Category C CIO Project Plans_Modified.pdf

Project Title: Disability-Inclusive Preventive Health Screening Implementation Guide

Population of Focus: Category C: Public Health System Components

Population of Focus Description:

community-based organizations, community health centers, primary care providers, hospitals, and education organizations

Project Plan Details Project Purpose: An estimated over 65 million adults in the U.S. live with a disability. People with disabilities are disproportionately impacted by chronic and infectious disease as well as injury and mental health conditions. Preventive health screenings are a critical component of public health practice as they can result in early diagnosis and treatment, reduced medical costs, and prevention of early death. People with disabilities experience multiple barriers at the individual, interpersonal, societal, and community level to accessing medical services, including preventative health screenings.

The U.S. Preventative Services Task Force (UPSTF) makes evidence-based recommendations about preventative screenings. Based on a review of available evidence, UPSTF grades screenings based on their potential net health benefits.

UPSTF also publishes information practice considerations, importance of the recommendation, along with implementation resources and guides. These materials are critical for public health practitioners and other public health partners to effectively recommend and implement these screenings in their jurisdictions.

Although existing UPSTF tools are extensive, none include a focus on people with disabilities. For example, practice considerations do not address how screenings can be made accessible to people with disabilities, the data supporting the importance of individual recommendations does not include people with disabilities, it is not clear what existing data systems can be used to monitor uptake of recommendations among people with disabilities, and none of the existing implementation resource focus on how to implement recommendations in a way that is inclusive and accessible for people with disabilities. In addition, existing recommendations may require adjustments for particular sub-populations of people with disabilities, such as people with intellectual and developmental disabilities (IDD) or individuals with mobility limitations (ML).

The objective of this project is to increase the inclusion of people with disabilities into UPSTF recommended preventative health screenings with an “A” or “B” score by developing, and disseminating, a tailored Implementation Guide. These materials will provide much needed tools that will increase public health practitioner capacity to implement and evaluate UPSTF recommended preventative health screenings among people with disabilities.

CIO: NCBDDD

Division/Branch/Office /Unit:

Division of Human Development and Disability (DHDD)

Proposed FY24 Project Funding Total:

$300,000.00

Funding Appropriation:

75-24-0958

Funding Statutory Authority:

Public Health Service Act 317C [42 U.S.C. 247b-4]

Expected Project Length:

1 Year

Recipient Organizational Capacity:

The applicant organization should have the capacity to evaluate and synthesize existing disability literature; be familiar with preventative health recommendations from UPSTF; and capacity, expertise, and mechanisms to engage a Technical Assistance Group (TAG) to include people with lived disability experience; and capability to develop and disseminate an implementation guide and implementation resources focused on increase inclusion of people with disabilities into preventative health screening recommendations from UPSTF.

Recipient Program Experience:

The applicant should have experience synthesizing existing literature to make recommendations and revisions, developing and disseminating capacity building implementation guides and resources to support the uptake and evaluation of recommended public health interventions. Applicant should have knowledge and familiarity with UPSTF preventative health recommendations and knowledge and familiarity with working in disability inclusion.

Expectations for Collaboration:

It is expected that the partner will meet regularly (weekly or biweekly) with CDC collaborators/team to discuss the project. It is also expected that partners will engage with a range of public health organizations and organizations focused on people with disabilities to disseminate the implementation guide and implementation resources. Depending on the specific project activities, additional types of cross organization collaboration may be appropriate and acceptable to accomplish project work plan objectives and deliverables. The applicant is expected to collaborate with people with disabilities participating in a Technical Assistance Group (TAG) across project activities and to use best practices when developing, and working with, the TAG.

Expected Subcontractual Work and Criteria:

The applicant may need to subcontract out work depending on their internal capability. Specifically, the applicant may need to subcontract with an organization with subject matter expertise in disability and health and/or preventative health screening to support project activities.

General Instructions for Use of Funds:

Funds may be used for: salaries and wages, fringe benefits, consultant costs, supplies, other categories (meetings), total indirect costs, total direct costs.

Strategic Area: Policy and Programs

Strategic Area Details

Outcomes: Short-term: Increased awareness of best/promising practices and/or tools by populations of focus of CBA services and products;Intermediate: Increased awareness and understanding of recommended processes, policies, programs, and practices within the strategic areas;Intermediate: Enhanced skill and ability to support decision-processes, policies, programs, and practices within the strategic areas

Activities: (1) Establish a Technical Assistance Group (TAG) made up of a diverse group of people with lived experiences to review and provide feedback on approaches taken in the project, and on materials developed under Activities 2-8. All meetings with the TAG should be fully accessible.

(2) Build upon existing literature reviews about each UPSTF recommendation with an “A” or “B” score and develop a summary of data supporting the recommendation among people with disabilities. Data summary should include a description of the disparities among people with disabilities compared to people without disabilities for the particular health topic, and data on screening rates by disability status compared to people without disabilities for the particular health topic. Data summary should also include sub-analyses among people with IDD and ML.

