Foa_Content_of_CDC-RFA-DP-23-0015.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH

PROMOTION

CDC’s National Networks Driving Action: Preventing Tobacco- and Cancer-Related Health

Disparities by Building Equitable Communities

CDC-RFA-DP-23-0015

05/31/2023

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-DP- 23-0015. 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:

CDC’s National Networks Driving Action: Preventing Tobacco- and Cancer-Related Health Disparities by Building Equitable Communities 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 this purpose, research is defined at https://www.gpo.gov/fdsys/pkg/CFR-2007-title42-vol1/pdf/CFR-2007-title42-vol1-sec52- 2.pdf. Guidance on how CDC interprets the definition of research in the context of public health can be found at https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr- 46/index.html (See section 45 CFR 46.102(d)).

New- Type 1

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DP-23-0015

E. Assistance Listings Number:

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.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html

93.431 F. Dates:

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

04/12/2023

2. Due Date for Applications:

05/31/2023 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

CDC will conduct a Zoom conference call for all interested applicants to provide technical assistance and respond to any questions regarding this Notice of Funding Opportunity. This call will take place on April 19, 2023 at 3:00 p.m. US Eastern Standard Time. The Zoom call information is:

https://cdc.zoomgov.com/j/1617670850?pwd=bXllZzFyUXQ0bkxvUFA3ckVaRER1QT09

Meeting ID: 161 767 0850

Passcode: Us2#!jdG

One tap mobile

+16692545252,,1617670850#,,,,*11856498# US (San Jose)

+16468287666,,1617670850#,,,,*11856498# US (New York)

Dial by your location

+1 669 254 5252 US (San Jose)

+1 646 828 7666 US (New York)

+1 646 964 1167 US (US Spanish Line)

+1 551 285 1373 US

+1 669 216 1590 US (San Jose)

+1 415 449 4000 US (US Spanish Line)

Meeting ID: 161 767 0850

Passcode: 11856498.

The call will also be recorded. Instructions for accessing the recording and a list of frequently asked questions will be available at https://www.cdc.gov/tobacco/about/foa/preventing-tobacco-cancer-health-disparities/index.html.

G. Executive Summary:

1. Summary Paragraph The Centers for Disease Control and Prevention’s Office on Smoking and Health and Division of Cancer Prevention and Control will fund nine National Networks, each focused on a specific population, to impact the prevalence of commercial tobacco use and cancer related health https://www.grants.gov/ https://cdc.zoomgov.com/j/1617670850?pwd=bXllZzFyUXQ0bkxvUFA3ckVaRER1QT09 https://www.cdc.gov/tobacco/about/foa/preventing-tobacco-cancer-health-disparities/index.html disparities. Populations of focus include African Americans/Blacks, American Indians/Alaskan Natives, Asian Americans/Pacific Islanders/Hawaiian Natives, Latinos/Hispanics, Lesbian, Gay, Bisexual and Transgender people, people with Lower Socioeconomic Status, people with Mental Health/Substance Use Disorders, Geographically Defined Populations with High Commercial Tobacco Use and Related Health Disparities, and people with Disabilities. Strategies include network administration/management; establishing/administering/managing a Community of Practice (CoP) focused on Social Determinants of Health (SDOH); training/technical assistance in the implementation of evidence-based/promising practice-based policy, systems, and environmental (PSE) change interventions; and mass reach health communication. Program outcomes include increased: participation in CoP, knowledge of the National and State Tobacco Control Program, National Comprehensive Cancer Control Program and other programs/partners through training and TA; and advancing of health equity through implementing (1) PSE change interventions; (2) innovative interventions addressing SDOH; and (3) mass reach health communication efforts.

