DP15-1509 -REVISED AMENDMENT I 11.03.14.pdf

Funding Opportunity Announcement DP15-1509 National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health

An amendment was made to this Funding Opportunity Announcement DP15-1509. All amendments to the following sections are noted in red type:

F. Dates, 3. Informational Conference Call for Potential Applicants D. Application and Submission Information, 9. Project Abstract Summary D. Application and Submission Information, 10. Project Narrative H. Other Information, Acceptable Attachments Delete text under Anticipated Funding Range for the Core Component that states ‘and previous spending history” page 10

National State-Based Tobacco Control Programs

CDC-RFA-DP15-1509

National Center for Chronic Disease Prevention and Health Promotion

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

DP15-1509, National State Based Tobacco Control Programs Page 1

Contents

Part I. Overview Information

A. Federal Agency Name

B. Funding Opportunity Title

C. Announcement Type

D. Agency Funding Opportunity Number

E. Catalog of Federal Domestic Assistance (CFDA) Number

F. Dates:

G. Executive Summary

Part II. Full Text

A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Application and Submission Information

E. Application Review Information

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

DP15-1509, National State-Based Tobacco Control Programs Page 2

Part I. Overview Information

At www.grants.gov, applicants will find “Send Me Change Notifications Emails” link on the announcement’s synopsis page. To ensure applicants receive notifications of any changes to DP15-1509, National State-Based Tobacco Control Programs, they 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)

B. Funding Opportunity Title:

National State-Based Tobacco Control Programs

C. Announcement Type: New—Type 1

This announcement is only for non-research domestic activities supported by CDC. If research is proposed, the application will not be considered. Research for this purpose is defined at http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf.

D. Agency Funding Opportunity Number:

CDC-RFA-DP15-1509

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

93.305 - National State-Based Tobacco Control Programs

F. Dates:

1. Letter of Intent Deadline: A Letter of Intent is not required, but is encouraged for those applying for the Competitive Component.

Monday, September 29, 2014, 11:59 p.m. U.S. Eastern Standard Time

2. Application Deadline:

Monday, December 1, 2014, 11:59 p.m. U.S. Eastern Standard Time, on www.grants.gov

3. Informational conference call/webinar for potential applicants:

CDC will conduct three conference calls/webinars for all interested applicants to provide technical assistance and respond to any questions regarding this Funding Opportunity Announcement.

Conference Call/Webinar Number 1: Tuesday, September 16, 2014, 10:00AM – 11:00AM, U.S.

Eastern Daylight Time.

Conference Call/Webinar Number 2: Wednesday, September 17, 2014, 3:30PM-4:30PM, U.S.

Eastern Daylight Time.

Conference Call/Webinar Number 3: Thursday, September 25, 2014, 2:00PM-3:00PM U.S.

Eastern Daylight Time

The conference call number and link for all three webinars is below:

http://www.grants.gov/ http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://www.cdc.gov/od/science/integrity/docs/cdc-policy-distinguishing-public-health-research-nonresearch.pdf http://intranet.cdc.gov/od/oadpg/docs/Www.Grants.gov

DP15-1509, National State-Based Tobacco Control Programs Page 3

A Bona Fide Agent is an agency/organization identified by the state as eligible to submit an application under the state eligibility in lieu of a state application. If applying as a bona fide agent of a state or local government, a legal, binding agreement from the state or local government as documentation of the status is required.

Toll-free: +1 (877) 907-9887 Participant code: 31703877 Join the meeting

In addition, a list of Frequently Asked Questions will be available at http://www.cdc.gov/tobacco/osh/foa/state_based/. Please submit questions related to this FOA to mailbox dp151509@cdc.gov.

G. Executive Summary:

1. Summary Paragraph:

The CDC, Office on Smoking and Health (OSH) announces the availability of Fiscal Year 2015 funds to implement DP15-1509, National State-Based Tobacco Control Programs.

This FOA supports the implementation of evidence-based environmental, policy, and systems interventions, strategies, and activities to reduce tobacco use, secondhand smoke (SHS) exposure, tobacco-related disparities and associated disease, disability, and death.

There are two components to this FOA:

Core Component – State-Based Tobacco Control Programs will be awarded to state health departments in all 50 states and the District of Columbia if a technically acceptable application proposing to implement a state-based tobacco control program using an evidence-based, comprehensive approach is submitted. Approximately $58 million per year is available.

