cdc-rfa-dp26-0233_forPublication.pdf

Notice of Funding Opportunity

Application due Monday, August 3, 2026

NCCDPHP

Great Health for America Opportunity number: CDC-RFA-DP26-0233

Contents

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 7

Agency priorities 9

Program description 12

Step 2: Get Ready to Apply 40

Get registered 41

Find the application package 42

Help applying 42

Step 3: Build Your Application 43

Application checklist 44

Applications contents and format 46

Step 4: Understand Review, Selection, and Award 55

Initial review 56

Selection process 57

Award notices 58

Step 5: Submit Your Application 59

Submission requirements and deadlines 60

Step 6: Learn What Happens After Award 61

Post-award requirements and administration 62

Contacts and Support 65

Before you begin 3

Endnotes 67

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 Monday, August 3, 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)

NCCDPHP

Transforming child health by addressing the root causes of chronic disease where kids live, learn, and grow

Have questions?

Go to Contacts and Support.

Key facts

Opportunity name:

Great Health for America

Opportunity number:

CDC-RFA-DP26-0233

Assistance listing:

93.809

NOFO version: Original

Key dates

Application submission deadline:

August 3, 2026

Expected award date:

August 31, 2026

Expected start date:

September 30, 2026

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

Summary In collaboration with U.S. Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC), state and federally funded programs, you will implement a project focused on reducing chronic disease rates within a defined geographic area within four communities: Lake County, Indiana; Sandusky and Toledo metro area, Ohio; Brownsville, Texas;

Petersburg, Virginia. The goal is to demonstrate how individual and system-level interventions can encourage healthier habits and choices that can reduce the burden of chronic disease in children. When these lifestyle and community changes are maintained over time, reductions in the burden of chronic diseases among adults in the United States may eventually result.

Findings from these demonstration programs will inform the potential replication of successful interventions in additional communities.

Additionally, HHS will use findings from this demonstration project to inform future approaches to funding and measuring effects of novel efforts to improve health for individuals and communities.

Step 1: Review the Opportunity 5

Funding details Funding type: Cooperative agreement

Anticipated awards: 4

Period of performance: Two years in 12-month budget periods.

Anticipated total program funding over the performance period:

$32,000,000

Estimated average award per applicant over the period of performance:

$8,000,000

Anticipated funding per applicant per 12-month budget period: $4,000,000

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

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.

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.

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

Step 1: Review the Opportunity 7 https://www.cdc.gov/grants/additional-requirements/ar-31.html

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 for one program site (Lake County, Indiana; Sandusky and Toledo metro area, Ohio; Brownsville, Texas; Petersburg, Virginia) 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.

Step 1: Review the Opportunity 8

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:

◦ Works 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 not support 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 [PDF]: 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 Background

Chronic diseases such as heart disease, cancer, diabetes, obesity, and asthma are the leading causes of death and disability in the United States, accounting for approximately $4.9 trillion in annual health care costs. Many preventable chronic diseases begin in childhood and are driven by modifiable risk behaviors — poor nutrition, physical inactivity, tobacco use, and substance use — compounded by environmental exposures, food insecurity, inadequate housing, and limited access to primary care.

Pediatric populations are increasingly affected. Among school-age children (ages 5–17) in a nationally representative 2018 survey, chronic disease prevalence rose by approximately 130,000 additional children per year since 1999, with asthma and mental and behavioral health conditions among the leading conditions. More than 1 in 5 children and adolescents have obesity nationally, with rates exceeding 1 in 4 among children enrolled in Medicaid — who are also more than twice as likely to have obesity as those with private insurance.

Addressing adult chronic disease rates requires intervening early. Many risk factors are established in utero, during childhood, and in early adolescence, shaped by the conditions in which children are born and raised. Family-centered, community-supported approaches that address poor nutrition, physical inactivity, and harmful environmental exposures can reduce obesity, diabetes, asthma, mental health diagnoses, and substance use across the lifespan.

