CDC-RFA-DP18-1813.pdf

Centers for Disease Control

National Center for Chronic Disease Prevention and Health Promotion

Racial and Ethnic Approaches to Community Health (REACH)

CDC-RFA-DP18-1813

Application Due Date: 07/16/2018

Racial and Ethnic Approaches to Community Health (REACH)

CDC-RFA-DP18-1813

TABLE OF CONTENTS

Part I. Overview Information A. Federal Agency Name B. Funding Opportunity Title C. Announcement Type D. Agency Funding Opportunity Number E. Catalog of Federal Domestic Assistance (CFDA) Number F. Dates G. Executive Summary

Part II. Full Text A. Funding Opportunity Description B. Award Information C. Eligibility Information D. Application and Submission Information E. Review and Selection Process F. Award Administration Information G. Agency Contacts H. Other Information I. Glossary

Part I. Overview Information Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Send Me Change Notifications Emails" link to ensure they receive notifications of any changes to CDC-RFA-DP18-1813. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

Centers for Disease Control and Prevention (CDC) / Agency for Toxic Substances and Disease Registry (ATSDR) B. Notice of Funding Opportunity (NOFO) Title:

Racial and Ethnic Approaches to Community Health (REACH) C. Announcement Type: New - Type 1 This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For this purpose, research is defined at https ://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf.

Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html (See section 45 CFR 46.102(d)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DP18-1813

E. Catalog of Federal Domestic Assistance (CFDA) Number:

93.738 F. Dates:

1. Due Date for Letter of Intent (LOI): 06/11/2018

2. Due Date for Applications: 07/16/2018, 11:59 p.m. U.S. Eastern

Standard Time, at www.grants.gov.

3. Date for Informational Conference Call:

Monday June 4th, 2018 3:00 PM EDT.

Adobe Connect link: https://adobeconnect.cdc.gov/r20b97dcdqw/ Phone Number 1-888-324-3482 Participant Code: 3283506

G. Executive Summary:

1. Summary Paragraph:

CDC announces the availability of fiscal year 2018 funds to implement CDC-RFA-DP18-1813:

Racial and Ethnic Approaches to Community Health (REACH). This 5-year program is to improve health, prevent chronic diseases, and reduce health disparities among racial and ethnic populations with the highest risk, or burden, of chronic disease, specifically for African Americans/Blacks, Hispanic Americans, Asian Americans, Native Hawaiian/Other Pacific https://www.grants.gov https://www.grants.gov https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.grants.gov https://adobeconnect.cdc.gov/r20b97dcdqw/

Islanders, American Indians, and Alaska Natives, by:

1. Supporting culturally tailored interventions to address the preventable health behaviors of tobacco use, poor nutrition and physical inactivity;

2. Linking community and clinical efforts to increase access to health care and preventive care programs at the community level; and

3. Supporting implementation, evaluation and dissemination of practice- and evidence-based strategies related to tobacco, nutrition, physical activity, and community-clinical linkages that ultimately lead to reduced health disparities in chronic conditions of hypertension, heart disease, Type 2 diabetes, and obesity

Funding will support recipients that:

1. Have a history of successfully working with an established coalition who addresses health or other disparities;

2. Select strategies that address the health disparities in the community based on a health needs assessment process;

3. Have organizational capacity to implement locally tailored evidence-based and practice-based strategies

a. Eligible Applicants: Open Competition

b. NOFO Type: Cooperative Agreement

c. Approximate Number of Awards: 32

d. Total Period of Performance Funding: $125,000,000

e. Average One Year Award Amount: $781,250

f. Total Period of Performance Length: 5

g. Estimated Award Date: 09/29/2018

h. Cost Sharing and / or Matching Requirements: N

Part II. Full Text A. Funding Opportunity Description

Part II. Full Text

1. Background

a. Overview Chronic diseases are the leading causes of death and disability in the United States, largely driven by preventable health behaviors. Health behaviors, such as tobacco use, poor nutrition and physical inactivity, are linked to chronic conditions, premature death, and disability. Chronic diseases and their outcomes disproportionately impact racial and ethnic populations including African Americans/Blacks, Hispanic Americans, Asian Americans, Native Hawaiian/Other Pacific Islanders, American Indians, and Alaska Natives. Addressing chronic disease health disparities is complex. The risk is affected by not only health behaviors and access to health care but also by factors that include income, education, economic opportunity, and location of residence. In addition, the risk for chronic disease starts very early in life. Attention to improving the access to high quality nutrition, opportunities for physical activity, and providing a smoke free environment for young children are critical steps in reducing health disparities. Thus, any effort to improve this multi-faceted challenge requires a long term vision and investment.

