FOA_Content_CDC-RFA-DP-24-0139.pdf

Division of Adolescent and School Health (DASH)

Notice of Funding Opportunity

Application due April 1, 2024 - 11:59 p.m. ET

Improving Adolescent Health and Well- Being Through School-Based Surveillance and the What Works in Schools Program Opportunity number: CDC-RFA-DP-24-0139

Contents Before you begin 3

Step 1: Review the Opportunity 4

Basic information 5

Eligibility 8

Program description 10

Step 2: Get Ready to Apply 44

Register 45

Step 3: Prepare Your Application 47

Application contents and format 48

Step 4: Learn About Review and Award 56

Application review 57

Award notices 66

Step 5: Submit Your Application 67

Application submission and deadlines 68

Step 6: Learn What Happens After Award 71

Post-award requirements and administration 72

Contacts and Support 76

Agency contacts 77

Grants.gov 77

SAM.gov 77

Reference websites 77

Contents 2

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

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

See Step 2: Get Ready to Apply

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

See Step 2: Get Ready to Apply

Apply by April 1, 2024 Applications are due by 11:59 p.m. Eastern Time on April 1, 2024.

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

Jump to a step

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1:

Review the Opportunity

In this step

Basic information 5

Eligibility 8

Program description 10

Basic information Centers for Disease Control and Prevention (CDC)

National Center for Chronic Disease Prevention and Health Promotion

Division of Adolescent and School Health (DASH)

Using prevention strategies and data to improve the health and well-being of young people.

Key facts

Opportunity Name:

Improving Adolescent Health and Well-Being Through School-Based Surveillance and the What Works in Schools Program

Opportunity Number:

CDC-RFA-DP-24-0139

Federal Assistance Listing:

93.079

Key dates

Application deadline:

Monday, April 1, 2024 - 11:59 p.m. ET

Optional letter of intent deadline:

Friday, March 1, 2024

Informational webinar:

Tuesday, February 13, Expected award date:

Monday, July 15, 2024

Expected start date:

Thursday, August 1, Summary Schools are an ideal setting to foster healthy behaviors and to prevent and buffer the impact of adverse experiences. This NOFO aims to improve the health and well-being of youth by supporting local education agencies in implementing CDC’s What Works in Schools program, and collecting and using school-based surveillance data. The What Works in Schools program is a proven approach that builds schools’ capacity to:

• Provide quality health education

• Connect students to health services, including mental and behavioral health services

• Create safe and supportive environments

The program strategies have been linked to reductions in sexual risk behaviors, experiences of violence, and substance use, and improvements in mental health for students.

As adolescent mental health worsens, with some youth experiencing higher levels of violence, emotional distress, and suicidality, the population-level impact of this program is key for improving well-being and reducing disparities. Funding will also support the collection and use of school-based surveillance data. These data, collected through the Youth Risk Behavior Surveillance System (YRBSS) and School Health Profiles (Profiles), will help assess needs to improve adolescent health, track behaviors and experiences over time, and understand the impact of programs and policies.

Have questions?

See Contacts and support.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 5 https://www.cdc.gov/healthyyouth/whatworks/index.htm

This NOFO includes three components:

• Component 1: Local implementation of What Works in Schools and school-based surveillance

• Component 2: Consortia support of What Works in Schools and school-based surveillance

• Component 3: State, territorial, and tribal school-based surveillance

Definitions

• A local education agency is a school district. We will use school district throughout the rest of the NOFO.

• A consortium is a group of multiple school districts that border each other and have a designated lead district or organization responsible for organizing these districts.

Funding details Type: Cooperative agreement

Expected total program funding over the performance period: $77,500,000

Expected total program funding per budget period: $15,500,000

Expected awards: 88

Expected average award amount per budget period:

• Component 1: $300,000 for What Works in Schools implementation, $60,000 for school-based surveillance, and an optional $7,500 for the addition of Adverse Childhood Experiences (ACEs) questions to the Youth Risk Behavior Survey (YRBS).

• Component 2: $300,000 for What Works in Schools implementation, $60,000 for school-based surveillance, and an optional $7,500 for the addition of ACEs questions to YRBS.

• Component 3: $100,000 for school-based surveillance and an optional $12,500 for the addition of ACEs questions to YRBS.

We plan to make up to 88 awards for 12-month budget periods for the 5-year period of performance. We will award only 1 project per state under Component 3.

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

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 6 https://www.cdc.gov/violenceprevention/aces/index.html https://www.cdc.gov/violenceprevention/aces/index.html https://www.cdc.gov/violenceprevention/aces/index.html

Funding strategy Funding may differ based on demonstration of need such as burden data, reach of proposed activities, and availability of funds.

• Component 1: If funding allows, we intend to fund up to 35 organizations for Component 1.

• Component 2: If funding allows, we intend to fund up to 5 organizations for Component 2.