(3) Building upon existing literature reviews about each UPSTF recommendation with an “A” or “B” score, and based on consultation from the TAG, develop a summary of adjustments or adaptations needed for people with disabilities to access screenings and overcome major barriers. Adaptations should focus on people with disabilities overall, and among people with IDD and ML.

(4) Building upon existing literature reviews about each UPSTF recommendation with an “A” or “B” score, and based on consultation with the TAG, develop practice considerations for people with disabilities (disability and IDD), with a focus on inclusion and accessibility. Practice considerations should focus on people with disabilities overall, and among people with IDD and ML.

(5) Identify existing population-based outcome indicators and data systems or sets (e.g., BRFSS, NHIS) that can be used to monitor and evaluate uptake of recommended screenings among people with disabilities. Data-systems identified should be ones that can allow for analyses among people with any disability, and/or among people with IDD and ML.

(6) Develop and disseminate implementation resources, including Clinician Summaries and Related Resources Tools, to support the implementation of UPSTF preventative health screening recommendations with an “A” or “B” score among people with disabilities. A sub-set of materials (e.g., infographics) should be developed in both English and Spanish. Capacity building resources should include sub-sections with implementation guidance for people with IDD and ML.

(7) Develop and disseminate a capacity building Implementation Guide that includes information developed through Activity 2-6 and provides a comprehensive resource for public health practitioners to increase the inclusion of people with disabilities into preventative health screening activities. A sub-set of materials included in the implementation guide should be developed in both English and Spanish. Materials should focus on people with disabilities overall, and among people with IDD and ML. Report should also include an introduction that provides a rationale for the project, including role of preventative health screening in secondary prevention efforts, existing disparities in access and utilization of preventative health screening among people with disabilities, and the potential for preventative health screenings to reduce morbidity and mortality.

(8) Conduct at least one, recorded, publicly accessible virtual sessions about the Implementation Guide and capacity building resources. Training should be fully accessible.

Process Measures: -number of people with lived experience on project advisory board

- minimum of 100 partner groups implementation guide shared with

- minimum of 30 clinician summaries developed

- minimum of 20 implementation resources, such as Infographics or Fact Sheets, developed

- number of partners implementation resources, such as clinician summaries and related resources tools, were shared with

- number of people attending virtual session about the Implementation Guide and capacity building resources

- minimum of 30 UPSTF recommendations with an “A” or “B” score with a summary of adjustments, adaptations, or modifications developed for people with disabilities

- minimum of 30 UPSTF recommendations with an “A” or “B” score with a summary of data supporting the recommendation developed among people with disabilities

- minimum of 30 UPSTF recommendations with an “A” or “B” score with practice considerations for people with disabilities developed

- number of existing data systems that can be used to monitor/track uptake of UPSTF recommendations with an “A” or “B” score among people with disabilities

Outputs: - Implementation guide

- Implementation resources, including clinician summaries and related resources tools

- Virtual, open-access, webinar

Budget Period Outcomes:

- Public health practitioners will have an increased capacity to implement, and evaluate, UPSTF preventative health screening recommendations with an “A” or “B” score among people with disabilities.

- People with disabilities will have increased inclusion, and access to, UPSTF recommended preventative health screening recommendations with an “A” or “B” score.

Outcome Measures: - At least 70% of webinar respondents report increase capacity to implement UPSTF recommended preventative health screening recommendations with an “A” or “B” score

- Clinician Summaries are developed for a minimum of 30 UPSTF recommended preventative health screening recommendations with an “A” or “B” score

- Implementation Guide includes implementation guidance for a minimum of 30 UPSTF recommended preventative health screening recommendations with an “A” or “B” score

- At least 20 implementation resources are developed

- Implementation guide shared with a minimum of 100 relevant partners or organizations

Project Title: Million Hearts: Preventing Hearts Attacks and Strokes with Improved Blood Pressure Control

Population of Focus: Category C: Public Health System Components

Population of Focus Description:

Physicians

Project Plan Details Project Purpose: The purpose of this project is to work with and through physicians to prevent heart attacks and strokes by improving blood pressure outcomes. Through this project we want to 1) test evidence-informed process improvements and/or implement evidence-based process improvements (e.g., change ideas from the Hypertension Control Change Package and/or the Hypertension in Pregnancy Change Package) to improve cardiovascular health outcomes among patients; 2) discover and develop new tools and strategies needed to improve performance on process measures and blood pressure outcomes of interest, especially among patient populations of focus (e.g., pregnant and postpartum women with hypertension, people from racial/ethnic minority groups, people with lower incomes, and/or people who live in rural areas or other ‘access deserts.’); 3) scale and spread implementation of high impact change ideas by building a supportive ecosystem for optimal delivery of cardiovascular disease prevention services; 4) test and refine the ways electronic health record data may be used to monitor and drive improvements in blood pressure outcomes for patients with uncontrolled hypertension and pregnant and postpartum women with hypertension.

