Foa_Content_of_CDC-RFA-CE-24-0027 (1).pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR INJURY PREVENTION AND CONTROL

Rape Prevention and Education

CDC-RFA-CE-24-0027

11/30/2023

Table of Contents A. Funding Opportunity Description

B. Award Information

C. Eligibility Information

D. Application and Submission Information

E. Review and Selection Process

F. Award Administration Information

G. Agency Contacts

H. Other Information

I. Glossary

Part I. Overview Applicants must go to the synopsis page of this announcement at www.grants.gov and click on the "Subscribe" button link to ensure they receive notifications of any changes to CDC-RFA-CE- 24-0027. Applicants also must provide an e-mail address to www.grants.gov to receive notifications of changes.

A. Federal Agency Name:

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

Rape Prevention and Education C. Announcement Type: New - Type 1:

This announcement is only for non-research activities supported by CDC. If research is proposed, the application will not be considered. For purposes of this NOFO, research is defined as set forth in 45 CFR 75.2 and, for further clarity, as set forth in 42 CFR 52.2 (see eCFR :: 45 CFR 75.2 -- Definitions and https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR- 2007-title42-vol1-sec52-2.pdf. In addition, for purposes of research involving human subjects and available exceptions for public health activities, please see 45 CFR 46.102(l) (https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section- 46.102#p-46.102(l)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-CE-24-0027

E. Assistance Listings Number:

93.136 F. Dates:

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

https://www.grants.gov/ https://www.grants.gov/ https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52-2.pdf https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l) https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-46/subpart-A/section-46.102#p-46.102(l)

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

2. Due Date for Applications:

11/30/2023 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

10/13/2023

2:00 p.m.-3:30 p.m. U.S. Eastern Standard Time https://cdc.zoomgov.com/meeting/register/vJItcuyvqDMrE5Anpxa34ix9c35lBLpOsTw

The purpose of this informational conference call/webinar is to help potential applicants understand the scope and intent of this Program Announcement: Rape Prevention and Education.

Participation on the conference call is not mandatory. Potential applicants are requested to call in using only one telephone line. This is a competitive process; therefore, applicants should follow the requirements for this program as they are laid out in the funding announcement and related amendments. Applicants who want to submit questions prior to the call, or should applicants find they have additional questions or need clarification after the call, please see the Agency Contact listed at the end of this Notice of Funding Opportunity (NOFO).

G. Executive Summary:

1. Summary Paragraph The purpose of this NOFO CDC-RFA-CE19-1902, is to build on the previous RPE NOFO CE- 23-0006, by continuing to enhance the capacity of state and territorial health departments (hereafter referred to as SHDs) to facilitate and monitor the implementation of sexual violence (SV) prevention programs, practices, and policies. This five-year funding opportunity requires that recipients build infrastructure for SV prevention; develop/enhance a state/territory action plan; implement community- and societal-level SV prevention strategies that promote health equity; and utilize data to inform action. Completing these activities should lead to increased capacity to promote health equity, implement/evaluate SV prevention at the community- and societal levels, increase partner and community awareness of effective prevention strategies, and increase partner coordination to prevent SV. Completing these activities should also result in the increased community-level implementation of SV prevention strategies that reach high-burden communities and address social determinants of health (SDOH), using data to understand inequities and monitoring and evaluation activities related to SV prevention. The actions outlined in this NOFO will build the foundation for recipients to decrease SV perpetration and victimization rates at the state/territory level and reduce disparities in SV by addressing associated inequities in social and structural determinants of health.

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

https://www.grants.gov/

$209,950,000

e. Average One Year Award Amount:

$803,000 Average $803,000.

Territories-$40,000 Awards will be made to states and territories using the following population based funding formula: U.S. Virgin Islands, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, the Republic of the Marshall Islands, Palau, American Samoa and Guam with approved applications will receive $40,000; the 50 states, District of Columbia and Commonwealth of Puerto Rico with approved applications will receive a base of $150,000.

The remainder of the funds will be allocated utilizing the percentage of each state's population (50 states, DC and Puerto Rico) divided by the total US population, as stated in Violence Against Women Act.

f. Total Period of Performance Length:

5 year(s)

g. Estimated Award Date:

January 31, 2024

h. Cost Sharing and / or Matching Requirements:

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

Consistent with the cited authority for this announcement and applicable grants regulations, sources for cost sharing or matching may include complementary CDC Foundation funding;

other U.S. government funding sources, including programs supported by HHS or other agencies (e.g., Department of Agriculture, Department of Education, Department of Housing and Urban Development, Department of Transportation, Environmental Protection Agency, National Park Service); and other funding sources. Applicants should coordinate with multiple sectors, such as public health, transportation, education, health care delivery, and agriculture.

