DD-24-0055.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES

Implementing Evidence-Based Health Promotion Programs for Attention-Deficit Hyperactivity Disorder (ADHD) or Tourette Syndrome (TS)

CDC-RFA-DD-24-0055

04/15/2024

Table of Contents 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 Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA- DD-24-0055. 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:

Implementing Evidence-Based Health Promotion Programs for Attention-Deficit Hyperactivity Disorder (ADHD) or Tourette Syndrome (TS)

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 purposes of this NOFO, research is defined as set forth in 45 CFR 75.2 and, for further clarity, as set forth in 42 CFR 52.2 (see eCFR :: 45 CFR 75.2 -- Definitions and https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR- 2007-title42-vol1-sec52-2.pdf. In addition, for purposes of research involving human subjects and available exceptions for public health activities, please see 45 CFR 46.102(l) (https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section- 46.102#p-46.102(l)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DD-24-0055

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.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l)

E. Assistance Listings Number:

93.073

F. Dates:

1. Due Date for Letter of Intent (LOI):

The LOI date will generate once the Synopsis is published if Days or a Date are entered.

2. Due Date for Applications:

04/15/2024 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

Informational Zoom Call - February 29, 3:00 PM to 4:00 PM, Eastern Standard Time

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G. Executive Summary:

1. Summary Paragraph The purpose of this Notice of Funding Opportunity (NOFO), Implementing Evidence-Based Health Promotion Programs for Attention-Deficit/Hyperactivity Disorder (Component A, ADHD) or Tourette Syndrome (Component B, TS), is to address identified needs, equitably reaching geographically, racially, and ethnically diverse audiences:

• To improve access to evidence-based information, support, and services for people with ADHD or TS and their families and communities,

• To strengthen the capacity among healthcare providers to appropriately diagnose and provide evidence-based treatments for persons with ADHD or TS, and

• To strengthen the capacity among education professionals to implement evidence-based strategies that provide support and facilitate academic success among children and youth with ADHD or TS.

Program strategies include creating, disseminating, evaluating, and continually improving tailored communication and education programs, products, and tools that promote the use of evidence-based ADHD and TS information with a focus on providing support and addressing disparities for the following audiences: 1) persons with ADHD or TS, their families, and communities, 2) healthcare providers; and 3) educators. The ultimate goal for this work is improving quality of life for all persons with ADHD or TS through better prepared and informed providers, educators, communities, as well as individuals with these conditions and their families.

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards One award for Component A (ADHD) and one for Component B (Tourette syndrome). Indicate Component A or B in application (applicants cannot apply for both components)

d. Total Period of Performance Funding:

$9,750,000 This amount is subject to the availability of funds.

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).

e. Average One Year Award Amount:

$975,000 Average award if funded for Component A, $850,000; average award if funded for Component B, $1,100,000

f. Total Period of Performance Length:

5 year(s)

g. Estimated Award Date:

August 01, 2024

h. Cost Sharing and / or Matching Requirements:

No Cost sharing or matching funds are not required for this program. Although no statutory matching requirement for this NOFO exists, leveraging other resources and related ongoing efforts to promote sustainability is strongly encouraged.

Part II. Full Text

A. Funding Opportunity Description

1. Background

a. Overview Attention-deficit/hyperactivity disorder (ADHD), and persistent tic disorders such as Tourette syndrome (TS), significantly impact the people with these conditions, their families and communities. In the US, approximately six million, or 1 in 10, children 3–17 years of age have been diagnosed with ADHD. Approximately 1 in 50 children aged 5–14 years have TS or another persistent tic disorder.

Research shows that healthcare providers often do not have sufficient knowledge of ADHD and TS to comfortably and accurately provide ADHD and TS diagnoses, treatment, and referral.

Children and youth with ADHD or TS also experience difficulties in school, and educators report challenges with understanding and supporting children with these conditions in the classroom.

Individuals with ADHD or TS would benefit from clinical and educational supports, having increased needs in the classroom and in healthcare compared to their peers. Individuals with ADHD or TS are at increased risk for co-occurring mental, behavioral, and developmental disorders. The presence of ADHD or TS is also associated with increased risk of feelings of isolation, problems with social relationships related to symptoms of ADHD or TS, substance use, and injury, including suicide.