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$45,000,000

e. Average One Year Award Amount:

$1,000,000

f. Total Period of Performance Length:

5 year(s)

g. Estimated Award Date:

August 31, 2023

h. Cost Sharing and / or Matching Requirements:

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

Part II. Full Text

A. Funding Opportunity Description

1. Background

a. Overview Cigarette smoking is the leading cause of preventable disease, disability, and death in adults in the United States (US), accounting for more than 480,000 deaths /year. More than 16 million Americans are living with a health condition caused by smoking. Cigarette smoking cost the US more than $600 billion in 2018, including more than $240 billion in healthcare spending and nearly $372 billion in lost productivity. Cancer is the second leading cause of death in the US; In the US, 1.7 million people are diagnosed with cancer/year and 599,589 cancer deaths occurred in 2019. Each year, $185 billion is spent on cancer care in the US. Death rates due to cancer are higher for some racial/ethnic groups and cancer health outcomes are often linked to

SDOH.

Some population groups have a higher percentage of tobacco use, secondhand smoke exposure and less access to cessation treatments. Nearly 25% of adults in the US have a mental health/substance use disorder, and these adults consume almost 40% of all cigarettes smoked by US adults. Systemic, unfair policies/practices and unjust conditions impact health and health outcomes of population groups and can cause tobacco- and cancer- related health disparities. The tobacco industry has aggressively marketed menthol cigarettes to African Americans and young people, especially in urban communities. Advertisement and promotion of certain tobacco products also appear to be targeted to specific communities including Hispanic/Latino people and people identifying as lesbian, gay, bisexual, or transgender. People living in certain geographic regions also experience tobacco-related health disparities. The percentage of adults who use commercial tobacco is higher in the U.S. South and Midwest than in the Northeast or West. Additionally, disparities persist in secondhand smoke exposure among those who do not smoke, with exposure remaining highest among African Americans, persons living in poverty, and youth.

Cigarette smoking causes 12 types of cancer including cancers of the lung, larynx, oral cavity and pharynx, esophagus, pancreas, bladder, stomach, liver, colon and rectum, kidney and renal pelvis, cervix, and acute myeloid leukemia. Secondhand smoke exposure causes lung cancer. Lung cancer is the leading cause of cancer death, making up almost 25% of all cancer deaths. Several populations experience a disproportionately higher rate of cancer diagnoses and cancer-related deaths. African Americans have the highest cancer death rates. People living in rural areas have an 18–20% higher lung cancer death rate compared to people living in urban areas and Native Americans have higher rates of lung cancer than non-Hispanic White people.

Evidence/practice-based public health approaches for reducing the risk of cancer recurrence and increasing the quality/duration of life following a cancer diagnosis include prevention and cessation of commercial tobacco use, reduced exposure to secondhand smoke, regular physical activity, and maintenance of a healthy weight. Centers for Disease Control and Prevention’s (CDC) Office on Smoking and Health (OSH) and Division for Cancer Control and Prevention (DCPC) will expand work to address tobacco-and cancer-related health disparities among populations disproportionately impacted by tobacco industry marketing tactics and higher cancer incidence/death rates. The NOFO seeks to increase equitable delivery of tobacco prevention strategies and related interventions to advance health equity by addressing SDOH.

b. Statutory Authorities This program is authorized under Sections 301(a) and 317(k)(2) of the Public Health Service Act as amended [42 U.S.C. 241(a) and 42 U.S.C. 247b(k)(2)].