This NOFO will provide communities the opportunity to improve health, prevent chronic diseases, and reduce health disparities among racial and ethnic populations with the highest risk, or burden, of chronic disease (i.e., hypertension, heart disease, Type 2 diabetes, and obesity). The tools to accomplish this are culturally tailored interventions to address preventable risk behaviors (tobacco use, poor nutrition and physical inactivity).

The approach for this program incorporates evidence-based strategies found in a variety of publications and expert recommendations. These include Best Practices for Comprehensive Tobacco Control Programs, Dietary Guidelines for Americans (2015), Surgeon General's Call to Action to Support Breastfeeding (2015), Community Preventive Services Task Force Recommendation for Built Environment Interventions to Increase Physical Activity (2017), and The Surgeon General's Call to Action to Promote Walking and Walkable Communities (2015).

b. Statutory Authorities This program is authorized under section 317(k)(2) of the Public Health Service Act, 42 U.S.C.

247b(k)(2).

c. Healthy People 2020 This NOFO supports the following Healthy People 2020 focus areas found at http://www.healt hypeople.gov:

Nutrition and Weight Status https://www.healthypeople.gov/2020/topics-objectives /topic /nutrition-and-weight-status

Social Determinants of Health https://www.healthypeople.gov/2020/topics-objectives /topic/social-determinants-of-health

Educational and Community Based Programs https://www.healthypeople.gov Physical Activity https://www.healthypeople.gov/2020/topics-objectives/topic/physical activity/2020 Tobacco Use https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use

d. Other National Public Health Priorities and Strategies

Health and Human Services (HHS) Action Plan to Reduce Racial and Ethnic Disparities:

http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&;;lvlid=10 http://www.healthypeople.gov/ http://www.healthypeople.gov/ https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status https://www.healthypeople.gov/2020/topics-objectives/topic/nutrition-and-weight-status https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health https://www.healthypeople.gov/2020/topics-objectives/topic/educational-and-community-based-programs https://www.healthypeople.gov/ https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity https://www.healthypeople.gov/2020/topics-objectives/topic/educational-and-community-based-programs https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=2&lvlid=10

National Partnership for Action to End Health Disparities: National Stakeholder Strategy for Achieving Health Equity: http://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl =1&;;lvlid=33&;;ID=286

The Dietary Guidelines for Americans https://health.gov/dietaryguidelines/ The Physical Activity Guidelines for Americans https://health.gov/paguidelines/guidelines Best Practices for Comprehensive Tobacco Control Programs 2014 https://www.cdc.gov

/tobacco/stateandcommunity/best_practices/index.htm Evidence -based community best practices such as found in The Community Guide and the Community Preventive Services Task Force findings related to obesity

e. Relevant Work

This REACH NOFO is relevant to past and current REACH Programs (i.e., REACH 2014, REACH 2010, REACH CORE, REACH U.S., REACH Minority-Serving Organizations, and REACH National Networks) that have addressed health disparities at the community level. A critical REACH program priority is to empower community members in priority populations(s) to seek better health, help change local healthcare practices, and mobilize communities to implement evidence-based public health programs to reduce health disparities across a broad range of health conditions. Please see following link for examples of relevant work:

https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

http://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286 http://minorityhealth.hhs.gov/npa/templates/content.aspx?lvl=1&lvlid=33&ID=286 https://health.gov/dietaryguidelines/ https://health.gov/paguidelines/guidelines/ https://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm https://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm https://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm https://www.thecommunityguide.org/ https://www.thecommunityguide.org/ https://www.thecommunityguide.org/ https://www.thecommunityguide.org/task-force-findings https://www.thecommunityguide.org/task-force-findings https://www.thecommunityguide.org/task-force-findings https://www.thecommunityguide.org/task-force-findings https://www.thecommunityguide.org/task-force-findings

Bold indicates those measures that are required reporting for the recipients

i. Purpose The purpose of this NOFO is to support communities in readily implementing population-wide solutions to improving health, preventing chronic disease, and reducing health disparities among priority populations with the highest risk or burden of chronic disease related to health risk behaviors - tobacco use, poor nutrition and physical inactivity.

ii. Outcomes See logic model

iii. Strategies and Activities Applicants must propose work in three of the four strategies and their accompanying activities.

The applicant should describe how the selected strategies are anticipated to improve the burden of chronic disease in the priority population(s) and include communication activities that will support the selected strategies.