By working with three main audiences (i.e., 1) persons with ADHD or TS, their families, and communities; 2) healthcare providers; and 3) educators), the purpose of this NOFO is to address the current ADHD and TS needs throughout the project, through:

• Improved access to evidence-based information, support, and services for people with ADHD or TS and their families and communities

• Strengthened capacity among healthcare professionals to appropriately diagnose and provide evidence-based services for persons with ADHD or TS

• Strengthened capacity among education professionals to implement evidence-based strategies that provide support and facilitate learning and academic success for children and youth with ADHD or TS

Racial and ethnic disparities are known to exist for diagnosis of ADHD and TS. The latest national estimates of ever-diagnosed ADHD have shown similar estimates between non-Hispanic White and non-Hispanic Black children, and lower estimates for Hispanic children and non- Hispanic Asian children. Nationally representative estimates of diagnosed TS among US children have generally shown higher estimates among non-Hispanic White compared with non- Hispanic Black and Hispanic children.

The prevalence of ADHD varies by other socio-demographic factors as well. Children 3–17 years of age living in rural areas were more likely to have ever been diagnosed with ADHD compared to children living in urban or suburban areas, and children living in low-income households have higher prevalence estimates of ADHD.

Thus, this NOFO prioritizes a focus on identifying and addressing disparities for either Component A (ADHD) or B (TS). This can include disparities, for example, by geographic region and/or racial/ethnic group based on 1) current evidence of differential rates of ADHD or TS diagnosis or care; and/or 2) evaluation results showing under-represented geographic and/or racial/ethnic groups in program, product, or tool access.

This award will build upon and expand previous efforts by incorporating current evidence on health communication and health education strategies, and on ADHD or TS diagnosis and treatment, with the goal of improving quality of life for all persons with ADHD or TS through better prepared, connected, and informed providers, educators, communities, families and individuals with these conditions.

b. Statutory Authorities This program is authorized under Section 317C [42 USC 247b-4] and Section 301(a) [42 USC 241a] of the Public Health Service Act, as amended.

c. Healthy People 2030 HSR01: Increase the ability of primary care and behavioral health professionals to provide more high-quality care to patients who need it and

MHMD-03: Increase the proportion of children with mental health problems who get treatment

EMC- 04: Increase the proportion of children and adolescents with ADHD who get appropriate treatment

d. Other National Public Health Priorities and Strategies Funding Opportunity Goals (new for 2023):

Equitably Protecting health, safety, and security

e. Relevant Work CDC works to help people reach their full potential, including public health activities to improve the lives of children with ADHD (http://www.cdc.gov/adhd) and TS (http://www.cdc.gov/tourette), and their families. Previous awards (“National Public Health Practice and Resource Center for Children with ADHD or Tourette Syndrome” and https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care/increase-ability-primary-care-and-behavioral-health-professionals-provide-more-high-quality-care-patients-who-need-it-ahs-r01 https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care/increase-ability-primary-care-and-behavioral-health-professionals-provide-more-high-quality-care-patients-who-need-it-ahs-r01 https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders/increase-proportion-children-mental-health-problems-who-get-treatment-mhmd-03 https://health.gov/healthypeople/objectives-and-data/browse-objectives/children/increase-proportion-children-and-adolescents-adhd-who-get-appropriate-treatment-emc-04 https://health.gov/healthypeople/objectives-and-data/browse-objectives/children/increase-proportion-children-and-adolescents-adhd-who-get-appropriate-treatment-emc-04 http://www.cdc.gov/adhd http://www.cdc.gov/tourette

“Implementing Evidence-Based Health Promotion Programs for Children with Attention- Deficit/Hyperactivity Disorder (ADHD) or Tourette Syndrome (TS)”) supported the dissemination of evidence-based information on diagnosis, co-occurring conditions, and condition management for people with ADHD or TS, their families and communities, healthcare providers, and educators.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-[DD-24-0055] Logic Model: [Implementing Evidence-Based Health Promotion Programs for Attention- Deficit/Hyperactivity Disorder (ADHD) or Tourette Syndrome

(TS)

NOTE: Organizations may submit one application for ADHD (Component A) or TS (Component B), but cannot apply for both

Strategies Short-term Outcomes Intermediate Outcomes

Long-Term Outcomes

Strategy 1. For people with ADHD or TS and their families and communities, create, disseminate, evaluate, and continuously improve tailored ADHD (Component A) or TS (Component B) communication and education* programs/products/tools/s upports that fill a demonstrated need, with a focus on addressing disparities**

1A. Increased number and geographic, racial, and ethnic diversity of people with ADHD or TS and their families and communities accessing ADHD or TS communication and education programs/products/tool s/supports