• Component 3: If funding allows, we intend to fund up to 50 states, 7 U.S.

territories, and 2 tribal nations for Component 3. We will fund only one Component 3 application per state, territory, or tribal nation.

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

Step 1: Review the Opportunity 7

Eligibility Who can apply

Eligible applicants Eligibility is unrestricted. Your organization may be any entity type, but you must meet the following requirements.

Other required qualifying factors (components 1 and 2 only)

Component 1 You must demonstrate:

• Legal authority and oversight for the policies and practices of your school district

• Your school district has at least 40,000 students

Component 2 You must demonstrate that you represent, as a fiscal agent and lead agency, a consortium made up of contiguous school districts. As fiscal agent and lead agency, you will be responsible for managing the financial and reporting duties on behalf of the consortium.

The lead agency must demonstrate that the consortium member school districts:

• Have the legal authority and oversight for the policies and practices of the school districts within their jurisdictions

• Have a combined student enrollment of at least 40,000 students

Districts can demonstrate this legal authority and oversight in the following ways:

• state, territorial, or local legislation

• a charter document

• a letter from the state or local superintendent

• a letter from the Governor’s office

Step 1: Review the Opportunity 8

Cost-sharing and matching funds This program has no cost-sharing requirement or matching funds requirement. If you choose to include cost-sharing funds as a contribution to the award, we won’t consider it during review of your application.

Step 1: Review the Opportunity 9

Program description Background Overview National data from 2011 to 2021 show mixed trends in the health and well-being of U.S. adolescents. While some health risks have decreased, some risk behaviors and experiences remain too common. Over the last decade, we have seen:

• A rise in depressive symptoms and suicidal thoughts and behaviors

• Concerning numbers of students using substances and experiencing violence

• A decline in protective sexual behaviors, including condom use

• Female and LGBTQ+ students experiencing higher levels of violence, substance use, poor mental health, and suicidality compared to their peers

• Varying disparities by racial and ethnic group. For example, Black and Hispanic students are more likely to miss school because of safety concerns, and Hispanic and multiracial students have higher rates of depressive symptoms.

The What Works in Schools program can positively impact adolescent behaviors and experiences. An evaluation of the program showed that students in schools where strategies were implemented were less likely to:

• Engage in sexual risk behaviors

• Use marijuana

• Miss school because of safety concerns

• Experience forced sex

• Have depressive symptoms and suicidal thoughts and behaviors

Related work This NOFO builds on the work of previous Division of Adolescent and School Health (DASH) NOFOs PS13-1308 and PS18-1807. It promotes the What Works in Schools program developed by DASH and supports collecting school-based surveillance through the Youth Risk Behavior Surveillance System and School Health Profiles.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 10 https://www.cdc.gov/healthyyouth/data/yrbs/pdf/YRBS_Data-Summary-Trends_Report2023_508.pdf https://pubmed.ncbi.nlm.nih.gov/34531096/ https://pubmed.ncbi.nlm.nih.gov/34935516/ https://www.grants.gov/search-results-detail/218715 https://www.grants.gov/search-results-detail/300663 https://www.cdc.gov/healthyyouth/whatworks/index.htm https://www.cdc.gov/healthyyouth/whatworks/index.htm https://www.cdc.gov/healthyyouth/data/yrbs/index.htm https://www.cdc.gov/healthyyouth/data/profiles/index.htm

Purpose

1. What Works in Schools Funding helps districts and schools implement the What Works in Schools program. This primary prevention approach aims to improve the behaviors and experiences of middle and high school students and reduce disparities in sexual risk behavior, substance use, experience of violence, poor mental health, and suicidality by supporting schools to:

• Deliver high-quality health education

• Increase access to needed health services, including behavioral and mental health services

• Create safe and supportive school environments

This approach also emphasizes:

• Reducing disparities in adolescent risk behaviors and experiences

• Fostering engagement with youth, families, and communities

2. School-based surveillance Funding supports the collection and use of surveillance data at the school district, state, territorial, and tribal levels. If awarded, you will conduct the Youth Risk Behavior Survey and School Health Profiles in your jurisdictions.

This NOFO achieves its two purposes with three components. You can only apply for one component. Choose the one that is most appropriate based on your reach and organization type. CDC requires a total enrollment of at least 40,000 students to help reach the largest number of students and maximize the impact of federal funds.

Component Recommended For

Component 1: Local implementation of What Works in Schools and school-based surveillance

School districts with a local reach and an enrollment of at least 40,000 students.

Component 2: Consortia support of What Works in Schools and school-based surveillance

School districts with a local reach and an enrollment of less than 40,000 students.