Chronic disease burden is higher in communities with high poverty, limited nutritious food access, aging housing, and constrained access to preventive care — which also face disproportionately high Medicaid utilization and costs from preventable hospitalizations and emergency visits. This funding opportunity targets four such communities:

• Lake County, Indiana

• Sandusky and Toledo metro area, Ohio

• Brownsville, Texas

• Petersburg, Virginia

Step 1: Review the Opportunity 12

Each community has elevated poverty and Medicaid enrollment rates, high rates of childhood chronic disease risk factors, existing public health infrastructure suitable for community-driven intervention, and meaningful potential for Medicaid savings through reduced preventable utilization.

Findings from this demonstration project will inform replication in additional communities and guide future HHS and CDC approaches to community-level funding and measurement.

Related work

• National Diabetes Prevention Program

• High Obesity Program

• What Works in Schools

• Healthy Schools

• Family Health Weight Programs

• State Physical Activity and Nutrition Program

National public health priorities and strategies Make America Healthy Again prioritizes decreasing the burden of chronic disease among children in the United States by advancing research, realigning incentives, fostering private sector collaboration, and increasing public awareness.

Purpose To reduce childhood chronic disease burden in four targeted communities — Lake County Indiana; Sandusky and Toledo metro area, Ohio; Brownsville, Texas; and Petersburg, Virginia — by funding community-driven demonstration projects that identify root causes, implement evidence-based interventions, and track measurable health outcomes. Findings will inform replication of successful approaches in additional communities and guide future HHS and CDC investments in community-level chronic disease prevention.

Approach This demonstration project aims to reduce the prevalence and burden of chronic disease among children in four targeted communities — Lake County, Indiana; Sandusky and Toledo metro area, Ohio; Brownsville, Texas; and Petersburg, Virginia — by addressing the biological, behavioral, social, and

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

Step 1: Review the Opportunity 13 https://www.cdc.gov/diabetes-prevention/index.html https://www.cdc.gov/hop/php/about/index.html https://www.cdc.gov/healthy-youth/what-works-in-schools/index.html https://www.cdc.gov/healthy-schools/about/index.html https://www.cdc.gov/family-healthy-weight/php/recognized-programs/index.html https://www.cdc.gov/span/php/about/index.html https://www.hhs.gov/maha/index.html environmental factors that drive poor health outcomes from early childhood through adolescence.

Each recipient will engage their community, assess local needs and assets, select and implement interventions, and track progress toward measurable health outcomes. Rather than prescribing a single intervention model, this project allows each community to identify an anchor chronic condition (diabetes, obesity, poor nutrition, physical activity, asthma, or other identified chronic condition) and tailor evidence-based strategies to their local context

— supported by HHS, CDC, and locally deployed federal staff. This approach recognizes that sustainable health improvement requires community ownership and that effective interventions must be adapted to the specific conditions, populations, and resources of each setting. Sustainable improvements in child health require more than clinical intervention — they depend on communities that are connected, engaged, and invested in one another’s wellbeing. This project seeks to strengthen intra-community connectedness by increasing the participation of residents, families, schools, and local institutions in collective health improvement efforts that extend beyond individual households to benefit neighbors and shared community spaces. Alongside this, the project aims to rebuild and deepen trust in local systems of care, recognizing that communities with stronger relationships with public health and clinical institutions are better positioned to prevent chronic disease and respond to health needs over time.

While individual intervention components draw on existing evidence — including CDC Community Guide recommendations and established clinical and public health best practices — the community-driven demonstration model itself is designed to generate new evidence. By implementing, monitoring, and evaluating locally tailored interventions across four different communities, this project will build the evidence base for how community-designed and community-implemented approaches can reduce childhood chronic disease burden and associated Medicaid costs at scale. Evaluation findings will be documented and shared to support replication in additional communities and inform future HHS and CDC funding strategies.

Program logic model The following logic model includes the strategies and activities allowed 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.

Step 1: Review the Opportunity 14

The asterisked ( * ) outcomes are those we expect you to achieve during the 2-year period of performance. You are required to report on these outcomes.

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.

Short-term outcomes are intended to be accomplished within one year, intermediate outcomes within two years, and long-term outcomes are expected to be met beyond the project period.

Table: Strategies and outcomes

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes

Strategy 1:

Community Engagement and Coalition Building

Establish and convene a diverse, multidisciplinary community coalition;

develop a strategy for community engagement.