Competitive Component - Advancing Evidence-Based Tobacco Control is competitive and will be awarded to four to seven applicants for 2-year project periods. State health departments in all 50 states and the District of Columbia are eligible to apply if they meet specific criteria outlined in this FOA. The Competitive Component seeks to advance evidence-based tobacco control through developing, implementing, and evaluating innovative and/or promising practices. Approximately $3 million per year is available.

a. Eligible Applicants: Limited – State and District of Columbia health departments or their Bona Fide Agents1. (NOTE: The Commonwealth of Puerto Rico, Virgin Islands, Commonwealth of the Northern Marianna Islands, American Samoa, Guam, Federated States of Micronesia, Republic of the Marshall Islands, and Republic of Palau are funded through another FOA, CDC-RFA-DP14-1406, thus are ineligible).

b. FOA Type: Cooperative agreement

c. Approximate Number of Awards:

https://www307.livemeeting.com/cc/cdc/join?id=MCF6CR&role=attend&pw=6nzCz%23MW8 https://www307.livemeeting.com/cc/cdc/join?id=MCF6CR&role=attend&pw=6nzCz%23MW8 http://www.cdc.gov/tobacco/osh/foa/state_based/

DP15-1509, National State-Based Tobacco Control Programs Page 4

Part II. Full Text

Core Component: 51 Competitive Component: 4 to 7

d. Total Project Period Funding: $305 million for 5 years, subject to availability of funding, including direct and/or indirect costs.

e. Average One Year Award Amount:

Core Component: $1 million Competitive Component: $500,000

f. Number of Years of Award:

Core Component: 5-year project period Competitive Component: Two, 2-year project periods

g. Approximate Date When Awards will be Announced: March 30, 2015

h. Cost Sharing and /or Matching Requirements:

Cost sharing is encouraged if it helps to leverage federal and state resources, is responsive to stated CDC recipient activities, is advantageous to chronic disease prevention and health promotion programs, supports the four National Tobacco Control Program goals, focuses on evidence-based interventions, strategies, and activities outlined in CDC’s Best Practices for Comprehensive Tobacco Control Programs - 2014 and the Community Preventive Services Task Force’s Guide for Community Preventive Services, does not compromise the integrity or the ability of the tobacco control program to accomplish proposed activities. Matching funds are not required under this cooperative agreement, but are encouraged.

A. Funding Opportunity Description

1. Background This FOA supports the implementation of evidence-based environmental, policy, and systems interventions, strategies, and activities to reduce tobacco use, secondhand smoke (SHS) exposure, tobacco-related disparities and associated disease, disability, and death. This FOA aligns with CDC’s Best Practices for Comprehensive Tobacco Control Programs - 2014 (Best Practices - 2014), the Community Preventive Services Task Force’s Guide for Community Preventive Services (Community Guide), the 2014 Surgeon General’s Report: The Health Consequences of Smoking-50 Years of Progress (SGR – 2014) and the National Center for Chronic Disease Prevention and Health Promotion’s (NCCDPHP) four domains to prevent and reduce chronic diseases and promote health. The NTCP aims to achieve four national goals (1) prevent initiation of tobacco use among youth and young adults; (2) promote quitting among adults and youth; (3) eliminate exposure to secondhand smoke, and (4) identify and eliminate tobacco-related disparities among population groups. These goals can be achieved through implementation of a state-based tobacco control program that supports state and community interventions, mass-reach health communication interventions, cessation interventions, surveillance and evaluation, and infrastructure, administration, and management. The goals of the NTCP complement the NCCDPHP four domains to reduce chronic diseases and promote health (Epidemiology and Surveillance; Environmental Approaches that Promote Health and Support and Reinforce Healthful Behaviors; Health System Interventions; and Community-http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm http://www.thecommunityguide.org/tobacco/index.html http://www.thecommunityguide.org/tobacco/index.html

DP15-1509, National State-Based Tobacco Control Programs Page 5

Clinical Links). State department of health chronic disease prevention and health promotion programs are stakeholders and partners in tobacco control. This award may be used to support interventions, strategies, and activities to address state tobacco control priorities as described in the state chronic disease prevention and health promotion plan provided that interventions, strategies, and activities are consistent with the evidence-base defined in CDC’s Best Practices - 2014 and the Community Guide and support achieving the four NTCP goals.

Based on current science, the most effective interventions for tobacco control are population-based environmental, policy and systems approaches that contribute to changes in social norms and behaviors related to tobacco use and SHS exposure. In order to have the greatest population impact, these evidence-based interventions must be sustained for a sufficient amount of time at the appropriate intensity and have the greatest span (economic, regulatory, and comprehensive) and reach. Research has demonstrated that the more states spend on comprehensive tobacco control programs, the greater the reductions in smoking, and that the longer states invest in such programs, the greater and faster the impact.

CDC recommended evidence-based interventions, strategies, recommendations, and guidance for comprehensive state based tobacco control programs are located in the following publications:

CDC’s Best Practices for Comprehensive Tobacco Control Programs – 2014

The Community Preventive Services Task Force’s Guide for Community Preventive Services

The 2014 Surgeon General’s Report: The Health Consequences of Smoking-50 Years of Progress

The 2012 Surgeon General’s Report: Preventing Tobacco Use Among Youth and Young Adults

The Institute of Medicines’ Ending the Tobacco Problem – A Blueprint for the Nation

CDC’s Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs

a. Statutory Authorities: This program is authorized under section 317(k)(2) of the Public Health Service Act, 42 U.S.C. 247b(k)(2), Comprehensive Smoking Education Act of 1984, and Comprehensive Smokeless Tobacco Health Education Act of 1986.

b. Healthy People 2020:

This program relates to the Tobacco Use focus area objectives of Healthy People 2020.

c. Other National Public Health Priorities and Strategies:

This program supports the Government Performance Results Modernization Act long term objective to reduce death and disability due to tobacco and CDC’s Winnable Battles.

d. Relevant Work:

This FOA continues to support efforts since 1999 to build state health department infrastructure and capacity to implement comprehensive tobacco control programs. This FOA replaces the tobacco control component of cooperative agreements DP09-901 and DP14-1415, Collaborative Chronic Disease, Health Promotion, and Surveillance Program Announcement:

Healthy Communities, Tobacco Control, Diabetes Prevention and Control, and Behavioral Risk http://www.cdc.gov/tobacco/osh/foa/state_based/ http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm http://www.thecommunityguide.org/tobacco/index.html http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm http://www.thecommunityguide.org/tobacco/index.html http://www.thecommunityguide.org/tobacco/index.html http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/ http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/ http://www.cdc.gov/tobacco/data_statistics/sgr/2012/ http://www.cdc.gov/tobacco/data_statistics/sgr/2012/ http://www.nap.edu/catalog.php?record_id=11795 http://www.cdc.gov/tobacco/tobacco_control_programs/surveillance_evaluation/key_outcome/ http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=41 http://www.cdc.gov/winnablebattles/tobacco/index.html

DP15-1509, National State-Based Tobacco Control Programs Page 6

Factor Surveillance System.

2. CDC Project Description

a. Approach: See Logic Model below.

DP15-1509, National State Based Tobacco Control Programs Page 7

National State-Based Tobacco Control Programs Logic Model

Inputs: CDC funding, training, technical assistance, and consultation on evidence-based strategies and activities, surveillance and epidemiology, and program evaluation

Evidence-Based Strategies and Activities Short-Term Outcomes (Years 1 – 2) Intermediate Outcomes (Years 2 – 4) Long Term Outcomes (Year 5)

State and Community Interventions

- Engage partners, mobilize communities, and develop coalitions

- Coordinate and collaborate across programs, agencies, and stakeholder groups

- Inform and educate leaders, decision makers and the public

- Strengthen community-based organization capacity

- Implement/support evidence based, culturally appropriate state/local interventions

Mass-Reach Health Communication Interventions

- Plan, implement, and evaluate health communication and counter-marketing campaigns

- Support media engagement efforts

- Expand, leverage and localize CDC media campaigns, Surgeon General Reports, and other science/evidence-based publications

Cessation Interventions

- Promote health systems change

- Educate decision makers about the benefits of comprehensive insurance coverage and evidence-based cessation treatments

- Maintain a state quitline/support state quitline capacity

Surveillance and Evaluation

- Develop an evaluation plan

- Collect, analyze and disseminate state and community-specific data

- Use data to identify disparate populations and inform public health action

- Monitor pro-tobacco influences and inform and educate leaders, decision makers and the public

- Develop/submit success stories and evaluation reports

Infrastructure, Administration and Management

- Develop and maintain infrastructure aligned with the five core components of the Component Model of Infrastructure (networked partnerships, multilevel leadership, engaged data, managed resources, responsive planning)

- Provide ongoing training and technical assistance

- Award and monitor subrecipient contracts and grants

- Develop and maintain a fiscal management system

Increased public-private partnerships addressing tobacco control, tobacco-related disparities and health equity

Increased public and decision-maker knowledge about the dangers of tobacco use, exposure to SHS, and tobacco-related disparities

Increased public and decision-maker awareness of effective tobacco control interventions, strategies and social norm change

Increased implementation and enforcement of interventions and strategies to support quitting, reduce exposure to SHS, and decrease access and availability of tobacco products

Increased health communication interventions and messages to reach populations disproportionately affected by tobacco use, exposure to SHS, and tobacco-related disparities

Increased health care system changes to promote and support cessation

Increased public awareness/support/awareness of actions to increase access to and utilization of evidence-based cessation treatments

Increased capacity to collect, analyze, and disseminate data related to tobacco-related disparities and health equity

Increased or maintained state health department infrastructure and capacity to support a state-based tobacco control program

Decreased exposure to pro-tobacco messages and availability of tobacco products

Increased awareness of pro-tobacco influence

Decreased susceptibility to experimentation with tobacco products

Increased public compliance with tobacco control policies

Increased coverage by and utilization of comprehensive insurance coverage for evidence-based tobacco cessation treatments

Increased quit attempts among current tobacco users

Increased successful cessation among current tobacco users

Increased development of innovative and/or promising practices that contribute to the tobacco control evidence-base

Increased implementation of evidence-based interventions and strategies that address vulnerable and underserved populations

NTCP Goal 1: Decreased initiation of tobacco use among youth and young adults

NTCP Goal 2: Decreased exposure to

SHS

NTCP Goal 3: Decreased tobacco use among adults and youth

NTCP Goal 4: Decreased tobacco-related disparities

*Bolded text indicate outcomes awardees will be held accountable for.