c. Healthy People 2030 Cancer Mental Health/Mental Disorder Tobacco Use https://academic.oup.com/jnci/article/111/12/1279/5498721 https://academic.oup.com/jnci/article/111/12/1279/5498721 https://permanent.access.gpo.gov/gpo39032/Preliminary%20Scientific%20Evaluation%20Menthol%20508%20reduced.pdf https://permanent.access.gpo.gov/gpo39032/Preliminary%20Scientific%20Evaluation%20Menthol%20508%20reduced.pdf https://www.sciencedirect.com/science/article/pii/S0749379721002324?via%3Dihub https://www.sciencedirect.com/science/article/pii/S0749379721002324?via%3Dihub https://www.sciencedirect.com/science/article/pii/S0749379721002324?via%3Dihub https://www.hhs.gov/surgeongeneral/reports-and-publications/tobacco/2020-cessation-sgr-factsheet-key-findings/index.html https://www.hhs.gov/surgeongeneral/reports-and-publications/tobacco/2020-cessation-sgr-factsheet-key-findings/index.html https://www.hhs.gov/surgeongeneral/reports-and-publications/tobacco/2020-cessation-sgr-factsheet-key-findings/index.html https://gis.cdc.gov/Cancer/USCS/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcancer%2Fdataviz%2Findex.htm#/Demographics/ https://gis.cdc.gov/Cancer/USCS/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcancer%2Fdataviz%2Findex.htm#/Demographics/ https://gis.cdc.gov/Cancer/USCS/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcancer%2Fdataviz%2Findex.htm#/Demographics/ https://health.gov/healthypeople/objectives-and-data/browse-objectives/cancer https://health.gov/healthypeople/objectives-and-data/browse-objectives/mental-health-and-mental-disorders https://health.gov/healthypeople/objectives-and-data/browse-objectives/tobacco-use

Neighborhood and Built Environment Health Care Access and Quality

d. Other National Public Health Priorities and Strategies National Stakeholder Strategy for Achieving Health Equity National Action Plan for Cancer Survivorship: Advancing Public Health Strategies HI-5: Health Impact in 5 Years HHS Action Plan to Reduce Racial and Ethnic Health Disparities

e. Relevant Work This NOFO builds on the successes of previously funded NOFO including DP18-1808. It aligns with CDC’s National and State Tobacco Control Program (NTCP) goals to prevent initiation of tobacco use among youth/young adults, eliminate exposure to secondhand smoke, promote cessation of tobacco use among adults and youth, and identify and eliminate commercial tobacco product-related inequities and disparities. It also aligns with the CDC’s National Comprehensive Cancer Control Program (NCCCP) priorities emphasizing primary prevention, promoting early detection and treatment, supporting cancer survivors, building healthy communities through PSE approaches, and achieving health equity.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA-DP-23-0015 Logic Model: CDC’s National Networks Driving Action:

Preventing Tobacco- and Cancer-Related Health Disparities by Building Equitable Communities

Strategies Short Term Outcomes Intermediate Outcomes

Long Term Outcomes

Administer and manage a national network

Establish, administer and manage a community of practice (CoP) that focuses on advancing health equity by addressing social determinants of health (SDOH)

Provide training and technical assistance

Increased awareness and knowledge among network members on the specific needs, strategies, and opportunities needed to advance health equity

Increased awareness and knowledge among network participants of the specific needs, strategies, and opportunities needed to identify and build cross sector partnerships to address commercial

Strengthened relationships between community leaders, partners from critical sectors, SMEs, CoP members, and National Network members

Advance health equity by assisting programs/partners/coa litions in the increased implementation of (1) evidence-based/promising practice PSE change

Improve the social, physical, and economic conditions that affect commercial tobacco initiation, use, and cessation, and cancer prevention and control among populations of focus https://health.gov/healthypeople/objectives-and-data/browse-objectives/neighborhood-and-built-environment https://health.gov/healthypeople/objectives-and-data/browse-objectives/health-care-access-and-quality https://www.mih.ohio.gov/Portals/0/Documents/CompleteNSS.pdf http://stacks.cdc.gov/view/cdc/6536/ https://www.cdc.gov/policy/opaph/hi5/index.html https://www.minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf https://www.cdc.gov/cancer/ncccp/related-programs/Networking2Save.htm https://www.cdc.gov/tobacco/stateandcommunity/tobacco-control/index.htm https://www.cdc.gov/cancer/ncccp/index.htm https://www.cdc.gov/cancer/ncccp/index.htm

(TTA) to support

NTCP, NCCCP

programs and other state and community-based programs/partners/coal itions in the implementation of evidence-based/promising practice-based policy, systems, and environmental change (PSE) interventions focused on commercial tobacco-and cancer-related health disparities

Support mass reach health communication efforts tobacco- and cancer-related disparities and upstream SDOH

Increased participation in Communities of Practice (CoP) among community leaders, partners from critical sectors, coalitions, SMEs, CoP members and National Network members.