Part II. Full Text A. Funding Opportunity Description

1. Background

a. Overview Sexual violence (SV) is a complex public health problem that affects persons across their lifespan. Over half of women (54.3%) and nearly one-third of men (30.7%) in the U.S. reported contact sexual violence victimization during their lifetime. SV often begins early and can lead to adverse short and long-term mental and physical health outcomes, contributing to a substantial public health burden. Certain communities face a more significant burden of sexual violence due to systemic inequities, exacerbating these adverse outcomes. These disparities highlight the need to address social and structural determinants of health. Preventing sexual violence is crucial for addressing various mental and physical health issues that disproportionately affect specific communities due to the negative health consequences linked to SV.

Achieving health equity means achieving a state in which everyone has a fair and just opportunity to attain the highest level of health. Some communities are more vulnerable to sexual violence due to social and structural factors. For example, half of the multiracial women in the U.S. (49.5%) and 45.6% of American Indian/ Alaska Native women experienced some form of contact SV during their lifetime compared to 38.9% of non-Hispanic white women.

Disparities persist even when accounting for other demographic and socioeconomic factors, such as age or income. SDOH are the conditions in which people are born, live, learn, work, play, worship, and age. Equal education, employment, and income opportunities are crucial for optimal health, safety, and well-being. Lack of access to food and housing increases the risk of sexual violence.

Community-wide strategies can be more effective in reducing sexual violence than focusing solely on individuals. This is because they target settings that increase or buffer against the risk for violence, particularly the social, economic, and environmental characteristics of neighborhoods, schools, workplaces, and other organizational settings as indicated by the outer levels of the Social-Ecological Model (SEM). The SEM provides a framework for understanding the way risk and protective factors at one level interact with those at another level. Community and societal-level prevention approaches are crucial in reducing sexual violence and creating lasting change.

This NOFO, Rape Prevention and Education (RPE), aims to build upon lessons learned from CDC-RFA-CE19-1902 by encouraging the expansion of strategies implemented and evaluated at the community- and societal level using a comprehensive approach across the SEM. Under RPE, recipients will have an opportunity to: (1) continue to build program and partner capacity to facilitate and monitor the implementation of SV prevention programs, practices, and policies; (2) continue to support state and territorial health department's implementation of community-and societal-level programs, practices, and policies to prevent SV; (3) continue to support the implementation of data-driven, comprehensive, evidence-based SV primary prevention strategies, and approaches focused mainly on health equity; and to (4) continuously conduct data to action activities to inform changes or adaptations to existing SV strategies or on selected and implemented additional strategies. Ultimately, the RPE NOFO will seek to reduce SV victimization rates and risk factors while increasing the protective factors associated with SV perpetration and victimization.

b. Statutory Authorities This award is authorized under the Violence Against Women Act Reauthorization Act of 2022, Section 393A of the Public Health Service Act [42 U.S.C. 280b-1b] and (d)(4)).

c. Healthy People 2030 This funding opportunity aims to reduce various forms of violence and abuse, including intimate partner violence, sexual violence, child abuse and neglect, bullying, and work-related assaults.

The outcomes are aligned with Healthy People 2030 developmental goal and include reducing rates of violent crimes committed by minors and young adults, as well as victimization from violent crimes https://health.gov/healthypeopleobjective-and-data/browse-objective/violence-prevention

d. Other National Public Health Priorities and Strategies This NOFO aligns with the National Health Initiatives, Strategies & Action Plans. Specifically:

• HHS Action Plan to Reduce Racial and Ethnic Health Disparities (https://www.minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf)

• National Plan to End Gender-Based Violence (https://www.whitehouse.gov/wp-content/uploads/2023/05/National-Plan-to-End-GBV.pdf)

• WHO RESPECT Women: Preventing Violence Against Women (https://www.who.int/publications/i/item/WHO-RHR-18.19)

• Thriving Together: A Springboard for Equitable Recovery and Resilience in Communities Across America (https://thriving.us/explore-the-springboard/)

• National Stakeholder Strategy for Achieving Health Equity

e. Relevant Work This NOFO builds on previous accomplishments and lessons learned from the Rape Prevention and Education Program, as well as other funding opportunities and guidance documents listed below but not limited to:

· CDC-RFA-CE19-1902 FY 2023 Supplement Funding Opportunity

· CDC-RFA-CE19-1902 FY 2022 Supplement Funding Opportunity-Health Equity Capacity Assessment

· CDC-RFA-CE19-1902 FY2021 Supplemental Funding Opportunity

· STOP SV: A Technical Package to Prevent Sexual Violence (cdc.gov)

· Violence Prevention in Practice | VetoViolence (cdc.gov)

· Connecting the Dots

For more information, visit https://www.cdc.gov/violenceprevention/index.html

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-CE-24-0027 Logic Model: Rape Prevention and Education