Component 3: State, territorial, and tribal school-based surveillance

Organizations with the capacity to conduct and use school-based surveillance at the state, territorial, or tribal level

Step 1: Review the Opportunity 11

Strategies, activities, and outcomes by component We know that many factors may affect your ability to implement all required activities. If there are state, territorial, tribal, or local policies or laws that prohibit specific required activities, you must describe in your application:

• Which activities are prohibited by policies or laws

• Alternative activities you will implement to achieve the outcomes in the logic model

Go to the applicable sections:

• Component 1

• Component 2

• Component 3

• Cross-component activities

Step 1: Review the Opportunity 12

Component 1: Local implementation of What Works in Schools and school-based surveillance

Approach The logic model shows the strategies and activities of the program along with the outcomes we expect over time. We will require you to report on the following outcomes indicated by an asterisk (*).

Strategies and Activities

Short-Term Outcomes Intermediate Outcomes Long-Term

Outcomes

Strategy 1A: Health education

• Implement a technical assistance plan and provide professional development to support delivery of quality health education

Strategy 1B: Health services

• Assess district and school capacity and implement a plan to increase access to school- and community-based services

Strategy 1C: Safe and supportive environments

• Foster safe and supportive school environments

• Support the mental health and well-being of students and staff

Teacher and staff knowledge, comfort, and skills to deliver health education*

Student access to health education instructional programs*

Student health-related knowledge, skills, and behaviors

Student and staff awareness of health services for students*

Staff awareness, knowledge, and skills for creating safe and supportive school environments*

Student participation in positive youth development approaches*

Student receipt of high-quality health education*

Student awareness of need for health services

Student receipt of health services*

District and school level policies and practices that support student access to health services, health education, and safe and supportive environments

District and school-level access to health services for students*

Partnerships to support student health outcomes*

Engagement of students, families, and communities in school programs

Student and staff perceptions of a safe and inclusive school environment*

Student and staff feelings of school connectedness*

Effective classroom management

Staff feelings of being supported by the school

Sexual health Sexual risk behaviors

Preventive behaviors that decrease risk for HIV, STD, and teen pregnancy

Violence

Experiences of violence

Mental health

Improved mental health

Suicidal thoughts and behaviors

Substance use

Use and misuse of alcohol and other drugs

Step 1: Review the Opportunity 13

Strategies and Activities

Short-Term Outcomes Intermediate Outcomes Long-Term

Outcomes

Strategy 1D: Family, school, and community engagement

• Establish a School Health Advisory Council (SHAC) and collaborations across the district

• Implement youth, family, school, and community engagement strategies

Strategy 1E: School-based surveillance

• Conduct Youth Risk Behavior Survey

• Conduct School Health Profiles

Student participation in safe and supportive school environment activities*

Staff participation in mental health and well-being activities*

Opportunities for student leadership in district and school decision-making*

School district awareness of youth risk behaviors and experiences and school health policies and practices

School district understanding of short-term trends in youth risk behaviors and experiences and of school health policies and practices*

Required strategies and activities The following required activities will help school districts implement the What Works in Schools program.

You must implement all activities at the secondary school level (grades 6 to

12) unless specified otherwise.

To reach as many middle and high school students as possible, you will implement each activity district-wide. Some activities are best implemented at the district level. Others are best implemented at the school level and must be implemented in secondary schools throughout the district.

Step 1: Review the Opportunity 14

Strategy 1A – Health education (HED)

You will implement a technical assistance plan and provide professional development to support the delivery of quality health education through the following activities:

• HED1. Develop, implement, and review a technical assistance plan. Its goal is to support and improve teacher and school staff’s knowledge, comfort, and skills for delivering health education to students in secondary grades (6 to 12). This includes sexual and mental health education.

• HED2. Each year, provide professional development for teachers and school staff delivering health education instructional programs to students in secondary grades (6 to 12). This includes sexual health and mental health education. Prioritize instructional competencies needed for culturally responsive and inclusive education.

• HED3. Each year, implement a health education instructional program for students in grades K to 12. Health education instructional programs should:

◦ Align with a district or school scope and sequence

◦ Be culturally responsive, inclusive, developmentally appropriate, and focused on meeting the needs of students who have been marginalized, including students from racial and ethnic minority groups, students who identify as LGBTQ+, and students with intellectual and developmental disabilities

◦ Incorporate sexual and mental health content

◦ Prioritize skills to identify and access health services

◦ Assess student performance

Strategy 1B – Health services (HS)

You will assess district and school capacity and implement a plan to increase access to school- and community-based services through the following activities:

• HS1. Each year, assess district and school capacity, infrastructure, and partnerships. The assessment reviews the ability to implement activities that increase student access to youth-friendly and inclusive sexual, behavioral, and mental health services.

Step 1: Review the Opportunity 15

• HS2. Build partnerships with health care providers. The goal is to support student access to youth-friendly and inclusive sexual, behavioral, and mental health services.