Increased bi-directional exchange of information, expertise, tools, and resources between National Network recipients and CoP members related to training, TA, and peer networking opportunities and needs associated with commercial tobacco- and cancer-related health disparities and SDOH

Increased knowledge of

NTCP, NCCCP

programs and other state, local, tribal, territorial, and community-based programs/partners/coal itions

Increased awareness among populations of focus on the dangers of commercial tobacco use, interventions (2) innovative interventions addressing upstream SDOH and (3) mass reach health communication efforts.

Increase in health systems changes, state, local, and jurisdictional comprehensive smokefree policies, comprehensive smokefree multiunit housing policies, and tobacco retail policies

Increase use of strategies to reduce cancer risk. This includes strategies to increase physical activity; improve nutrition; prevent or mitigate adverse childhood experiences (ACEs); enhance commercial tobacco control; and increase use of vaccines that prevent cancer

Increased use of clinical preventive services (i.e., cancer screening services, tobacco screening and cessation interventions)

Decreased exposure to secondhand smoke among the populations of focus initiation of commercial tobacco use among the

Increased tobacco cessation among the cancer incidence am ong the detection of cancer at early stage among the quality of secondhand smoke, the health benefits of quitting, and resources to help people who use tobacco quit

Increased awareness of primary cancer prevention, early detection, and cancer survivorship strategies among populations of focus

Increased support for cancer control self-management among cancer survivors in priority populations for increased quality and duration of life life for cancer survivors among the populations of focus

Bold indicates period of performance outcome.

i. Purpose To accelerate the decline in commercial tobacco use and reduce the incidence/mortality of tobacco-related cancers, it is critical to focus prevention and control efforts on the following populations experiencing a higher burden of tobacco- and cancer-related health disparities:

people who are African American/Black, American Indian/Alaska Native, Asian American/Pacific Islander/Native Hawaiian, Hispanic/Latino, LGBT; people with lower socioeconomic status; people with mental health or substance use disorders; geographically defined populations; and people with disabilities.

ii. Outcomes By the end of the period of performance, recipients are expected to achieve the following outcomes:

1. Increased participation in Communities of Practice (CoP) among community leaders, partners from critical sectors, coalitions, SMEs, CoP members and National Network members. The goal of participation in the CoP includes increased multi sectoral partnership opportunities, leveraging resources, setting priorities, action planning, expanding training and technical assistance (TTA) opportunities and multi-level, multi sectoral coordination.

2. Increased knowledge of NTCP, NCCCP programs and other state, local, tribal, territorial, and community-based programs/partners/coalitions, through TTA, of evidence-based/promising practice policy, systems, and environmental (PSE) change interventions and mass reach health communication efforts focused on advancing health equity by addressing social determinants of health (SDOH).

3. Advance health equity by assisting programs/partners/coalitions in the increased implementation of (1) evidence-based/promising practice PSE change interventions (2) innovative interventions addressing upstream SDOH to advance health equity and (3) mass reach health communication efforts.

iii. Strategies and Activities Recipients are expected to implement the following strategies and activities:

Administer and manage a national network

Recruit and maintain organizations to become and remain active members of the Network Increase inclusion of cross sector organizations addressing commercial tobacco-related and cancer-related health disparities as well as inequities in upstream social determinants of health.

Develop and maintain information management and collection systems on Network members and their contributions to network activities and efforts.

Disseminate population specific data to key decision makers, partners, and Network members.

Facilitate communication and engagement within the Network and across other National Networks.

Award and monitor sub-recipient contracts and grants.

Establish, administer, and manage a virtual/hybrid community of practice (CoP) that focuses on advancing health equity by addressing the social determinants of health (SDOH)

Recruit and engage a variety of traditional and non-traditional partners (e.g. faith based organizations, health care providers/systems, non-governmental organizations, state and local funded programs, governmental officials, civil society organizations, community based organizations) with knowledge and/or experience in advancing health equity by addressing upstream SDOH as part of the CoP to support the NTCP, NCCCP, and their partners/coalitions to implement promising practices/evidence-based interventions to advance health equity.