Bold indicates period of performance outcome

*SHDs includes both state and territorial health departments https://health.gov/healthypeople https://health.gov/healthypeople https://www.who.int/publications/i/item/WHO-RHR-18.19

Strategies and Activities

Short-term Outcomes Intermediate Outcomes

Long-Term Outcomes

Strategy 1: Build Infrastructure for SV prevention

1A. Build internal capacity to facilitate and monitor implementation

1B.Build capacity for partner organizations

1C.Conduct prevention capacity assessment with health equity focus

1D.Participate in CDC sponsored activities

Strategy 2: Develop State Action Plan

2A.Develop or enhance existing state/territory plan with partners

2B. Leverage multi-sector partners towards SV prevention

2C. Engage multi-sector partners including but not limited to Sexual Assault and Tribal Coalitions

Strategy 3: Implement SV Prevention Approaches

3A. Identifying, implementing and adapting SV prevention strategies at the community and societal level focused on reducing disparities

Strategy 4:

1.1 Increased

capacity to implement and evaluate primary prevention of SV at the community- and societal- levels within SHDs

1.2 Increased

capacity to promote and incorporate health equity program activities relevant to SV prevention among partners organizations

2.1 Increased partner

awareness of states/territories efforts to prevent SV.

2.2 Increased partner

and community awareness of effective primary prevention strategies and the disparate burden of

SV

2.3 Increased

coordination and collaboration among partners and between SHDs, SA coalitions, Tribal SA coalitions, representatives from underserved communities and other sectors to prevent SV

3.1 Increased

community-level

1.3 Increased capacity

for statewide program implementation and SV prevention

2.4 Increased partner

support to implement, evaluate, and adapt state- and community-level strategies to prevent

SV.

3.4 Increased reach of

prevention strategies that impact communities and populations with disproportionately high rates of SV

3.5 Increase in

number of community- and societal-level strategies that promote health equity and reduce inequities in SV by addressing social and structural determinants of health

3.6 Increase in

protective factors and decrease in risk factors associated with SV

4.3 Increased use of

data-driven decision making to reduce inequities impacting populations and communities with

Decrease in rates of SV, particularly in communities disproportionately burdened with high rates of SV.

Decrease in rates of SV perpetration and victimization at the state or territory level.

Reduce inequities in SDOH that impact disparities in SV rates

Use Data to Inform Action

4A. Gather and synthesize publicly available data

4B. Use data to identify and select prevention strategies

4C. Develop and implement equity focused evaluation plan

4D. Use monitoring and evaluation data to improve SV prevention implementation implementation of SV prevention strategies

3.2 Increased

implementation of prevention strategies among communities and populations with disproportionately high rates of SV

3.3 Increased

implementation of prevention strategies that seek to prevent SV by addressing social and structural determinants of health

4.1 Increased access

and use of data to understand inequities within populations and communities with disproportionately high rates of SV

4.2 Increased

monitoring and evaluation activities and sharing of data related to SV prevention disproportionately high rates of SV

4.4 Increased state-

and community-level monitoring of trends in SV outcomes and

SDOH

i. Purpose This NOFO aims to promote health equity and prevent sexual violence by addressing social factors like poverty and discrimination that contribute to the prevalence of these factors.

Additionally, it urges recipients to foster meaningful engagement and coordination among health departments and territories while building sustainable infrastructure.

ii. Outcomes Measurable outcomes determine the extent to which implemented approaches and activities achieve their intended effects. Outcomes are results that the program intends to achieve and usually indicate the intended direction of change.

Recipients are expected to achieve the following short-term outcomes within the first two years of the project:

Strategy 1: Build Infrastructure for SV Prevention

• Increased capacity to implement and evaluate primary prevention of SV at the community- and societal- levels within SHDs

• Increased capacity to promote and incorporate health equity program activities relevant to SV prevention among partner organizations

Strategy 2: Develop State Action Plan

• Increased partner awareness of states/territories efforts to prevent SV

• Increased partner and community awareness of effective primary prevention strategies and the disparate burden of SV

• Increased coordination and collaboration among partners and between SHDs, SA coalitions, Tribal SA coalitions, representatives from underserved communities and other sectors to prevent SV

Strategy 3: Implement Strategy

• Increased community-level implementation of SV prevention strategies

• Increased implementation of prevention strategies among communities and populations with disproportionately high rates of SV

• Increased implementation of prevention strategies that seek to prevent SV by addressing social and structural determinants of health

Strategy 4: Use Data to Inform Action

• Increased access and use of data to understand inequities within populations and communities with disproportionately high rates of SV

• Increased monitoring and evaluation activities and sharing of data related to SV prevention

Recipients are expected to achieve the following intermediate outcomes within three to five years of the project:

