 2nd paragraph - logical next step = proposed solution
– Aims
– Final Summary Paragraph
• Style: Non-technical.
– Write this section for ALL study section members - they’ll all read it.
• This section must include everything that is important and
exciting about your project – but without a lot of detail.

3. 1st paragraph: Capture Attention
Hook/GAP/Critical Need
(Setup Logical Next Step=Your Proposed Solution)
• First 1-2 sentences = HOOK.
– What this proposal is about/why important
– Reference NIH/IOM reports
– Emphasize impact (how many millions effected etc.)
• What is known (~3-5 sentences) CONCISE
– Just enough to educate reviewer
• GAP in knowledge that your research will fill
• Final sentence: CRITICAL NEED for your study
– Need for hypothesis-driven knowledge/technique/treatment
you will develop
– Should set up logical next step=your proposed solution to
advance the field

4. Hook/GAP/Critical Need
There is strong consensus . . that routine pre-op testing for
cataract surgery is inappropriate.1-4 . . .the American Academy
of Ophthalmology even named reducing routine pre-op testing
for cataract surgery as their #1 issue . . . . .5 (HOOK)
Yet despite these widely endorsed evidence-based
recommendations, most seniors undergoing cataract surgery
still receive unnecessary blood testing . . . .6 (GAP)
7 . . . widespread reduction. . would save billions of dollars,
reduce exposure to unnecessary and potentially harmful tests,
and allow millions of seniors to spend more time enjoying life
rather than wasting their time receiving inappropriate health
care. (CRITICAL NEED)

5. Your team’s path towards this project
• can mention prelim studies (not too much detail)
• Show that your team has the expertise to fill that
critical gap you identified in first paragraph
• Include:
– Hypothesis and Rationale
– Proposal objectives
– Team’s qualifications (if possible)
2nd paragraph:
Logical Next Step=Proposed
Solution/Segue into Aims

6. 2nd Para: Logical Next
Step=Proposed Solution/
Segue into Aims
We hypothesize that an .. . . intervention . . will
dramatically reduce pre-op testing for cataract
surgery . . . . (LOGICAL NEXT STEP=Proposed
Solution)
We propose to test this hypothesis by
conducting a pragmatic randomized trial,
implementing our intervention at . . . (Segue into
aims)

7. Aims
• Keep the number of aims reasonable (3-5).
• Each aim should consist of one sentence: be
concise and concrete; clarity is the goal.
• Each aim should
• Describe the experimental approach
• Be clear how tests hypotheses
• Have a realistic time frame
• Have a definitive outcome
• Not be absolutely dependent on the
success of another aim

8. Our Specific Aims are:
1. Integrate a 2-pronged behavioral economics intervention into the UCLA
Health EHR. The intervention will include two types of behavioral nudges
to promote the desired reduction in low value care:
– Nudge #1: (3 lines of text)
– Nudge #2: (3 lines of text)
2. Randomize cataract surgery patients over a one-year period to one of 4
types of pre-operative visits (. . . ) and measure and compare the efficacy
of each intervention using a 2x2 factorial design. Outcomes will be
measured 12-months after the intervention start including:
• Primary outcome = (describe w detail)
• Secondary patient, physician, and system-level outcomes
• Patients: (list a few)
• Physicians (list a few)
• System: (list a few)

9. Final “Paragraph”:
Few sentences to get reviewer
excited to read your proposal
If Aims are an hourglass (wide = general/big
pic, narrow = details), this is the “broad base”
that supports your proposal
• Innovation: what this adds that is NEW
• Outcomes (if you have not stated in Aims)
• Impact/PAYOFF. How this is going to help those that you
mentioned in the first paragraph

10. Final Para (get excited)
Reducing patient exposure to unnecessary care is central to
improving patient outcomes and value. . . Because of the close
partnership between our UCLA Informatics co-Investigators
and the EHR vendor (Epic), the low-cost intervention that we
propose to implement and test would be easily available to all
Epic-based health systems, with potential to dramatically
reduce inappropriate pre-op testing across the nation.
EHRs are in their infancy, and we as a scientific community are
only beginning to learn how to use them as tools to promote
desired care processes.8 This proposed pragmatic trial would
break new ground in our understanding of how behavioral
economics approaches can be used to tamp down on care that
does not promote better patient outcomes.

11. Refer to Specific Aims
throughout Approach Section
• Restate aims and include hypotheses
• Conceptual Model figure very important
– Illustrate Aims on the figure
• Consistent terminology is essential!!
– Measures, analysis, timeline . . .

12. Acknowledgment
• http://www.biosciencewriters.com/NIH-
Grant-Applications-The-Anatomy-of-a-
Specific-Aims-Page.aspx