• HS3. Provide annual professional development to help staff support student access to health services, specifically sexual, behavioral, and mental health services. Each year, you must provide professional development to both:

◦ Staff who provide health services, and

◦ Other school staff

• HS4. Implement or enhance school-based activities that increase access to services. The goal is to increase student access to youth-friendly and inclusive school- and community-based sexual, behavioral, and mental health services. Activities must include at least one of the following:

◦ Create a referral system to link students to sexual, behavioral, and mental health services.

◦ Provide school-based sexual, behavioral, and mental health services to students. For example, STI screening, making condoms available, school-based counseling, and mental health supports.

◦ Provide school-based health center services that support sexual, behavioral, and mental health services for students.

Strategy 1C – Safe and supportive environments (SSE)

You will foster safe and supportive school environments and support the mental health and well-being of students and staff through the following activities:

• SSE1. Each year, implement activities that support youth who have been marginalized, and foster safe and supportive school environments for all youth.

◦ In Year 1, designate a staff person at the district level to lead and coordinate diversity, equity, and inclusion activities with school-level champions.

◦ Establish or enhance student-led clubs that support youth, including youth with LGBTQ+ identities. These are often known as Genders and Sexualities Alliances (GSAs).

◦ Develop, implement, improve, and enforce policies that prohibit harassment based on a student’s perceived or actual sexual orientation or gender identity. These policies are in addition to federally mandated policies on the basis of race, color, national origin, disability, age, sex (including gender identity, sexual

Step 1: Review the Opportunity 16 orientation, and pregnancy) or other constitutionally protected statuses.

◦ Identify “safe spaces” where all youth, including those with LGBTQ+ identities, can receive support from administrators, teachers, or other school staff. These could be a counselor’s office, designated classroom, or student organization space.

• SSE2. Each year, provide professional development to school staff on fostering safe and supportive school environments. Professional development topics should consist of supporting youth including those with LGBTQ+ identities and racial and ethnic minority youth, classroom management, and mental health awareness and crisis response.

• SSE3. Implement activities to support school staff’s mental health and well-being.

• SSE4. Implement school-wide practices to support the behavioral and mental health and social and emotional well-being of students.

◦ Establish dedicated time within the school schedule for students to connect with teachers and peers. The goal is to hold structured discussions that promote social-emotional well-being and strengthen relationships. These might include advisory programs or periods and morning meetings.

◦ Implement schoolwide positive behavioral interventions and support for student and teacher well-being. This includes:

▪ Setting positive behavioral expectations for students

▪ Teaching academic and social behaviors that students need to meet school expectations

▪ Defining behaviors that negatively affect school environments

▪ Using positive disciplinary practices to respond to negative behaviors

• SSE5. Implement positive youth development approaches. Specifically, provide school-based mentoring, service learning, or other positive youth development programs or connect students to community-based programs.

Strategy 1D – Family, school, and community engagement

(ENGAGE)

You will establish a School Health Advisory Council (SHAC) and collaborations across the district through the following activities:

Step 1: Review the Opportunity 17

• ENGAGE1. Establish and maintain a SHAC, or similar council or team. It must include representation from students, school staff, parents, and community members. The goal is to allow them to regularly provide district or school-level guidance to support and improve health-related policies, programs, and practices.

• ENGAGE2. Establish and maintain interdepartmental collaborations across the school district. The goal is to help implement district or school-level activities that support and improve school health policies, programs, and practices.

You will implement youth, family, school, and community engagement strategies through the following activities:

• ENGAGE3. Implement family, school, and community engagement strategies. The goal is to engage parents, caregivers, guardians, and community members in health education, health services, and safe and supportive environments activities. Such strategies might include:

◦ Providing seminars, workshops, and information

◦ Providing opportunities for feedback on program activities

◦ Leveraging school and community resources

• ENGAGE4. Implement youth engagement strategies. The goal is to actively engage students in health education, health services, and safe and supportive environments activities. Strategies should create space for youth to share their ideas. They might include:

◦ Implementing school-wide, student-planned marketing campaigns

◦ Creating district-wide youth advisory councils (YACs)

In addition to the strategies above, you are also required to:

• Submit success stories as you accomplish work plan milestones. Submit them as they occur and include them with work plan status reports every 6 months.

• Submit all HIV-related materials to a Program Review Panel. You can find information on this HIV Program Review Panel on the CDC website.

Materials might include written, audiovisual, pictorials, questionnaires, survey instruments, proposed group educational sessions, educational curricula, and like materials.

Strategy 1E – School-based surveillance

You will conduct the Youth Risk Behavior Survey (YRBS) and School Health Profiles (Profiles). For the activities and requirements, see Cross-Component Activities, YRBS and Profiles Activities and Requirements.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 18 https://www.cdc.gov/healthyyouth/fundedprograms/1807/resources.htm

In addition to those requirements, you must also include all Profiles questions and a subset of specific YRBS questions on your questionnaires for program evaluation purposes. We outline the requirements in the Evaluation and Performance Measurement section.