• Functioning community coalition established with documented membership, meeting cadence, and input mechanisms.*

• Community coalition input incorporated into program design, intervention selection, and evaluation planning.*

• Sustained multidisciplinary partnerships;

increased community capacity to design and evaluate health improvement initiatives.

• Increased intra-community connectedness, reflected in greater resident participation in collective health improvement efforts.

• Communities with self-sustaining health improvement coalitions capable of identifying and addressing emerging chronic disease priorities without ongoing federal investment.

• Increased social connectedness and mutual investment in community health and strengthened trust in local systems of care.

Strategy 2:

Community Health Assessment and Priority Setting

Compile census-tract-level secondary data;

engage coalition in assessment; identify disease incidence and

• Completed community health assessment with baseline data on childhood chronic conditions by census tract.*

• HHS/CDC-

approved anchor condition and

• Shared understanding among stakeholders of root causes driving childhood chronic disease;

integration of existing federal, state, and local

• A replicable community assessment model that can be applied in additional communities.

Step 1: Review the Opportunity 15

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes prevalence, social, nutritional and, environmental triggers; assess Medicaid utilization in children; submit anchor condition to HHS/CDC for approval.

priority intervention areas selected.

• Documented baseline Medicaid utilization and cost data for the anchor condition.* programs aligned to project priorities.

Strategy 3:

Data Infrastructure and Dashboard Development

• Finalize Data Management Plan;

establish HIE sub-award; aggregate secondary data;

deploy data monitoring dashboard;

establish data governance processes.

• Finalized DMP submitted within 30 days of Notice of Award.*

• Data monitoring dashboard deployed within three months of Notice of Award, stratified by census tract.*

• Bi-weekly analytic updates and on-demand reporting to HHS and CDC initiated.*

• Real-time dashboard data used to inform program decisions and demonstrate progress toward outcomes;

standardized data elements developed to support comparability across project sites.*

• A replicable data infrastructure model for monitoring chronic disease burden and program performance in near-real time.

Strategy 4:

Intervention Implementation

Develop and implement HHS/CDC-approved intervention plan; strengthen partnerships;

implement evidence-based interventions across clinical, nutrition, physical activity, family support, and policy

• HHS/CDC-

approved intervention plan implemented per work plan.*

• Increased children with access to evidence-based prevention or management services including clinical, environmental,

• Adoption of policies, systems, and environmental changes in schools and community settings; improved clinical management of the anchor condition.*

• Decreased emergency department visits and

• Decreased incidence and prevalence of obesity, diabetes, asthma, and/or related conditions;

replication of successful interventions in additional communities.

Step 1: Review the Opportunity 16

Strategies and activities Short-term outcomes Intermediate outcomes Long-term outcomes domains; document implementation fidelity.

nutritional, and social.*

• Increased access to nutritious food and physical activity opportunities in child-relevant settings including school and home.* hospitalizations for the anchor condition.*

• Reduced Medicaid costs associated with the anchor condition.*

Strategy 5:

Evaluation and Continuous Quality Improvement

Finalize performance measures; submit Evaluation and Performance Measurement Plan;

conduct ongoing monitoring; share findings with coalition; document lessons learned;

submit required reports.

• Evaluation and Performance Measurement Plan submitted within six months of Notice of Award.*

• Process and outcome data collected and reported to HHS and CDC on required schedule.*

• Evidence base generated to support future replication;

continuous quality improvement demonstrated through documented program adaptations and recommendations for possible sharing savings with community.

• Findings inform HHS and CDC approaches to future community-level funding and replication of successful chronic disease prevention interventions.

* Indicates outcomes you are required to report on.

Step 1: Review the Opportunity 17

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.

Activities

Strategy 1: Community Engagement and Coalition Building The recipient is expected to identify and convene a community coalition that represents the community early in the project period. This coalition should include, but is not limited to, representatives from:

• Community members, parents, and families with children.

• Community-based organizations, faith communities, and neighborhood groups.

• Local schools and school districts.

• Primary care providers, federally qualified health centers, and hospitals.

• Local public health agencies.

• Local government, including housing and parks and recreation departments.

• Social service organizations addressing food access, housing, and economic stability.

• Relevant state agencies with jurisdiction over Medicaid, education, or environmental health.