DP15-1509, National State Based Tobacco Control Programs Page 8

i. Problem Statement:

Tobacco use remains the leading preventable cause of death and disease in the United States resulting in more deaths annually than HIV/AIDS, alcohol use, cocaine use, heroin use, homicides, suicides, motor vehicle crashes, and fires combined. Each year, approximately 480,000 people die from smoking or exposure to SHS and another 16 million suffer from serious smoking-related illnesses. For every person who dies from smoking or exposure to SHS, 30 more people suffer with at least one serious smoking-related illness. Moreover, annual costs associated with tobacco-related illness amount to nearly $280 billion in medical expenses and lost productivity. Cigarette smoking causes numerous types of cancer, respiratory and cardiovascular diseases, diabetes, eye disease, complications to pregnancy and reproduction, and comprises the immune system. The burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products;

rapid elimination of their use will dramatically reduce this burden. If current trends continue, the national Healthy People 2020 objective to reduce cigarette smoking prevalence to 12% will not be met.

ii. Purpose:

The purpose of the FOA is to provide funding support, technical assistance, and guidance in collaboration with state health departments and their state and community partners to establish and maintain sufficient tobacco control program capacity to achieve the four NTCP goals using population-based environmental, policy, and systems interventions and strategies demonstrated to effectively impact the tobacco epidemic.

iii. Outcomes:

Short Term Outcomes

Increased public-private partnerships addressing tobacco control, tobacco-related disparities and health equity

Increased public and decision-maker knowledge about the dangers of tobacco use, exposure to SHS, and tobacco-related disparities

Increased public and decision-maker awareness of effective tobacco control interventions, strategies and social norm change

Increased implementation and enforcement of interventions and strategies to support quitting, reduce exposure to SHS, and decrease access and availability of tobacco products

Increased health communication interventions and messages to reach populations disproportionately affected by tobacco use, exposure to SHS, and tobacco-related disparities

Increased health care system changes to promote and support cessation

Increased public awareness/support/awareness of actions to increase access to and utilization of evidence-based cessation treatments

Increased capacity to collect, analyze, and disseminate data related to tobacco-related disparities and health equity http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=41

DP15-1509, National State-Based Tobacco Control Programs Page 9

Increased or maintained state health department infrastructure and capacity to support a state-based tobacco control program

Intermediate Outcomes

Decreased exposure to pro-tobacco messages and availability of tobacco products

Increased awareness of pro-tobacco influence

Decreased susceptibility to experimentation with tobacco products

Increased public compliance with tobacco control policies

Increased coverage by and utilization of comprehensive insurance coverage for evidence-based tobacco cessation treatments

Increased quit attempts among current tobacco users

Increased successful cessation among current tobacco users

Increased development of innovative and/or promising practices that contribute to the tobacco control evidence-base

Increased implementation of evidence-based interventions and strategies that address vulnerable and underserved populations

Long-Term Outcomes

Decreased initiation of tobacco use among youth and young adults

Decreased exposure to SHS

Decreased tobacco use among adults and youth

Decreased tobacco-related disparities

iv. Funding Strategy:

There are two components to this FOA:

The Core Component will be awarded to state health departments in all 50 states and the District of Columbia if a technically acceptable application proposing to implement an evidence-based state tobacco control program is submitted. The Core Component supports CDC’s Best Practices – 2014 recommendations that states establish and sustain comprehensive tobacco control programs that contain the following overarching components to reduce tobacco use, exposure to SHS, tobacco related disparities, and associated disease, disability, and death: (1) State and community interventions, (2) Mass-reach health communication interventions, (3) Cessation interventions, (4) Surveillance and evaluation, and (5) Infrastructure, administration and management. These elements will be supported by core public health activities such as partner engagement, coordination and collaboration, strategic planning, workforce development, training and technical assistance, and promoting health equity. Approximately $58 million per year is available. Core Component applications will be objectively reviewed and scored. The project period for the Core Component is 5 years, with a 12-month budget period and an anticipated start date of March 30, 2015.

The Competitive Component seeks to advance evidence-based tobacco control through http://www.cdc.gov/tobacco/stateandcommunity/best_practices/index.htm

DP15-1509, National State-Based Tobacco Control Programs Page 10 designing, implementing and evaluating innovative and/or promising practices and will be awarded to four to seven applicants. Applicants can apply for the Competitive Component if they meet the following criteria:

Had a state smoking prevalence rate <19% in calendar year 2012

Have a full-time tobacco control program manager

Have dedicated state funding for the state tobacco control program

Proof of published program evaluation results for cooperative agreements DP09-901 or

DP14-1415

Have an active statewide coalition, advisory board, or other tobacco control entity that brings external partners together with the state department of health in addressing tobacco control issues

Capacity to conduct tobacco control program evaluation

Capacity to conduct tobacco control surveillance

Awardees of the Competitive Component are expected to collaborate with each other and CDC to maximize opportunities for coordination and leveraging resources to avoid duplication. State health departments awarded the Competitive Component will implement and rigorously evaluate innovative and/or promising practices in partnership with organizations that may or may not have worked with state health departments in the past (e.g. not-for-profit organizations, law enforcement, economists, business sector, governmental fiscal management offices, researchers, CDC funded National Networks, and other key organizations necessary to change the dynamic for reducing tobacco use). Examples of innovative and/or promising practices include those aimed at the retail environment, point-of-sale, dual use of tobacco products, new tobacco products, and other relevant emerging areas of tobacco control consistent with applicable federal laws. Approximately $3 million per year is available.

