cdc-rfa-ck-26-0221_forPublication.pdf

Notice of Funding Opportunity

Application due Friday, July 17, 2026

Division of Parasitic Diseases and Malaria Parasitic Diseases Branch

Reducing the burden of parasitic infections in the United States through evidence-based prevention and control activities Opportunity number: CDC-RFA-CK-26-0221

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 7

Agency priorities 9

Program description 12

Step 2: Get Ready to Apply 50

Get registered 51

Find the application package 52

Help applying 52

Step 3: Build Your Application 53

Application checklist 54

Application contents and format 56

Step 4: Understand Review, Selection, and Award 65

Application review 66

Award notices 69

Step 5: Submit Your Application 70

Submission requirements and deadlines 71

Step 6: Learn What Happens After Award 73

Post-award requirements and administration 74

Contacts and Support 78

Before you begin 3

Contents 2

Before you begin If you believe you are a good candidate for this funding opportunity, secure your SAM.gov and Grants.gov registrations now. If you are already registered, make sure your registrations are active and up to date.

SAM.gov registration (this can take several weeks) You must have an active account with SAM.gov. This includes having a Unique Entity Identifier (UEI).

See Step 2: Get Ready to Apply

Grants.gov registration (this can take several days) You must have an active Grants.gov registration. Doing so requires a Login.gov registration as well.

See Step 2: Get Ready to Apply

Apply by the application due date Applications are due by 11:59 p.m. Eastern Time on Friday, July 17, 2026.

To help you find what you need, this NOFO uses internal links. In Adobe Reader, you can go back to where you were by pressing Alt + Left Arrow (Windows) or Command + Left Arrow (Mac) on your keyboard.

Before you begin 3 https://sam.gov/ https://grants.gov/

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 7

Agency priorities 9

Program description 12

Basic information Centers for Disease Control and Prevention (CDC)

Division of Parasitic Diseases and Malaria

Parasitic Diseases Branch

Reducing the burden of parasitic infections in the United States.

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name:

Reducing the burden of parasitic infections in the United States through evidence-based prevention and control activities

Opportunity number:

CDC-RFA-CK-26-0221

NOFO version:

Original

Assistance listing:

93.084

Key dates

Application submission deadline:

July 17, 2026

Optional letter of intent deadline:

July 3, 2026

Expected award date:

September 29, 2026

Expected start date:

September 30, 2026

See Submit Your Application for other time frames that may apply to this NOFO.

Summary The purpose of this Notice of Funding Opportunity (NOFO) is to decrease the impact of specific parasitic infections in the U.S. with public health practices and disease control strategies. The NOFO focuses on three parasitic infection areas:

• Chagas disease.

• Soil-transmitted helminths.

• Other parasitic diseases of domestic concern in the U.S.

This NOFO will continue CDC’s Parasitic Disease Branch work to help healthcare providers (HCPs) better understand, detect, treat, and prevent parasitic infections. Improved understanding and management of parasitic diseases in the U.S. will help make Americans stronger, safer, and more prosperous.

There are three components of this NOFO. You may apply for only one:

• Component A will improve HCPs’ knowledge and practices. Increase testing and management of people with or at risk of Chagas disease.

Expand the use of best practices, training tools, and materials.

• Component B will strengthen public health efforts to monitor and control soil-transmitted helminth infections (like hookworm). It focuses on areas in the Southeastern U.S. (as defined by the U.S. Census Bureau) that are historically affected.

• Component C will target the prevention, control, health education, and, where applicable, elimination of other parasitic diseases in the U.S.

Diseases include cyclosporiasis, cysticercosis, echinococcosis, leishmaniasis, lymphatic filariasis, and toxoplasmosis.

Step 1: Review the Opportunity 5

We will not accept proposals focused on malaria, amoebiasis, cryptosporidiosis, giardiasis, or any international activities. Your strategies should aim for significant public health benefits and reach a large portion of at-risk populations.

Funding details Funding type: Cooperative agreement

Expected awards: Up to 11

• Component A: Up to 3 awards.

• Component B: Up to 3 awards.

• Component C: Up to 5 awards.

Period of performance: We plan to award projects for five years in 12-month budget periods.

Expected total program funding over the performance period: $23,750,000.

• Component A: $3,750,000.

• Component B: $7,500,000.

• Component C: $12,500,000.

Estimated average award per applicant over the period of performance:

• Component A: $1,250,000.

• Component B: $2,500,000.

• Component C: $2,500,000.

Expected funding per applicant per 12-month budget period: $1,250,000.00.

• Component A: $250,000.

• Component B: $500,000.

• Component C: $500,000.

The number of awards is subject to available funds and program priorities.

Funding strategy Applicants can apply for only one of the components in this NOFO. Annual funding is subject to the availability of funds.

Step 1: Review the Opportunity 6

Eligibility Eligible applicants Only these types of organizations may apply.

• State governments.

• County governments.

• City or township governments.

• Special district governments.

• Independent school districts.

• Public and state-controlled institutions of higher education.

• Native American tribal governments (federally recognized).

• Public housing authorities and Indian housing authorities.