Recruit and engage multi-level, multi-sector organizations and partners from critical sectors (e.g., community safety, transportation, education, humane housing, etc.) with knowledge and/or experience in advancing health equity by addressing upstream, cross-sectorial SDOH, to participate in the CoP.

Convene a CoP under a unified charge, inclusive of having facilitated communication among members to support the development of a coordinated action plan. The action plan should focus on evidence-based interventions, promising practices, training, technical assistance, and multi-level/multi-sectoral partnerships to accelerate progress on advancing health equity by addressing SDOH, which have a role in ultimately reducing the prevalence of commercial tobacco use and tobacco-related cancers. The action plan should be purposefully aligned with key SDOH prioritized by CDC/NCCDPHP (e.g., social connectedness; tobacco policy; built environment; community-clinical linkages;

food and nutritional security) and other upstream SDOH. The action plan should include, at minimum: details regarding interventions, training and education, and technical assistance strategies; the role of the multi-level/multi-sectorial members of the CoP and National Networks in the implementation of the plan; and the intended audience(s) for the interventions, training, and technical assistance.

Support interventions for commercial tobacco- and cancer-related health disparities which are: 1) evidence-based or promising practices; 2) culturally responsive; 3) based in state, territorial, local, or community settings; and 4) when appropriate, align with key SDOH prioritized by CDC/NCCDPHP.

Provide training and technical assistance (TTA) to support NTCP, NCCCP programs and other state and community-based programs/partners/coalitions in the implementation of evidence-based/promising practice-based policy, systems, and environmental change (PSE) interventions focused on decreasing commercial tobacco- and cancer-related health disparities and, when appropriate, aligns with key SDOH prioritized by CDC/NCCDPHP

Assess the training and technical assistance needs of the NTCP, NCCCP, and other state and community-based programs/partners/coalitions.

Plan, develop, and deliver ongoing appropriate training, technical assistance, and guidance to NTCP, NCCCP, and other state and community-based programs/partners/coalitions based on CoP recommendations as well as the results of the training and technical assistance needs assessment.

Provide training, technical assistance, and guidance to NTCP, NCCCP, and other state and community-based programs/partners/coalitions to assist them in identifying and building partnerships and improving knowledge in strategies/activities that will advance health equity by addressing upstream, cross-sectorial SDOH.

Plan, develop, and deliver ongoing appropriate training, technical assistance, and guidance to NTCP, NCCCP, and other state and community-based programs/partners/coalitions that increases awareness and supports an increase in the implementation of interventions within the population of focus including health care system change approaches that 1) increase delivery and use of tobacco- and cancer-related clinical preventive services and 2) advance linkage of clinical services to community-based interventions.

Plan, develop, and deliver ongoing appropriate training, technical assistance, and guidance to NTCP, NCCCP, and other state and community-based programs/partners/coalitions in implementing community-based policy, systems, and environmental change strategies and activities using a community-led approach to address populations that are disparately affected by commercial tobacco use and dependence and secondhand smoke (SHS) exposure in specific communities within the state.

Assist and advise NTCP, NCCCP, and other state and community-based programs/partners/coalitions in identifying, collecting, and using available data sources related to disparities, health equity, and SDOH.

Provide resources that highlight current evidence-based/promising practice PSE interventions that support commercial tobacco control and cancer-related health disparities (e.g., compendium of evidence-based/promising practice PSE interventions).

Support Mass Reach Health Communication Intervention Efforts

Support traditional (e.g., newspaper, billboards) and digital (e.g., social media, podcasts) media engagement efforts at the national, state, tribal, territorial, community, and local levels by:

Increasing health communication interventions and messages to reach populations of focus experiencing commercial tobacco- and tobacco-related cancer health disparities, including intersectional populations and underlying SDOH factors that influence health outcomes. Health communication interventions and messages should address the dangers of commercial tobacco use, secondhand smoke, the health benefits of quitting, resources to help people who use tobacco quit, primary cancer prevention, early detection, and cancer survivorship among populations of focus.