Tobacco strategy: Collaborate with partners to promote tobacco free living among priority population(s).

Support and leverage CDC 's national tobacco education campaigns (i.e., Tips from Former Smokers) and tobacco-related Surgeon General Reports at the community-level.

Develop and implement community-based culturally-appropriate messages that focus on:

harmful effects of tobacco use; exposure to secondhand smoke; encouraging tobacco users to quit; and promoting the quitline (i.e., 1-800-Quit Now, 1-855-DEJELO-YA, and the Asian Smoker?s Quitline).

Work with health care providers to ensure that every patient is screened for tobacco use, advised to quit, and provided resources for counseling and medications.

Identify and train community-level spokespersons to communicate the burden of tobacco use and secondhand smoke exposure through local media outlets and community events.

Inform and educate leaders, decision makers and the public about the evidence-based solutions to protect workers and multi-unit housing residents from exposure to second hand smoke.

Support implementation of tobacco free policies within workplaces and multi-unit housing.

Engage and leverage community stakeholders and assets to address healthier retail options.

Nutrition strategy: Collaborate with partners to improve nutrition in priority population(s).

Work with food vendors, distributors and producers to enhance healthier food procurement and sales; establish/support food hubs; establish a network of food sales outlets; establish a group purchasing collective; develop tools to match local producers with institutions; and explore innovative practices that can support this work.

Establish healthy nutrition standards in key institutions such as hospitals, afterschool and recreation programs, community health centers, faith-based organizations, food banks/pantries, and early care and education.

Make improvements to local programs/systems (e.g., voucher incentive programs, increased electronic benefit transfer acceptance where food is purchased, improved public transportation routes to food stores, access to healthier foods at community venues.

Increase continuity of care/community support for breastfeeding by incorporating services into existing community support services (early care and education centers, community health centers, home visiting programs, etc.); establishing lactation support services (support groups, walk-in clinics, Baby Cafés, etc.) that are accessible and culturally appropriate for the priority population; and providing breastfeeding support training to health care providers, community health workers, peer support providers, etc., that work with mothers and babies.

Physical Activity Strategy: Collaborate with partners to improve physical activity in priority population(s) to connect sidewalks, paths, bicycle routes, public transit with homes, early care and education, schools, worksites, parks, or recreation centers through implementing master plans and land use interventions.

Establish new or improved pedestrian, bicycle, or transit transportation systems (i.e., activity-friendly routes) that are combined with new or improved land use or environmental design (i.e., connecting everyday destinations).

Community- Clinical Linkages strategy: Collaborate with partners to increase referral and access to community-based health programs for the priority population(s).

Promote the use of appropriate and locally available programs for individuals in the priority population(s) (e.g., Diabetes Prevention Program, Chronic Disease Self- Management Program, tobacco cessation services, Food Nutrition Education Programs, Special Supplemental Nutrition Program for Women, Infants, and Children, access to food banks, and assistance with housing or job training).

Expand the use of health professionals such as Community Health Workers, patient navigators, and, pharmacists, to increase referral of individuals in the priority population(s) to appropriate and locally available health and preventive care programs.

It is expected that recipients will leverage the resources of their partners to complete the work of the NOFO, particularly those strategies that may by necessity include both allowable (e.g.

planning and design) and unallowable (e.g. construction of sidewalks, construction of running trails) costs.

1. Collaborations

a. With other CDC programs and CDC-funded organizations:

Recipients are encouraged to collaborate with other CDC-funded programs in their geographic area. This will ensure proposed activities are complementary with other CDC funded programs operating in the same area and avoid duplications of efforts. State- and/or local-level CDC funded programs for chronic disease:

High Obesity Program: https://www.cdc.gov/nccdphp/dnpao/state-local-programs/high-obesity-program.html.

Sodium Reduction in Communities Program: https://www.cdc.gov/dhdsp/programs /sodium_reduction.htm;

WISEWOMAN https://www.cdc.gov/wisewoman/ Scaling the National Diabetes Prevention Program in Underserved Areas; National

Diabetes Prevention Program: https://www.cdc.gov/diabetes/programs/index.html National Comprehensive Cancer Control Program: Tobacco Control Programs: https