• Native American tribal organizations, other than federally recognized tribal governments.

• Nonprofits having a 501(c)(3) status, other than institutions of higher education.

• Nonprofits without 501(c)(3) status, other than institutions of higher education.

• Private institutions of higher education.

• For-profit organizations other than small businesses.

• Small businesses.

• Bona fide agents applying on behalf of state, territorial, local, and tribal government organizations.

Bona fide agents must submit documentation that demonstrates their arrangement with the eligible applicant. See attachments.

Step 1: Review the Opportunity 7

Responsiveness criteria We will review your application to make sure it meets these requirements.

These are the basic requirements you must meet to move forward in the competition. We won’t consider an application that:

• Is from an organization that doesn’t meet all eligibility criteria. See requirements in eligibility.

• Is submitted after the deadline.

• Proposes research activities. See the definition of research.

• Asks for more funding than the budget limit for a specific component.

• Applies for more than one component. You can only apply to one (A or B or C).

See the application checklists to understand which elements of your application are part of the responsiveness criteria.

Application limits You must follow these limits on the number of applications your organization can submit.

Under this NOFO, you may submit only one application under your organization’s Unique Entity Identifier (UEI).

Cost sharing and matching funds This program has no cost-sharing requirement, meaning you do not need to contribute to the costs of this project.

If you choose to include cost-sharing funds, we won’t consider it during review. If you receive an award, we will include your voluntary commitment in the award, and you must report on the funds.

Post-award requirements

Before you apply, make sure you understand the requirements that come with an award.

See Step 6: Learn What Happens After Award for information on regulations that apply, reporting, and more.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 8 https://www.cdc.gov/grants/additional-requirements/ar-31.html

Agency priorities Required alignment with CDC priorities The recipient of this award must implement any funds awarded under this NOFO to effectuate program goals or agency priorities in accordance with the Centers for Disease Control and Prevention (CDC) Priorities when authorized (for a full description of the CDC Priorities, please follow the provided hyperlink).

Funded activities must:

• Align with CDC’s core priorities by demonstrating a commitment to gold-standard science, transparency, and evidence-based practices.

• Support CDC’s mission to protect Americans from infectious and chronic diseases, strengthen public health systems, and advance innovation in health data and infrastructure.

• Contribute to rapid, science-driven responses to health threats, promote global health leadership, and adhere to principles of integrity, accountability, and compliance with applicable laws and federal priorities.

Consistent with CDC’s values, in carrying out any project funded under this NOFO, the recipient must adhere to the following principles where consistent with the authority and scope of the award and its activities:

• A commitment to gold-standard science and ensuring trust, transparency, and credibility: To build trust and improve CDC’s ability to lead during health crises, CDC will increase transparency, be more accountable, and follow strict, gold-standard scientific practices that are open, unbiased, and based on clear evidence.

• A commitment to global leadership: With staff in 63 countries and supporting 20 more, CDC’s Global Health Center:

◦ Work to prevent disease and advance emergency response

◦ Detect health threats early, send response teams, train health workers, and provide personal protective equipment, vaccines, and medicines.

◦ Test disease samples from around the world to prepare for flu and other serious outbreaks.

◦ Has strengthened systems to better protect people at home and abroad after the COVID-19 outbreak.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 9 https://www.cdc.gov/about/cdc/index.html

• A commitment to ensuring rapid, evidence-based responses to crises:

During public health emergencies, ensuring rapid, science-driven responses is critical to minimizing harm, maintaining public trust, and restoring stability. To meet this goal, CDC must continue to strengthen its emergency response systems by:

◦ Streamlining internal processes.

◦ Improving risk communication strategies.

◦ Ensuring that laboratory capacity is fully equipped and tested—capable of rapidly developing and deploying scalable diagnostics during crises.

◦ Embedding structures for real-time learning, independent after-action reviews, and the application of lessons learned will ensure that each crisis response is smarter, faster, and more effective than the last.

• A commitment to vaccine safety and efficacy research: CDC will apply “gold-standard” science to all of its vaccine safety and effectiveness research. It will make vaccine data, research methods, and related datasets publicly available through simple data use agreements to improve transparency, accountability, and trust.

• A commitment to advancing our understanding of the causes of autism spectrum disorder (ASD), neurodevelopmental disorders (NDDs), and chronic disease: CDC conducts research and works with partners to better understand the causes of autism spectrum disorder, neurodevelopmental disorders, and chronic diseases. It will use new and existing data to study the rise in these conditions, including the increase in autism diagnoses from 1 in 150 to nearly 1 in 31 over the past 25 years.

• A commitment to modernizing public health infrastructure and enhancing our approach to health data: CDC will modernize public health infrastructure to create a faster, more efficient health system that can detect and respond to outbreaks in real time. This effort includes:

◦ Replacing data silos with integrated systems.

◦ Using advanced technology.

◦ Strengthening partnerships with states to ensure shared responsibility and strong local health data systems.

◦ Emphasizing collaboration across federal and state partners, resilient and adaptable systems, and accountability for funded programs to ensure they align with these priorities and federal requirements.