1B. Increased strength and number of local and national connections between 1) the award recipient and people with ADHD or TS, their families, and communities; 2) families of and individuals with ADHD or TS and other families of and individuals with ADHD or TS

Increased individual, family and community knowledge of ADHD or TS symptoms, diagnosis, and treatments;

increased individual and family satisfaction that provided tools and supports meet their needs related to ADHD or

TS

• Improved quality of life for all persons with ADHD or

Healthcare providers, educators, families, and communiti es are prepared to support people with ADHD or

Strategy 2. For healthcare providers, create, disseminate, evaluate, and continuously improve tailored ADHD (Component A) or TS (Component B) communication and education* programs/products/tools that fill a demonstrated need related to ADHD or TS, with a focus on addressing disparities**

2A. Increased number, provider-types, and geographic, racial, and ethnic diversity of healthcare providers accessing ADHD or TS communication and education s

2B. Increased strength national connections between award recipient, TS or ADHD Regional Centers, healthcare providers, provider organizations, and persons with ADHD and TS

Increased healthcare provider capacity to provide evidence-based care through increased healthcare provider knowledge about ADHD or TS symptoms, diagnosis, and treatments;

and increased use of evidence-based guidelines in diagnosis and care of persons with ADHD or TS

Strategy 3 For educators, create, disseminate, evaluate, and continuously improve tailored ADHD (Component A) or TS (Component B) communication and education* programs/products/tools that fill a demonstrated need related to ADHD or TS, with a focus on addressing disparities**

3A. Increased number, educator-types, and geographic, racial, and ethnic diversity of educators accessing ADHD or TS communication and education s

3B. Increased strength national connections between award

Increased educator capacity to support students’ needs through increased knowledge of ADHD or TS symptoms, diagnosis, and classroom/sch ool strategies;

and increased

• Decreased disparities in access to evidence-based ADHD or

TS

diagnosis, treatment, and other supports recipient, TS or ADHD Regional Centers, educators, and educator organizations use of evidence-based educational strategies for ADHD or TS in education setting

*ADHD or TS communication and education promotes the use of:

• Evidence-based information about symptoms and diagnosis of ADHD or Tourette syndrome

• Evidence-based information about treatments and services

** A focus on addressing disparities can include disparities, for example, by geographic region and/or racial/ethnic group based on 1) current evidence of differential rates of ADHD or TS diagnosis or care; and/or 2) evaluation results showing under-represented geographic and/or racial/ethnic groups in program, product or tool access (for people with ADHD or TS and their providers and educators).

See GLOSSARY on last page of NOFO for more definitions

i. Purpose This work intends to address identified needs through:

• Improving understanding of ADHD or TS and access to evidence-based services and supports for people with ADHD or TS and their families, equitably reaching those from geographically/racially/ethnically diverse audiences

• Strengthening capacity among healthcare professionals to appropriately diagnose and provide evidence-based services for persons with ADHD or TS

• Strengthening capacity among education professionals to implement evidence-based strategies to provide support and facilitate learning for children and youth with ADHD or

TS

ii. Outcomes The expected NOFO outcomes are:

• Increased number and geographic, racial, and ethnic diversity of people with ADHD or TS and their families and communities accessing ADHD or TS communication and education* programs/products/tools/supports

• Increased strength and number of local and national connections between 1) the award recipient and people with ADHD or TS, their families, and communities; 2) families of and individuals with ADHD or TS and other families of and individuals with ADHD or TS

• Increased individual, family, and community knowledge of ADHD or TS symptoms, diagnosis, and treatments

• Increased individual and family satisfaction that provided tools and supports meet their needs related to ADHD or TS

• Increased number, provider-types and geographic, racial, and ethnic diversity of healthcare providers accessing ADHD or TS communication and education* programs/products/tools

• Increased strength and number of local and national connections between award recipient, TS or ADHD Regional Centers, healthcare providers, healthcare provider organizations, and persons with ADHD and TS

• Increased healthcare provider knowledge and expertise of ADHD or TS symptoms, diagnosis, and treatments

• Increased healthcare provider use of evidence-based guidelines in diagnosis and care of persons with ADHD or TS

• Increased number, educator-types, and geographic, racial, and ethnic diversity of educators accessing ADHD or TS communication and education* programs/products/tools

• Increased strength and number of local and national connections between the award recipient, TS or ADHD Regional Centers, and educators/educator organizations