Outcomes We expect you to achieve the short-term and intermediate outcomes asterisked in the Component 1 logic model by the end of the 5-year project period.

Step 1: Review the Opportunity 19

Component 2: Consortia support of What Works in Schools and school-based surveillance

Approach The logic model shows the strategies and activities of the program along with the outcomes we expect over time. We will require you to report on the following outcomes indicated by an asterisk (*).

Strategies and Activities Short-Term Outcomes Intermediate Outcomes Long-Term

Outcomes

Strategy 2A:

Partnership

• Build partnerships and facilitate peer-sharing and community of practice (CoP) opportunities

Strategy 2B:

Educate and support

• Identify barriers and facilitators to implementing What Works in Schools

(WWIS)

• Provide technical assistance to districts and schools

Strategy 2C:

School-based surveillance

Formalized partnerships to support implementation of

WWIS*

Consortium understanding of barriers and facilitators to implementing WWIS

Awareness and support for implementing WWIS among key decision-makers and partners*

Consortium awareness of youth risk behaviors and experiences and school health policies and practices

Use of CDC tools and resources to strengthen health-related policies, programs, and practices by school and district staff

Student health-related knowledge, skills, and behaviors

Teacher and staff knowledge, comfort, and skills to deliver health education.

Student access to health education instructional programs*

Student and staff awareness of health services for students*

Staff awareness, knowledge, and skills for creating safe and supportive school environments*

Student participation in positive youth development approaches

Student participation in activities that create safe and supportive school environments

Staff participation in mental health and well-being activities

Sexual health Sexual risk behaviors

Preventive behaviors that decrease risk for HIV, STD, and unintended teen pregnancy

Violence

Experiences of violence

Mental health

Improved mental health

Suicidal thoughts and behaviors

Substance use

Use and misuse of alcohol and other drugs

Step 1: Review the Opportunity 20

Strategies and Activities Short-Term Outcomes Intermediate Outcomes Long-Term

Outcomes

• Conduct Youth Risk Behavior Survey

• Conduct School Health Profiles

Opportunities for student leadership in district and school decision-making

District and school-level policies and practices that support student access to health services, health education, and safe and supportive environments

Engagement of students, families, and communities in school programs

Student and staff perceptions of a safe and inclusive school environment

Consortium understanding of short- term trends in youth risk behaviors and experiences and school health policies and practices*

Required strategies and activities The following required activities support the implementation of the What Works in Schools program in consortium member school districts.

You must implement all activities at the secondary school level (grades 6 to

12) unless we specify otherwise in the required activity.

To reach as many middle and high school students as possible, you will implement each activity district-wide in your consortium member school districts. Some activities are best implemented at the district level. Others are best implemented at the school level and must be implemented in secondary schools throughout each district.

Strategy 2A – Partnership

You will build partnerships and facilitate peer-sharing opportunities through the following activities:

Step 1: Review the Opportunity 21

• Partnership1. Establish and maintain partnerships between consortium member districts, their schools, and relevant local, state, and national organizations to support the implementation of the What Works in Schools program.

• Partnership2. Coordinate cross-district School Health Advisory Council (SHAC) networks. These networks include representation from all consortium member school districts. The goal is to provide district or school-level guidance to support and improve health-related policies, programs, and practices for students in grades kindergarten through 12.

• Partnership3. Facilitate peer-sharing and community of practice (CoP) opportunities for consortium member districts and schools around implementing the What Works in Schools program.

Strategy 2B – Educate and support (ES):

You will identify barriers and facilitators to implementing What Works in Schools through the following activity:

• ES1. Each year, conduct a needs assessment. The goal is to identify barriers and facilitators that influence the implementation of the What Works in Schools program.

You will provide technical assistance to districts and schools through the following activities:

• ES2. Provide professional development for teachers and school staff to improve knowledge, comfort, and skills in implementing the What Works in Schools program.

• ES3. Provide technical assistance to consortium member districts and schools to support the implementation of the What Works in Schools program.

• ES4. Provide support for the coordination of sexual, behavioral, and mental health education and services in consortium member districts and schools.

In addition to the strategies above, you are also required to:

• Submit success stories as you achieve work plan milestones. Submit them as they occur and include them with work plan status reports every 6 months.

• Submit all HIV-related materials to a Program Review Panel. You can find information on this HIV Program Review Panel on the CDC website.

Materials might include written, audiovisual, pictorials, questionnaires,

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 22 https://www.cdc.gov/healthyyouth/fundedprograms/1807/resources.htm survey instruments, proposed group educational sessions, educational curricula, and similar materials.

Strategy 2C – School-Based Surveillance:

You will conduct the Youth Risk Behavior Survey (YRBS) and School Health Profiles (Profiles). For the activities and requirements, see Cross-Component Activities, YRBS and Profiles Activities and Requirements.