CIO: NCCDPHP

Division/Branch/Office /Unit:

Division for Heart Disease and Stroke Prevention (DHDSP)

Proposed FY24 Project Funding Total:

$1,000,000.00

Funding Appropriation:

Further Consolidated Appropriations Act, 2024 (P.L. 118-47)

Funding Statutory Authority:

Sec. 301(a) of the Public Health Service Act (42 U.S.C. 241(a)); Sec. 317(k)(2) of the Public Health Service Act (42 U.S.C. 247b(k)(2)) and Patient Protection and Affordable Care Act, 2010 (P.L. 111-148)

Expected Project Length:

5 Years

Recipient Organizational Capacity:

The applicant should have the ability to provide technical assistance to a variety of entities that support work physicians, including those working at community health centers. The applicant should have expertise in quality improvement work and implementation science physician processes and the health information technology infrastructure used by physicians. The applicant needs the capacity to document, track, and use clinical quality measures to inform implementation of process improvements. Expertise with health information technology and use of electronic health record data to describe and improve the quality of cardiovascular disease preventive services. The applicant needs the capacity to report blood pressure metrics bi-annually to CDC. Finally, the applicant needs the ability to work nationally with public and private partners to build the capacity of physicians in a variety of low resource environments to improve the cardiovascular health of racially, ethnically, and socioeconomically diverse patient populations that are disproportionately burdened with uncontrolled hypertension.

Recipient Program Experience:

The applicant should have a deep understanding of primary care physicians and how they operate with the support of primary care associations, health center controlled networks, and other public and private partners to provide quality anti-hypertensive care to patients. The applicant should have experience directing clinical quality improvement activities and promoting and scaling interventions.

Experience developing and publishing resources and peer-reviewed articles is also required. Ideally, the applicant would be familiar with Million Hearts evidence-based strategies, data metrics, quality improvement resources (e.g., Million Hearts change packages) and other translational and implementation science activities.

Expectations for Collaboration:

Collaboration with CDC is expected, especially in the development and analysis of priorities and evaluation of impact. Additionally, recipient would be expected to collaborate with other public health partners working on similar blood pressure control quality improvement projects or initiatives. CDC has historically worked successfully with the National Association of Community Health Centers (NACHC), primary care associations, health center controlled networks, and community health centers to produce outcomes that align with the aim of this project. Additional potential partners may include women's health care providers, population health management product developers, and other federal agencies (e.g., Health Resources and Services Administration). The ideal candidate would have some history of engaging with scientific and programmatic collaborators of stature.

Expected Subcontractual Work and Criteria:

Applicant is expected to provide national oversight and support to the project, but much of the technical work will take place at subcontracted primary care.

Additional subcontracts may be needed to work with a clinical repository and a population health management system to test self-measured blood pressure monitoring clinical care process improvements. It may also be appropriate to subcontract for evaluation, writing, and/or other support activities.

General Instructions for Use of Funds:

Funds should be used to generate strategies and tools, collect data, produce, disseminate, and scale interventions. It is reasonable for some funds to be devoted to supporting national efforts (e.g., collaboration to support the widespread use of self-measured blood pressure monitoring, advancement of health IT solutions, increased access to and use of data to inform care processes, etc.). Travel is permissible but should be minimized for maximum impact. It would be helpful for the budget to be scalable. Funding to primary care practices should be carefully determined to optimize the project’s reach and to assess the degree to which capacity-building activities can be replicated in other regions with no or minimal supplemental resources. Funding to support resource development and communication activities is permissible. Overall, the funds should provide flexibility to work with at least 5 primary care networks with an anticipated reach of at least 500,000 adult patients.

Strategic Area: Organizational Capacity and Performance Improvement

Strategic Area Details

Outcomes: Short-term: Increased use of CBA services and products by populations of focus;Intermediate: Increased implementation and sharing of recommended processes, policies, programs, and practices within the strategic areas

Activities: • Develop an annual action plan with CDC to outline the focus for the upcoming year’s activities to test and implement, discover and develop, and scale and spread.

• Develop an evaluation plan with CDC that aligns with annual action plan.

• Recruit primary care practices to participate in the project.

• Support project participants in implementing evidence-based process improvements (e.g., change ideas from the Hypertension Control Change Package and/or the Hypertension in Pregnancy Change Package) to improve cardiovascular health outcomes (e.g., develop care processes to systematically diagnose and treat or refer pregnant and/or post-partum patients with hypertension, test health IT solutions to facilitate the bi-directional exchange of blood pressure measurements, etc.).