Supporting the NTCP/NCCCP in the implementation of tailored and/or culturally responsive evidence/practice-based mass-reach health communications interventions and linkages to reach populations experiencing commercial tobacco- and tobacco-related cancer health disparities, including intersectional populations and underlying SDOH factors that influence health outcomes.

Expanding, leveraging, and providing input on CDC media campaigns (e.g., Tips From Former Smokers®, Screen for Life, Bring Your Brave, Inside Knowledge) and publications highlighting science/evidence/practice-based interventions and related successes.

1. Collaborations

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

The recipient is required to recruit and engage in the CoP a variety of traditional and non-traditional partners with knowledge and/or experience advancing health equity by addressing upstream SDOH to support NTCP and NCCCP recipients and their partners/coalitions to implement promising practices/evidence-based interventions. Recipients will be required to collaborate with other CDC funded organizations. The applicant must describe their capacity in the following ways:

Participation in partner meetings and other collaborative efforts with public health partners to provide consultation to CDC and CDC-funded organizations.

Support to CDC-funded organizations and CDC in collaborative efforts to proactively identify the needs of, and respond to requests from, NCCCP and NTCP and their partners.

Providing technical assistance and training to the NCCCP and NTCP recipients and their partners.

Applicants should also consider seeking collaborative opportunities with the following CDC-funded organizations (Optional):

CDC funded Immunization Programs Racial and Ethnic Approaches to Community Health (REACH) programs Closing the Gap with Social Determinants of Health Accelerator Plans programs Strengthening U.S. Public Health Infrastructure, Workforce, and Data Systems Grant

The applicant is required to provide CDC with three letters of support from CDC funded organizations that describes key collaborative efforts. Applicants must file the letters of support, as appropriate, name the file, “Letters of Support”, and upload it as a PDF file at www.grants.gov. . These letters should state the commitment of the organization in supporting the development and implementation of workplan activities, an overall description of the program/partner/organization, and their experience (if any) working with population of focus/intersectional population(s)/SDOH. The letters of support must be dated within 30 days of the application.

https://www.cdc.gov/ncird/isd.html https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm https://www.cdc.gov/populationhealth/sdoh/index.htm#:~:text=Closing%20the%20Gap%20with%20Health%20Accelerator%20Plans%20The,reduce%20chronic%20diseases%20among%20people%20experiencing%20health%20disparities.

https://www.cdc.gov/infrastructure/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fworkforce%2Fresources%2Finfrastructuregrant%2Findex.html

Applicants should describe how their partner organizations will support the development and implementation of workplan activities using a table format. This should include all potential partners (including those providing letters of support) that will support the work of the NOFO.

A sample format is provided below. Applicants are not required to use this format. If a different format is used the elements of the sample must be included.

Partner Involvement

Sector

Potential Areas of Expertise

Organization or Program Name/Representative and

Contribution

b. With organizations not funded by CDC:

The recipient is required to recruit and engage in the CoP a variety of traditional and non-traditional partners with knowledge and/or experience advancing health equity by addressing upstream SDOH to support NTCP and NCCCP recipients and their partners/coalitions to implement promising practices/evidence-based interventions. Recipients are required to build and/or continue strategic public health partnerships and collaborations with:

Federal agencies such as Indian Health Service, Food and Drug Administration, Health Resources and Services Administration, Housing and Urban Development, National Institutes of Health, National Cancer Institute, Substance Abuse and Mental Health Services Administration, National organizations that have a role in achieving the NOFO outcomes and proposed activities.

Other state, local, tribal, and territorial organizations/partners/programs/coalitions including organizations working with specific populations of focus, intersectional population(s) the recipient identified, faith-based organizations, health care providers/systems, non-governmental organizations, state and local funded programs, governmental officials, civil society organizations, community-based organizations, community safety programs, transportation services, education, humane housing, and social organizations.