Competitive Component applications will be objectively reviewed and scored. There will be a second opportunity for all Core Component awardees to compete for the Competitive Component during the Year 3 application period. The project period for the Competitive Component is two-years (First Round FY 2015 – FY 2017) (Second Round FY2018 – FY 2020) with a 12-month budget period and an anticipated start date of March 30, 2015.

Anticipated Funding Range for the Core Component Approximately $58 million is available for fiscal year 2015 to fund 51 awards to state-based tobacco control programs. State and District of Columbia departments of health will be able to apply for funding in the ranges listed below, with an average award of $1 million.

These funding ranges were derived from the following funding formula - [Base ($500,000 + Weighted Proportion of Metrics] of two factors (number of smokers and level of poverty) from CDC’s Best Practices - 2014. The final award amount will be based on the technical merit and quality of the application (using evaluation criteria scores.

The table below provides guidance related to the minimum and maximum amount of funding

DP15-1509, National State-Based Tobacco Control Programs Page 11 available for the Core Component.

State Floor of Award Ceiling of Award

Alabama $933,284 $1,366,605

Alaska $658,418 $987,628

Arizona $931,452 $1,364,315

Arkansas $887,842 $1,309,803

California $1,748,060 $2,385,075

Colorado $826,415 $1,233,019

Connecticut $715,961 $1,073,941

Delaware $684,184 $1,026,276

District of Columbia $699,280 $1,048,920

Florida $1,461,746 $2,027,182

Georgia $1,139,101 $1,623,876

Hawaii $686,073 $1,029,109

Idaho $763,286 $1,144,928

Illinois $1,193,934 $1,692,417

Indiana $1,020,612 $1,475,765

Iowa $749,824 $1,124,736

Kansas $776,486 $1,164,730

Kentucky $990,042 $1,437,553

Louisiana $967,501 $1,409,376

Maine $703,104 $1,054,656

Maryland $790,332 $1,185,498

Massachusetts $851,081 $1,263,851

Michigan $1,177,875 $1,672,344

Minnesota $821,118 $1,226,397

Mississippi $871,815 $1,289,769

Missouri $992,680 $1,440,850

Montana $751,206 $1,126,808

Nebraska $686,744 $1,030,116

Nevada $803,558 $1,204,448

New Hampshire $605,921 $908,881

New Jersey $948,186 $1,385,233

New Mexico $813,119 $1,216,399

New York $1,380,531 $1,925,664

North Carolina $1,138,846 $1,623,558

North Dakota $611,072 $916,608

Ohio $1,274,118 $1,792,648

Oklahoma $872,258 $1,290,323

Oregon $815,634 $1,219,543

DP15-1509, National State-Based Tobacco Control Programs Page 12

Pennsylvania $1,261,458 $1,776,823

Rhode Island $693,362 $1,040,042

South Carolina $947,603 $1,384,504

South Dakota $696,734 $1,045,100

Tennessee $1,052,654 $1,515,817

Texas $1,710,171 $2,337,714

Utah $716,064 $1,074,096

Vermont $640,585 $960,877

Virginia $946,289 $1,382,861

Washington $918,846 $1,348,558

West Virginia $825,367 $1,231,709

Wisconsin $892,397 $1,315,496

Wyoming $661,393 $992,089

v. Strategies and Activities:

Core Component Awarded applicants are required to implement the five overarching areas of tobacco control outlined in CDC’s Best Practices - 2014, but have flexibility in selecting evidence-based strategies and activities as long as they aren’t linked to specific outcomes required under this cooperative agreement (e.g., strategic plan, communication plan, and sustainability plan, success stories, etc.)

State and Community Interventions

Establish statewide programs that support and/or facilitate tobacco prevention and control partnership and coalition development, as well as links to other related partnerships and coalitions (e.g., cancer control, cardiovascular disease, diabetes, asthma)

Establish a strategic plan for comprehensive tobacco control with appropriate partners at the state and community levels

Educate state leaders, decision-makers, and the public about the burden of tobacco use and evidence-based policy and other strategies to reduce this burden

Engage stakeholders and partners on approaches, such as message development and messengers, to reach populations with the greatest disparities in tobacco use

Collect, disseminate, and analyze state and community-specific data

Develop and implement culturally appropriate interventions with appropriate multicultural involvement

Sponsor community, regional, and statewide trainings, conferences, and technical assistance on best practices for effective tobacco use prevention and cessation programs

Monitor pro-tobacco influences to facilitate public discussion and debate among partners, decision makers, and other stakeholders at the state and community level

DP15-1509, National State-Based Tobacco Control Programs Page 13

Support new ways of implementing evidence-based interventions and strategies to address unique characteristics of the communities where the interventions are being implemented

Provide support to community-based organizations in order to strengthen the capacity of these groups to positively inform social norms regarding tobacco use