://www.cdc.gov/cancer/ncccp/ Million Hearts Initiative® https://millionhearts.hhs.gov/index.html Disability and Health Program: Improving the Health of People with Mobility Limitations and Intellectual Disabilities through State-based Public Health Programs (known as State https://www.cdc.gov/nccdphp/dnpao/state-local-programs/high-obesity-program.html https://www.cdc.gov/nccdphp/dnpao/state-local-programs/high-obesity-program.html https://www.cdc.gov/dhdsp/programs/sodium_reduction.htm https://www.cdc.gov/dhdsp/programs/sodium_reduction.htm https://www.cdc.gov/wisewoman/ https://www.cdc.gov/diabetes/programs/index.html https://www.cdc.gov/cancer/ncccp/ https://www.cdc.gov/cancer/ncccp/ https://millionhearts.hhs.gov/index.html

Disability and Health Programs): https://www.cdc.gov/ncbddd/disabilityandhealth/progr ams.html

b. With organizations not funded by CDC:

Community Coalition: The applicant is required to identify and propose a community coalition.

For the purposes of this program, a community coalition is defined as a community-based formal arrangement for cooperation and collaboration among groups or sectors of a community in which each group retains its identity, but all agree to work together toward a common goal. Recipients will engage the community coalition in executing activities to use community specific best practices to address health disparities, monitor progress and oversee communications within their communities to address tobacco use, poor nutrition, and physical inactivity and create sustainable community-level change through environmental strategies. Recipients will collaborate with the coalition to develop and carry out an action plan to address community specific health disparities and social determinants of health which may result in offering a coalition model for replication in other geographic areas. The recipient will work with the community coalition in encouraging collaboration with other CDC prevention programs within state or local health departments that address chronic disease and conditions.

The community coalition proposed by the applicant, at a minimum, should have the below identified partners:

Applicant Community coalition leader(s) Priority population(s) representative(s) Healthcare organization representative (who provides services for the priority population(s)) Local Community Based Organization representative (with work aligned with the selected strategies) State and/or local public health department representative

The community coalition proposed by the applicant should have the following capacities and/or characteristics:

Demonstrated ability to leverage partnerships across settings and sectors to address key contributors to the chronic disease disparities within their community

Represent diverse cross-section of the community Represent multi-sectors in the community Incorporate input from those who represent the proposed priority population(s) Use Community Based Participatory Approaches (http://ctb.ku.edu/en/table-of-contents

/analyze/where-to-start/participatory-approaches/main) in their planning approach Reflect the composition of the proposed priority population A history of success in working together with partners on issues relating to health or other disparities.

Demonstrated effectiveness and progress in mobilizing partners to assist in https://www.cdc.gov/ncbddd/disabilityandhealth/programs.html https://www.cdc.gov/ncbddd/disabilityandhealth/programs.html http://ctb.ku.edu/en/table-of-contents/analyze/where-to-start/participatory-approaches/main http://ctb.ku.edu/en/table-of-contents/analyze/where-to-start/participatory-approaches/main implementation of local evidence-based or practice-based improvements that are culturally tailored to the priority population(s)

Additional Requirements for the Application: Letters of involvement from a minimum of two members of the community coalition are required for the application and must include a specific description of their role in support of the proposed work. Letters of involvement must be named :LOInvolement_PartnerName and uploaded as PDFs into www.grants.gov Throughout the award, the recipient and the community coalition are encouraged to work with other organizations that can facilitate the success of their proposed work in addressing health disparities and preventing chronic disease. These collaborations might include entities such as state or local health departments; community-based organizations; health care organizations;

faith-based organizations; tribal organizations; local, regional, state, or national organizations with local affiliates; university/academic institutions, or non-traditional partners (e.g., local education agencies, parks and recreation, transportation, environmental health, housing and urban development, public safety, and financial organizations).

A letter of acknowledgement from the State Chronic Disease Director is required for the application. The letter should acknowledge: 1) the applicant is applying for this NOFO; 2) the proposed priority population(s); and 3) the geographic area in the state where work is proposed.

Letters of acknowledgement must be named LOA and uploaded as PDFs into www.grants.gov

2. Target Populations

Applicants will select up to two of the five priority populations listed below for work on this award.

o African Americans/Blacks o American Indians/Alaska Natives o Asian American o Hispanic Americans o Native Hawaiian/Other Pacific Islanders population

Applicant must use the results from a community health needs assessment completed within the last 5 years that provides specific information on disparities experienced by the proposed priority population(s) and a justification for the proposed geographical area.

The applicant must cite the data sources used to define and describe the priority population(s).

The description should include demographic characteristics, health status, and geographic area.