Strategy 1: Build Infrastructure for SV Prevention

• Increased capacity for statewide program implementation and SV prevention

Intermediate Outcomes Associated with Strategy 2: Develop State Action Plan

• Increased partner support to implement, evaluate, and adapt state- and community-level strategies to prevent SV

Strategy 3: Implement Strategy

• Increased reach of prevention strategies that impact communities and populations with disproportionately high rates of SV

• Increase in number of community- and societal-level strategies that promote health equity and reduce inequities in SV by addressing social and structural determinants of health

• Increase in protective factors and decrease in risk factors associated with SV

Strategy 4: Use Data to Inform Action

• Increased use of data-driven decision-making to reduce inequities impacting populations and communities with disproportionately high rates of SV

• Increased state- and community-level monitoring of trends in SV outcomes and SDOH

Recipients will be expected to submit a state-level logic model within 120 days of award. It is not required as part of the initial application. CDC will provide specific guidance after award, and the state-level logic model will be included in the evaluation plan.

Recipients will be expected to submit a state-level logic model as part of their evaluation plan within 120 days of award. It is expected that states implement their planned activities using a public health approach, which should align with the short-term, intermediate, and long-term outcomes provided in the logic model template.

Recipients should utilize the provided outcomes in the logic models as a guide to align their activities and should also expand on and add details to these outcomes and additional outcomes specific to their activities and state/community context. The logic model should illustrate linkages across activities, short-term outcomes, intermediate outcomes, and long-term outcomes to paint a cohesive understanding of your program.

When expanding and adjusting an outcome to better fit their program activities, recipients should indicate specific details such as connections and relationships among state and local level activities, and specific risk and protective factors.

Some example risk factors include media violence, harmful norms around masculinity and femininity, cultural norms that support aggression toward others, diminished economic opportunities/high unemployment rates, poor neighborhood support and cohesion, and high alcohol outlet density.

Some example protective factors include community support/and connections/commitment to school.

With technical guidance and support from CDC, recipients will identify, measure, and monitor indicators aligned with the outcomes related to the activities and strategies specified in their logic model. While recipients are only expected to achieve the short-term and intermediate outcomes during the NOFO period of performance. CDC will work with recipients to identify and develop strategies for measuring outcomes that track long-term impact on SV and health equity.

Recipients are required to report their progress and accomplishments using the DVP Partners Portal. The Evaluation and Performance Measurement section further describes the methods for evaluation and performance monitoring of this NOFO.

** Territory recipients should contact their assigned RPE Project Officer to further discuss capacity and TA needs to fulfill outcomes after funding is awarded. **

iii. Strategies and Activities This section of the NOFO describes the Strategies and Activities from the Approach section and expands on specific activities under each Strategy in detail. These strategies are designed to increase the sustainability of the program beyond the performance period and were selected for their potential to advance health equity.

Recipients of this NOFO will be expected to use and ensure their sub-recipients use the public health approach and conduct prevention strategy implementation of program or policy-related activities. RPE funds may be used for policy-related activities such as analyzing data to identify trends and opportunities; analyzing and understanding policy options; collaborating with partners to educate about policy issues; providing evidence and education to key partners and policymakers; educating the public about existing policies; and evaluating the impact of policies.

For example, a state health department recipient may choose to work with partners to conduct a health impact assessment on a certain policy or benefit and then disseminate the results of that assessment to relevant partners. Please see the following guidance concerning prohibitions on the use of CDC award funds for impermissible lobbying: see Anti-Lobbying Restrictions for CDC Grantees

Required Strategies and Activities

Recipients are required to implement all Strategies and Activities below.

Funded recipients are strongly encouraged to coordinate these activities with the RPE-funded SA Coalitions and Tribal Coalitions when appropriate in their state or territory. Some examples of how recipients can meaningfully engage SA and Tribal Coalitions in their work are provided within the activities below.

At the time of application, each applicant will submit a detailed Work plan for the first year of the project, and a high-level work plan for the subsequent years of funding. This work plan should include details on how applicants plan to implement each of the activities listed below.

More details on the work plan are provided in the Work plan section.

Strategy 1: Build Infrastructure for SV prevention.

Activity 1A: Continue to build internal program capacity to facilitate and monitor the implementation of prevention programs/policies by acquiring, training, and retaining staff

Recipient organizations are required to continually build their internal capacity to facilitate and monitor SV prevention efforts and to achieve the strategies and activities of this NOFO.

