Proceedings of: Workshop on Improving Building Design for Persons with Low Vision

Research Issues

Cheri Wiggs, Ph.D., Program Officer, National Eye Institute, NIH

Well, I do want to thank the sponsors here for inviting me to this program. I first said, well, I’m really hoping that I can just sit at the table and take notes because I feel like I have a lot to learn. Not as much to offer you all, especially in terms of the immediate goals at hand [and formation of} recommendations for new guidance on building design.

NIH Interest

But as I was thinking about this, it’s really nice to be up front at the beginning of this to let you all know that NIH is extremely interested in these types of collaborative efforts. So what I’m hoping is that I plant that seed in your heads and that as you have these discussions today, as insights come up, as you all talk with one another, that possibly this could evolve into future research projects that NIH could support and eventually, perhaps, that kind of research could then further refine the recommendations that you make actually after this workshop.

So what I’d like to do is plant that seed and then just go over a very brief overview of the NIH and the types of programs that exist at the NIH that could support that kind of research efforts. I knew that there would be a number of architects at the workshop here, so I did want to show at least one building at the NIH (slide 2). That’s where Francis Collins, the director of NIH; that’s where his office is. All I know is that my important paperwork always ends up at Building One.

NIH Mission

As you all probably know, much of the biomedical research in the United States is supported by the NIH. But what I wanted to do is sort of further drill down to what that mission is (slide 2). I think when people hear biomedical, they immediately think of the scientists in the wet labs curing cancer. But that’s actually, it’s defined pretty broadly in terms of getting fundamental knowledge about the nature and behavior of living systems and then applying that knowledge so that we can better the health of the public and importantly, to reduce the burdens of illness and disability. And so that’s actually a pretty broad swath and can include rehabilitative efforts, behavioral work, all sorts of discussions that I think we’ll have at this table.

NEI Mission

You’ll notice that the National Institutes of Health is a plural and indeed it’s a big plural. There are 27 centers and institutes that are housed under that NIH umbrella (slide 3). Twenty-four of these are funding agencies, each one with a different caliber of disease-related missions, one of which is the National Eye Institute. The NEI mission is to conduct and support research, training, health information dissemination, other programs with respect to blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight and special health problems and requirement of the blind (slide 4).

I wanted to read that because I wanted to make sure that every component actually was spelled out. The important thing, again, to keep in mind is this can range from very, very basic science up to translational and clinical and rehabilitative efforts. And I’ve underlined conduct and support research because that’s a nice reminder for me to tell you that actually defines the organization of NEI.

NEI Organization

The intramural program has actually a relatively small component of the budget that supports research at laboratories on NIH’s campus (slide 5). There are staff scientists that are actually doing research at NIH. But a larger part of the budget – over 80 percent of NEI’s budget – goes to the extramural program. And that’s NEI administering grants out there to the scientific community, funding research at universities or different institutions that are related to the NEI mission (slide 6).

You’ll notice that the National Institutes of Health is a plural and indeed it’s a big plural. There are 27 centers and institutes that are housed under that NIH umbrella. Twenty-four of these are funding agencies, each one with a different caliber of disease-related missions, one of which is the National Eye Institute. The NEI mission is to conduct and support research, training, health information dissemination, other programs with respect to blinding eye diseases, visual disorders, mechanisms of visual function, preservation of sight and special health problems and requirement of the blind.

I wanted to read that because I wanted to make sure that every component actually was spelled out. The important thing, again, to keep in mind is this can range from very, very basic science up to translational and clinical and rehabilitative efforts. And I’ve underlined conduct and support research because that’s a nice reminder for me to tell you that basically that actually defines the organization of NEI.

The intramural program has actually a relatively small component of the budget that supports research at laboratories on NIH’s campus. There are staff scientists that are actually doing research at NIH. But a larger part of the budget – over 80 percent of NEI’s budget – goes to the extramural program. And that’s NEI administering grants out there to the scientific community, funding research at universities or different institutions that are related to the NEI mission.

Now, I’m at the Division of Extramural Research. As I mentioned, I’m a Program Officer. One of my portfolios of grants is the low vision and blindness rehabilitation program (slide 7). There’s a relatively wide swath of the kinds of research that’s supported in this program: all the way from basic to translational and to technology and methods development.

What I’ve done here is taken parts of the strategic plan that are up on our website. But I wanted to highlight the issue pointed out at the bottom, which is that this program does support work that helps to develop a knowledge base of design requirements that might be necessary for individuals with visual impairment. And so, just optimizing navigation can be supported in this program.

In addition, I wanted to drill down a bit to some other program missions because I think that they apply to the group here. And one is that we do support research that helps to develop a knowledge base of design requirements for architectural structures (slide 8). And I know there’s actually quite a bit of work that’s been supported by NEI on understanding wayfinding in buildings, understanding wayfinding in open spaces and the challenges that people have low vision have in those situations. There’s also parts of the program that help to develop assisted devices that could be useful for people with low vision.