The geographic area must have at least 20% of the population with income below 100% federal poverty threshold (based on census tract or community health needs assessment data). Census tract data can be obtained at the following link sources:

Census Bureau (http://www.census.gov/): This site is a leading source of quality data about the nation's people and economy.

http://www.grants.gov/ http://www.census.gov/

Community Commons (http://www.communitycommons.org: This site can provide the information applicants will need all in one site, including maps and data. On this website, applicants can find a link to community health needs assessments https://www.commu nitycommons.org/chna/. The community health needs assessment link can assist applicants in identifying assets and potential disparities in their area as it relates to community health and well-being. Free registration is required to use the site so searches can be saved. These data can supplement or update the data contained in the applicant's community health needs assessment process.

Community Health Rankings is an interactive web application that produces health profiles for all 3,143 counties in the United States. http://www.countyhealthrankings.org.

Disability and Health Data System (http://dhds.cdc.gov/) provides instant access to state-level health and demographic data about adults with disabilities with capacity to search state by disability type and race or ethnicity.

The community health needs assessment process must clearly describe the link to the geographic area(s) and the priority population(s) with whom the applicant proposes to work.

a. Health Disparities

This NOFO is designed to address health disparities in priority population(s). Applicants are encouraged to consider people with disabilities in all aspects of the program (e.g., advisory boards, planning committees, project staff, consultants, etc.). Where appropriate, applicants are encouraged to also include: rural populations; non-English speaking populations; lesbian, gay, bisexual, and transgender (LGBT) populations; and people with limited health literacy.

iv. Funding Strategy Awards will range from approximately $500,000 to $900,000 and will be based on the following criteria:

Consideration of the scope of the work proposed Consideration of the priority population(s) size and geographic area where work is proposed Consideration of whether work is performed in rural or urban settings

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy Recipients are responsible for reporting intermediate outcomes identified in the logic model.

CDC will develop an evaluation framework to guide relevant and timely evaluation for the REACH program which will include conducting program evaluations on the effectiveness of the program at achieving its outcomes and to understand key issues related to the impact and http://www.communitycommons.org/ https://www.communitycommons.org/chna/ https://www.communitycommons.org/chna/ http://www.countyhealthrankings.org/ http://dhds.cdc.gov/ scalability of the strategies for future CDC investments. The framework will specify the types of evaluations to be conducted, the timing of the evaluations and how the evaluations will assist CDC in continuous quality improvement of the program.

Key evaluation questions include:

How have community environments changed since the implementation of REACH strategies?

To what extent have tobacco free living , healthy eating, and physical activity increased in priority populations?

To what extent have community clinical collaborations increased to improve access for priority populations?

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

Plans for updating the Data Management Plan (DMP), if applicable, for accuracy throughout the lifecycle of the project. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data; data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additionalrequirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, they should be directed to:

Describe the type of evaluations (i.e., process, outcome, or both).

Describe key evaluation questions to be addressed by these evaluations.

Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, within the first 6 months of award, as described in the Reporting Section of this NOFO.

CDC and recipients will use evaluation and performance measurement to determine if program https://www.cdc.gov/grants/additionalrequirements/ar-25.html activities are scalable and effective at reaching the priority populations. In developing evaluation and performance measurement plans, applicants are encouraged to use the following resource:

CDC Framework for Program Evaluation in Public Health (www.cdc.gov/eval). CDC will work with recipients during the first six months to revise and finalize evaluation plans and performance measures.

The performance measures serve as an integral source of data for CDC's evaluation efforts. The applicant must demonstrate the ability to monitor program performance by establishing a performance measurement strategy. The table below depicts the list of intermediate measures recipients will be required to report.

STRATEGY

Intermediate Measure

Tobacco: Collaborate with partners to promote tobacco free living among priority population(s)

· Support and leverage CDC's national tobacco education campaigns (i.e., Tips from Former Smokers) and tobacco-related Surgeon General Reports at the community-level.

· Develop and implement community-based culturally-appropriate messages that focus on:

harmful effects of tobacco use; exposure to secondhand smoke; encouraging tobacco users to quit; and promoting the quitline (i.e., 1-800- Quit Now, 1-855-DEJELO-YA, and the Asian Smoker?s Quitline).

· Work with health care providers to ensure that every patient is screened for tobacco use, advised to quit, and provided resources for counseling and medications.

· Identify and train community-level spokespersons to communicate the burden of tobacco use and secondhand smoke exposure through local media outlets and community events.

· Inform and educate leaders, decision makers and the public about the evidence-based solutions to protect workers and multi-unit housing residents from exposure to secondhand smoke.

Increased number of workplaces and multi-unit housing complexes that implement tobacco free policies

Increased number of persons in workplaces and multi-unit housing complexes with tobacco free policies

· Support implementation of tobacco free policies within workplaces and multi-unit housing.