Recipients should work with their state/territory organization, their state or territorial sexual assault coalition, as well as other local, state, and national sexual violence partners to build their capacity for SV prevention. Examples of capacity building activities can include:

• Increasing education, support, and training provided to internal staff around health equity, data to action, and primary prevention of SV

• Hiring, contracting, or partnering with evaluators to expand capacity for tracking SV indicators and monitoring and evaluation of implementation efforts

• Organizing/participating in learning collaborative or coalitions

• Attending/presenting at conferences related to sexual violence prevention and health equity

Activity 1B: Conduct/promote training's to build capacity of partner organizations to promote health equity

Recipients are required to maintain strong and collaborative working relationships with partner organizations including sexual assault coalitions to achieve the strategies and activities of this https://www.cdc.gov/grants/documents/Anti-Lobbying-Restrictions.pdf https://www.cdc.gov/grants/documents/Anti-Lobbying-Restrictions.pdf

NOFO. Recipients are expected to work with and educate local-level coalitions, community organizations, and service providers to build local capacity to engage communities at an increased risk for violence and develop plans for population-specific implementation efforts.

Examples of supportive educational and capacity building activities can include:

• Integrating primary prevention into the education, support and technical assistance provided to service providers and local coalitions.

• Including prevention information in the resources provided to service providers and local coalitions.

• Informing service providers and local coalitions about relevant webinars and events related to SV prevention that are accessible to them.

• Disseminating information about primary prevention efforts occurring in the state to local coalitions and service providers.

Activity 1C: Conduct, or leverage, an existing primary prevention capacity assessment with a focus on health equity Recipients are required to conduct or leverage an existing health equity capacity assessment to determine current capacity to enhance and expand health equity work. The assessment should reflect:

• Current internal capacity to meet the current and future needs of the program related to advancing health equity. Data availability, use of available data, and access to additional data needs to advance health equity.

• Current capacity to provide training and technical assistance on health equity and opportunities for improvement.

• Current distribution of program activities across the SEM and capacity to shift work towards the outer layers.

• Once completed, the assessment should be used in a variety of ways and findings should be incorporated into the State Action Plan and Evaluation Plan.

Examples of how the capacity assessment can be used includes:

• To determine where gaps exist in capacity to address health equity in the implementation of SV prevention strategies and identify recommendations to fill those gaps.

• To increase the use of information and data in decisions around ways to integrate health equity into programming.

• To be used as a jumping off point for discussions about health equity within organizations and with partners

• To identify needed resources.

Upon award, CDC will provide further guidance for conducting a health equity capacity assessment.

Activity 1D: Participate in CDC-sponsored programs and activities.

Recipients are required to participate in the following activities that are designed to support implementation of the NOFO.

• Attendance at the Annual Recipient's Meeting

• Participation in CDC-provided regularly scheduled technical assistance and training, including but not limited to, monthly Project Officer calls, Evaluation office hours, webinars, and routine site visits.

Recipients are additionally expected to participate in the following training and technical support activities.

• RPE leadership and/or regional training's for the purposes of training, technical assistance, and sharing lessons learned. Participation in e-learning collaborative's on sexual violence prevention and evaluation, facilitated by a CDC-funded technical assistance provider.

• Participation in sexual violence prevention and evaluation training, technical assistance, and resources provided in-person or virtually by CDC-funded National Technical Assistance Resource Center for the Prevention of Sexual Violence, Violence Prevention Technical Assistance Center (VPTAC), and other funded TA providers.

Recipients are also expected to participate in CDC’s initiative-level evaluation of this NOFO.

The purpose of the initiative-level evaluation is to observe and document the progress, achievements, and lessons learned of recipients as they work toward NOFO activities and outcomes through implementing and evaluating community- and societal-level SV primary prevention approaches. Through the duration of the cooperative agreement, recipients are required to participate in the CDC-requested data collection activities. Initiative-level data collection activities may include but are not limited to focus groups, surveys, and interviews.

In the approach section of their project narrative, applicants must clearly describe how they will build internal program capacity to facilitate and monitor implementation of prevention programming through staffing, partnerships, and training. In addition, applicants should describe how they will conduct or leverage an existing primary prevention capacity assessment with a focus on health equity.

Strategy 2: Develop State Action Plan

Activity 2A: Develop or enhance an existing state/territory action plan (in collaboration with SA coalitions, Tribal SA coalitions, and representatives from underserved communities of the State or Territory) to support state- and community-level implementation and sustainability of SV prevention

Within the first six months, all states and territories must work with identified state-level partners to either develop or enhance an existing state action plan (SAP) to help them strategically and intentionally plan, prioritize, and establish a portfolio of SV prevention approaches based on the best available evidence to prevent SV. The SAP should not exceed 50 pages; however, exceptions may be made on a case-by-case basis. A final SAP is due with the Annual Progress Report (APR) submission, due 120 days before the end of the fiscal year. Any updates made to the final SAP will be reported by recipients in their APRs each year.

The following components must be included in the SAP:

• The ways in which the recipient and partners will prioritize primary prevention at the outer layers of the SEM to reduce health inequities associated with SV through the implementation of primary prevention strategies intended to address SDOH and the root causes of violence to prevent SV.