• Increased educator knowledge of ADHD or TS symptoms, diagnosis, and classroom/school strategies

• Increased use of evidence-based ADHD or TS educational strategies in education settings

*ADHD or TS communication and education that promotes:

• Evidence-based information about symptoms and diagnosis of ADHD and TS

• Evidence-based information about treatments and services

iii. Strategies and Activities Applicants are encouraged to share developed materials back with CDC and to incorporate current evidence for successful communication, education and dissemination in all activities proposed (Online CDC guidance resources are available including The Guide to Community Preventive Services (The Community Guide)) and CDC Health Equity Guiding Principles for Inclusive Communication https://www.cdc.gov/healthcommunication/Health_Equity.html

Strategy 1. Create, disseminate, evaluate, and continuously improve tailored ADHD (Component A) or TS (Component B) communication and education https://www.thecommunityguide.org/ https://www.thecommunityguide.org/ https://www.cdc.gov/healthcommunication/Health_Equity.html program/products/tools/supports that fill a demonstrated need for people with ADHD or TS and their families and communities, with a focus on addressing disparities*

• S1. Activity 1. Identify ADHD or TS disparity* priorities, information gaps, and education/communication/support needs. Recipient must seek and incorporate direct input from those with ADHD or TS and family members of people with ADHD or TS to inform development and dissemination of communication and education programs/products/tools

• S1. Activity 2. Provide Information/Consultation and Referral Programs (ICRP).

Respond to questions, and provide on-demand, evidence-based ADHD or TS information for people with ADHD or TS and their families

• S1. Activity 3. Develop and disseminate evidence-based ADHD or TS education and communication programs/products/tools/supports. Address identified needs/priorities (see S1. Activity 1), incorporating existing materials as appropriate. A dissemination plan should be developed that includes evidence-based communication channels and engagement strategies. The materials should contain tested message concepts that are acceptable and accessible and if possible, tested by people with ADHD or TS and/or their families

• S1. Activity 4. Evaluate (including measuring disparity* audience receipt), and continuously improve each ADHD or TS program/product/tool, and the communication channels and engagement strategies used for dissemination.

Ensure all programs/products/tools are respectful and responsive to geographically, racially, and ethnically diverse populations, communication needs; adapt tools when needed o Online CDC guidance resources are available including ADDIE Model |Training Development | CDC).

• S1. Activity 5. Facilitate connections for families/persons with ADHD or TS.

Create, promote, and make available local and national opportunities for persons or family members of persons with ADHD or TS to foster meaningful connections to other persons or family members of persons with ADHD or TS (e.g., support groups);

and/or organize education/training for cohorts of persons or family members of persons with ADHD or TS (e.g., youth leadership training or parent/caregiver training groups)

• S1. Activity 6. Support the development of new and/or provide support to existing regional ADHD or TS centers. Improve local access to tools and support needed by people with ADHD or TS and their families for ADHD or TS management with a focus on addressing disparities at the local level

• S1. Activity 7. Coordinate information sharing (between award recipient, people with ADHD or TS, families/communities, and regional centers). This can include regional centers jointly developing individual, family and community resources, regional centers sharing local resources with families and individuals, and/or local projects or small grants in different states to pilot innovative approaches to address priority needs, potentially including health risk behaviors, or disparities https://www.cdc.gov/training/development/addie-model.html

Strategy 2. Create, disseminate, evaluate, and continuously improve tailored ADHD (Component A) or TS (Component B) communication and education programs/products/tools that fill a demonstrated need related to ADHD or TS for healthcare providers, with a focus on addressing disparities among their patients*

• S2. Activity 1. Identify ADHD or TS disparity* priorities, information gaps, and education/communication needs for healthcare providers

• S2. Activity 2. Develop or adapt existing ADHD or TS training and education programs/products/tools and a dissemination plan that is evidence-based, instructionally sound (i.e., incorporating adult learning principles and effective educational strategies), innovative, and culturally appropriate and that address identified needs/priorities (see S2. Activity 1) for healthcare providers. Provide continuing education credits when possible and appropriate

• S2. Activity 3. Develop ADHD or TS communication strategies (e.g., outreach, messaging and engagement) as needed, that are evidence-based, accurate, incorporate existing materials and tested message concepts, as available, and are acceptable to the educator audience, to address identified needs/priorities (see S3. Activity 1) of the healthcare provider audience

• S2. Activity 4. Evaluate (including measuring disparity* audience receipt), and continuously improve each ADHD or TS program/product/tool and the outreach, messaging channels, and engagement strategies used for dissemination. Ensure all programs/products/tools are inclusive and responsive to diverse provider-types, geographically, racially, and ethnically diverse populations, communication needs;

adapt tools when needed to address disparities* o CDC technical assistance available including online guidance resources ADDIE Model |Training Development | CDC for guidance).