• Discover and develop new tools and strategies needed to improve performance on blood pressure outcomes of interest, especially among patient populations of focus (e.g., pregnant and postpartum women with hypertension, people from racial/ethnic minority groups, people with lower incomes, and people who live in rural areas or other ‘access deserts.’). An example of year one activities could be to bolster chronic care management services to help patients take and send their blood pressure measurements to their prescribing clinician(s).

• Scale and spread implementation of high impact change ideas by identifying needs for a supportive ecosystem for optimal delivery of cardiovascular disease prevention services (e.g., provide staffing to coordinate and align the work of national public and private partners to improve blood pressure control among African Americans, expand use of population health interventions to close gaps in the diagnosis and management of hypertension, identify and promote policies to facilitate the delivery of medication management services in trusted community-based settings with qualified clinical staff).

• Test and refine the ways electronic health record data may be used to monitor and drive improvements in blood pressure control outcomes, as deemed appropriate and timely. This includes working with population health management vendors to generate hypertensive disorders of pregnancy-related data reports.

• Test the connection between a clinical repository and a population health management system to benefit primary care networks implementing self-measured blood pressure monitoring.

• Capture, clean, and report quality improvement data bi-annually.

Process Measures: • # of primary care networks engaged in the project (≥5)

• # of practices engaged in the project

• # of adult patients reached (≥500,000)

• % of data-reporting entities that have completed electronic health record data extraction, validation, cleaning, normalization, aggregation, and descriptive analysis (100%)

• % of data-reporting entities that have completed reporting specified data (100%)

Outputs: • Spreadsheet with the primary care practice participants and prospective number of lives impacted by the project.

• Summary of workflows and/or ecosystem parameters to be changed for optimal impact.

• Report of resources used by contracted organizations networks (e.g., funds, staffing needs, space, equipment, etc.) to implement process improvements.

• New tools or resources, as needed, to facilitate implementation of change ideas to improve blood pressure control.

• Report of clinical quality measures and other metrics of interest from project participants.

Budget Period Outcomes:

• Increased implementation of existing and emerging Million Hearts® evidence-based strategies to improve blood pressure control.

• More pregnant and postpartum women with hypertension, people from racial and ethnic minority groups, people with lower incomes, and people living in rural areas or other access deserts receive clinical guideline-recommended care to lower their risk for having a heart attack or stroke.

• Increased awareness and communication of approaches taken or planned by public and private national partners to improve blood pressure control

Outcome Measures: • At least 500,000 adult patients are at lower risk for having a heart attack or stroke.

Project Title: Women’s Heart Disease Education and Awareness - Community Capacity Building

Population of Focus: Category C: Public Health System Components

Population of Focus Description:

Regional and local community-based organizations and local and regional public health systems reaching populations of women at risk for or diagnosed with heart disease and/or HVD. CBOs may also include national organizations with local and/or regional chapters. CBOs are generally non-profit and health focused. Women at risk for or diagnosed with heart disease and/or HVD are diverse in age, race, geography, income, and language. The populations may lack healthcare access more generally or lack access to a physician familiar with diagnosis and management/treatment of HVD and other heart conditions. Capacity building assistance efforts will likely benefit from collaborating with individuals and organizations familiar with heart disease broadly, and HVD specifically. Prospective CBOs may need support to continue capacity building activities in the topic area of women’s heart disease and of HVD.

Project Plan Details Project Purpose: This project seeks to build capacity among community-based organizations

(CBOs) and local and regional public health systems to increase education and awareness of heart disease in women with a dedicated focus on heart valve disease (HVD) among women who have or at risk of heart disease and HVD.

The project will focus on developing a communication, partner and community engagement strategy at the local and regional level to be piloted among 3 (or more) communities or geographic regions. These efforts are intended to enhance and expand the capacity of local and regional organizations to increase awareness and education among at-risk women of heart disease risk factors including reducing and managing risk factors, signs and symptoms of heart disease conditions and cardiac events in women and accessing diagnosis and treatment support. Efforts must include some specific education and awareness on HVD risk factors, signs and symptoms, diagnosis, and care.

CDC was supported by Abt and Associated in 2023-24 to develop and disseminate HVD messaging and communication resources for individuals at risk for or diagnosed with HVD. CDC also initiated partnerships with organizations actively working on HVD education and awareness like the Alliance for Aging Research who leads a Heart Valve Disease Awareness Day and Campaign.

This project focus on HVD education and awareness is directed by FY24 funding and appropriations report language and the Cardiovascular Advances in Research and Opportunities Legacy (CAROL) Act.

