Call for Proposals FAQs

What is Systems for Action?

Systems for Action (S4A) is a signature research program of the Robert Wood Johnson Foundation (RWJF) that builds a Culture of Health by rigorously testing new ways of connecting the nation’s fragmented medical, social, and public health systems. Health is shaped by a complex web of social, economic, and environmental conditions that extend far beyond the reach of the medical care system. S4A uses a wide research lens that includes and extends beyond the medical care and public health systems to incorporate social service systems such as housing, transportation, education, employment, food and nutrition assistance, child and family support, criminal and juvenile justice, and economic and community development. The national program office for the S4A program is based at the Department of Health Systems, Management and Policy at the Colorado School of Public Health, University of Colorado. 

What is a Systems Alignment Mechanism?

An alignment mechanism is an action or set of actions that helps medical, social, and public health systems operate in more integrated and coordinated ways, ultimately leading to improved health and health equity for a defined population group of interest. We view systems alignment as a deliberate process to coordinate the work of multiple independent systems and sectors, including the development of shared priorities and goals, shared governance and decision-making, shared financing and resource allocation, and shared data and information. See for example: S4A has studied a variety of novel approaches for aligning systems using rigorous scientific methods to determine their impact on health and health equity. But unfortunately, many promising ideas for systems alignment have yet to be rigorously studied.

What do you mean when you use the term “systems”?

The S4A program is interested in aligning delivery systems and/or financing systems that operate within the three broad domains of medical care, public health and social services. Delivery systems include the organizations, people, information, and materials used to deliver services.  Financing systems include the revenue sources, payment mechanisms, and flow of funds needed to deliver services.

What would or would not be considered a system?

Every program, service or intervention is implemented through a delivery system. A delivery system is the constellation of organizations, people, policies, and resources that allow the program to be implemented for members of the target population. Similarly, a financing system is the constellation of financial resources, funding mechanisms, funders, and payment policies that support implementation of a program or service. Applicants should articulate clearly how they define the delivery and/or financing systems to be aligned through their proposed research.

What organizations and activities are considered to be part of social service systems?

We define the social services sector to include any organization, program or service that works to address fundamental human needs in the community and promote social well-being. This sector includes organizations and programs that provide education, housing, income support, employment assistance, diversity and inclusion initiatives, food assistance, transportation, child and youth development, recreation and physical activity, legal assistance, disability support services, violence prevention, arts and cultural programming, criminal justice and juvenile justice services, and community and economic development.

What organizations and activities are considered to be part of medical care systems?

We define the medical care sector to include any organization, program, or service that helps individuals obtain access to clinical services that prevent, treat, or manage diseases and injuries, including services for physical health conditions, mental health conditions, substance abuse, and developmental disabilities. This sector includes the providers, purchasers, insurers, and payers of these services as well as the suppliers of associated products and technologies, such as pharmaceutical products and health information technologies.  

What organizations and activities are considered to be part of public health systems?

We define the public health sector to include any organization, program or activity that works to create the conditions in which people can live healthy lives, including activities to prevent disease and injury and promote health for the population at large. They include governmental public health agencies working at local, state, and federal levels, as well as nongovernmental organizations that contribute to the performance of core public health functions. A defining feature of public health systems is their focus on actions designed to protect and improve health at a population level rather than purely at an individual level through delivery of personal health services.  Public health systems implement activities to protect populations from communicable diseases, to prevent chronic disease risks and injuries, to promote healthy behaviors, and to reduce environmental health risks in the air, water, food, and built environment.

What types of projects are eligible under this Call for Proposals?

The S4A program funds rigorous scientific studies that are designed to evaluate the impact of initiatives that align medical, social, and public health systems. This 2022 call for proposals (CFP) will provide funding for a new cohort of research studies to produce new, actionable evidence about how to help medical, social, and public health systems work together to address structural barriers to health and health equity, including racism and the social conditions that impact health. We are particularly interested in studies that address one or more of the five areas for future development described above, including studies that incorporate one or more recommendations identified by the RWJF National Commission to Transform Public Health Data Systems. Each study supported by the S4A program must examine a novel approach to systems alignment that engages actors from medical care, public health, and social services systems in collaborative efforts to dismantle structural and systemic racism and improve health equity. For definitions and examples of structural and systemic racism, along with approaches for dismantling them, please see this recent review article. Read the full CFP for more information about this specific funding opportunity.

The S4A program is particularly interested in studies that engage all three types of systems implicated in the S4A research agenda: 1) medical care; 2) public health; and 3) social services. Proposals that focus purely on implementing a strategy, without a strong scientific approach for evaluating the implementation and/or impact of the strategy, will not be funded.

Should projects focus on all three sectors (medical, social, and public health) or can you focus on only two sectors for alignment?

Studies must evaluate proposed solutions that engage all three types of systems implicated in the S4A research agenda: 1) medical care; 2) public health; and 3) social services.