• S2. Activity 5. Support the development of new and/or provide support to existing ADHD or TS regional centers. Address local healthcare provider training needs with a focus on addressing disparities*

• S2. Activity 6. Coordinate information sharing for healthcare providers (between award recipient, healthcare providers, and regional centers). This can include joint trainings with multiple regions, communication innovations to connect regional hubs of providers, promotion of sharing provider resources and lessons learned across regions, and/or supporting local projects or small grants in different states to pilot innovative approaches to address priority needs or disparities*

• S2. Activity 7. Increase linkages between recipient and organized, professional healthcare provider organizations/networks (e.g., nursing, medical or allied health professional organizations, academic clinical institutions)

• S2. Activity 8. Create, maintain, and distribute a list of local healthcare providers and/or local resources to improve connection between different healthcare providers (for referral purposes) and between healthcare providers and persons with ADHD or

Strategy 3. Create,disseminate, evaluate, and continuously improve tailored ADHD or TS communication and education program/products/tools that fill a demonstrated need related to ADHD or TS for educators, with a focus on addressing disparities*

• S3. Activity 1. Identify disparity priorities, ADHD/TS information gaps, and education/communication needs for educators

• S3. Activity 2. Develop or adapt existing ADHD or TS training and education programs/products/tools and dissemination plans that are evidence-based, instructionally sound (i.e., incorporating adult learning principles and effective educational strategies), innovative, and culturally appropriate and that address identified needs/priorities (see S3. Activity 1) for educators. Provide continuing education credits when possible and appropriate

• S3. Activity 3. Develop ADHD or TS communication strategies (e.g., outreach, messaging and engagement), as needed, that are evidence-based, accurate, incorporate existing materials and tested message concepts, as available, and are acceptable to the educator audience, to address identified needs/priorities (see S3. Activity 1) for educators

• S3. Activity 4. Evaluate (including measuring disparity* audience receipt), and continuously improve each ADHD or TS program/product/tool and the outreach, messaging channels, and engagement strategies used for dissemination. Ensure all programs/products/tools are respectful and responsive diverse educator-types, geographically, racially, and ethnically diverse populations, communication needs;

adapt tools when needed to address disparities* o CDC technical assistance available including online guidance resources ADDIE Model |Training Development | CDC for guidance).

• S3. Activity 5. Support the development of new, and/or provide additional support to existing ADHD or TS regional centers to address local educator training needs with a focus on addressing disparities*

• S3. Activity 6. Coordinate information sharing for educators (between award recipient, educators, and regional centers). This can include joint trainings with multiple regions, communication innovations to connect regional hubs of educators, promotion of sharing of educator resources and lessons learned across regions, and/or supporting local projects or small grants in different states to pilot innovative approaches to address priority needs or disparities

• S3. Activity 7. Increase linkages of recipient to organized educator organizations/networks (e.g., Department of Education Office of Special Education Programs, state/local school boards, professional teacher organizations, parent teacher organizations)

* This can include disparities, for example, by geographic region and/or racial/ethnic group based on 1) previous knowledge of differential rates of ADHD or TS diagnosis or care; and/or

2) evaluation results showing under-represented geographic and/or racial/ethnic groups in program, product or tool access (for people with ADHD or TS and their providers and educators).

See GLOSSARY on last page of NOFO for more definitions

1. Collaborations

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

The ADHD and TS recipients are expected to collaborate in identifying and sharing common work practices, lessons learned, and strategies to accomplish the objectives of the NOFO, and participate in meetings of groups interested in the main audiences, as needed, and provide consultation to CDC and programs as requested.

Collaborations with interested CDC programs and CDC-funded programs with overlapping work are encouraged. The funding office (NCBDDD) intends to link the successful recipient with applicable CDC programs. The linkages will provide the recipient with information and resources to assist with implementing activities to achieve the NOFO period of performance outcomes, including health equity-related outcomes. The exact nature and activities within these collaborations will be determined post-award.

b. With organizations not funded by CDC:

Recipients are expected to form and/or strengthen strategic partnerships and collaborations with organizations that have a role in achieving the NOFO outcomes and activities to ensure the highest quality, evidence-based information and resources have the greatest reach possible.