The coalition should reflect the community it serves, with particular attention to ensuring representation from neighborhoods and populations with the highest burden of childhood chronic disease.

The recipient is expected to increase intra-community connectedness, reflected in greater resident participation in collective health improvement efforts — including support for neighbors, schools, and community institutions — and increased trust in and engagement with local public health and clinical care systems.

Expected role of the coalition

The community coalition is expected to serve as the primary vehicle for local input throughout the project. Its expected contributions include:

• Advising on the community health assessment design and interpretation of findings.

Step 1: Review the Opportunity 18

• Participating in the selection of the anchor condition and priority interventions.

• Providing ongoing input on program implementation, including identification of barriers and facilitators.

• Reviewing and interpreting data dashboard outputs and progress toward outcomes.

• Supporting community communication and dissemination of findings.

The coalition is not a governance or approval body for federal funds; final programmatic decisions remain with the recipient, HHS, and CDC. However, the recipient should establish clear mechanisms for incorporating coalition input into project decisions and should document how community input has informed program design and implementation.

Key activities

• Develop and implement a stakeholder engagement plan within 60 days of the Notice of Award.

• Convene an initial coalition meeting within 90 days of the Notice of Award.

• Establish regular coalition meeting cadence (at minimum quarterly) and document participation and input.

Develop a community communication strategy to keep broader community informed of project activities and findings.

Strategy 2: Community Health Assessment and Priority Setting The recipient will conduct a community health assessment using a community-based participatory research (CBPR) framework, in partnership with the community coalition, HHS, CDC, and locally assigned federal staff.

The assessment should draw primarily on existing secondary data sources) — including a state or regional Health Information Exchange (HIE), Medicaid claims data, electronic health record data, local health department data, school health data, and publicly available surveillance data such as CDC

PLACES.

The assessment should be organized around the following questions:

• What is the prevalence and distribution of childhood chronic conditions in the target geographic area, including by census tract?

Step 1: Review the Opportunity 19

• What are the leading risk factors and root causes — biological, developmental, behavioral, social, and environmental — for the priority conditions in this community?

• What Adverse Childhood Experiences (ACEs) are prevalent in the community, and how do they interact with chronic disease risk?

• What environmental triggers of chronic illness exist in homes and locations where children reside (e.g., mold, lead, air quality)?

• What existing federal, state, and local programs and resources are available to address these risk factors, and where are the gaps?

• What are the current Medicaid utilization patterns and costs associated with childhood chronic conditions in the target geographic area?

The assessment findings, together with community coalition input, will inform the selection of the project’s anchor condition and priority intervention areas.

A summary of the assessment findings and proposed anchor condition must be submitted to HHS and CDC for review and approval within six months of the Notice of Award.

Key activities

• Identify and compile relevant secondary data sources at the census-tract level within 60 days of the Notice of Award.

• Engage the community coalition in reviewing and interpreting assessment findings.

• Identify environmental triggers of chronic illness in homes and community settings and connect community members with mitigation and remediation resources.

• Document existing federal, state, and local programs to identify integration opportunities and avoid duplication.

• Prepare and submit a community assessment summary and proposed anchor condition and priority areas to HHS and CDC for approval within six months of the Notice of Award.

• Use assessment findings to develop a baseline against which program outcomes will be measured.

Step 1: Review the Opportunity 20

Strategy 3: Data Infrastructure and Dashboard Development The recipient will establish a data monitoring dashboard that aggregates existing secondary data from health, social service, and community sources, drawing primarily on data that already exist within health information exchange organizations (HIEs), Medicaid managed care organizations, local health systems, and other data partners. The primary recipient may sub-award to one or more sub-awardees, such as an HIE or health data utility (HDU), capable of supporting data management activities. All data management activities must be conducted in accordance with a Data Management Plan (DMP) approved by HHS and CDC.

Data sources may include, but are not limited to: Medicaid claims data;

electronic health record (EHR) data; local health information exchange data;

school health and attendance data; environmental data (e.g., housing inspection records, air quality monitoring); and social services data (e.g., SNAP, WIC participation, housing assistance).

At minimum, the dashboard must:

• Display key process and outcome metrics, stratified by census tract, demographics, and service utilization.