Step 1: Review the Opportunity 10

• Conflicts of interest: CDC will not support funding programs with conflicts of interest and ensure its work is based on transparent, unbiased science.

• Immigration: CDC funds will not be used to support or encourage illegal immigration, consistent with federal law.

• Protecting life and the family: CDC funds will not be used to support elective abortions, consistent with the Hyde Amendment, and will promote maternal health, the dignity of life, and strong families.

• Ending disorder on America’s streets: CDC will prioritize evidence-based programs that reduce homelessness, drug use, and public disorder. It will support comprehensive services for people with serious mental illness and substance use disorder. CDC will not support housing first strategies, harm-reduction or safe consumption sites, or related activities. To the extent allowable by federal law, CDC intends to give priority to grantees in States and municipalities that have laws and policies that support and enforce CDC’s priorities.

• Gender ideology and protecting children: CDC will not fund medical interventions for minors seeking gender transition and will define sex based on biological criteria.

• DEI: CDC will not support DEI initiatives based on group identity and focus on merit-based, evidence-driven approaches to improve health outcomes.

• Parental rights: CDC will support policies that protect parental authority, promote transparency, and give parents greater control over their children’s education.

The recipient must demonstrate ongoing compliance with the full description and listing of CDC values and priorities, in all programs that are authorized to advance them, through program design, implementation, reporting, and evaluation.

Failure to meaningfully align funded activities with the applicable requirements may result in corrective action, additional reporting requirements, or other enforcement actions consistent with federal grant regulations found at 2 CFR Part 200 and the terms and conditions of this award. The full CDC Priorities Statement can be found here: Centers for Disease Control and Prevention (CDC) Priorities.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 11 https://opa.hhs.gov/sites/default/files/2025-11/gender-dysphoria-report.pdf

Program description Background Parasitic infections, including Chagas disease, soil-transmitted helminthiases (STH), toxoplasmosis, and other parasitic diseases of domestic concern, affect millions of people in the United States, particularly among underserved and at-risk populations. These infections remain underrecognized, and gaps persist in surveillance, healthcare provider awareness, and access to timely diagnosis, treatment, and prevention.

This NOFO supports CDC’s commitment to gold-standard science and aligns with national strategic priorities to strengthen public health infrastructure, improve infectious disease surveillance, and prevent adverse health outcomes. Funded activities will enhance surveillance capacity, increase healthcare provider awareness and diagnostic readiness, promote evidence-based prevention, and reduce the risk of congenital transmission.

These efforts support CDC’s mission to protect Americans from infectious diseases and strengthen national capacity to prevent, detect, and respond to parasitic diseases of domestic concern.

Chagas disease Over 300,000 people in the U.S. are infected with Trypanosoma cruzi, the parasite that causes Chagas disease. The infection often goes undiagnosed because it usually doesn’t cause severe symptoms at first. But later, it can lead to heart disease or gastrointestinal problems. In the United States, the annual lost productivity due to Chagas-disease-related mortality is estimated to be almost a billion dollars.

Those at risk for Chagas disease include people who have previously lived in rural areas of Mexico, Central America, or South America, as well as children born to infected mothers, who may become infected congenitally. Few locally-acquired vector-borne infections have been documented in U.S. Southern states, where there are triatomines and animals infected with the parasite.

This NOFO aims to help prevent the long-term consequences of infections with Trypanosoma cruzi (Chagas disease) through increased provider awareness and understanding of diagnosis and treatment.

Step 1: Review the Opportunity 12

Soil-transmitted helminths Soil-transmitted helminths (STH) infections are spread through contact with contaminated soil. These infections are common in warm, humid climates, including temperate zones during warmer months, with poor sanitation and hygiene.

In the early 1900s, STH infections were widespread across the Southeastern U.S. Eradication campaigns were launched. However, environmental and socioeconomic conditions that support these infections still exist in many of the same areas. Recent data on STH prevalence in the United States are lacking.

Other parasitic infections Parasitic infections in the United States can be acquired abroad or within the country. They’re often caused by parasites that can infect both animals and humans. Many healthcare providers and public health professionals are unfamiliar with how to recognize, prevent, or control these diseases. For example, leishmaniasis is a parasitic disease found in many parts of the world and in some areas of the U.S. Still, it’s poorly understood in terms of diagnosis, treatment, and control. Other targeted parasitic infections of interest are cyclosporiasis, cysticercosis, echinococcosis, lymphatic filariasis, and toxoplasmosis.

Strategies to manage and eliminate parasitic diseases exist globally, but they’re not commonly used in the U.S.

Related work This NOFO builds on the cooperative agreement GH20-2083: Reducing the burden of parasitic infections in the United States through evidence-based prevention and control activities.

This NOFO expands CDC’s work on parasitic infections that are prioritized for public health action, based on how many people are infected, the severity of illnesses, and the ability to prevent and treat them. It builds on past successes to further expand healthcare knowledge and awareness about Chagas disease. Previous CDC efforts include:

• Educational presentations for HCPs in over 10 states where people at risk for Chagas disease reside.

• An online training for HCPs about congenital Chagas disease.