Build relationships among multiple sectors of the community, such as housing, education, business, planning, and transport

Empower local agencies to build community coalitions and partnerships that facilitate collaboration among programs in local governments, voluntary and civic organizations, and diverse community-based organizations

Collaborate with partners and other programs to implement evidence-based interventions and build and sustain capacity through technical assistance and training;

Support community strategies or efforts to educate the public and media, not only about the health effects of tobacco use and exposure to SHS, but also about available cessation services

Promote public discussion among partners, decision makers, and other stakeholders about tobacco-related health issues and pro-tobacco influences

Establish community strategic plans of action that are consistent with the comprehensive state tobacco control plan

Ensure that community grantees measure and evaluate social norm change outcomes (e.g., policy adoption, increased compliance) resulting from their interventions

Ensure that partners receiving funding for tobacco control from various entities work collaboratively

Mass-Reach Health Communication Interventions

Deliver evidence-based, strategic, culturally appropriate, high-impact messages through sustained and adequately funded health communication campaigns and counter-marketing strategies

Raise awareness, educate the public and decision-makers, promote cessation, increase prevention, increase protection from SHS and address the impact of tobacco use on others using hard-hitting, emotionally evocative messaging

Use a broad range of channels to effectively reach target audiences, such as paid television, radio, billboard, print, Web, digital, and social media, as appropriate

Ensure counter-marketing and other media has sufficient reach, frequency and duration

Conduct formative, process, and outcome evaluation of health communication interventions

Support and leverage CDC’s national tobacco education campaigns and Surgeon General Reports about tobacco at the state and community level

DP15-1509, National State-Based Tobacco Control Programs Page 14

Review and consider effective campaigns housed in the CDC’s Media Campaign Resource Center (MCRC) previously created by other states and partners

Cessation Interventions

Sustain or improve existing evidence-based state quitline services that increase quit attempts and successful cessation among adults and young people

Expand efforts to promote the use of the quitline and expand its reach, including among populations with especially high tobacco use rates

Inform and educate the private and public healthcare systems , health insurers, and employers about how quitting smoking reduces tobacco-related disease and death, and health care costs

Address and/or reduce barriers in order to provide seamless language services and promotion of existing culturally and linguistically appropriate federal resources such as the Spanish Quitline Portal 1-855-DEJELO-YA (1-855-335-3569) and the Asian Quitline .

Increase collaborations with healthcare systems and providers

Maintain active membership in the North American Quitline Consortium

Collect the Minimum Data Set, as defined by the North American Quitline Consortium

Participate in the CDC, OSH, National Quitline Data Warehouse (NQDW) (i.e., quarterly reporting of intake data on quitline callers and information on services provided through the NQDW Online Services Survey

Participate in continuing education activities related to quitline operations and evaluation

Evaluate the state quitline

Surveillance and Evaluation

Establish a surveillance and evaluation system designed to monitor and document key short-term, intermediate, and long-term outcomes within populations

Collect data on tobacco use behaviors and other key risk factors and health outcomes using Behavioral Risk Factor Surveillance System (BRFSS), Youth Risk Behavior Surveillance System (YRBSS), Pregnancy Risk Assessment Monitoring System (PRAMS), and the Adult or Youth Tobacco Surveys (ATS/YTS)

Work in partnership with universities, Prevention Research Centers (PRCs), and other research institutions as appropriate to tap into existing expertise in surveillance and evaluation

Develop and implement a written evaluation plan for the tobacco control program

Conduct evaluations designed to inform and engage stakeholders, including members of the target population, at each step, including planning, implementation, interpretation, dissemination, and use of results http://www.asiansmokersquitline.org/

DP15-1509, National State-Based Tobacco Control Programs Page 15

Develop key questions to be answered by the evaluation of the program

Conduct evaluation activities consistent with CDC’s Framework for Evaluation

Identify credible evidence and verify its accuracy and appropriateness with stakeholders

Use surveillance data to monitor programmatic state and local progress toward program objectives

Communicate evaluation findings and lessons learned to stakeholders

Infrastructure, Administration and Management Networked Partnerships

Maintain active strategic partnerships and established communication systems at the state and community level that support the achievement of the four NTCP goals.

Partnerships may include state and local organizations, tribes, tribal organizations, and Tribal Support Centers, National Networks for Tobacco Control and Prevention, organizational members of the Funders Alliance for State-Based Tobacco Prevention and Control Programs, organizations serving populations disproportionately affected by tobacco use, exposure to SHS, and tobacco-related diseases, organizations that represent diverse communities, voluntary health organizations, educational institutions, housing and education authorities, private and business sector, local health departments, community-based organizations, the private and business sector, state and local coalitions, commissions, and advisory groups.

Multilevel Leadership

Identify and nurture leaders and champions at all levels. This includes leadership above the tobacco control program in the state health department or other organizational units where the tobacco control program is located; leadership within the tobacco control program beyond the program manager; leadership in local health departments and boards of health; leadership among partners and other chronic disease areas;

leadership in local programs, and leadership in groups outside of public health.