Can applicants propose to study system alignment strategies that are implemented in settings outside the U.S.? 

The S4A program focuses on building evidence about system alignment strategies that are successful in advancing health equity in American communities.  We recognize that promising ideas for system alignment can come from many sources, including settings and experiences outside the U.S.  As such, we encourage applications that utilize ideas, evidence, and inspiration from international settings to inform their work within the U.S. 

We also recognize that the opportunities and challenges encountered in aligning medical, social and public health systems within the U.S. may be very different from the issues faced in other countries due to unique historical and contemporary developments in policy, politics, economics, institutions, culture and society. Similarly, the forms of structural racism and inequity that have become embedded within U.S. health and social systems derive from historical and contemporary developments that are specific to U.S. contexts and cultures, and may not reflect the situations found in international contexts.  As such, system alignment strategies that are successful in international settings may not work the same way in American communities, or may need to be adapted for unique American systems, contexts and community needs. 

For all of these reasons, we anticipate that is unlikely that the S4A program will support a system alignment study that is implemented exclusively outside of the U.S., because the findings from such a study will be unlikely to be immediately generalizable, translatable and usable in U.S. communities – at least not without subsequent study to support adaptation and testing within the U.S.  Nevertheless, if you believe that your international study idea would produce evidence that is immediately translatable and useable within U.S. contexts, then we encourage you to contact the S4A National Program Office in advance of submitting your application to discuss your ideas and receive additional guidance.  

What is the duration and amount per grant awarded?

Applicants may apply for one of two awards – either a Developmental award or an Impact award. The Developmental award is up to 12 months in duration and up to $100,00 in total funding from RWJF. Impact awards are up to 36 months in duration with up to $500,000 in total funding from RWJF.

It is important to note that you may only apply to ONE type of award. The Impact award category is open only to applicants who have completed a pilot study of their proposed system alignment approach and can provide documentation of pilot test results that confirm the feasibility of the approach and its acceptability to key stakeholders within the relevant medical, social, and public health systems. 

What is health equity? 

Health equity is achieved when everyone has the opportunity to live their healthiest life possible regardless of who they are, where they live, or how much money they make. Funded studies must focus on system alignment mechanisms that have the potential to improve health equity.

Alignment mechanisms that aim to promote efficiency, reduce costs, or improve outcomes without improving health equity are not responsive to this CFP. Studies must examine the ability of the system alignment mechanism to contribute to an environment in which everyone has the opportunity to achieve their full health potential, and in which no one is disadvantaged from achieving this potential because of social position or circumstance.

Applicants are encouraged to follow recommendations of the National Academy of Medicine regarding strategies for measuring health equity, available at: Measures should quantify differences in health outcomes, risks, or determinants across key population subgroups of interest such as those based on race, ethnicity, gender, socioeconomic status, disability status, geography, or other subgroups that experience differences in opportunity, social position or power.

What types of studies are considered rigorous scientific studies? 

The S4A program highly values scientific rigor in the studies that it supports. To be considered scientifically rigorous, the proposed study design and analytic approach must be sufficient to support inferences about the causal impact of the systems alignment mechanism under study. Many different types of experimental and quasi-experimental research designs can be used to estimate causal impact. See for example: Shadish WR, Cook TD, and Campbell DT.  Experimental and Quasi-Experimental Designs for Generalized Causal Inference, 2nd Edition.  New York: Houghton Mifflin, 2001. Well-designed and validated simulation studies may also provide scientifically rigorous estimates of potential causal impact.  Studies must be designed to estimate the counterfactual – what would have happened in the absence of the proposed systems alignment mechanism?  Additionally, studies must be able to credibly rule out the possibility that other factors beyond the potential mechanism are responsible for producing the observed effects.  Purely qualitative research designs, descriptive studies, exploratory studies, cross-sectional designs, uncontrolled pre-post studies, post-test only designs, and pilot studies are unlikely to satisfy these requirements.  Other study characteristics that determine the level of scientific rigor include: sample sizes and statistical power; validity and reliability of data sources and measures; representativeness and generalizability of study settings; appropriateness of comparison groups; and strength of analytic approaches.

Can this grant funding be used for implementation funding?

This CFP is not appropriate for applicants who primarily seek funding to implement their proposed solution. Because S4A is a research program, grantees are expected to use all or most of their grant funding to carry out the research study, rather than to implement the proposed solution. Applicants who propose to use part of their grant funding to support implementation may be at a competitive disadvantage relative to other applicants, for several reasons: (1) these applicants will have fewer resources available to carry out a scientifically rigorous research study; (2) these applicants will have greater difficulty demonstrating the feasibility of their proposed solution, because implementation will depend upon receipt of grant funding; and (3) these applicants will have greater difficulty demonstrating the sustainability of the proposed solution beyond the end of the grant period. 

What is the deadline for submitting proposals?