• Articles published in professional journals.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 13 https://www.federalcompass.com/rfp-opportunity-detail/CDC-RFA-GH20-2083

• Screening programs for pregnant mothers.

• Networks to connect providers and public health professionals across states.

This NOFO continues CDC’s work with state partners to investigate STH in the Southeast. Earlier efforts focused on Alabama and Mississippi. This NOFO now includes additional states across the South region (as defined by the U.S.

Census Bureau). It excludes areas in Alabama and Mississippi which have already been completed.

CDC also offers technical support for surveillance and response to state and local health departments to help them respond to cases and outbreaks of other parasitic diseases. These diseases include cyclosporiasis, echinococcosis, and toxoplasmosis. This NOFO will provide funding to increase awareness and knowledge about them, helping health departments and providers recognize, prevent, and control when cases or outbreaks occur.

More information, including fact sheets and links to open access publications, can be found on the CDC website, regarding parasites and soil-transmitted helminths.

National public health priorities and strategies Activities supported under this NOFO will address key priority areas, including:

• Environmental health: Reducing risk factors associated with parasitic disease transmission, including sanitation, water quality, and environmental exposures.

• Infectious disease prevention: Improving provider awareness, surveillance, diagnosis, and prevention of Chagas disease, soil-transmitted helminths, toxoplasmosis, and other parasitic diseases of public health importance.

• Maternal, infant, and child health: Preventing congenital parasitic infections through increased awareness, early diagnosis, and improved prevention and treatment.

These efforts support national public health priorities and contribute to reducing the burden of parasitic diseases in the United States through strengthened surveillance, improved prevention, and evidence-based public health action.

1. Review 2. Get Ready 3. Build 4. Understand 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 14 https://www.cdc.gov/parasites/index.html https://www.cdc.gov/parasites/index.html https://www.cdc.gov/sth/about/index.html https://www.cdc.gov/sth/about/index.html

Purpose The purpose of this NOFO is to reduce complications from Chagas disease, detect and address soil-transmitted helminth infections, and increase awareness of parasitic diseases in the United States.

Approach Overview This NOFO has three components. You may apply for one component. Each component has its own outcomes and approach as follows.

Component A: Chagas disease This NOFO aims to:

• Educate public health partners to recognize and diagnose Chagas disease.

• Support the Division of Parasitic Disease and Malaria (DPDM) strategic goal of reducing deaths, illnesses, and disabilities caused by parasitic diseases in the United States.

The approach for this component includes:

• Create and share educational materials, prevention strategies, and community-level recommendations to lower illness and death from Chagas disease, in the U.S.

Component B: Soil-transmitted helminths This NOFO aims to:

• Confirm whether STH infections are still present in historically endemic areas.

• Identify risk factors for STH infection.

• Develop and implement prevention and control measures to stop STH infections.

Expected outcomes include:

• Updated data on STH prevalence.

• Increased awareness of these infections in communities and among HCPs.

• Stronger local capacity in health departments and healthcare centers to detect, prevent, and manage STH infections.

Step 1: Review the Opportunity 15

The approach for this component includes:

• Identify areas at risk for STH infections in the Southeastern U.S. (this includes states in the South region, as defined by the U.S. Census Bureau, except for areas of Alabama and Mississippi where work was previously completed). Determine whether these infections are still prevalent and implement control strategies.

Component C: Other parasitic diseases of domestic concern This NOFO aims to improve the ability of health departments and healthcare providers to identify, treat, control, and prevent parasitic diseases of domestic concern in their areas.

The approach for this component includes:

• Develop and disseminate educational materials, community-level prevention and control recommendations, and strategies to reduce morbidity and mortality due to other parasitic diseases of domestic concern in the United States.

Program logic model The following logic model includes the strategies and activities required under this NOFO.

The logic model also includes the program’s expected outcomes. Outcomes are the results that you intend to achieve. They usually show the intended direction of change, such as increase or decrease.

Not all outcomes apply to all strategies. The table shows how they apply. You will use these outcomes as a guide for developing performance measures.

Component A: Chagas Disease

Inputs Activities Outputs (Performance Measures)

Short-Term Outcomes

Intermediate Outcomes

Long-Term Impact

CDC

scientific expertise

Activity A1.1:

Develop and disseminate evidence-informed educational resources for healthcare providers

Number of educational materials developed for healthcare providers

Increased healthcare provider knowledge of Chagas disease diagnosis and management

Increased screening and testing for Chagas disease among at-risk populations

Earlier detection and treatment of Chagas disease

Step 1: Review the Opportunity 16

Inputs Activities Outputs (Performance Measures)

Short-Term Outcomes

Intermediate Outcomes

Long-Term Impact

Cooperative agreement funding

Conduct trainings and webinars for healthcare providers

Number of healthcare providers trained

Improved awareness of diagnostic and treatment protocols

Improved clinical management of individuals diagnosed with Chagas disease

Improved health outcomes among affected populations

Partnerships with healthcare systems

Activity A1.2:

Develop and disseminate culturally appropriate educational resources for patients and at-risk communities