• The ways in which health disparities and disproportionate burden will be addressed using state or local level data

• The ways in which coordination with partners will be increased and/or maintained

• The ways in which the recipient plans to leverage partnerships and resources to increase and sustain primary prevention efforts in the state

• Plans for expanding the tracking and use of statewide data, including, but not limited to, SV indicators and SDOH

• A summary of current primary prevention program or policy strategies being implemented in the state, with an emphasis on increasing community and societal level strategies

• A sustainability section that describes how RPE work will be sustained at the state and local level

Plans for implementation of the strategies selected for each focus area which should include:

• The selected strategies and corresponding focus areas and level of the SEM

• Description of the population of focus and setting for each strategy

• The evidence, theory, or rationale to support the selection of each strategy

• The essential elements and complementary components

• The risk and protective factors and social determinants of health to be addressed by each strategy and how they relate to the population of focus

• A high-level description of how the recipient or sub-recipient intends to implement the strategy

Upon award, CDC will provide further guidance for completing the State Action Plan.

Activity 2B: Leverage multi-sector partners and resources toward SV prevention

All states and territories must engage in a systematic process of identifying potential public and private partnerships that can provide assistance on program implementation and evaluation. In addition, all recipients should ensure that their sub-recipients engage in a systematic process of identifying partnerships. Once potential partners are identified, recipients should establish formal partnerships (through mechanisms such as contracts, consultations, or memorandums of understanding). Some examples of functions that partners could perform include:

• Collaborating on program selection and implementation.

• Providing guidance on program evaluation and data use

• Providing population specific support

• Providing technical assistance in building program implementation and evaluation capacity of sub-recipients

Activity 2C: Participate in meaningful engagement with SA coalitions, Tribal SA coalitions, representatives from underserved communities of the State or Territory and other collaborators working to prevent SV

The RPE program seeks to increase the SV primary prevention knowledge and capacity of all SV prevention organizations through the sharing of information from RPE recipients. Additionally, sharing program results, evaluation findings, tools, and lessons learned will contribute to the building of practice-based evidence in the field of SV prevention.

To contribute to this aim and goal recipients are expected to serve as leaders in the field of SV prevention at both national and state levels by sharing resources, lessons learned, and participating in relevant conferences and meetings. The CDC specifically encourages recipients to share and collaborate with their state’s SA coalitions, Tribal SA coalitions, and local communities.

Some examples of how funded recipients can meaningfully engage with SV collaborators include:

• Providing technical assistance to SA coalitions, Tribal SA coalitions, and other SV partners

• Including SV partners in SV Action Planning to align SV work across the State/Territory

• Collaboration with RPE-funded SA Coalitions and Tribal Sexual Assault Coalitions

• Sharing data and making data available to SA coalitions and Tribal SA coalitions

In the approach section of their project narrative, applicants should clearly describe how they will collaborate with SA coalitions, Tribal SA coalitions, and representatives from underserved communities in their State or Territory to develop or enhance a state/territory action plan to support state- and community-level implementation and sustainability of SV prevention. In addition, applicants should describe how they will identify and leverage multi-sector partners and resources towards SV prevention and meaningfully engage with SA coalitions, Tribal SA coalitions, representatives from underserved communities of the State or Territory and other collaborators working to prevent SV

Strategy 3: Implement SV Prevention Approaches

Activity 3A: Identify, implement, and adapt SV prevention approaches that increase health equity through reduced disparities in targeted SDOH, with a focus on implementation at the community- and societal-levels

Recipients are required, with coordination of their sub-recipients, to implement programs and policies within the following focus areas: Focus Area 1- Strengthen economic supports, Focus Area 2 - Create protective environments, and Focus Area 3 – Promote social norms that protect against violence. Recipients are required to implement at least one program/policy effort from each of the 3 Focus Areas.

While some elements of the approaches and programs in these focus areas are focused on the individual- or relationship-level, recipients are encouraged to focus the majority of their implementation efforts on the community- and societal-level. Rather than individual- and relationship-level programs and policies that target characteristics of individuals or individual behaviors (e.g., social-emotional learning, increasing severity of punishment for alcohol offenses, bystander knowledge), community- and societal-level programs and policies focus on contextual or environmental factors that promote population health and well-being (e.g., laws around where alcohol can be sold or advertised, greening activities) as fundamental drivers of public health problems such as sexual violence.