The applicant is also required to provide CDC three letters of support from organizations not funded by CDC that describes key collaborative efforts. These letters should state the organization's commitment to supporting the development and implementation of workplan activities, an overall description of the program/partner/organization, and their experience (if any) working with population of focus/intersectional population(s)/SDOH. The letters of support must be dated within 30 days of the application . Applicants must file the letters of support, as appropriate, name the file, “Letters of Support”, and upload it as a PDF file at www.grants.gov.

Applicants should describe how their partner organizations will support the development and implementation of workplan activities using a table format. This should include all potential partners (including those providing letters of support) that will support the work of the NOFO.

A sample format is provided below. Applicants are not required to use this format. If a different format is used the elements of the sample must be included.

Partner Involvement

Sector

Potential Areas of Expertise

Organization or Program Name/Representative and

Contribution

2. Target Populations Certain population groups experience a higher prevalence of tobacco- and cancer-related health disparities including disparities incommercial tobacco use, secondhand smoke exposure, related health problems (including cancer) , access to cessation treatment. These disparities are also based on where they live, learn, work, and play as well as other social and demographic factors including race, ethnicity, age, sexual orientation, disability status, level of education, income, and/or behavioral health status.

https://www.cdc.gov/tobacco/health-equity/index.htm https://www.cdc.gov/tobacco/health-equity/index.htm https://www.cdc.gov/tobacco/health-equity/index.htm https://www.cdc.gov/tobacco/health-equity/index.htm https://www.cdc.gov/tobacco/health-equity/index.htm

Applicants must identify and focus on one disproportionately affected population that experiences high prevalence of commercial tobacco- and cancer- related health disparities including: 1) African American/Black people; 2) American Indian/Alaskan Native people; 3) Asian American/Pacific Islander/Hawaiian Native people; 4) Latino/Hispanic people; 5) Lesbian, Gay, Bisexual, and Transgender people; 6) People with Lower Socioeconomic Status; 7) People with Mental Health and Substance Use Disorders; 8) Geographically Defined Populations with High Commercial Tobacco Use and Related Health Disparities; and 9) People with Disabilities.

Applicants are also required to address the inclusion of intersectional population(s) within the identified population of focus that can benefit from the program strategies listed in this NOFO.

These identified intersectional population(s) can include: older adults, individuals who were formally incarcerated, individuals experiencing housing insecurity or who are unsheltered, immigrants, military/veteran populations, or any overlapping and intersecting groups or populations whose unique needs may otherwise be overlooked by CDC and other public health funded programs. In addition, applicants will be expected to provide specific activities to address the variances in disparities within the identified population of focus and intersectional population(s). (For more information, see Strategies for Reducing Health Disparities, 2016 ).

a. Health Disparities The complex interaction of multiple factors (e.g., socioeconomic status, cultural characteristics, acculturation, inequitable policy implementation and enforcement, childhood adversity and toxic stress) and generations of unfair and unjust policies and practices, including the tobacco industry’s aggressive and targeted marketing to certain people and communities, have led to longstanding disparities related to tobacco product initiation, use, and cessation as well as secondhand smoke exposure. Similar factors also contribute to cancer-related health disparities including socioeconomic status, cultural characteristics, diet, and access to healthcare services.

Continued efforts are necessary to address the unique need for population-specific capacity and infrastructure to support commercial tobacco and cancer control strategies and promote access to tobacco cessation services, cancer prevention, and treatment and survivor resources for populations experiencing disparities.