And the last point that I put on here is actually a reflection of how old the strategic plan is. It’s about four years old. We’re in the process of updating it now. But at that point, what we were talking about was supporting the development of infrastructure and programs for training people in the importance of multidisciplinary efforts that go into rehabilitation. And what I’d say is that this table is a great example of – it’s still important to train people in those efforts, but it looks like we’re actually getting to recognize that it has to be multidisciplinary and that people are already working in a more team-oriented fashion and the NIH is definitely supportive of that.

Program Types

So if you have these ideas, how you get them to the NIH to get funded, I’ve listed lots of NIH-ese on this slide – I apologize for all the gibberish with the combinations of letters and numbers (slide 9). But I’ve highlighted two research programs that I think would be most important for people to keep in mind and that are supported by the low vision program. And that’s the research project grants and the small business grants.

Research Projects Grant Program

The research projects grant program or the R01 that tends to be NIH’s bread and butter; these are investigator initiated projects that come to the NIH as a grant (slide 10). It’s the most commonly used grant program. It’s used to support a discrete research project that typically lasts between three and five years.

A new development – relatively new development – at NIH is that typically, you would have one principal investigator of this kind of a project. But now there are multi PI grants or multi principal investigator grants. Part of that really does reflect that the science has moved to be more integrated, to require different areas of expertise and to work in tandem with one another, really informing one another. So these multi PI grants really do reflect that we want to maximize what you can get out of team science and not just one individual’s input.

The R01 is pretty familiar, I know, with a number of the scientists on this panel. But the other area of the program that I did want to highlight because I think there’s a lot of potential for folks in the group here is the small business research program (slide 11). And NIH actually offers support for small businesses that want to develop high-risk technologies that have commercial promise.

Small Business Grants

The two main mechanisms that are used for that support are the small business innovation research grants, the SPIRs, and small business technology transfer, the STTRs (slide 12). Both of these mechanisms have similarities in that the main aim is to stimulate technological innovation and invigorate some private-sector commercialization of those health-related projects.

They run in three phases. The first phase is just establishing feasibility of the project. The second, to actually do research and development for the project. And the third, to actually get it out to market.

The main difference between these two is that with the STTR, the idea is to stimulate technology transfer, possibly from a research lab out into the market. So there’s a required collaboration between a small business and a non-profit, most typically a research university.

Summary

So the bottom line here is that I think there are a lot of research opportunities that could come out of the discussions that take place over the next two days (slide 13). This is really ripe for collaboration. Obviously, the organizers here realize that if you integrate different fields, we’re going to get more than the sum of the parts. We’re really going to have one field really helping to guide in one direction; the other field saying where it would work or where it won’t work.

But I think in addition, and from my own perspective, what’s exciting is that there’s an opportunity for each field to inform the other. So if I think about the different frameworks people have, the different ideas about the way the visual system works or the way buildings are designed, that after these discussions, it could actually – you may find yourself adjusting that framework. And you can only do that when you have people with different backgrounds talking to one another and poking where things don’t seem to make sense or where they do.

The other exciting opportunity, again, from NIH’s perspective, is the opportunity to evaluate new technologies and again their importance for individuals with low vision. We’ve seen lots of exciting use of leveraging these new technologies for use as a system [and] that’s all extremely exciting. I know engineering has been involved with some really, really important new developments.

But I think the flip side of that is that there are also a lot of new challenges for the low vision population with some of these new technologies. We’ve already heard a little bit about that. I expect to hear a lot more over the next two days.

And then I think all of this also – another message that can come out, is that it’s not just going to benefit individuals with low vision; but it could benefit the public at large. And we’ve already seen that in terms of discussions of principles of universal design and I look forward to hearing a bit more about that during the discussions.

I just want to leave you with a couple of places to go if you do think about submitting applications to the NIH. Going to the NEI website (slide 14) is a great resource for finding what kinds of research funding is supported by the NEI and research that’s going on at the NEI, just to get a sense of the kinds of publications coming out there.

But in terms of research funding, you may find program announcements that would be right up your alley and they’d be listed there (slide 15). And especially if you’re a new grantee. I recommend, when you go to the main NIH website, you will see, there are so many places you go, it could be incredibly overwhelming.

I find that the website for the office of extramural research is really, really helpful. It’s sort of one-stop shopping. It’s where you can go to download the electronic forms for submitting an application. But there’s also a lot of guidance for new grantees: what happens when your application comes into NIH. There’s been lots of changes to peer review there and those are all, pretty, I’d say it’s a pretty straightforward website. Most of them aren’t, but this one really is. I think you can navigate – (inaudible).

And most importantly, contact a program officer. When you have these ideas, when you’ve already discussed, you’ve got a sense and you want to know first off would NEI be interested on this project. Program officers are a great resource. I’ve listed my name associated with the research project grants because I’m the person who handles those and [related] portfolios (slide 16). And my colleague, Jerry Wujek, is the one who handles the small business grants. The number, if you can [remember] that first area code and the 451, 2020 is pretty easy to remember, but we’re also available on the website. Send an e-mail or just call.