SV Prevention Strategy Focus Areas

The specific focus areas for the SV prevention strategies and approaches of interest are based on guidance from CDC’s VetoViolence Violence Prevention in Practice tool (https://vetoviolence.cdc.gov/apps/violence-prevention-practice/#!/). The Violence Prevention in Practice tool encompasses violence prevention strategies and approaches from all of CDC’s Violence Prevention Resource for Action (previously referred to as Technical Packages). This includes the Sexual Violence Prevention Resource for Action (previously referred to as STOP SV). Violence Prevention in Practice provides information about selecting, implementing and evaluating strategies, approaches, and programs based on the best available evidence.

Communities and states can use these resources to prioritize their efforts on activities with the greatest potential to reduce multiple forms of violence.While the focus of this NOFO is on prevention of Sexual Violence, we encourage applicants to utilize CDC’s Connecting the Dots framework (https://www.cdc.gov/violenceprevention/about/connectingthedots.html) and other relevant research to understand the causes and connections between different forms of violence.

Recipients should identify, implement, and adapt prevention strategies that reduce SV and increase health equity through reduced disparities in targeted SDOH.

Recipients are required to select example program or policy efforts from the NOFO Focus Areas listed below OR continue/propose a program or policy area that is not included as an example below, but meets the following criteria:

• Fits within one of the Focus Areas of this NOF

• Has documented evidence of effectiveness, OR includes one or more of the following criteria:

a. Is grounded in theory of primary prevention of SV

b. Has demonstrated evidence of preventive effects on SV or associated community or societal level risk and protective factors through a less rigorous evaluation for the population of focus

c. Has been successfully implemented prior to the time of application

• Addresses risk and protective factors for SV

• Demonstrates a link between the theory of the program/policy effort and targeted outcomes addressing SV

• Is feasible to implement and evaluate

Once funded, recipients can work with their assigned Project Officer for review of any proposed programs or policy areas that are not included as an example below.

Focus Area 1: Strengthen economic supports

Employment, stable housing, financial stability, and food security are important protective factors for women’s risk of SV victimization. Policies and programs that work to improve financial stability can also reduce the risk factors associated with SV victimization. Two approaches with existing evidence are Strengthen Household Financial Security and Family- Friendly Policies. Strengthening household financial security addresses some violence risk factors, including poverty, unemployment, financial stress and hardship, childcare instability, parental stress, family conflict, depression, and gender inequality. Providing income supports http://www.cdc.gov/violenceprevention/about/connectingthedots.html)

(e.g., tax credits, childcare subsidies, livable wages), income-generating opportunities to empower and support women, and decreasing the gender pay gap directly target these risk factors. Family-friendly policies may change the context for households by improving the balance between work and family responsibilities, while helping ensure economic security.

These supports help individuals and families increase household income and buffer against risk for multiple forms of violence. Programs and policies that address this approach at the community- and societal-level have the potential to decrease gender inequality and economic instability, both risk factors for SV.

The list below includes the approaches and corresponding example programs, practices and policies under Focus Area 1:

• Strengthen household financial security o Family assistance programs such asTANF and SNAP o Tax Credits such as Earned IncomeTax Credit (EITC) and Child Tax Credit o Subsidized/Affordable Child Care o Livable Wages o Microfinance programs o Comparable worth policies

• Family-friendly policies o Paid leave policies o Workplace flexibility policies

Focus Area 2: Create Protective Environments

In order to achieve population-level reductions in SV rates, SV prevention should include community- and societal-level strategies that change community characteristics, so they are safe, healthy, and protective. Community- and societal-level prevention strategies go beyond changing individual attitudes, beliefs, and behaviors, and focus on modifying community structures, social norms, environment, and policies. Approaches with existing evidence are Improve School Climate and Safety, Improve Organizational Environments, Reduce Exposure to Community-level Risks, and Modify the Physical and Social Environment. Improving safety and monitoring in schools includes modifying the school environment to reduce SV and to increase safety and support for students. Organizational policies establish and enforce standards of behavior in the work environment and create healthy organizational climates, which in turn can help prevent sexual harassment, child sexual abuse, and gender-based bullying. Community-level risks for SV include concentrated poverty, housing insecurity, economic and residential instability, violence exposure, high numbers of alcohol retailers in an area, and weak neighborhood support and cohesion (like a lack of mutual support among community members). Implementing programs and policies that address these risks can reduce the risk for SV by changing the community environment and incentivizing behavioral expectations. Modifications to the physical and social environment can include increasing lighting, managing accessibility of buildings and public spaces, repairing or replacing abandoned buildings, creating green spaces, and organizing events and activities that bring together community members and provide them with opportunities for more community involvement.