Number of community education materials developed and disseminated

Increased awareness of Chagas disease prevention and risk factors among affected populations

Increased healthcare-seeking behavior among individuals at risk

Reduced morbidity associated with Chagas disease

Partnerships with maternal and child health programs

Activity A1.3:

Support implementation of congenital Chagas disease screening programs

Number of healthcare facilities implementing screening protocols

Improved availability of congenital screening services

Increased detection of congenital Chagas disease cases

Improved maternal and child health outcomes

Public health workforce and clinical partners

Activity A1.4:

Strengthen clinical capacity for Chagas disease diagnosis and management

Number of healthcare providers trained on screening and referral protocols

Improved provider confidence in diagnosing and managing Chagas disease

Increased appropriate referral and treatment

Reduced complications associated with delayed diagnosis

Step 1: Review the Opportunity 17

Component B: Soil-Transmitted Helminths (STH)

Outputs (Performance Measures)

Short-Term Outcomes

Intermediate Outcomes

Long-Term Impact

CDC

epidemiologic expertise

Activity B1.1:

Conduct epidemiologic surveillance to assess current

STH

transmission

Number of geographic areas evaluated for

STH

transmission

Increased availability of surveillance data describing

STH

transmission patterns

Improved identification of areas with ongoing or re-emerging

STH

transmission

Strengthened national surveillance for parasitic diseases

Surveillance systems and data tools

Conduct field surveys in historically endemic areas

Number of individuals tested for STH infection

Increased understanding of infection prevalence

Improved targeting of prevention and control strategies

Reduced transmission of STH infections

Environmental health expertise

Activity B1.2:

Conduct environmental assessments to identify transmission risk

Number of environmental samples tested for STH contamination

Improved understanding of environmental risk factors

Evidence-based targeting of interventions

Reduced environmental transmission risk

Laboratory diagnostic capacity

Activity B1.3:

Strengthen laboratory diagnostic capacity for STH detection

Number of laboratories supported for diagnostic testing

Improved diagnostic capacity for STH detection

Faster identification of ongoing transmission

Improved public health response

Public health partnerships

Activity B1.4:

Disseminate surveillance findings and program evaluation results

Number of surveillance reports disseminated

Increased awareness among public health partners

Increased use of surveillance data for program planning

More effective

STH

prevention and control strategies

Step 1: Review the Opportunity 18

Component C: Parasitic Diseases of Domestic Concern

Outputs (Performance Measures)

Short-Term Outcomes

Intermediate Outcomes

Long-Term Impact

CDC

scientific expertise

Activity C1.1:

Assess healthcare provider knowledge and training needs

Number of healthcare providers completing knowledge assessments

Improved understanding of training needs

Development of targeted training programs

Increased provider capacity to diagnose and manage parasitic diseases

Public health partnerships

Activity C1.2:

Develop and disseminate educational resources for healthcare providers and communities

Number of informational materials developed and disseminated

Increased awareness among healthcare providers and communities

Increased use of prevention strategies

Reduced burden of parasitic diseases

Surveillance data systems

Activity C1.3:

Develop or strengthen surveillance methodologies for parasitic diseases

Number of jurisdictions implementing surveillance activities

Improved surveillance data availability

Increased use of surveillance data for decision-making

Strengthened national monitoring systems

Data analysis capacity

Activity C1.4:

Disseminate surveillance findings and program evaluation results

Number of reports, presentations, or manuscripts disseminated

Increased awareness among public health partners

Increased use of evidence to guide prevention and control programs

Improved public health response to parasitic diseases

Step 1: Review the Opportunity 19

Program implementation roadmap The following roadmap outlines the expected progression of activities across the project period. Recipients should implement activities aligned with their proposed approach and may adjust sequencing as appropriate for their program context.

Project Phase Program Focus Key Activities Expected Outputs

Expected Outcomes

Year 1: Program Planning and Capacity Development

Establish program infrastructure and partnerships

Conduct healthcare provider knowledge assessments; establish partnerships with healthcare systems and laboratories; develop educational resources;

establish surveillance methodologies; develop data collection and reporting systems

Educational materials developed;

partnerships established;

surveillance plans finalized;

training curricula developed

Improved understanding of training and surveillance needs;

increased readiness to implement program activities

Year 2: Program Implementation and Initial Data Collection

Implement education, surveillance, and prevention activities

Conduct healthcare provider trainings;

implement community outreach; initiate surveillance activities;

support screening programs; begin laboratory testing and data collection

Healthcare providers trained;

outreach activities conducted;

surveillance surveys initiated;

screening programs operational

Increased awareness among healthcare providers and communities;

improved availability of surveillance data

Year 3: Program Expansion and Program Monitoring

Expand program activities and strengthen implementation

Expand surveillance activities to additional areas; strengthen laboratory diagnostic capacity; increase provider training and outreach efforts;

monitor program performance using collected data

Expanded surveillance coverage;

increased number of trained providers;

additional communities reached

Increased detection of parasitic infections;

improved surveillance data quality

Step 1: Review the Opportunity 20

Project Phase Program Focus Key Activities Expected Outputs

Expected Outcomes

Year 4: Program Evaluation and Optimization

Evaluate program performance and refine strategies

Conduct program evaluations; analyze surveillance and program data; adjust program strategies based on evaluation findings; continue education and surveillance activities