In addition to those requirements, you must also include all Profiles questions and a subset of specific YRBS questions on your questionnaires for program evaluation purposes. We outline the requirements in the Evaluation and Performance Measurement section.

Outcomes We expect you to achieve the short-term and intermediate asterisked outcomes in the Component 2 logic model by the end of the 5-year project period.

Step 1: Review the Opportunity 23

Component 3: State, territorial, and tribal school-based surveillance

Approach The logic model shows the strategies and activities of the program along with the outcome we expect over time. We will require you to report on the following outcome indicated by an asterisk (*).

Strategies and Activities Short-term Outcomes Intermediate Outcomes Long-Term Outcomes

Conduct Youth Risk Behavior Survey Conduct School Health Profiles

Awareness of youth risk behaviors and experiences and school health policies and practices by education and public health agencies

State, territory, or tribe understanding of short-term trends in youth risk behaviors and experiences and school health policies and practices*

State, territory, or tribe understanding of long-term trends in youth risk behaviors and experiences and school health policies and practices

Required strategies and activities Component 3 establishes, implements, and strengthens systematic procedures to collect Youth Risk Behavior Survey (YRBS) and School Health Profiles (Profiles) data. You will collect data and report results to help support the development of policies and practices that reduce priority health risk behaviors and experiences among youth.

Component 3 applicants are encouraged to apply for funding for both YRBS and Profiles but can apply for a reduced amount of funding for a single survey (either YRBS or Profiles).

To maximize U.S. coverage, we will fund only one application per state. If multiple applicants from the same state apply, we will select the highest-scoring applicant from that state.

Activities

You will conduct the Youth Risk Behavior Survey (YRBS) and School Health Profiles (Profiles). For the activities and requirements, see Cross-Component Activities, YRBS and Profiles Activities and Requirements.

Step 1: Review the Opportunity 24

Outcomes We expect you to achieve the asterisked intermediate outcome in the Component 3 logic model by the end of the 5-year project period.

Step 1: Review the Opportunity 25

Cross-component activities

YRBS and Profiles activities and requirements You will conduct the Youth Risk Behavior Survey (YRBS) and School Health Profiles (Profiles) to collect, analyze, and report on:

• Data related to adolescent health risk behaviors and experiences

• School health policies and practices

You will complete each activity described for YRBS and Profiles in years 1 to 5.

You will conduct:

• YRBS in odd-numbered years (2025, 2027, and 2029)

• Profiles in even-numbered years (2026 and 2028)

You will conduct the activities for your jurisdiction:

• Component 1, Strategy 1E: Across the school district

• Component 2, Strategy 2C: Across each of the consortium member school districts

• Component 3: Across all public secondary schools in the jurisdiction for Profiles and across all public high schools in the jurisdiction for YRBS. If you apply for only YRBS or only Profiles, you are only required to conduct activities for that system.

Additionally, Component 1 and 2 recipients must include all Profiles questions and a subset of specific YRBS questions on your questionnaires for program evaluation purposes. We outline the requirements in the Evaluation and Performance Measurement section.

Funding designated for this purpose must only be used for the administration, dissemination, and use of the YRBS and Profiles. You cannot use these funds to support any other school-based surveillance activities.

YRBS years 1 to 5 required activities

• Establish and maintain a YRBS coalition to support survey administration.

• Prepare for and conduct the YRBS according to procedures outlined in the Handbook for Conducting Youth Risk Behavior Surveys for that survey cycle. We will provide the Handbook with detailed instructions to funded applicants. Activities for conducting YRBS include:

◦ Developing a questionnaire

◦ Producing a sampling frame

◦ Selecting classes for surveying

Step 1: Review the Opportunity 26

◦ Obtaining school agreements and parental permission

◦ Coordinating with any other CDC-funded entities conducting YRBS in schools in your jurisdiction

◦ Collecting and submitting data

• Disseminate YRBS results and submit examples of the materials you disseminate.

YRBS years 1 to 5 optional activity CDC will offer financial incentives to jurisdictions that choose to include up to 16 questions, developed by CDC, related to Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs) on their 2025, 2027, and 2029 YRBS questionnaires.

We will offer two tiers of financial incentives. Funding amounts will depend on the number of participating jurisdictions. Question wording cannot be altered.

• Tier 1 jurisdictions must include the 8 traditional ACEs questions and will receive up to 7.5% of their annual YRBS award funding.

• Tier 2 jurisdictions must include all 16 ACEs and PCEs questions and will receive up to 12.5% of their annual YRBS award.

Profiles years 1 to 5 required activities

• Prepare for and conduct Profiles according to procedures outlined in the

Handbook for Conducting School Health Profiles that survey cycle. We will provide the Handbook with detailed instructions to funded applicants. Activities for conducting Profiles include:

◦ Producing a sampling frame

◦ Collecting data

◦ Following up with nonresponding principals and teachers

◦ Coordinating with any other CDC-funded entities conducting Profiles in schools in your jurisdiction

◦ Submitting data

• Disseminate Profiles results and submit examples of the materials you disseminate.