Partners may play a role in development and dissemination of information, and promotion of public health activities, and may include federal agencies (e.g., SAMHSA, HRSA), state health departments, community-based organizations addressing ADHD or TS and associated conditions, schools, medical and university research centers, nursing, medical or allied health professional organizations (e.g., the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the Child Neurology Society, and the American Nurses Association), and educator organizations/networks (e.g., Department of Education Office of Special Education Programs, state/local school boards, professional teacher organizations, parent teacher organizations)). Applicants should provide letters of support, where applicable (i.e., to demonstrate support for a collaboration). Letters of support should be combined in one file named “Letter(s) of Support,” and uploaded as a PDF, Word, or Excel file at www.grants.gov

2. Population(s) of Focus The populations of focus for this NOFO currently include children and adolescents with ADHD (Component A) or TS (Component B). Activities focused on adolescents transitioning to early adulthood are also currently permitted. This NOFO focuses on three main audiences 1) persons with ADHD or TS, their families, communities, 2) healthcare providers, and 3) educators. All project activities should consider disparities, for example, by geographic region and/or racial/ethnic group based on 1) current available evidence of differential rates of ADHD or TS diagnosis or care; and/or 2) evaluation results showing under-represented geographic and/or racial/ethnic groups in program, product, or tool access.

http://www.grants.gov

Continued measurement of suitability and reach of all ADHD or TS communication and education programs/products/tools and communication channels is expected as part of evaluation activities, and continuous programmatic adjustments are expected. Where disparities exist between the known populations and those reached, including disparities, for example, that are related to geography, race, and ethnicity of the population, products/tools/programs/communication channels should be tailored to reach those previously under-represented.

ADHD or TS sub-populations, including potentially adults and/or other groups with newly identified public health needs, might be added to the populations of focus during the project period by CDC.

This NOFO, including funding and eligibility, is not limited based on, and does not discriminate on the basis of race, color, national origin, disability, age, sex (including gender identity, sexual orientation, and pregnancy) or other constitutionally protected statuses.

a. Health Disparities The goal of health equity is for everyone to have a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.

Broadly defined, social determinants of health are non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces (e.g., racism, climate) and systems include economic policies and systems, development agendas, social norms, social policies, and political systems. See content below and in other sections (e.g., Approach, Collaborations, Populations of Focus) for information on how this specific NOFO affects social determinants of health.

A health disparity is a preventable difference in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by populations that have been socially, economically, geographically, and environmentally disadvantaged. Health disparities are inextricably linked to a complex blend of social determinants that influence which populations are most disproportionately affected by these diseases and conditions.

This NOFO aims to address health disparities with a strategic focus on healthcare providers and educators. By better educating and training healthcare providers and educators, those with ADHD and TS can have more equitable access to healthcare and education.

The NOFO also aims to evaluate, and continuously improve each ADHD or TS program/product/tool to ensure all programs/products/tools are respectful and responsive to diverse populations, communication needs, and languages. Recipients will adapt tools when needed to address disparities, for example, by geographic region and/or racial/ethnic group based on 1) current available evidence of differential rates of ADHD or TS diagnosis or care; and/or 2) evaluation results showing under-represented geographic and/or racial/ethnic groups in program, product, or tool access (for people with ADHD or TS and their providers and educators).

iv. Funding Strategy Component A: Implementing Evidence-Based Health Promotion Programs for Attention- Deficit/Hyperactivity Disorder (ADHD). This component is for applicants that propose to provide education and outreach activities specifically catered to individuals, families/communities, healthcare providers, and educators that address the information and educational needs in relation to living with ADHD, equitably reaching geographically, racially, and ethnically diverse audiences.

Component B: Implementing Evidence-Based Health Promotion Programs for Tourette Syndrome (TS). This component is for applicants that propose to provide education and outreach activities specifically catered to individuals, families/communities, healthcare providers, and educators that address the information and educational needs in relation to living with TS, equitably reaching geographically, racially, and ethnically diverse audiences.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Since this NOFO does not involve the generation or collection of public health data, a Data Management Plan is not required.

Applicants are required to provide an evaluation and performance measurement plan that identifies evaluation measures for each strategy and activity. Findings from the evaluation and performance measurement strategy will inform continuous program improvement and help the recipients determine whether their program strategies are working to achieve the desired outcomes, and if their communication and education programs/products/tools are equitably reaching geographically, racially, and ethnically diverse audiences.