Engaged Data

Collect, analyze, and use data from a variety of viewpoints and multiple stakeholders for the purposes of program planning, implementing and evaluating

Use data in a manner that engages staff, leadership, partners, decision makers, and local programs to act

Use data to promote public health goal

Share data and experiences to facilitate dissemination of new promising practices

Managed Resources

Ensure an adequate number of diverse and qualified staff and partners are available to effectively implement the tobacco control program. A full-time program manager to http://www.cdc.gov/eval/framework/index.htm

DP15-1509, National State-Based Tobacco Control Programs Page 16 administer the program is required. In addition to a full-time program manager, ideal staffing levels include a policy coordinator, communication specialist, cessation coordinator, surveillance and evaluation staff, fiscal management systems staff, and administrative staff.

Implement a training and technical assistance process to address the needs of state and local health department staff, coalitions, and partners involved in tobacco prevention and control activities.

Responsive Plans/Planning Develop plans in collaboration with partners that are dynamic and evolve in response to contextual influences, such as changes in scientific evidence, priorities, funding levels, and external support. Awarded applicants will develop the following plans:

a. Comprehensive State Tobacco Control Plans: Awarded applicants will develop a five-year comprehensive state tobacco control plan or update an existing multi-year plan that aligns with or builds upon the state chronic disease and health promotion plan and spans the proposed funding cycle with active participation of a diverse group of stakeholders. The plan should outline the overall goals, objectives, activities, and evidence-based interventions and strategies for tobacco control in the state. The comprehensive state tobacco control plan should be based on data from state health department surveillance systems and other data gathering efforts, including an environmental scan; outline, and provide justification for all major tobacco control outcome objectives to be addressed over the term of the plan; serve as a framework for decisions on annual programmatic direction; provide a foundation for the development of annual work plans that include appropriate evidence-based interventions and strategies that support the outcome objectives identified in the plan; identify and provide support for addressing areas of tobacco-related disparities and health equity; incorporate sustainability measures from the state sustainability plan, if applicable; assist in benchmarking and performance monitoring; complement other state chronic disease prevention and health promotion plans to reduce tobacco-related diseases; stimulate change; and include a schedule for annual review of the plan to revise programmatic direction as appropriate.

b. Sustainability Plan: Awarded applicants will develop a plan to ensure funding sustainability and maintaining a state based tobacco control program. This plan is to be developed with partners from multiple sectors, including the private sector with a goal of maintaining or increasing funding for the comprehensive state tobacco control program and sustaining programmatic accomplishments. State tobacco control programs and their partners should increase leadership and other decision-makers’ knowledge, awareness, and support of tobacco control; build and maintain relationships with the media to increase public support for tobacco control; identify strategies to increase public knowledge of the health and economic burden of tobacco use and exposure to SHS based on state data, evaluation reports, personal stories and testimonials; demonstrate the return on investment and the importance of a well-funded tobacco control program; convene partners on a regular basis to identify new relationships and

DP15-1509, National State-Based Tobacco Control Programs Page 17 outlets for informing the public and decision-makers about tobacco use, exposure to SHS, tobacco-related disparities, and to pro-tobacco practices that disproportionately affect vulnerable and underserved populations.

C. Health Communication Plan: Awarded applicants will develop a health communication plan to educate leaders, decision-makers and the public about the dangers of tobacco use, the dangers of exposure to SHS, and available cessation support and resources.

Benchmarks The following list of benchmarks are key milestones for maintaining a functioning program infrastructure. Awardees will work with CDC annually to provide evidence of infrastructure components and context for tobacco control using the CDC defined reporting system.

Benchmarks for Core Component Frequency of Reporting to CDC

Evidence state health officer and other senior state health department management involvement in the tobacco control program

Annually

Evidence of written success story Annually

Evidence of an annual work plan that addresses 5-year outcome measures

Annually

Evidence of executed sustainability plan and activities

Annually

Evidence of an approved mass-reach health communications plan to educate leaders, decision-makers, and the public about the dangers of tobacco use, the dangers of exposure to SHS, and available cessation support and resources

Annually

Evidence that the state health department has dedicated human resources to administer and manage the tobacco control program effectively

Annually

Evidence of the provision of ongoing training for staff through participation in CDC sponsored training, meetings, conferences and other continuing education opportunities as identified by state health department program staff

Annually

Evidence that training and technical assistance needs have been assessed and provided by the program to state and local health department staff, coalition members, and partners statewide

Annually

Evidence of use of funding to support Annually

DP15-1509, National State-Based Tobacco Control Programs Page 18 environmental, policy, and systems interventions and strategies that are evidence-based and reach populations disproportionately affected by tobacco use, exposure to SHS and tobacco-related diseases

Evidence of on-time submission of Federal Financial Reports

Annually

Evidence of increased community networks and community-based organizations and individuals who have been affected by tobacco use to educate the community’s decision makers and leaders

Annually

Evidence of identifying and training tobacco control spokespersons for each Designated Market Area

(DMA)

Annually

Evidence of participating in the CDC, OSH, NQDW (i.e., quarterly reporting of intake data on quitline callers and information on services provided through the NQDW Online Services Survey)