Evaluation reports produced;

updated program strategies;

continued training and outreach

Increased use of surveillance data and evaluation findings to guide program improvement

Year 5:

Sustainability and Dissemination of Findings

Strengthen sustainability and share program findings

Disseminate program findings through reports, presentations, and publications;

strengthen partnerships with public health stakeholders; support integration of successful approaches into routine public health practice

Reports and manuscripts disseminated;

stakeholder briefings conducted;

sustainable program practices documented

Strengthened national capacity to prevent, detect, and respond to parasitic diseases

Strategies and activities This section elaborates on the strategies and activities described in the logic model and provides details about how we expect you to implement your program. The following activities are distinct from the strategies. They represent actionable steps to carry out each strategy.

Component A: Chagas disease Strategy

1.1 Creating and sharing information about diagnosis, treatment, and care management with healthcare providers (HCPs).

1.2 Surveying HCPs to understand what they know about the disease, what information they need, and their preferred training formats.

1.3 Assessing patient knowledge, attitudes, and behaviors to help design a patient education program in collaboration with HCPs.

Step 1: Review the Opportunity 21

1.4 Evaluate possibility of setting up a congenital transmission screening program.

Activities

• Activity A: Develop standardized, evidence-based educational materials for healthcare providers (HCPs) on Chagas disease diagnosis, treatment protocols, referral pathways, and long-term care management, aligned with CDC guidance.

• Activity B: Conduct structured surveys and/or interviews with HCPs to assess baseline knowledge, clinical practices, information gaps, and preferred training modalities (e.g., webinars, job aids, clinical decision tools).

• Activity C: Analyze HCP assessment findings to tailor training curricula and dissemination strategies for different provider audiences (e.g., primary care, obstetrics, infectious disease specialists).

• Activity D: Conduct patient knowledge, attitudes, and behaviors (KAB) assessments in collaboration with HCPs and community partners to identify barriers to care, treatment adherence challenges, and education needs.

• Activity E: Co-develop culturally and linguistically appropriate patient education materials informed by KAB findings and provider input.

• Activity F: Conduct a feasibility assessment for congenital Chagas disease screening, including review of existing screening infrastructure, laboratory capacity, clinical workflows, and jurisdictional policies.

• Activity G: Produce a feasibility report summarizing findings, recommendations, and potential implementation pathways for congenital screening.

Component B: Soil-transmitted helminths Strategy

2.1 Gathering information about current knowledge, attitudes and practices, design, and pre-test communication modalities.

2.2 Designing, testing, implementing, and monitoring prevention and control programs in areas with ongoing STH transmission.

2.3 Checking areas with a history of STH transmission to see if the infections are still spreading.

2.4 Identifying new at-risk areas for STH infections.

Step 1: Review the Opportunity 22

2.5 Assessing HCPs to understand what they know about the disease, what information they need and their preferred training formats.

2.6 Creating and sharing information about diagnosis, treatment, and clinical management information with HCPs.

2.7 Sharing the findngs of investigations, surveillance methodologies, impact assessments and trends with communities, HCPs, public health organizations, governments, and other stakeholders.

Activities

• Activity A: Conduct community-level knowledge, attitudes, and practices (KAP) assessments related to STH transmission, prevention behaviors, and treatment-seeking.

• Activity B: Design, pre-test, and refine health communication materials and modalities (e.g., print, digital, community outreach) based on KAP findings.

• Activity C: Design and implement STH prevention and control programs in areas with ongoing transmission, including environmental, behavioral, and clinical interventions as appropriate.

• Activity D: Establish routine monitoring protocols to assess program implementation fidelity, reach, and effectiveness.

• Activity E: Conduct reassessments in areas with historical STH transmission to determine whether transmission is ongoing or re-emerging.

• Activity F: Identify and prioritize new geographic areas or populations at risk for STH infection using surveillance data, environmental indicators, and partner input.

• Activity G: Conduct HCP knowledge and needs assessments related to STH diagnosis, treatment, and reporting.

• Activity H: Develop and disseminate clinical guidance and training materials for HCPs on STH diagnosis, treatment, and management.

• Activity I: Analyze and synthesize findings from surveillance, investigations, and program evaluations.

• Activity J: Disseminate findings and recommendations to communities, HCPs, public health agencies, governments, and other stakeholders through reports, briefings, and data products.

Step 1: Review the Opportunity 23

Component C: Parasitic diseases of domestic concern Strategy

3.1 Surveying HCPs to understand what they know about the disease, what information they need, and their preferred training formats.

3.2 Developing and sharing information about diagnosing, treating, and managing parasitic diseases with HCPs.

3.3 Creating and implementing surveillance methods to understand the spread and impact of the targeted parasitic diseases.

3.4 Sharing findings from investigations, surveillance, and assessments with communities, HCPs, public health organizations, governments, other stakeholders.

