NIH Pragmatic Trials Conducted in Health Care Systems

The National Institutes of Health (NIH) intends to publish a Notice of Funding Opportunity (NOFO) for pragmatic and implementation trials conducted in health care settings. The funding opportunity will support large-scale pragmatic trials that test intervention effectiveness in routine clinical care and/or implementation trials that evaluate strategies for delivering interventions within health care settings. The trials should be designed to directly inform decision-makers about the comparative benefits, burdens, and risks of biomedical or behavioral interventions. Applicants are encouraged to select care settings where the target condition is commonly seen, include multiple health system types, and assess adaptation across systems and regions. The interventions under study should be embedded in routine care, and trials may integrate one or more interventions with established efficacy into appropriate health care settings or implement system-level changes to improve health outcomes. Some key points to consider include: • The funding opportunity will use a milestone-driven cooperative agreement mechanism, supporting a planning phase and a phase for full trial execution. • Applications are not being solicited at this time, but potential applicants are encouraged to begin developing meaningful collaborations and responsive projects. • The estimated synopsis posting date is November 24, 2026, and the estimated application response date is February 23, 2027. • The estimated award date is December 1, 2027.