· Engage and leverage community stakeholders and assets to address healthier retail options.

Nutrition: Collaborate with partners to improve nutrition in priority population(s).

· Work with food vendors, distributors and producers to enhance healthier food procurement and sales: establish/support food hubs; establish a network of food sales outlets;

establish a group purchasing collective;

develop tools to match local producers with institutions; and explore innovative practices that can support this work.

· Establish healthy nutrition standards in key institutions such as hospitals, afterschool and recreation programs, community health centers, faith-based organizations, food banks/pantries, and early care and education.

· Make improvements to local programs/systems (e.g., voucher incentive programs, increased electronic benefit transfer acceptance where food is purchased, improved public transportation routes to food stores, access to healthier foods at community venues.

· Increase continuity of care/community support for breastfeeding by incorporating services into existing community support services (early care and education centers, community health centers, home visiting programs, etc.); establishing lactation support services (support groups, walk-in clinics, Baby Cafés, etc.) that are accessible and culturally appropriate for the priority population; and providing breastfeeding support training to health care providers, community health workers, peer support providers, etc., that work with mothers and babies.

Increased number of places offering healthier foods Increased number of persons with access to healthier foods Increased number of continuity of care/community support actions implemented for breastfeeding

Physical Activity: Collaborate with partners to improve physical activity in priority population(s) to connect sidewalks, paths, bicycle routes, public transit with homes, early care and education, schools, worksites, parks, or recreation centers through implementing master plans and land use interventions.

· Establish new or improved pedestrian, bicycle, or transit transportation systems (i.e., activity-friendly routes) that are combined with new or improved land use or environmental design (i.e., connecting everyday destinations).

Increased number of places that improve community design by connecting safe and accessible places for physical activity

Increased number of persons with safe and accessible places for physical activity

Community-Clinical Linkages: Collaborate with partners to increase referral and access to community-based health programs for the priority population(s)

· Promote the use of appropriate and locally available programs for individuals in the priority population(s) (e.g., Diabetes Prevention Program, Chronic Disease Self- Management Program , tobacco cessation services, Food Nutrition Education Programs, Special Supplemental Nutrition Program for Women, Infants, and Children, access to food banks, and assistance with housing or job training).

· Expand the use of health professionals such as Community Health Workers, patient navigators, and, pharmacists, to increase referral of individuals in the priority population(s) to appropriate and locally available health and preventive care programs.

Increased use of appropriate and locally available health or community programs.

c. Organizational Capacity of Recipients to Implement the Approach Recipients must be able to readily implement this program in readied communities upon receipt of award. To ensure that recipients are able to execute REACH program requirements and meet period of performance outcomes, applicants must demonstrate: relevant experience to implement the activities and achieve the project outcomes; experience and capacity to implement the evaluation plan, and have a staffing plan and project management structure sufficient to achieve the project outcomes and which clearly defines staff roles.

The applicant must demonstrate the ability to execute the program strategies and activities.

Applicants must demonstrate established experience and organizational capacity to ensure successful planning, implementation, and evaluation for this project in order to meet implementation readiness requirements which includes the following:

A history of successfully working with an established community coalition to address issues relating to health or other disparities and capable of affecting community-level change.

Results from a community health needs assessment completed within the last 5 years.

Community Coalition leadership and management to plan and supervise the project and improve outcomes (at a minimum, this should include a principal investigator or designee to serve as a chair and a program manager to manage day-to day operations).

Demonstrated diversity in membership and past use of the CBPA process in decision making and the setting of community priorities.

Partnership development and coordination to leverage resources and maximize reach and impact of nutrition and physical activity activities within the community.

Subject matter/content expertise in tobacco, nutrition, physical activity, and community clinical collaborations.

Subject matter expertise and experience working with the selected priority population(s) Budget management and administration to establish financial procedures and track, monitor, and report expenditures (at a minimum this should include a fiscal manager).

Contract management to manage the required procurement efforts, including the ability to write, award, and monitor contracts in accordance with applicable grants regulations.

Evaluation and performance monitoring to develop and implement the evaluation plan and maintain programmatic quality, consistency, and fidelity.

Data management to design collection and evaluation strategies to produce useful data that demonstrates impact, program improvement, and sustainability.

Communication support to collect, develop and disseminate program messages and successes related to the communication activities that directly support the NOFO strategies

Active community coalition in place: The applicant must propose an established community coalition to engage in executing activities under this NOFO throughout the entire award period.