CIO: NCCDPHP

Division/Branch/Office /Unit:

Division for Heart Disease and Stroke Prevention (DHDSP)

Proposed FY24 Project Funding Total:

$1,000,000.00

Funding Appropriation:

FY 2024 Further Consolidated Appropriations Act, P.L. 118-47

Funding Statutory Authority:

Cardiovascular Advances in Research and Opportunities Legacy Act (Public Law 117–224)

Expected Project

3 Years

Recipient Organizational Capacity:

The recipient should be able to conduct training, technical assistance, information sharing, and materials development, and have existing staff to dedicate time to the project given the financial support. They should have a reach and expertise with populations at risk for or living with heart disease conditions including HVD, or the ability to subcontract to an organization or organizations serving women’s heart disease and/or HVD populations. Recipients should have strong ties with local community-serving organizations and may also have some ties clinical communities such as physicians, hospitals/hospital systems, and community health centers.

Recipient Program Experience:

The recipient organization will have expertise in women’s heart disease and conditions and preferably HVD. They should have experience in health communication and education, partner engagement and working with CBOs to build capacity to educate community members on health issues. Recipients should also have experience translating clinical and scientific information using clear and plain language (as appropriate).

Expectations for Collaboration:

The recipient is expected to collaborate with CDC to develop plans that build off and complement current and existing women’s heart disease and HVD awareness and education efforts. The recipient would engage with additional partners active in women’s heart disease and/or HVD to develop and implement work related to the project. Collaborative efforts should be efficient and contribute toward reaching program goals.

Expected Subcontractual Work and Criteria:

Yes, recipient may subcontract with private, non-profit partners serving women’s heart disease and HVD populations and with community-based organizations with a health-focus and reach of at-risk populations in 3 or more communities or regions selected for outreach to ensure necessary expertise and reach to accomplish the goals. This may be up to $800,000 during the period of performance.

General Instructions for Use of Funds:

The recipient will be able to spend project funds between Sep 30, 2024, and July 31, 2025. They will not use the funds for federal advisory committees or furnishing products to CDC. Any meetings or conferences will be ancillary in purpose. The recipient will use funds only for reasonable program purposes such as personnel, travel, supplies, and services, and justify their expenses in their budget narrative (adapted from PHIC guidelines document).

Strategic Area: Partnership Development and Engagement

Strategic Area Details

Outcomes: Short-term: Increased availability of and access to CBA services and products that address the strategic areas;Short-term: Increased awareness of best/promising practices and/or tools by populations of focus of CBA services and products;Short-term: Increased use of CBA services and products by populations of focus;Intermediate: Increased awareness and understanding of recommended processes, policies, programs, and practices within the strategic areas

Activities: The project awardee will collaborate with CDC/DHDSP to develop a communication, partner and community engagement strategy that will increase CBO capacity to educate and support women who have or are at risk of heart disease. Efforts must include some dedicated focus on HVD. Key activities will likely include:

- Promote awareness of women’s heart disease broadly as well as HVD risk factors, signs and symptoms, and key actions for identification and monitoring through broadly accessible materials and outreach.

- Identify and partner with CBO(s) in 3 or more communities and/or geographic region(s) to support women’s heart disease and HVD community education and awareness engagement efforts.

- Assess community and CBO familiarity and education, training and resource needs related to understanding women’s heart disease and conditions including HVD signs and symptoms, screening and monitoring.

- Develop community engagement plan(s) and provide TA on implementation through participating CBOs.

- Adapt and build on existing women’s heart disease and HVD education and awareness materials and resources as needed to support community engagement activities.

Process Measures: - The number of communities and/or geographic region(s) where the plan is implemented.

- The number of CBO(s) partnered with, highlighting those who have wanted to do cardiovascular health work in the past but lacked the support to do so (capacity building).

- The development of (an) engagement plan(s).

Outputs: Outputs may include:

- Report on total numbers of individuals reached with women’s heart disease and HVD messages and resources in those communities.

- New or adapted women’s heart disease and HVD materials, training, and resources.

- Report on the number and type of materials/channels/mechanisms/activities by which information is distributed.

- Report that summarizes the capacity of the CBOs and the type of support needed by each of the CBOs, and recommendation for further community scaling of these efforts.

Budget Period Outcomes:

Budget period outcomes may include:

- Increased availability of women’s heart disease and HVD education and awareness messages and materials among CBOs in the community.

- Increased awareness reported among individuals served by partnering CBOs on women’s heart disease and HVD risk factors, signs and symptoms, and engaging healthcare to discuss screening and monitoring.

- Increased linkage to care and or risk reduction resources for individuals served by partnering CBOs.

- Evidence to inform future scale and spread in other communities.

Outcome Measures: Outcome measures may include:

- Percent increase of individuals served by partnering CBOs reporting increased awareness of women’s heart disease and HVD risk factors, signs and symptoms and how to engage healthcare from baseline.

- Percent increase in women who have or at risk of heart disease and/or HVD participating in community engagement activities who are linked to care and/or risk reduction resources from baseline.