The list below includes the approaches and corresponding example programs, practices and policies under Focus Area 2:

• Improve school climate and safety o Environmental approaches at the building level (e.g., Shifting Boundaries intervention program) o School Restorative Justice Programs

• Improve organizational environments o Proactive sexual harassment prevention policies and procedures Reduce exposure to community-level risks o Assisted Housing Mobility o Low Income Housing Tax Credits o Alcohol-related policies

• Modify the physical and social environment o Greening activities o Business Improvement Districts (BIDs) o Crime Prevention Through Environmental Design

Focus Area 3: Promoting Social Norms That Protect Against Violence

Approaches that focus on changing the social norms (group-level beliefs and expectations of members behavior) related to the acceptance of violence and restrictive gender norms of priority groups have the potential to reduce rates of SV perpetration and victimization. The approaches with existing evidence for this strategy are Bystander Approaches and Men and Boys as Allies in Prevention. Bystander approaches are designed to build peer leadership for promoting social norms that protect against violence and that encourage safe intervention for all forms of SV.

Approaches that mobilize men and boys as allies focus on promoting positive norms around masculinity, gender, and violence, which are then diffused through peer social networks. In order to be considered community-level, programs proposed within this focus area should focus on components which aim to change social norms (e.g., a social norms or social marketing campaign), thereby addressing social norms at the setting-level (school or community).

The list below includes the approaches and corresponding example programs, practices and policies under Focus Area 3:

• Bystander Approaches o Green Dot o Bringing in the Bystander

• Men and Boys as Allies in Prevention o Coaching Boys Into Men

For more information on each of the evidence informed approaches and example program/policy efforts listed below, please use the Approach search tool on VetoViolence (https://vetoviolence.cdc.gov/apps/violence-prevention-practice/approach-search#!/).

Adaptations to Programs and Policies Recipients should consider and plan for future program and policy adaptations when possible.

Adaptations may include additions, deletions, modifications to content and/or delivery methods such as changes to sequence or other adaptations that could impact program fidelity. Recipients are expected to utilize the Essential Elements Framework to assess whether those adaptations may affect a strategy’s effectiveness and whether adaptations being considered are congruent with the underlying theory and intent of the strategy. Recipients can reference this resource:

Select, Adapt, Evaluate | VetoViolence (https://vetoviolence.cdc.gov/apps/adaptation-guidance/) for more information on how to adapt programs while retaining the Essential Elements of the program.

Recipients may determine that one or more adaptations are necessary for the purposes of:

• Increasing implementation feasibility given limited time and resources

• Improving the intended community’s ability to understand and engage with the program content

• Increasing the relevancy of the program given cultural characteristics of the intended population and delivery setting

Recipients must indicate and track any planned adaptations in the implementation and evaluation plans for each impacted program or policy. Recipients should also track any additional adaptations made during implementation (i.e., field adaptations) and document the rationale to support the need for these changes. In addition, adaptations to implementation efforts will require consideration of the impact on evaluation of those efforts. Adaptations that change the essential elements of a program/policy may require a more rigorous evaluation. CDC will provide guidance and tools for tracking and planning adaptations after the start of the period of performance.

In the approach section of their project narrative, applicants must clearly describe how they will identify, implement, and adapt SV prevention strategies that increase health equity through reduced disparities in targeted SDOH, with a focus on implementation at the community- and societal-levels. Applicants should describe plans for implementing at least one program/policy effort in each of the 3 Focus Areas and describe how any new program/policy efforts not listed as examples in the VetoViolence approach search tools meet the required criteria for new program/policy efforts listed in the NOFO. In addition, applicants should describe how they will make their programs accessible and available to participants regardless of age, race/ethnicity, sexual orientation, gender identity, sex, ability, or socioeconomic status. Applicants should also describe how the proposed programs or policy efforts will address inequities in social and structural determinants of health to advance health equity and prevent SV before it starts (primary prevention).

Strategy 4: Use Data to Inform Action

Activity 4A: Gather and synthesize publicly available state-, territory- and community-level data to inform SV prevention, track disparities in targeted SDOH and rates of SV in priority populations, and use this data to select communities and populations for intervention and to improve programmatic activities.

Recipients must identify, track, and report on state-level SV indicators for this NOFO.

Indicators, for the purpose of this NOFO, are measures or other factors with empirical or theoretical links to SV. These should include SV outcomes, risk and protective factors, SDOH, or conditions that can serve as proxies for SV and are periodically available to track over time.

Selected indicators must link back to the outcome evaluation component of the state-level evaluation plan. See “Evaluation and Performance Measurement” section of this NOFO for more information about specific measurement requirements. Recipients are expected to do the following for this NOFO activity:

• Select SV indicators to track and include them in the state-level evaluation plan, due six months following the award date. Selection of final indicators must be submitted with the final state-level evaluation plan, due with the first APR. Recipients are encouraged to select indicators for which there are publicly accessible state-level and local-level data that can measure SV outcomes (e.g., SV perpetration or victimization), risk and protective factors related to SV (e.g., proxies for gender norms), and SDOH (e.g. income inequality, policies).

• Select indicators that help them to identify…