The applicant must have a key role in or at a minimum, be an active member of the community coalition being proposed. The recipient must work to strengthen collaborations that support the efforts of a community based coalition that is working to seek better health for residents, help change local healthcare practices, and mobilize communities to implement evidence-based, community specific public health programs to reduce health disparities (see the Collaboration Section for specific requirements).

d. Work Plan At a minimum, the work plan must include:

Activities and time lines to support achievement of outcomes that align with the NOFO logic model.

Measures for the relevant outcomes. These should align with the performance measures listed in the evaluation and performance measurement section.

Milestones for accomplishing tasks encompassed by the key activities related to each outcome.

Staff, partners, contractors and administrative roles and functions to support implementation of the award.

Applicants must submit a detailed work plan for Year 1 of the award and provide a general summary of work plan activities for Years 2-5 in narrative form. The work plan should describe how the applicant plans to implement all of the required activities to achieve NOFO outcomes.

For Year 1, applicants are required to include all of the elements listed within the sample work plan template, provided below. CDC will provide feedback and technical assistance to recipients to finalize the work plan activities post-award. Applicants must name this file "Work Plan_REACH_name of applicant" and upload it as a PDF file on www.grants.gov.

This work plan should include the proposed strategies and activities with the specific communication activities that directly support the NOFO strategies. Applicants are not required to use the template but are required to include all of the elements listed in the template as follows:

Period of Performance Outcome:

[from Outcomes section or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities

Process Measure [from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

1.

2.

3.

4.

5.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

Tracking recipient progress in achieving the desired outcomes.

Ensuring the adequacy of recipient systems that underlie and generate data reports.

Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

Recipients will participate on monthly conference calls to track progress, barriers, unexpected events, activities, successes, and other relevant information to describe the implementation of the strategies.

f. CDC Program Support to Recipients (THIS SECTION APPLIES ONLY TO

COOPERATIVE AGREEMENTS)

CDC will have substantial involvement beyond site visits and regular performance and financial monitoring during the period of performance. CDC activities to ensure the success of the project will include the following:

Provide ongoing technical assistance.

Provide REACH implementation guidance to recipients on identifying and implementing strategies and activities.

Facilitate collaborative opportunities with national partners.

Information Sharing between recipients.

Facilitate routine conference calls, webinars, and information exchange between recipients.

Develop mechanism for documenting and sharing lessons learned.

Convene recipient meetings.

CDC will:

1. Ensure that recipients have access to expertise found throughout NCCDPHP. For example, a team of subject matter experts could include, but is not limited to, the project officer, health scientists, epidemiologists, statisticians, policy analysts, communication specialists, health economists, and evaluators to provide technical assistance to recipients.

Technical assistance teams will also work in collaboration with other programs and divisions across NCCDPHP to identify specific actions that improve efficiency and greater public health impact.

2. Collaborate with recipients to explore appropriate flexibilities needed to meet public health outcomes and goals. Flexibility in cooperative agreements includes recipient's ability to propose alternative methods to achieve the outcomes and goals of the cooperative agreement that align with recipient's opportunities for success, infrastructure, partner and stakeholder buy-in, demographics, and burden. This includes bringing together resources from multiple cooperative agreements to jointly advance the goals of each, and expanding the dialogue to bring in other CDC and recipient staff to reach a win/win solution.

3. Create greater efficiencies and consistency across NCCDPHP programs for recipients.

Examples of how NCCDPHP divisions and programs work together to achieve this include but are not limited to:

Joint site visits that maximize the ability to do collaborative problem solving, offer insights and ideas to strengthen or augment recipient approaches, and increase understanding of recipient's context to accomplish chronic disease prevention and health promotion.

Jointly developed resources and tools that focus on cross-cutting functions, settings, domains, risk factors, conditions and diseases to ensure consistent messages and to meet recipient technical assistance needs.

Joint training and technical assistance opportunities that help recipients produce policies and programs that are more holistic and fully supportive of work in tobacco, nutrition, physical activity, chronic disease management and other strategies and topics, as appropriate. Continue and expand support for recipients to leverage NCCDPHP resources to address cross-cutting functions, domains, settings, risk factors and diseases.

4. Continue and expand support for recipients to leverage NCCDPHP resources to address cross-cutting functions, domains, settings, risk factors and diseases.

B. Award Information

1. Funding Instrument Type: Cooperative Agreement CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism: U58

3. Fiscal Year: 2018

4. Approximate Total Fiscal Year Funding: $25,000,000

5. Approximate Period of Performance Funding: $125,000,000

This amount is subject to the availability of funds.