Project Title: Heart Valve Disease Education and Awareness - Healthcare Professional Capacity Building

Population of Focus: Category C: Public Health System Components

Population of Focus Description:

Healthcare Professionals (HCP) across the healthcare team (e.g., physicians, nurses, physician’s assistants) or part of public health systems reaching populations at risk for or diagnosed with HVD. These HCPs may work in community health centers, federally qualified health centers, other public clinics, private practices, or hospitals. They will most likely be primary care physicians and their supporting healthcare team members.

Where the HCPs own experience with HVD is limited or seems infrequent, this work would build HCPs individual capacity to educate, detect and refer patients with these conditions. The populations served by these HCPs may be diverse in age, race, geography, income, and language, as HVD can be congenital or result after structural damage to the heart. Capacity building assistance efforts will likely benefit from collaborating with healthcare professional organizations familiar with heart disease broadly, and HVD specifically.

Project Plan Details Project Purpose: This project seeks to build capacity among health care professionals across the health care team (physicians, nurses, physician's assistants) in a primary care setting or part of public health systems to increase their familiarity with heart valve disease (HVD) and its identification and monitoring and increase health care team capacity to educate patients who have or at risk of HVD on risks, signs and symptoms, and, as needed, identification and monitoring. The project will focus on developing an engagement strategy at the community level and piloting it in 3 or more communities or geographic regions. CDC was supported by Abt and Associates in 2023-24 to develop and disseminate HVD messaging and communication resources for healthcare professionals to help educate their patients on HVD risk factors, symptoms, and screening processes. CDC has also initiated partnerships with national health care professional organizations to support dissemination. This project focus on HVD education and awareness is directed by FY24 funding and appropriations report language and the Cardiovascular Advances in Research and Opportunities Legacy (CAROL) Act.

CIO: NCCDPHP

Division/Branch/Office /Unit:

Division for Heart Disease and Stroke Prevention (DHDSP)

Proposed FY24 Project Funding Total:

$1,000,000.00

Funding Appropriation:

FY 2024 Further Consolidated Appropriations Act, P.L. 118-47

Funding Statutory Authority:

Cardiovascular Advances in Research and Opportunities Legacy Act (Public Law 117–224)

Expected Project Length:

3 Years

Recipient Organizational Capacity:

Per the PHIC drafting guidelines, the recipient will be able to conduct training, technical assistance, information sharing, and materials development, and have existing staff to dedicate time to the project, given the financial support. They will also have a reach and expertise with training and interacting with healthcare professionals across the healthcare team, or the ability to subcontract to such an organization with this reach and expertise.

The recipient organization will have expertise in clinical primary care and/or heart conditions, preferably HVD. They should have experience in health education, partner engagement and working with HCPs across the healthcare team to build capacity to educate patients on health issues.

Expectations for Collaboration:

Collaborate with additional partners working on HVD education for HCPs.

Expected Subcontractual Work and Criteria:

Yes, recipient may subcontract with private, non-profit partners who educate HCPs on heart disease and HVD and/or with community-based organizations working with HCPs in 3 regions selected for outreach to ensure necessary expertise and reach to accomplish the goals. This may be up to $700,000 during the period of performance.

General Instructions for Use of Funds:

The recipient will be able to spend project funds between Sep 30, 2024, and July 31, 2025. They will not use the funds for federal advisory committees or furnishing products to CDC. Any meetings or conferences will be ancillary in purpose. The recipient will use funds only for reasonable program purposes such as personnel, travel, supplies, and services, and justify their expenses in their budget narrative (adapted from PHIC guidelines document).

Strategic Area: Partnership Development and Engagement

Strategic Area Details

Outcomes: Short-term: Increased availability of and access to CBA services and products that address the strategic areas;Short-term: Increased awareness of best/promising practices and/or tools by populations of focus of CBA services and products;Short-term: Increased use of CBA services and products by populations of focus;Intermediate: Enhanced skill and ability to support decision-processes, policies, programs, and practices within the strategic areas

Activities: The project awardee will collaborate with CDC/DHDSP to develop and implement a community-level engagement strategy that will increase healthcare professionals’ (HCP) capacity to educate, support, identify, and monitor people who have or are at risk of heart valve disease (HVD). This strategy will be piloted in 3 or more communities or geographic regions. Sub-contracting with up to 3 other HVD population-serving organizations that reach HCPs is highly recommended. Key activities will likely include:

- Identify and partner with primary care HCPs and clinics in 3 or more communities and/or geographic region(s).

- Assess partnering HCP and clinic familiarity and education, training and resource needs related to understanding HVD signs and symptoms, screening and monitoring.

- Adapt and build on existing HVD materials, training, and resources for HCPs in the primary care space to meet identified needs.

- Provide technical assistance on implementation through participating clinics.

- Partner with professional organizations at a national, regional and/or local level of various types of HCPs on a healthcare team to broadly spread HVD education and awareness messages and materials with their members.