Step 1: Review the Opportunity 27

Focus populations Schools play a crucial role in shaping the health of young people. They can address health disparities through equity-focused strategies that promote protective factors.

Protective factors are characteristics, conditions, and behaviors that improve people’s health outcomes or reduce the effects of stressful life events and other risk factors.

We include activities to address disparities in each strategy of Component 1 and Component 2. They aim to address the needs of students who have been marginalized, such as:

• Students from racial and ethnic minority groups

• Students with LGBTQ+ identities

• Students with intellectual and developmental disabilities

These strategies can also help to support all students.

Health disparities The goal of health equity is for everyone to have a fair and just opportunity to attain their highest level of health. Health disparities are often caused by social determinants that influence which populations are more affected by health conditions.

A health disparity is a difference in health burdens between groups of people with differing social determinants of health.

Social determinants of health are conditions in the environments where people are born, live, learn, work, play, worship, and age. These determinants affect a wide range of health, functioning, and quality-of-life outcomes and risks.

You will work to address disparities using each strategy of Component 1 and Component 2. Activities include:

• Delivering culturally sensitive health education

• Increasing student access to youth-friendly and inclusive sexual, behavioral, and mental health services

• Offering activities that support youth who have been marginalized and fostering safe and supportive school environments for all youth

• Engaging parents, caregivers, guardians, and community members in the planning and implementation of school-based strategies

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 28 https://www.cdc.gov/about/sdoh/index.html

Organizational capacity Describe your capacity to meet the requirements of this funding. Use examples of your past experience or new capabilities.

Capacity to conduct activities for components 1 and 2 Component 1: Describe your district’s capacity to complete Strategies 1A to 1D.

Component 2: Describe your consortium’s capacity to complete Strategies 2A and 2B.

You should be able to describe:

• That your total district or consortium enrollment is at least 40,000 students.

• Your capability to conduct work in an area where youth are at increased risk for adverse health outcomes.

• Support from your leadership and districts. Include how you can leverage current adolescent sexual, behavioral, and mental health policies, programs, and practices.

• Your resources to implement adolescent sexual, behavioral, and mental health policies, programs, and practices for health education, health services, safe and supportive environments, and engagement strategies.

Include a detailed staffing plan and resources that will support implementation.

• How you will align this work with other adolescent health plans within your school district.

• Your ability to analyze key adolescent health issues and disparities and implement What Works in Schools to address them.

• Your ability to supervise program implementation to guarantee quality, consistency, and program improvement.

• Your ability to create or improve external partnerships to provide additional experience in adolescent sexual, behavioral, and mental health. For example, these partners can provide training, technical assistance, school-based health centers, community-based youth-friendly clinics.

• Your existing partnerships with local or state health departments to address adolescent sexual, behavioral, and mental health needs.

Step 1: Review the Opportunity 29

• Your ability to build staff capacity, increase student access to programs and services, and engage parents and community partners to address required activities.

• Your ability to manage the required procurement efforts, including ability to write and award contracts in agreement with grants regulations.

Capacity to conduct YRBS and Profiles Component 1: Describe your district’s capacity to complete Strategy 1E.

Component 2: Describe the lead organization’s capacity to complete Strategy 2C.

Component 3: Describe your organization’s capacity to complete required activities.

You should be able to describe:

• How your organization is structured and who will have management authority over school-based surveillance. Provide an organizational chart that shows lines of authority.

• Your experience conducting YRBS and Profiles, or similar school-based surveys.

• Your experience recruiting schools to participate in school-based surveys.

• Your experience disseminating and using YRBS and Profiles or similar school-based survey results to inform policy and practice decisions.

• Potential barriers to successfully completing required activities and how you will overcome the barriers to conduct YRBS and Profiles.

• A job description for the person who will lead the YRBS and Profiles.

Include the percentage of time they will spend on this work.

Collaborations Collaboration and partnerships are essential for program success. They:

• Improve resource efficiency

• Foster information exchange among experts in education, public health, and other fields

• Enhance outcomes

You must collaborate as necessary across program components for a comprehensive approach.

Step 1: Review the Opportunity 30

With CDC and our partners All components

• Collaborate with other recipients to coordinate data collection for national, state, territorial, tribal, and local Youth Risk Behavior Surveys and School Health Profiles in the same jurisdiction.

• Collaborate with CDC and its partners to coordinate Youth Risk Behavior Survey and School Health Profiles activities.

Components 1 and 2

• Collaborate with CDC and its partners to support the What Works in Schools program’s implementation and evaluation activities.