Estimated Total Funding: $125,500,000

6. Approximate Period of Performance Length: 5 year(s)

7. Expected Number of Awards: 32

8. Approximate Average Award: $781,250 Per Budget Period

9. Award Ceiling: $900,000 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor: $500,000 Per Budget Period

11. Estimated Award Date: 09/29/2018

12. Budget Period Length: 12 month(s)

Throughout the project period, CDC will continue the award based on the availability of funds, the evidence of satisfactory progress by the recipient (as documented in required reports), and the determination that continued funding is in the best interest of the federal government. The total number of years for which federal support has been approved (project period) will be shown in the “Notice of Award.” This information does not constitute a commitment by the federal government to fund the entire period. The total period of performance comprises the initial competitive segment and any subsequent non-competitive continuation award(s).

13. Direct Assistance Direct Assistance (DA) is not available through this FOA.

C. Eligibility Information

1. Eligible Applicants Eligibility Category: 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/Indian housing authorities Native American tribal organizations (other than Federally recognized tribal governments)

Nonprofits having a 501(c)(3) status with the IRS, other than institutions of higher education Nonprofits without 501(c)(3) status with the IRS, other than institutions of higher education Private institutions of higher education Small businesses Others (see text field entitled "Additional Information on Eligibility" for clarification)

Additional Eligibility Category:

Government Organizations:

State governments or their bona fide agents (includes the District of Columbia)

Local governments or their bona fide agents

Territorial governments or their bona fide agents in the Commonwealth of Puerto Rico, the Virgin Islands, the Commonwealth of the Northern Marianna Islands, American Samoa, Guam, the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.

State controlled institutions of higher education

American Indian or Alaska Native tribal governments (federally recognized or state-recognized)

Non-government Organizations:

American Indian or Alaska native tribally designated organizations

2. Additional Information on Eligibility N/A

3. Justification for Less than Maximum Competition N/A

4. Cost Sharing or Matching Cost Sharing / Matching Requirement: No

5. Maintenance of Effort Maintenance of effort is not required for this program.

D. Application and Submission Information

1. Required Registrations An organization must be registered at the three following locations before it can submit an application for funding at www.grants.gov.

a. Data Universal Numbering System:

All applicant organizations must obtain a Data Universal Numbering System (DUNS) number.

A DUNS number is a unique nine-digit identification number provided by Dun & Bradstreet (D&B). It will be used as the Universal Identifier when applying for federal awards or cooperative agreements.

The applicant organization may request a DUNS number by telephone at 1-866-705-5711 (toll free) or internet at http:// fedgov.dnb. com/ webform/ displayHomePage.do. The DUNS number will be provided at no charge.

If funds are awarded to an applicant organization that includes sub-recipients, those sub-recipients must provide their DUNS numbers before accepting any funds.

b. System for Award Management (SAM):

The SAM is the primary registrant database for the federal government and the repository into which an entity must submit information required to conduct business as a recipient. All applicant organizations must register with SAM, and will be assigned a SAM number. All information relevant to the SAM number must be current at all times during which the applicant has an application under consideration for funding by CDC. If an award is made, the SAM information must be maintained until a final financial report is submitted or the final payment is received, whichever is later. The SAM registration process can require 10 or more business days, and registration must be renewed annually. Additional information about registration procedures may be found at www.SAM.gov.

c. Grants.gov:

The first step in submitting an application online is registering your organization at www.grants.gov, the official HHS E-grant Web site. Registration information is located at the “Get Registered” option at www.grants.gov.

All applicant organizations must register at www.grants.gov. The one-time registration process usually takes not more than five days to complete. Applicants should start the registration process as early as possible.

https://www.grants.gov/ http://fedgov.dnb.com/webform/displayHomePage.do https://www.sam.gov/portal/public/SAM/ https://grants.gov/ https://www.grants.gov/ https://www.grants.gov/ https://www.grants.gov/

Step System Requirements Duration Follow Up 1 Data

Universal Number System

(DUNS)

1. Click on http:// fedgov.dnb.com/ webform

2. Select Begin DUNS search/request process

3. Select your country or territory and follow the instructions to obtain your DUNS 9-digit #

4. Request appropriate staff member(s) to obtain DUNS number, verify & update information under DUNS number

1-2 Business Days

To confirm that you have been issued a new DUNS number check online at (http:// fedgov.dnb.com/ webform) or call 1-866-705-5711

2 System for Award Management

(SAM)

formerly Central Contractor Registration

(CCR)

1.…