• Support near-real-time data refresh with data currency indicators.

• Allow export of summary data for reporting purposes.

• Be informed by feedback from community members.

• Support segregated access by user type, including HHS, CDC, and other federal staff as outlined in the DMP.

• Support routine display of Medicaid cost data.

Required activities

• Submit a preliminary DMP with the application.

• Submit a finalized DMP within 30 days of the Notice of Award.

• Deploy an initial dashboard within three months of the Notice of Award.

• Provide bi-weekly updates to analytic outputs after initial dashboard deployment, and on-demand updates as needed.

• Establish data governance processes, including data use agreements with all data partners.

Step 1: Review the Opportunity 21

Data Management Plan requirements

The DMP must address, at minimum:

• Description and lineage of data to be collected, used, or generated, including use of secondary data sources and whether an HIE or sub-awardee is the source

• Data quality and modification methodology, including use of artificial intelligence

• Complete inventory of variables collected, with data type classification, estimated volume, and update frequency

• Access controls, storage location, and dashboard platform, including specifications for locally deployed federal staff

• Mechanisms for access and sharing between sub-awardees, the recipient, and HHS or CDC

• Plan for archiving, long-term preservation, and future DMP updates

Strategy 4: Intervention Implementation The recipient has flexibility to select interventions appropriate for the anchor condition and community context identified through the assessment process.

All interventions must be evidence-based — drawing on peer-reviewed literature, CDC Community Guide recommendations, or other recognized evidence repositories — or, where the evidence base is limited, must include a clear evaluation plan. Interventions must be approved by HHS and CDC prior to implementation.

Interventions should address the full spectrum of factors influencing the anchor condition. The following domains represent areas where evidence-based approaches are available and likely applicable across all four target communities:

• Clinical and health care access: Expand access to primary and preventive care, including through non-traditional delivery points (e.g., school-based health centers, community health workers); improve clinical management and care coordination for the anchor condition.

• Nutrition and food access: Expand nutrition education and improve access to nutritious foods in schools, childcare centers, and community settings; support policies and environmental changes that increase demand for healthy foods.

• Physical activity and healthy environments: Increase physical activity opportunities in school and community settings; identify and remediate

Step 1: Review the Opportunity 22 environmental triggers of chronic illness (e.g., mold, lead) in homes and community settings.

• Family and community support: Implement family-centered approaches supporting healthy behaviors; connect families to existing federal and state programs (SNAP, WIC, housing, early childhood); engage faith community and schools as trusted platforms for health promotion;

engage community members in supporting and reinforcing health behaviors in homes, schools, and neighborhoods.

• Policy, systems, and environmental change: Promote adoption of policies in schools and community spaces that support healthful behaviors and reduce chronic disease risk; leverage existing federal programs addressing root causes of poor child health at the census-tract level.

The recipient is not restricted to these domains, but must document the rationale, evidence base, and anticipated contribution to measurable outcomes for any selected intervention in the work plan, subject to HHS and CDC approval.

Key activities

• Develop an intervention selection plan informed by community assessment findings and coalition input, and submit to HHS and CDC for approval.

• Establish or strengthen partnerships with health care providers, schools, community organizations, and other implementation partners.

• Implement approved interventions in accordance with the project work plan.

• Establish referral pathways and care coordination mechanisms connecting children and families across intervention components.

• Document implementation fidelity and adapt interventions as needed based on ongoing monitoring and community input.

• Coordinate with location-based HHS and CDC staff on implementation support and technical assistance.

Strategy 5: Evaluation and Continuous Quality Improvement The recipient will establish a performance measurement system that draws on the data infrastructure developed under Strategy 3 and is aligned with the project’s logic model and work plan. The performance measurement system should track both process measures — indicators of whether interventions

Step 1: Review the Opportunity 23 are being implemented as planned — and outcome measures — indicators of whether those interventions are achieving the intended results for children and families.

Final performance measures will be developed in collaboration with HHS and CDC following the award and will be incorporated into the Evaluation and Performance Measurement Plan due six months after the Notice of Award.