Potential partners

• Other Division of Adolescent and School Health recipients including those funded through DP22-2203 and DP23-0002

• Other CDC divisions

• State and local health departments

• U.S. Department of Education

• Organizations funded by other federal agencies including Department of Health and Human Services’ Office of Adolescent Health or Administration for Children and Families’ Family and Youth Services Bureau

• Other organizations involved in HIV, STD, pregnancy, violence, suicide, substance use prevention, and adolescent mental health promotion

With others You should maximize program outcomes by leveraging funding and in-kind resources. We expect you to also collaborate with other organizations interested in adolescent health and well-being.

These collaborations should align with local needs and help establish effective policies, programs, and practices at district and school levels.

Prioritize collaboration with organizations addressing disparities in students’ sexual risk behavior, substance use, experience of violence, mental health, and suicidality. See Focus Populations.

1. Review 2. Get ready 3. Prepare 4. Learn 5. Submit 6. Award Contacts

Step 1: Review the Opportunity 31 https://www.grants.gov/search-results-detail/334850 https://www.grants.gov/search-results-detail/342776

Component 2 only

The lead organization must submit a Memorandum of Understanding (MOU) that includes commitment of involvement from each school district in the consortium. See Memorandum of Understanding.

Data, monitoring, and evaluation CDC strategy Throughout the 5-year period of performance, we will work with you to monitor activities to demonstrate program impact through process and outcome evaluation.

We will assess the extent to which CDC-funded activities at each site lead to intended outcomes, including the public health impact of systemic change in schools.

We will use the evaluation data to:

• Help monitor your program activities

• Suggest possible program improvements

• Tailor professional development and technical assistance to recipient needs

• Inform future program and policy directions for increasing adolescent protective factors and reducing risks

• Determine how activities impact systemic school changes and student health and, ultimately, refine school-centered approaches to improve student health

To support quality improvement and measure progress on program activities and outcomes, we will provide multiple reports from the data you provide to us:

• Annual evaluation reports: Annual evaluation reports summarize quantitative data, select qualitative data, and program activities for you and all other recipients. These findings help us ensure that you are implementing program activities and offer technical assistance and professional development to improve the implementation and quality of program activities. We will seek to send you this report two months after you submit your data.

• Final Evaluation Report: A cumulative 5-year final evaluation report will highlight whether you and all other recipients accomplished intended

Step 1: Review the Opportunity 32 outcomes. A combination of data sources will inform this report, including program evaluation, YRBS, and Profiles data to help measure:

◦ School and student outcomes

◦ Information from program plans and reports

◦ Information about technical assistance and professional development

◦ Factors that influence school implementation of activities and student outcomes

Required performance measures We will require you to report on evaluation questions and performance measures for each strategy. The performance measures correspond to the activities and asterisked outcomes in the logic model.

We will likely refine the required performance measures. If so, we will work with you and finalize them before we require you to submit any data.

Component 1 evaluation questions and sample performance measures

Health education

Evaluation questions include:

• To what extent do recipients support schools to implement quality health education?

• To what extent do students receive health education in recipient school districts?

Sample performance measures include:

• Activity: Percentage of recipients that deliver professional development that prioritizes instructional competencies for secondary school teachers and staff to deliver culturally responsive and inclusive sexual and mental health education

• Short-term outcome: Number of trainings and resources that recipients offered or provided to teachers or school staff delivering health education

• Intermediate outcome: Percentage of students across districts who received a health education instructional program

Step 1: Review the Opportunity 33

Health services

Evaluation questions include:

• To what extent do recipients implement or support activities to increase access to sexual health services for students?

• To what extent do recipients implement or support activities to increase access to behavioral and mental health services for students?

• To what extent do students receive sexual health services? To what extent do students receive behavioral and mental health services?

Sample performance measures include:

• Activity: Percentage of recipients that implement school-based activities to increase student access to youth-friendly and inclusive school and community sexual health and behavioral and mental health services

• Short-term outcome: Percentage of schools across districts that implement activities to increase student awareness of health services

• Intermediate outcome: Percentage of students across districts who received a preventive health visit in the past 12 months

Safe and supportive environments

Evaluation questions include:

• To what extent do recipients provide support for safe and supportive school environments for students and school staff?

• To what extent do students participate in activities that foster safe and supportive environments?

Sample performance measures include:

• Activity: Percentage of recipients that provide student harassment policy enumerated for sexual orientation and gender identity

• Short-term outcome: Percentage of schools across districts implementing school-wide positive behavioral supports and interventions

• Intermediate outcome: Percentage of students across districts who feel close to others at school

Family, school, and community engagement

Evaluation questions include:

• To what extent do recipients engage district, school, family, and community partners in school health policies, programs, or strategies?

Step 1: Review the Opportunity 34

Sample performance measures include:

• Activity: Percentage of recipients that establish and maintain district-level school health advisory councils or teams

• Short-term outcome: Percentage of districts in which a Youth Advisory Council annually presents capstone projects or…