Annually

Evidence of monitoring the percentage of population covered by state and local comprehensive smoke-free indoor air laws covering worksites, bars and restaurants

Annually

Evidence of monitoring the percentage of public housing authorities with 100% smoke-free indoor air policies

Annually

Evidence of monitoring the percentage of public mental health and substance abuse facilities with tobacco–free policies for their campuses

Annually

Evidence of participation with CDC defined evaluation technical advisor and CDC evaluation team to conduct evaluation activities (i.e. awardee-level evaluation and national-level evaluation)

Annually

Evidence of a five-year, evidence-based and data-supported comprehensive state tobacco control plan

Year 1

Evidence of an evaluation report reflecting program infrastructure (as defined by the CMI), process measures, outputs, outcomes, and impacts

Year 3 and Year 5

DP15-1509, National State-Based Tobacco Control Programs Page 19

The Competitive Component seeks to advance evidence-based tobacco control.

Awarded applicants will:

Design, implement and rigorously evaluate innovative and/or promising practices in tobacco control.

Collaborate with each other and CDC to maximize opportunities for coordination and leveraging resources to avoid duplication.

Partner with organizations such as not-for-profit organizations, economists, business sector, governmental fiscal management offices, researchers, CDC funded National Networks for Tobacco Control and Prevention, other key organizations and law enforcement.

1. Collaborations

a. With CDC funded programs:

Required Collaborations: Awarded applicants are required to collaborate with CDC and relevant CDC funded programs. Partnerships include CDC funded programs within state health department chronic disease prevention and health promotion programs, CDC funded programs conducting tobacco control activities at the community level, and CDC funded surveillance programs responsible for collecting, analyzing, and disseminating risk factor and tobacco-related disease, death, and disability data. Working with partners includes building capacity through training, technical assistance and consultation, as well as collaboration on implementing evidence-based interventions and strategies. Collaborative activities under this FOA should align with state tobacco control priorities as described in the comprehensive state tobacco control plan and state chronic disease and health promotion plan, be consistent with CDC’s Best Practice - 2014 and the Community Guide, and support the four NTCP goal areas.

Optional Collaborations: Awarded applicants may partner with other public health programs such as asthma, environmental health, HIV, TB, maternal and child health, and other related programs.

b. With organizations external to CDC:

Required Collaborations: Awarded applicants are required to collaborate with local health departments, organizations representing specific subgroups experiencing tobacco-related disparities within their respective populations, tribes and organizations that represent tribes, Tribal Support Centers, and members of the Funders Alliance for State-Based Tobacco Prevention and Control Programs within their state. Applicants must submit Letters of Support from specific tribes they plan on collaborating with.

Optional Collaborations: Awarded applicants may partner with state and local organizations, voluntary health organizations, educational institutions, multi-sector partners such as housing, business, and education, community-based organizations, other state agencies, statewide and local coalitions, and boards, commissions, and advisory groups who have a stake in tobacco control.

2. Target Populations:

Awarded applicants of the Core Component and the Competitive Component will address http://www.thecommunityguide.org/tobacco/index.html

DP15-1509, National State-Based Tobacco Control Programs Page 20 populations disproportionately affected by tobacco use, exposure to SHS, and associated disease, disability, and death through the implementation of (1) State and community interventions, (2) Mass reach health communications, (3) Cessation interventions, (4) Surveillance and evaluation, and (5) Infrastructure, administration, and management.

Additional guidance addressing tobacco-related disparities and health equity can be found in CDC’s Best Practices – 2014 and A Practitioner’s Guide for Advancing Health Equity – Community Strategies for Preventing Chronic Disease.

Inclusion:

Awarded applicants must be inclusive of specific populations that are disproportionately affected by tobacco use, exposure to SHS, and associated disease, disability, and death.

Awarded applicants should be inclusive of populations experiencing tobacco-related disparities by age, disability/limitation, educational attainment, geographic location (e.g., rural/urban), income, mental health status, occupation, race/ethnicity, sex, sexual orientation and gender identity, substance abuse conditions, veteran and military status and other relevant dimensions (e.g., tribal communities) in all aspects of tobacco control.

b. Evaluation and Performance Measurement:

i. CDC Evaluation and Performance Measurement Strategy:

CDC will work with awarded applicants to accomplish two levels of evaluation, (1) awardee-level evaluation, and (2) national-level evaluation. Awardee-level evaluation will answer questions most important to each individual state health department tobacco control program, their context and need for information to inform program improvement and decision making.

The national-level evaluation will serve to synthesize information across awardees, facilitate informing improvements, render judgments as well as generate knowledge depending on which purpose(s) are chosen to guide the evaluation plan development. CDC will include the evaluation professional networking group and feedback groups as appropriate when developing evaluation plans, tools, and technical assistance. CDC will provide technical assistance if requested for the development of required evaluation reports.

In addition, CDC will:

Provide ongoing training, technical assistance and consultation on implementing evidence-based environmental, policy, and systems interventions and strategies for tobacco control

Collaborate with selected sites, such as the National Networks for Tobacco Control and Prevention, on the evaluation of innovative…