Your Aims Are Not Your Science — And That Confusion Is Costing You Scores

There is a sentence I find myself writing in nearly every Aims page review I do, whether I am reviewing for study section, for a colleague, or for a participant in the Lost In Translation curriculum.

The sentence is some version of this: I can see what you are going to do. I cannot see what you think is true.

It surfaces so often because the mistake underneath it is so consistent. Applicants write their specific aims as activity descriptions — what they will do, what they will measure, what they will analyze. And they believe that by describing the activities clearly enough, they have communicated their science.

They have not. They have communicated their workflow.

An aim that says "Determine the relationship between X and Y" tells the reviewer that you plan to investigate something. It does not tell them what you expect to find, why you expect it, or what it would mean if you are right. It gives them a task. It does not give them a position.

And successful grants do not focus on tasks. They focus on positions.

This distinction — between an aim that describes an activity and an aim that asserts a testable position — is the single most consequential writing choice on your Specific Aims page. It is also the one that most grantsmanship advice skips, because the advice focuses on formatting and structure rather than on what the aims are actually doing on the page.

What an activity aim looks like

You have read these. You have probably written them. I have written them myself, earlier in my career, before I understood what they were doing — and failing to do — in a reviewer's hands.

An activity aim typically begins with a verb of investigation: Determine. Examine. Assess. Evaluate. Characterize. Explore. It then names a relationship, a phenomenon, or a comparison. And it often ends with a brief description of the method or sample.

"Aim 1: Determine the effect of a community health worker-led intervention on lung cancer screening uptake among individuals who smoke in northern New Jersey."

This aim is clear. It is well-scoped. It names the intervention, the outcome, the population, and the geography. A reviewer reading it knows exactly what you plan to do.

And that is precisely the problem. Because "knowing what you plan to do" is not the same as "knowing what you think is true about the science." The aim tells me the activity. It does not tell me the hypothesis. It does not tell me the mechanism. It does not tell me why you believe this particular approach will work when other approaches have not.

When a reviewer encounters an activity aim, they have to do the scientific thinking for you. They have to infer what you expect, why you expect it, and what the implications are. Some reviewers will do that work generously. Many will not — because they are reading dozens of applications in compressed timeframes and they do not have the cognitive bandwidth to reconstruct your scientific reasoning from an activity description.

If the reviewer has to infer your science, you have already lost control of how your application gets read.

What a position aim looks like

A position aim begins from a fundamentally different place. It does not start with what you will do. It starts with what you believe is true — and then it names how you will test that belief.

Take the same science and rewrite it:

"Aim 1: Community health worker-led navigation that addresses tobacco-related stigma — not tobacco use itself — as the operative barrier to screening will increase lung cancer screening completion among screening-eligible individuals who smoke, by reducing the stigma-driven avoidance that suppresses uptake."

This aim does something the activity version cannot. It takes a scientific position. It asserts a specific mechanism — that stigma, not tobacco use per se, is the operative barrier. It names the behavioral process — stigma-driven avoidance suppressing uptake. And it implies a testable prediction: if you address the stigma rather than the behavior, screening completion will increase.

Now the reviewer has something to evaluate. Not a task list. A claim. They can agree with your mechanistic reasoning or challenge it. They can assess whether your preliminary data supports the position you are taking. They can evaluate whether your methods are designed to test what you say you believe.

The entire application sharpens, because the reviewer is no longer asking "what are they going to do?" They are asking "are they right?" And that is a fundamentally more engaged, more intellectually invested form of reading.

"But I already write hypothesis-driven aims"

If you have had formal grantsmanship training, you may be reading this and thinking: I already do this. I write hypotheses under my aims. How is this different?

It is a fair question. And the answer is structural, not cosmetic.

The conventional format most trained grant writers produce looks like this:

Aim 1: Determine the effect of a community health worker-led intervention on lung cancer screening uptake among individuals who smoke. Hypothesis 1: The intervention will increase screening completion rates compared to usual care. Hypothesis 1a: The effect will be mediated by reduction in tobacco-related stigma.

This is better than a pure activity aim. The hypotheses are present. The mechanism is named. But look at where the hypothesis lives — it is subordinate to the activity. The aim statement itself is still "Determine the effect of." The reviewer's first impression, the thing their eye lands on and their brain registers as "what this aim is about," is an investigation. The hypotheses are indented underneath, formatted as sub-points to the main event.

Now compare:

Aim 1: Community health worker-led navigation that addresses tobacco-related stigma — not tobacco use itself — as the operative barrier to screening will increase lung cancer screening completion among screening-eligible individuals who smoke, by reducing the stigma-driven avoidance that suppresses uptake.

The hypothesis is not beneath the aim. It is the aim. The reviewer cannot read the aim without encountering your scientific reasoning. There is no activity wrapper to skim past before reaching the claim.

Both formats contain the same scientific information. They do not create the same reading experience.

When hypotheses are subordinate to an activity aim, reviewers often process the aim statement and skim the hypothesis lines — because the aim already told them the category of work being done, and the hypotheses read as predictions appended to a task. The claim is decorating the activity.

When the aim itself is the position, the reviewer cannot skim past your hypothesis because there is nothing else to read. The claim is doing the structural work. The activity follows from it, not the other way around.

That difference in processing — whether the reviewer's first cognitive impression is "what they will do" or "what they believe is true" — is what shapes the Factor 1 impression before the Research Strategy is ever opened. The conventional format buries your strongest scientific thinking one level below the thing the reviewer actually reads. A position aim puts it where the eye goes first.

Why this distinction matters for scoring

When a reviewer reads an activity aim, the evaluative question defaults to feasibility. Can this team do this work? Is the timeline realistic? Is the sample size adequate? These are important questions, but they live in the middle of the scoring range. They determine whether your methods are adequate. They do not determine whether your science is important.