The recipient will use dashboard data and performance measure results to support ongoing, data-driven decision-making throughout the project. This includes:

• Reviewing performance data with HHS and CDC at regular intervals (at minimum quarterly) and adjusting implementation strategies as needed.

• Sharing performance data and emerging findings with the community coalition to support community accountability and inform local decision-making.

• Documenting lessons learned, implementation challenges, and adaptations made during the project period to support future replication.

The recipient will provide bi-weekly updates to dashboard analytic outputs and participate in on-demand reviews as requested by HHS or CDC.

Outcomes This section includes information about the outcomes we expect you to report progress on and achieve within the performance period.

These correspond to the asterisked outcomes in the logic model.

Short-term outcomes Community Engagement and Coalition Building

• A functioning, multidisciplinary community coalition is established with documented membership, a regular meeting cadence, and clear mechanisms for community input

• Community coalition input is incorporated into program design, intervention selection, and evaluation planning, with documentation of how input has shaped program decisions

Community Health Assessment and Priority Setting

• A completed community health assessment with baseline data on the prevalence and distribution of childhood chronic conditions by census tract

Step 1: Review the Opportunity 24

• An HHS/CDC-approved anchor condition and priority intervention areas, selected based on assessment findings and community coalition input

• Documented baseline Medicaid utilization and cost data for the anchor condition in the target geographic area

Data Infrastructure and Dashboard Development

• A finalized Data Management Plan submitted within 30 days of the Notice of Award

• A functioning data monitoring dashboard deployed within three months of the Notice of Award, displaying key process and outcome metrics stratified by census tract and accessible to HHS, CDC, and authorized federal staff

• Bi-weekly analytic updates and on-demand reporting to HHS and CDC initiated following dashboard deployment

Intervention Implementation

• An HHS/CDC-approved intervention plan implemented in accordance with the project work plan and timeline

• Increased number of children with access to evidence-based prevention or management services for the anchor condition

• Increased access to nutritious food and physical activity opportunities in child-relevant settings, including schools and childcare centers

• Decreased emergency department visits and hospitalizations for the anchor condition among children in the target area

Evaluation and Continuous Quality Improvement

• An Evaluation and Performance Measurement Plan submitted within six months of the Notice of Award

• Ongoing process and outcome data collected and reported to HHS and CDC on the required schedule

Intermediate outcomes Data Infrastructure and Dashboard Development

• Real-time dashboard data is used to inform program decisions, identify implementation gaps, and demonstrate progress toward outcomes

• Increased social connectedness and mutual investment in community health, including greater participation of residents, families, and institutions in supporting the health of their neighbors, schools, and shared community spaces, and strengthened trust in local systems of care

Step 1: Review the Opportunity 25

Evaluation and Continuous Quality Improvement

• Reduced Medicaid costs associated with the anchor condition in the target area, as demonstrated through Medicaid claims data analysis

• An evidence base generated for project interventions, including documentation of implementation context, fidelity, and outcomes to support future replication

• A continuous quality improvement cycle demonstrated through documented program adaptations based on data and community feedback

• Development of measures of trust and engagement of the community in their health and with health systems

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 26

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.

• Increased number of children with access to evidence-based prevention or management services for the anchor condition

• Increased access to nutritious food in child-relevant settings (schools, childcare centers, community sites, homes)

• Increased number of schools and childcare settings with physical activity opportunities meeting evidence-based guidelines

• Reduction in environmental triggers of chronic illness in assessed homes and community settings

Evaluation and performance measurement plan You must provide an evaluation and performance measurement plan. Use the measures required under the CDC strategy.

The measures selected should also reflect the proposed performance measures and outcomes described in previous sections.

Include the following elements.

Step 1: Review the Opportunity 27

Methods Describe how you will:

• Collect the performance measures.

• Incorporate evaluation and performance measurement into planning, implementing, and reporting project activities.

• Use evaluation findings for continuous program quality improvement.

Additionally, explain:

• How key program partners will participate in the evaluation and performance measurement process.

• How feasible it will be to collect appropriate evaluation and performance data.

• How you will share evaluation findings with communities.

• Other relevant information, such as performance measures you propose.