Proposals must be submitted through the RWJF online system by October 5, 2022 at 3:00pm ET. Late applications will not be permitted. You will be required to register at MYRWJF at before you begin the application process.

What is the deadline for submitting a Letter of Intent (LOI)? If I missed the deadline can I submit a full proposal? 

The deadline for LOIs is September 6, 2021. LOIs are not required in order to submit a full proposal and there will be no extension.

To submit your full application, register on the MYRWJF site at Proposals and submit by October 5, 2022 at 3:00pm ET. Late applications will not be permitted. 

What types of organizations are eligible for funding?

Applicants must be either public entities or nonprofit organizations that are tax-exempt under Section 501(c)(3) of the Internal Revenue Code and are not private foundations or non-functionally integrated Type Ill supporting organizations. Applicant organizations must be based in the United States or its territories. Awards will be made to organizations, not to individuals. Multi-organizational consortia are encouraged to apply if a single eligible organization is designated as the primary applicant responsible for maintaining consortium agreements with other participating organizations.

Do the eligibility requirements for applicant organizations also apply to partners?

No, but subcontracts or partner relationships with for-profit entities or entities based outside the United States may require additional financial and/or legal due diligence.

Can an organization submit multiple proposals?

Yes, an organization may submit more than one proposal as long as each proposal submitted is distinct in terms of both project and research team. 

Can I apply for this opportunity if I have previously been or am currently funded by RWJF?

Yes, previously or currently funded RWJF grantees are eligible to apply for this funding opportunity, but the proposed project must be different from previously funded work.

How will my proposal be evaluated?

Applicants will submit narrative proposals containing the project rationale, significance, approach and information about the project’s budget, staffing, collaborators, and institutional support. Applications will be reviewed by a review panel that includes members of the S4A National Advisory Committee, S4A staff, Robert Wood Johnson Foundation staff, and subject matter experts. Applicants are encouraged to submit a one-page letter of intent (LOI) providing a preliminary title, a brief description of the proposed research, and a listing of the participating investigators and institutions. This LOI is not binding and not required, but it ensures that the program office is able to recruit reviewers with appropriate subject matter expertise to review your application thoroughly. See the CFP for the specific review criteria.

What type of investigators should apply?

We are looking for research teams from diverse health and social service fields that have expertise in the three broad types of delivery and financing systems implicated in the S4A research agenda: (1) medical care; (2) public health; and (3) social and community services and supports. This includes investigators from a variety of areas and disciplines, including but not limited to medicine, public health, social work, sociology, business, economics, education, transportation, housing, criminal justice, communication, public policy, political science, system science, and urban planning and community development. Because S4A is a research program, all applicants should ensure their team includes individuals with relevant expertise in scientific research design, data analysis methodologies, and scientific publication. Applicants from non-academic settings that do not have an embedded research unit are strongly encouraged to partner with a research institution to provide this expertise.

We especially encourage applications that include individuals having backgrounds and life experiences that are underrepresented on research teams.

If I am not chosen for this funding opportunity can I apply for another RWJF grant opportunity?

Yes, interested applicants may apply for other RWJF grants. You must actively submit to other opportunities in which you are interested as proposals declined by S4A will not automatically be considered by other programs

How can I tell if I am applying to the correct RWJF program?

Within the Foundation’s Research, Evaluation, and Learning initiative, RWJF funds a range of research to expand understanding of what will allow everyone in our nation to have an equitable opportunity to live the healthiest life possible, and which types of interventions may have greatest potential for impact. Its three signature research programs, including Systems for Action, work to identify root causes of inequitable health outcomes in America, and potential solutions which engage multiple sectors and disciplines.

The Systems for Action (S4A) program, based at the University of Kentucky within the College of Public Health and the Gatton School of Business and Economics, conducts rigorous research on ways to align, coordinate, and integrate the many delivery and financing systems that promote health and well-being on a population-wide basis, including medical, public health, and social services and supports sectors.

The Policies for Action (P4A) programbased at the Urban Instituteinvestigates how policies, laws, regulatory changes, systems interventions, and community dynamics can be leveraged to support population health, well-being, and equity. P4A is building a robust, actionable evidence base on how these critical levers can advance a Culture of Health, with a goal of delivering these data and insights to key policymakers, community leaders, and other change agents. (Call for Proposals is currently closed)

The Evidence for Action (E4A) program, based at the University of California, San Francisco, awards grants to encourage and support innovative, rigorous research on the impact of programs, policies, and partnerships on health and well-being, with a particular focus on research that will help advance health equity. It is the broadest of the three programs – it does not have a formal research agenda, and it funds across all areas of the Culture of Health Action Framework. Learn more about E4A’s rolling application process.

To learn more about additional current and upcoming RWJF funding opportunities of interest visit the Foundation’s Funding Opportunities page and/or use RWJF’s new Program Finder tool to identify programs that may align with your interests and goals.