Examples of potential evaluation measures are provided below. The recipients will have 6 months after the award receipt to discuss and finalize the measures in collaboration with CDC.

Applicants are encouraged to suggest additional measures as applicable for their proposed activities.

Evaluation Measure Examples

Outcome Measures Strategies 1-3

Within the project period, individuals receiving ADHD or TS communication or education programs/products/tools demonstrate:

o Increased knowledge (potentially measured pre/post) among persons with the ADHD or TS, families, providers, and educators of:

▪ Evidence-based information about symptoms and diagnosis of ADHD or TS

▪ Evidence-based information about treatments and services

▪ Satisfaction that provided tools and supports meet their needs related to ADHD or TS (among individuals with ADHD or TS and their families),

▪ Increased use of evidence-based guidelines in diagnosis and care of persons with ADHD or TS (healthcare providers)

▪ Increased use of evidence-based ADHD or TS educational strategies in education setting (educators)

Process Measure Examples

Strategy 1 Address identified needs for people with ADHD or TS and their families and communities

Activity 1. Identify ADHD or TS disparity* priorities, information gaps, and education/communication/support needs

• Number and type of documented ADHD or TS individual/family/community communication and education needs and/or priorities

• Number of identified needs/priorities that were informed by direct input from those with ADHD or TS and family members of people with ADHD or TS

Activity 2. Provide Information/Consultation and Referral Programs (ICRP)

• Number and types of requests received in Information/Consultation and Referral Programs (ICRP), delineated by type of requestor and subject of request

Activity 3. Develop and disseminate evidence-based ADHD or TS education and communication programs/products/tools and dissemination plan

• Number and type of communication/education programs and materials developed and/or revised for people with ADHD or TS and/or their families

• Number of materials people with ADHD or TS and/or their families provided input/feedback

Activity 4. Evaluate and continuously improve each ADHD or TS program/product/tool and dissemination plan

• Number of evaluation surveys disseminated/completed

• Number and racial/ethnic/geographic distribution of persons accessing programs/products/tools

• Number of states/counties/zip codes with individuals accessing programs/products/tools

• Number of programs/products/tools created or adapted to be culturally/linguistically/contextually responsive to address disparities*

Activity 5. Facilitate connections for families/persons with ADHD or TS

• Number and types of trainings and/or support groups

• Number of states/counties/zip codes accessing training and/or support groups

• Number and racial/ethnic/geographic distribution of families or persons with ADHD or TS attending activities/programs where connection with other individuals and families with ADHD or TS is the focus

Activity 6. Support the development of new and/or provide support to existing regional ADHD or TS centers

• Number of regional affiliates or centers with formal relationship with recipient participating in NOFO activities

• Number and types of new partnerships and collaborations between the award recipient and people with ADHD or TS, their families, and communities at the local level (e.g., via regional ADHD or TS centers) o This could include local projects or small grants in different states to pilot innovative approaches to address disparities or priority needs

• Number and racial/ethnic/geographic distribution of individuals accessing programs/products/tools via regional center distribution

Activity 7. Coordinate information sharing

• Number of individual, family and community resources shared between ADHD or TS regional centers

• Number of individual, family and community resources developed jointly between ADHD or TS regional centers

• Number of meetings of ADHD or TS regional centers and number of centers attending meetings

Strategy 2 & 3. Address identified needs for healthcare providers/educators related to ADHD or TS

Activity 1. Identify disparity* priorities, ADHD/TS information gaps, and education/communication needs for healthcare providers/educators

• Number and type of documented healthcare provider/educator communication and education needs and disparity priorities

• Number of identified needs/priorities that were informed by direct input from healthcare providers/educators

Activity 2. Develop/adapt training and education programs/products/tools and dissemination plans

• Number and type of healthcare provider/educator education or training programs and materials developed and/or adapted

• Number and racial/ethnic/geographic distribution of healthcare providers/educators accessing education or training programs/products/tools

• Number and type of continuing education credits provided, if applicable

Activity 3. Develop communication programs/products/tools and dissemination plans

• Number of communication materials tested by healthcare providers/educators

• Number and type of healthcare provider/educator communication programs and materials developed and/or revised

• Number and provider-type/racial/ethnic/geographic details (including those from groups with known disparity of diagnosis/care or previous program receipt) of healthcare providers/educators accessing communication programs/products/tools