3.5 Identifying and monitoring areas at risk for parasitic infections of concern.

3.6 If applicable, designing, testing, implementing, and monitoring prevention and control programs in areas with ongoing disease transmission.

3.7 For toxoplasmosis specifically: Evaluating feasibility of setting up a congenital transmission screening program.

Activities

• Activity A: Conduct surveys and/or interviews with HCPs to assess knowledge, diagnostic practices, information gaps, and preferred training formats for parasitic diseases of concern.

• Activity B: Develop and disseminate evidence-based guidance on diagnosis, treatment, and clinical management tailored to identified provider needs.

• Activity C: Design and implement surveillance methodologies to monitor disease burden, transmission patterns, and population impact for targeted parasitic diseases.

• Activity D: Identify and monitor geographic areas and populations at increased risk using surveillance data and partner reports.

• Activity E: Conduct investigations and assessments to better understand disease transmission dynamics and risk factors.

• Activity F: Share surveillance findings, investigation results, and assessment outcomes with communities, HCPs, public health organizations, governmental partners, and other stakeholders to inform decision-making.

Step 1: Review the Opportunity 24

• Activity G: When applicable, design, test, implement, and monitor prevention and control programs in areas with ongoing transmission.

• Activity H: For toxoplasmosis specifically, conduct a feasibility assessment for congenital transmission screening, including evaluation of clinical workflows, laboratory capacity, and public health infrastructure.

• Activity I: Document and disseminate feasibility findings and recommendations to inform future program planning.

Work plan You must provide a work plan for your project. The work plan connects your performance outcomes, strategies and activities, and measures. It provides more detail on how you will measure outcomes and processes.

Table: Sample format

Activities you will implement

Progress or process measures

From the data, monitoring, and evaluation section.

Relevant period of performance outcomes

From the outcomes section.

Responsible position or party

Completion date

Strategy 1:

1.

2.

3.

Strategy 2:

1.

2.

3.

Step 1: Review the Opportunity 25

Data, monitoring, and evaluation CDC strategy CDC collects and reports on indicators to measure progress toward achieving the activities and outcomes. CDC will also use results for program planning, improvement, accountability, and reporting. CDC will share the results with key parties.

CDC will work with you throughout the life of an award to ensure that all activities and expected outcomes align with your strategies and goals, and those of the U.S. government.

You should dedicate some of award funds to evaluate and monitor the performance of your project. You and CDC will agree on the final funding amount, but we expect that you will dedicate approximately 5 to 10% of your project’s funding to monitoring, reporting, and evaluation activities.

Required performance measures This section describes the draft performance measures you will need to report on after award. We will likely refine the required measures for this program. If so, we will work with you and finalize them before we require you to submit any data.

Evaluation and performance measurements show how well the project goals are being met, strengthen the evidence base for specific interventions, and help determine how these interventions work in different communities, places, and situations. Evaluation and performance measurements also support ongoing improvements and assess whether strategies and activities can be expanded upon and effectively reach the target populations. This information helps CDC ensure recipients are on track, show the NOFO’s success in achieving outcomes, and identify ways to improve the program throughout the agreement period.

Throughout the 5-year agreement, CDC will work with funding recipients to track strategy implementation and assess progress in achieving NOFO outcomes. Process measures will inform CDC to what extent the recipient has implemented the activities as intended. Outcome measures would inform CDC if the recipient achieved the period of performance outcomes.

Recipients will report progress toward program outcomes once a year. CDC will help develop performance measurements that align with the project’s purpose and goals, including timelines for tracking progress. Some measures

Step 1: Review the Opportunity 26 may be required in the first year, while others may cover several years. CDC and the recipient will have regular calls to review performance, discuss progress, and address any challenges. The schedule for these calls will be determined after the cooperative agreement is awarded.

The performance measures directly align with the strategies, activities, and outcomes outlined in the logic model. Both qualitative and quantitative assessments may be used for evaluation. At least once a year, recipients will submit reports summarizing the progress and short-term outcomes for each project. These performance outcome measures may include:

Component A: Chagas disease Strategy 1: Improve healthcare provider and patient knowledge of Chagas disease prevention, diagnosis, treatment, and clinical management.

Recipients should implement activities that strengthen awareness and clinical capacity related to Chagas disease among healthcare providers and affected communities.

• Activity 1.1:

Develop and disseminate educational resources for healthcare providers on the diagnosis, treatment, and clinical management of Chagas disease.

Example process measures:

◦ Number of educational materials developed for healthcare providers.

◦ Number of educational materials disseminated to healthcare providers.

◦ Number of trainings, webinars, or workshops conducted for healthcare providers.

◦ Number of healthcare providers participating in training activities.

◦ Percentage of trained providers reporting increased knowledge following training.

• Activity 1.2:

Develop and disseminate culturally appropriate educational materials for patients and at-risk communities.

Example process measures:

◦ Number of informational materials developed for at-risk communities.

◦ Number of informational materials disseminated to at-risk communities.

Step 1: Review the Opportunity 27

◦ Number of community outreach events or awareness campaigns conducted.