Data management plan You or your sub-awardees are expected to collect or generate the data needed to implement funded public health activities and submit a Data Management Plan (DMP) describing the data and how it will be collected, managed, and shared. The DMP is designed to present a high-level summary of how you or your sub-awardees will handle information related to this project in terms of collection, use, generation, stewardship, access, sharing, disclosure, archiving, retention, or preservation. It also allows you to describe how existing data standards may be relevant to this project.

For all public health data you plan to collect, a preliminary data management plan (DMP) is required at the time of application. For a definition of “public health data” and other key information, see Data Management and Access.

• Submit your DMP with your application using Data-Management-Plan-template.docx and include:

Inputs that may be considered in the DMP include but are not limited to:

• Information about data collection, use, or generation:

◦ Description of data to be collected, used, or generated or if secondary data sources will be used in lieu of direct data collection or data generation.

◦ The origination (lineage) of the data; describe whether the source is through a sub-awardee or partner of the recipient, such as a HIE.

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

Step 1: Review the Opportunity 28 https://www.cdc.gov/grants/additional-requirements/ar-25.html https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.cdc.gov%2Fnccdphp%2Fdch%2Fmedia%2Ffiles%2FData-Management-Plan-template.docx&wdOrigin=BROWSELINK https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.cdc.gov%2Fnccdphp%2Fdch%2Fmedia%2Ffiles%2FData-Management-Plan-template.docx&wdOrigin=BROWSELINK

◦ The methodology of data quality and data modifications (including whether artificial intelligence is used to generate or analyze the data):

▪ Complete inventory of all variables collected.

▪ Data type classification (surveillance, research, evaluation, etc.).

▪ Estimated volume and update frequency.

▪ Methods used to link individuals within the data repository for longitudinal assessments.

• Information about data stewardship:

◦ Who can access data and how it will be protected, including access specifications for locally-deployed federal staff (e.g., PHS Officers) directly supporting program implementation.

◦ Storage location and dashboard platform location.

◦ File formats (non-proprietary where feasible).

◦ Migration planning for long-term preservation.

• Information about access, sharing, and disclosure:

◦ Description of data to be collected, used, or generated that is planned to be accessed by HHS or CDC or disclosed to HHS or CDC, including aggregate data products and program evaluation findings.

◦ Whether there are reasons why you cannot share data collected or generated under this award with HHS or CDC (e.g., legal, regulatory, policy, or technical limitations).[1]

◦ Mechanisms for access and sharing between any sub-awardees, you as the recipient, and HHS or CDC.

• Information about data standards and documentation:

◦ Plan for allowing the flexibility necessary to incorporate future data standards into dashboard construction, data analytics, and data cleaning processes.

◦ Existing management or architecture standards applied to collected or generated data.

◦ In partnership with HHS and CDC, considerations that include applying standardized data elements and functions that could lead to interoperability across jurisdictions (e.g., common methods for describing disease prevalence).

• Information about archiving, retention, and preservation.

• Plan for archiving and long-term preservation.

Step 1: Review the Opportunity 29

• Long-term steward designation.

• Budget planning for preservation.

• Future DMP updates.

How to incorporate new information as it becomes available over the life of the project? For example, DMP updates as part of annual reporting; for more information about CDC’s policy on the DMP, see Data Management and Access Requirement at CDC’s website

Evaluation activities You must take on specific evaluation activities. Describe:

• The type of evaluations you will complete, such as process, outcome, or both.

• Key evaluation questions these evaluations will address.

• Measures and data sources.

• Any other relevant information.

Submit an initial draft of your evaluation and performance measurement plan, including the DMP, with your application. You must submit a more detailed plan within the first six months of the award. See reporting.

Final evaluation approaches (i.e., process, outcome, or both), questions or topics, and data sources will be determined together with funder after the award is issued. The approved evaluation topics and data sources should be incorporated into the Evaluation Performance Measurement Plan that you submit once the award period begins.

Paperwork Reduction Act Any activities involving information collection from 10 or more individuals or organizations may require the Paperwork Reduction Act (PRA) approval. The PRA requires review and approval of the information collection by the White House Office of Management and Budget. To determine if a proposed activity requires PRA approval, contact your program contact.

Collections include items like surveys and questionnaires. If you have collections requiring PRA approval, CDC is responsible for working with OMB to gain the approval.

For more information about…