Activity 4. Evaluate, improve programs/products/tools and communication/dissemination channels

• Number of education materials tested by healthcare providers/educators

• Number and type of healthcare provider/educator education programs and materials developed and/or revised

• Number occupation-type/racial/ethnic/geographic details of healthcare providers/educators accessing educator programs/products/tools

• Number of evaluation surveys disseminated/completed by healthcare providers/educators

• Number of healthcare provider/educator programs, products or tools created or adapted to be culturally/linguistically/contextually responsive to address disparities*

Activity 5. Support the development of new and/or provide additional support to existing regional ADHD or TS regional centers

• Number and types of new partnerships and collaborations between the award recipient and healthcare providers/educators at the local level (e.g., via regional TS or ADHD centers)

• Number of healthcare providers/educators accessing programs/products/tools via regional center connections

• Number of healthcare provider/educator trainings supported by ADHD or TS regional centers addressing disparities*

Activity 6. Coordinate information sharing

• Number of healthcare provider/educator resources shared between ADHD or TS regional centers

• Number of healthcare provider/educator resources developed jointly between ADHD or TS regional centers

• Number of healthcare provider/educator collaborations with other provider/educators at the local level (e.g., via regional TS or ADHD centers) o This could include joint trainings with multiple regions, communication innovations to connect regional hubs, promotion of sharing resources and lessons learned across regions, and supporting local projects or small grants in different states to pilot innovative approaches to address disparities or priority needs

Activity 7. Increase linkages of recipient to existing partner organizations/networks

• Number and type of ADHD or TS materials or other resources shared with partner organizations/networks (e.g., nursing, medical or allied health professional organizations, academic institutions with clinicians or school boards, professional teacher organizations, parent teacher organizations, and the Department of Education)

Activity 8. Create, maintain, and distribute listing of local healthcare providers and/or local resources (Healthcare provider only)

• Number of states, counties, zip codes included in list of healthcare providers and/or local resources

• Number of persons accessing healthcare provider list

NOTE: The program activities in this NOFO do not meet the criteria for research, so the results will not be generalizable. Proposed programs will adhere to all applicable rules and regulations for human participants in non-research projects. All applicants are responsible for adhering to all federal regulations relevant to information collection, including developing Information Collection Requests according to the Paperwork Reduction Act.

* This can include disparities, for example, by geographic region and/or racial/ethnic group based on 1) current evidence of differential rates of ADHD or TS diagnosis or care; and/or 2) evaluation results showing under-represented geographic and/or racial/ethnic groups in program, product or tool access.

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, including, as applicable to the award, how findings will contribute to reducing or eliminating health disparities and inequities.

• 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).

• How evaluation findings will be disseminated to communities and populations of interest in a manner that is suitable to their needs.

• Plans for updating the Data Management Plan (DMP) as new pertinent information becomes available. If applicable, throughout the lifecycle of the project. Updates to DMP should be provided in annual progress reports. 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/additional-requirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, the applicant 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, if applicable, within the first 6 months of award, as described in the Reporting Section of this NOFO.

c. Organizational Capacity of Recipients to Implement the Approach The applicants should have the organizational capacity to develop, implement, and manage health education and communication programs that promote the health and well-being of persons living with ADHD (Component A) or TS (Component B), by providing evidence-based information, support, and resources to individuals, families, communities, healthcare providers, and educators. The applicant should demonstrate national and regional leadership on behalf of those living with ADHD or TS.

Specifically, the applicant should:

• Demonstrate ability to implement evidence-based health communication and education programs to main audiences across the US ((i.e., 1) persons with ADHD or TS, their families, and communities; 2) healthcare providers; 3) educators)

• Demonstrate understanding of diverse audience information needs, including knowledge and understanding of effective methods to reach and engage ethnically, racially, and geographically diverse members of main audiences

• Demonstrate understanding of ADHD or TS, including https://www.cdc.gov/grants/additional-requirements/ar-25.html o Evidence-based information about symptoms and diagnosis of ADHD and Tourette syndrome o Evidence-based information about treatments and services

• Demonstrate access to racially, ethnically, and geographically diverse (across the US, US territories, and freely-associated states) main audiences

• Show history and expertise working with main audiences including knowledge and understanding of effective methods to equitably reach and engage diverse audiences

• Demonstrate ability to track and characterize information and service requests

• Demonstrate expertise in planning, developing, and evaluating instructionally sound (i.e., incorporating adult learning principles and effective…