◦ Number of community members reached through educational activities.

• Activity 1.3:

Support implementation of congenital Chagas disease screening programs within maternal and child health settings.

Example process measures:

◦ Number of healthcare facilities supported to implement congenital Chagas screening protocols.

◦ Number of laboratories engaged to conduct maternal or infant diagnostic testing.

◦ Number and percentage of eligible pregnant individuals screened for Chagas disease.

◦ Number and percentage of infants born to Chagas-positive mothers who complete diagnostic testing.

◦ Average time from specimen collection to diagnostic result reporting.

• Activity 1.4:

Train healthcare providers on screening, referral, and management of congenital Chagas disease.

Example process measures:

◦ Number of healthcare providers trained on congenital screening and referral procedures.

◦ Percentage of providers demonstrating improved knowledge or practices following training.

◦ Number of clinical protocols, workflows, or SOPs developed or adopted to support screening programs.

• Expected outcomes:

Recipients implementing these activities are expected to achieve improvements in the following areas:

◦ Increased healthcare provider knowledge of Chagas disease diagnosis, treatment, and management.

◦ Improved provider awareness of appropriate actions when parasitic infections are suspected.

Step 1: Review the Opportunity 28

◦ Increased availability of educational resources for providers, patients, and communities.

◦ Expanded screening and early identification of congenital Chagas disease.

• Example outcome measures:

◦ Change in provider knowledge scores from pre- to post-training assessments.

◦ Number of healthcare facilities implementing Chagas disease screening protocols.

◦ Number of jurisdictions tracking Chagas disease cases.

◦ Percentage increase in providers reporting confidence in diagnosing or managing Chagas disease.

Component B: Soil-transmitted helminths Process measures

• Activity: Gathering information about current knowledge, attitudes and practices, design, and pre-test communication modalities.

◦ Measure: Numbers of completed evaluations of any implemented prevention and control program in areas with evidence of ongoing STH transmission.

◦ Measure: Numbers of proposed new strategies for prevention and control activities in affected areas, based on the results of evaluations.

• Activity: Designing, testing, implementing, and monitoring prevention and control programs in areas with ongoing STH transmission.

◦ Measure: Numbers of areas with historical transmission of STH evaluated and monitored for current or ongoing transmission.

◦ Measure: Conduct active epidemiologic surveillance in areas with historical STH transmission to assess current prevalence and intensity of infection in human populations, using appropriate sampling methodologies.

◦ Measure: Implement targeted community- or school-based screening activities to identify current STH infections among at-risk populations in historically endemic areas.

◦ Measure: Collect and analyze environmental samples (e.g., soil sampling), where appropriate, to assess the presence and distribution of STH contamination and support interpretation of human surveillance findings.

Step 1: Review the Opportunity 29

◦ Measure: Strengthen or support laboratory diagnostic capacity for STH detection, including specimen collection, processing, and quality assurance, to ensure accurate identification of ongoing transmission.

◦ Measure: Analyze surveillance and environmental data to identify transmission hotspots, trends, or re-emergence of STH, and to inform targeted public health response or control strategies.

◦ Measure: Disseminate findings to relevant stakeholders (e.g., local health authorities, program implementers, and partners) to support evidence-based decision-making, monitoring, and program planning for STH control or elimination.

◦ Measure: Number of areas with historical transmission of STH evaluated and monitored for current or ongoing transmission.

• Activity: Checking areas with a history of STH transmission to see if the infections are still spreading.

◦ Measure: Numbers of new at-risk areas for STH infection evaluated and numbers identified as positive for STH.

◦ Measure: Number of new geographic areas assessed for STH transmission risk and number identified as having evidence of STH infection or ongoing transmission.

◦ Measure: Number of targeted surveys or field assessments conducted in suspected at-risk areas and number of individuals tested for STH infection.

◦ Measure: Number of environmental assessments conducted (e.g., soil sampling) and number or percentage of samples testing positive for STH contamination, where applicable.

◦ Measure: Number of laboratories or diagnostic platforms utilized or supported to confirm STH infection in newly identified at-risk areas.

◦ Measure: Number of newly identified at-risk areas prioritized for further surveillance, prevention, or control interventions based on assessment findings.

◦ Measure: Number of reports, maps, or data products developed to stakeholders summarizing findings on newly identified at-risk areas for STH infection.

◦ Measure: Number of reports, maps, or data products disseminated to stakeholders summarizing findings on newly identified at-risk areas for STH infection.

• Activity: Identifying new at-risk areas for STH infections.

Step 1: Review the Opportunity 30

◦ Measure: Description of outreach activities supported by this award designed to reach the indicated short-term outcomes.

◦ Measure: Numbers of informational items developed or disseminated to healthcare providers for the diagnosis, treatment, and clinical management of STH infections.

◦ Measure: Numbers of educational materials developed or disseminated to healthcare providers.

◦ Measure: Other quantitative measures of work to deliver educational information to improve STH infection knowledge and diagnostic and management skills.

• Activity: Assessing HCPs to understand what they know about the disease, what information they need, and their preferred training formats.

◦ Measure: Number and percentage of…