When a reviewer reads a position aim, the evaluative question shifts to significance and innovation. Is this the right mechanistic framing? Does this challenge what the field currently assumes? If this position is supported, does it change how we think about the problem?

Those are Factor 1 questions. Factor 1 — Importance of the Research — encompasses both Significance and Innovation, and under the Simplified Review Framework it functions as a ceiling. NIH's own scoring guidance states it directly: a project of moderate or limited importance on Factor 1 cannot be made more impactful by a strong approach on Factor 2 or appropriate expertise and resources on Factor 3. Your Factor 1 score sets a limit for the best possible overall impact score.

This is why the activity-versus-position distinction matters so much for scoring. A position aim does Factor 1 work on two fronts simultaneously. It signals significance by naming the stakes — here is what is happening because this question remains unanswered. And it signals innovation by asserting a mechanistic framing the field has not yet tested — here is why existing approaches have missed the operative barrier. An activity aim does neither. It defers both significance and innovation to the Research Strategy, by which point the reviewer's Factor 1 impression may already be set.

I have reviewed applications where the science in the Research Strategy was genuinely innovative, but the Aims page presented it as a series of activities. By the time I reached the innovation, my initial impression — formed entirely from the Aims page — was that this was competent but incremental work. The Research Strategy had to overcome an impression that the Aims page created. That is a structural disadvantage you impose on yourself.

The fear underneath the activity aim

There is a reason applicants default to activity aims, and it is not laziness or lack of scientific sophistication. It is fear.

A position aim requires you to state what you believe is true before you have proven it. It requires you to commit — on the page, in writing, for reviewers to read — to a specific mechanistic claim. And that feels risky, because what if the reviewer disagrees? What if your mechanism is wrong? What if the data do not support the position?

Activity aims feel safer because they are noncommittal. "Determine the relationship between X and Y" does not require you to say what you think the relationship is. It lets you defer the commitment until the data are in. It protects you from being wrong on the page.

But here is what that protection costs you: it also prevents you from being interesting on the page. It prevents you from demonstrating the depth of your scientific thinking. It prevents the reviewer from engaging with your ideas rather than your procedures. The safety of the activity aim is the safety of being invisible — your science is there, but the reviewer has to find it.

And under the current review conditions — fewer applications discussed, simplified summary statements, reviewers reading dozens of grants in compressed timeframes — invisible is a position you cannot afford.

If the last newsletter was about the variables you cannot control, this one is about one you absolutely can. The language of your aims — whether they assert a position or describe an activity — is entirely within your hands. And it is the single revision most likely to change how a reviewer reads everything that follows.

How to know if your aims are activities or positions

There is a diagnostic question that cuts through every rationalization: Can the reviewer tell what you think is true about the science without reading your Research Strategy?

If your aim says "Determine the effect of X on Y" — the answer is no. The reviewer knows what you will investigate. They do not know what you believe, what mechanism you are proposing, or what would constitute a meaningful finding. They have to read further to discover your science. And some will not read further with the generosity your science deserves, because the Aims page did not earn it.

If your aim says "X operates through mechanism Z to produce outcome Y, and we will test this by..." — the answer is yes. The reviewer knows your position. They can evaluate it. They are engaged before the Research Strategy begins.

The permission you need to give yourself

In my experience, the barrier is almost never that researchers do not have a position. It is that they have not given themselves permission to state it.

Researchers know more than their aims reveal. They have spent years thinking about these questions. They have intuitions grounded in deep familiarity with the literature and the population. But the culture of scientific caution — the training that says you cannot claim something until it is proven — makes them reluctant to commit on the page.

Grantsmanship requires a different register than publication. A published paper reports what you found. A grant application argues what you believe and asks for the resources to test it. If you write your aims in the register of reporting, you are writing the wrong document.

The willingness to state a position — clearly, specifically, with the understanding that you might be wrong — is not arrogance. It is the fundamental requirement for intellectual engagement. No one argues with a task list. Everyone engages with a claim.

Beyond grants

This principle operates wherever persuasion and evidence intersect. A consulting proposal that describes the engagement activities ("We will conduct stakeholder interviews and develop a strategic roadmap") is less compelling than one that asserts a diagnosis ("Your retention problem is not compensation — it is a middle-management trust gap, and here is how we will demonstrate that and address it"). A job talk that describes the studies you ran is less memorable than one that asserts the position those studies tested. An op-ed that reports findings is less publishable than one that argues their implication.

In every case, the audience is asking the same question the reviewer is asking: What do you actually think? Not what did you do. Not what will you investigate. What is your position?

What is one aim, argument, or proposal you have written that described what you planned to do when it should have stated what you believed was true?

Next week: the Research Strategy — how to write significance that the reviewer has already decided they agree with before they finish reading it.

~Lisa Carter-Bawa, PhD, MPH, APRN, ANP-C, FAAN, FSBM

More insights at lisacarterbawa.com/insights

Lost In Translation (LIT) grantsmanship curriculum is available as an institutional cohort for cancer centers, training programs, and research-intensive departments.

The LIT October 2027 Deadline Cohort is full. If you would like to be placed on the waiting list in case a seat opens, or if you want to indicate interest in the March 2027 Cohort, let me know here: https://forms.gle/Eysi8qEjBXNY1w388

Future cohorts will be timed to the NIH grant submission cycle. Each cohort includes five live Monday sessions, full access to the LIT course (14 modules + 13 workbooks), and a post-cohort Translation Feedback Brief — a one-on-one review of your revised Aims page and/or full grant returned in time for your submission.

Contact lisa@soultosoulleadership.com with any questions or visit lisacarterbawa.com/losttranslation to learn more.