Process Measures: - To increase from 0 to 3 or more communities and/or geographic region(s) where the project is implemented.

- To increase from 0 to 50 or more HCPs and/or clinics partnered with where needs are identified and addressed with materials, training and resources and complementary TA.

- To increase from 0 to 5 or more professional organizations partnered with to promote HVD education among HCPs broadly.

Outputs: Outputs may include:

- Report on total numbers of HCPs reached with HVD messages and resources in selected communities.

- New or adapted HVD materials, training, and resources for HCPs in the primary care space.

- Report on the number and type of materials/channels/mechanisms/activities by which information is distributed.

- Report on the number of member impressions and engagement from promotion through partnering larger professional organizations.

- Report that summarizes the type of capacity building support needed by HCPs and/or clinics engaged and recommendation for further community scaling of these efforts.

Budget Period Outcomes:

Budget period outcomes may include:

- Increased availability of HVD education and awareness messages and materials among HCPs and for their patients.

- Increased awareness reported among project-engaged HCPs of HVD risk factors, signs and symptoms, and key actions for identification and monitoring of patients.

- Increased use reported by HCPs across the health care team of messages and materials to educate patients on signs and symptoms of HVD and to listen for heart murmurs.

- Evidence to inform future scale and spread in other communities.

Outcome Measures: Outcome measures may include:

- Increase to 65 percent from baseline of participating HCPs reporting increased awareness of HVD risk factors, signs and symptoms, and key actions for identification and monitoring of patients.

- Increase to 50 percent from baseline of participating HCPs reporting use of HVD messaging and education resources with patient.

Project Title: Community Engagement to Improve Cardiovascular Risk Reduction Among Black Adults

Population of Focus: Category C: Public Health System Components

Population of Focus Description:

This work provides capacity-building and community ambassadors network expansion assistance to benefit local and regional community-based organizations focused on improving the health and wellbeing of their community with an ability to reach Black adults. The efforts here will increase the capacity of these respective organizations to sustain existing work and to spread the reach of communication and community engagement efforts through a community ambassadors network to improve cardiovascular health in black adults.

Project Plan Details Project Purpose: This effort aims to strategically expand on the current work underway in support of the "Million Hearts Communication Partnerships: Reducing Cardiovascular Risk Among Black Adults” project (also known as Live to the Beat). This effort aims to reduce cardiovascular disease related risk factors among Black adults within priority communities via collaboration and capacity building within local community-based organizations and among local and regional partners. This work supports CDC priorities to increase awareness of CVD risk factors and to scale and spread efforts to improve cardiovascular health among priority populations and women with a focus on small steps like moving more, eating healthy, and managing blood pressure through a communications campaign and an established community ambassadors network. To date, CDC has partnered successfully with CDC Foundation on campaign design, development, and implementation and current, broad partner engagement efforts through a community ambassadors network.

CIO: NCCDPHP

Division/Branch/Office /Unit:

Division for Heart Disease and Stroke Prevention (DHDSP)

Proposed FY24 Project Funding Total:

$1,000,000.00

Funding Appropriation:

FY 2024 Further Consolidated Appropriations Act, P.L. 118-47

Funding Statutory Authority:

Sec. 301(a) of the Public Health Service Act (42 U.S.C. 241(a)); Sec. 317(k)(2) of the Public Health Service Act (42 U.S.C. 247b(k)(2))

Expected Project Length:

1 Year

Recipient Organizational Capacity:

Recipients should possess experience and expertise related to delivery of capacity-building assistance reaching Black adults within priority communities.

Prospective recipients should possess specific, demonstrated, and diverse experiences both developing supporting health communication activities to reach local and regional audiences. Additionally, recipients should be able to develop agile and scalable health communication strategies. Applicants should have expertise in developing, refining, and disseminating health communication/risk reduction messages at the local and regional level. This should include the ability to identify specific methods and tactics needed to reach priority audiences.

Prospective recipients should have experience and capacity related to media buying (e.g., web/digital, out of home, radio/broadcast). Recipients should also have experience collecting and interpreting communication data and analytics that will drive strategic decision making.

Highly qualified recipients should have experience promoting cardiovascular disease (and/or related forms of chronic disease) to priority populations.

Prospects must also understand working within community, providing capacity building assistance and working within cultural contexts as this work will focus on Black adults – with a focus on women.

Expectations for Collaboration:

Collaboration with CDC, community-based organizations, and CDC partners will be central to this work as a portion of the activities will require expanding the reach of current health communication messages and supporting existing activities, partnerships, and community relationships.

Expected Subcontractual Work and Criteria:

CDC is amenable to subcontract work provided the primary recipient provides direct oversight of subcontractor activities and that the work products and contributions maintain fidelity to project goals and activities.

