Tannaz Moin, MD, MBA, MSHS Associate Professor of Medicine at UCLA Assistant Director, UCLA Specialty Training and Advanced Research (STAR) Program

1. How to write the
"Specific Aims"
section of a grant
application
Tannaz Moin, MD, MBA, MSHS
UCLA CTSI R Workshop
December 8, 2022
Special thanks to Drs. Catherine Sarkisian and O. Kenrik Duru

2. Specific Aims
• This is arguably the most important
section of your application
• WRITE EARLY AND CIRCULATE
• This section must include everything that
is important and exciting about your
project – but without a lot of detail.

3. One Page Document All Reviewers Will Read
• Format can vary but suggest:
1. Intro paragraph: capture attention (HOOK/GAP/Critical Need)
2. 2nd paragraph: logical next step = proposed solution
3. Enumerated Aims
4. Final Summary Paragraph
• Style: Non-technical. No figures allowed.
• Write this section for ALL study section members

4. 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/NAM 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
• “addresses an important problem or a critical
barrier to progress in the field” (review criteria for
significance)
• Should set up logical next step=your proposed
solution to advance the field

5. Hook
GAP
Critical Need
Example
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)

6. 2nd Paragraph:
Logical Next Step =
Proposed Solution/
Move into Aims
Your team’s path towards this project
• Can mention prelim studies (do not
need 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)

7. 2nd Paragraph Example:
Logical Next Step= Proposed Solution/Transition to 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 . . .
(Move into Aims)

8. Enumerated Aims
• Keep the number of aims reasonable (3-5)
• Each Aim should consist of one sentence:
be concise and concrete; clarity is the goal.
• Matter of style whether to state specific
hypotheses for each Aim here
• 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

9. 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 with detail)
• Secondary = patient, physician, and system-level outcomes
• Patients: (list a few)
• Physicians (list a few)
• System: (list a few)

10. 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

11. Final
Paragraph
Example
(Build Excitement)
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, 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.

12. 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 . . .

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