General Instructions for Use of Funds:

Funds for this project may be used to support direct costs needed to support this work. This should include digital/paid media support, media buying, content development, and community-engagement activities. Indirect costs should be primarily focused on staff and operational expenses. Travel will be limited to local and regional activity within the Southeastern US. Expenditures related to technology (e.g., media monitoring, project management software) will be determined on the as needed basis.

Strategic Area: Partnership Development and Engagement

Strategic Area Details

Outcomes: Short-term: Increased availability of and access to CBA services and products that address the strategic areas;Short-term: Increased awareness of best/promising practices and/or tools by populations of focus of CBA services and products;Short-term: Increased use of CBA services and products by populations of focus;Intermediate: Increased implementation and sharing of recommended processes, policies, programs, and practices within the strategic areas

Activities: - Develop and execute a strategic communication plan focused on expanding the reach of existing health communication campaign and community engagement activities.

- Review and refine (if/as appropriate) existing health communication materials and resources intended to reduce cardiovascular risks among priority populations and communities.

- Collaborate with local partners (existing and prospective) to create and disseminate tailored health communication messages and resources ranging from community event resources to digital and print materials within local (and potentially, regional) markets.

- Develop the principles and practices to equip local community members to develop and disseminate CVD risk reduction among and within priority communities.

- Share CVD health communication campaign principles, practices, and resources within and among participating communities.

Process Measures: - Develop and implement a plan to maintain and expand the network of Live to the Beat (LTTB) campaign Community Ambassadors.

- Develop and implement paid media activities to support the community engagement and health communication efforts required to engage priority audiences and communities.

- Create a framework for a CVD risk reduction campaign focused on women ages 25 to 45 (potentially subject to minor change dependent on forthcoming CDC data) to include initial campaign themes and concepts.

- Explore expansion network of LTTB community and health system partners.

Outputs: - Develop a suite of targeted, community-centered, health communication resources that promote cardiovascular risk reduction activities within priority communities and populations (as identified by CDC).

- Creating increased capacity on the part of local community ambassadors to support hypertension control efforts the local/community level.

- Increased number of LTTB campaign Community Ambassadors.

- Create a concept summary report for CVD risk reduction campaign focused on women ages 25 to 45.

Budget Period Outcomes:

- An increase in the number and capacity of LTTB Campaign Ambassadors.

- Development and implementation of a local/regional paid media strategy.

- Increased capacity of local partners and community-based organizations to advance CVD prevention through health communication efforts.

Outcome Measures: - An increase in the numbers and types (e.g., community-based organization, faith community, health systems) of LTTB Community Ambassadors.

- Development of a framework for community and population-based insights into campaign themes and needs for priority audiences to include Black adults and women.

Project Title: HEDIS measures for colorectal cancer screening follow-up

Population of Focus Description:

Specialty Physicians

Project Plan Details Project Purpose: The purpose of this project is to develop health care quality measures for follow-up of abnormal colorectal cancer (CRC) screening results, based on data from Electronic Clinical Data Systems (ECDS). More than 227 million people are enrolled in health plans that report Healthcare Effectiveness Data and Information Set (HEDIS) quality measures. HEDIS measures enable health plan performance to be compared with the performance of other health plans and with national or regional benchmarks. HEDIS measures also enable evaluation of trends in year-to-year health plan performance. HEDIS measures for CRC screening currently include the percent of adults aged 45–75 who had appropriate screening for CRC with any of the following tests: annual fecal occult blood test, flexible sigmoidoscopy every 5 years, colonoscopy every 10 years, computed tomography colonography every 5 years, or stool DNA test every 3 years. Abnormal stool-based CRC screening tests require colonoscopy to evaluate positive test results, but reported follow-up colonoscopy rates vary substantially, from less than 50% to 90% within one year of a positive test.

Modeling studies suggest that every month after an abnormal stool-based test until colonoscopy can be associated with a cancer incidence risk increase of 0.3% per month, compared with individuals who received colonoscopies within 2 weeks, and a mortality risk increase of 1.4% per month. Health plans/systems vary in their ability to track abnormal stool-based CRC screening tests and follow-up colonoscopy. Currently, HEDIS does not include healthcare quality measures focused on follow-up of abnormal CRC results. When HEDIS measures were initially developed, health plans/systems obtained the information for HEDIS measures from hard copy medical records. Current HEDIS measures are developed as digital measures to build upon data modernization, informatics, and information technology advances in healthcare delivery in the United States.

Starting in 2024, the HEDIS colorectal cancer screening measure is based on data from ECDS and requires collection and reporting of electronic clinical data in a standardized way. Leveraging electronic clinical data enriches the information available to healthcare teams and patients. Standardized data collection supports the ability of providers to securely and appropriately share that information to improve patient care.

CIO: NCCDPHP

Division/Branch/Office /Unit:

Division of Cancer Prevention and Control (DCPC)

Proposed FY24 Project Funding Total:

$2…