The recipient will work to enhance collaboration among the NTCP, NCCCP, and other state, local, community, tribal, and territorial program/partner with the goals of leveraging and pooling resources, supporting those groups in advancing health equity, and increasing implementation of culturally appropriate interventions deployed through a health equity lens (e.g., intervention development, implementation, and evaluation). Program activities will be purposefully aligned with CDC/NCCDPHP Health Equity and Social Determinants of Health priority areas, and both OSH goals and DCPC priorities. They will address the unique need for population-specific capacity and infrastructure to support prevention and control of commercial tobacco use as well as cancer control strategies. They will promote access to tobacco cessation services, cancer prevention, and treatment and survivor resources for populations experiencing disparities. Current national and state surveillance systems and data reporting systems will be used to demonstrate and quantify impact for targeted outcome indicators. Culturally tailored approaches for specific populations, with consideration given to intersectional characteristics of different populations, may accelerate the elimination of health disparities and help prevent additional new ones, thus achieving the benefits of an overall population-based approach to commercial tobacco use prevention and control. Successful tobacco control strategies will lead to https://www.cdc.gov/minorityhealth/strategies2016/index.html https://www.cdc.gov/chronicdisease/healthequity/social-determinants-of-health-and-chronic-disease.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fchronicdisease%2Fprograms-impact%2Fsdoh.htm https://www.cdc.gov/tobacco/about/osh/index.htm https://www.cdc.gov/cancer/ncccp/priorities/index.htm decreases in new cancers and cancer deaths as well as lowering the number of people whose cancer comes back.

iv. Funding Strategy Up to 9 recipients will be funded with an average award amount of $1,000,000. No more than one award will be made for each population of focus. Organizations will not be funded for more than one population of focus.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

CDC will use outcomes, associated performance measures, annual progress reports, as well as independent evaluation to measure the effectiveness of NOFO activities, inform future activities focused on health equity, and answer key CDC evaluation questions, such as:

1. To what extent do the National Networks maintain an active network and CoP membership that is representative of experience in working with the populations of focus, and how are they maintaining or growing the network and CoP membership representation over time?

2. What is the impact of the National Network training and technical assistance on state, tribal, territorial, community and local jurisdictions’ ability reach populations of focus using evidence-based/promising practice PSE change interventions as well as innovative interventions addressing upstream SDOH?

3. To what extent did the National Networks help reach tobacco and cancer prevention and control long term outcomes among populations of focus?

As part of CDC evaluation requirements, recipients will report performance measures annually using a template provided by CDC. These performance measures will demonstrate the process and resulting outcomes of National Network efforts to reduce tobacco- and cancer-related health inequities. CDC will work with recipients to finalize the performance measures, including how they are operationalized and reported.

Outcomes and Associated Performance Measures

Outcomes Performance Measures

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

ii. Applicant Evaluation and Performance Measurement Plan Applicants must provide an evaluation and performance measurement plan that demonstrates how the recipient will fulfill the requirements described in the CDC Evaluation and Performance Measurement and Project Description sections of this NOFO. At a minimum, the plan must describe:

How the applicant will collect the performance measures, respond to the evaluation questions, and use evaluation findings for continuous program quality improvement.

How key program partners will participate in the evaluation and performance measurement planning processes.

Available data sources, feasibility of collecting appropriate evaluation and performance data, and other relevant data information (e.g., performance measures proposed by the applicant)

A) Increased participation in CoP among community leaders, partners from critical sectors, coalitions, SMEs, CoP members and National Network members. The goals of participation in the CoP includes increased multi-sectoral partnership opportunities, leveraging resources, setting priorities, action planning, expanding TTA opportunities and multi-level, multi-sectoral coordination

Number, by type, of participants (multi-level, multi-sectorial organizations, and partners) participating in the CoP

B) Increased knowledge of NTCP, NCCCP programs and other state, local, tribal, territorial, and community-based programs/partners/coalitions, through training and TA, of evidence-based/promising practice PSE change interventions and mass reach health communication efforts focused on advancing health equity by addressing SDOH

Number and proportion of individuals reporting an increase in knowledge of evidence-based strategies/promising practice PSE change interventions and mass reach health communication efforts focused on advancing health equity by addressing SDOH

C) Advance health equity through increased implementation of (1) evidence-based/promising practice PSE change interventions, (2) innovative interventions addressing upstream SDOH to advance health equity, and (3) mass reach health communication efforts

Number and type of evidence-based/promising practice PSE change interventions, innovative interventions addressing upstream SDOH to advance health equity, and mass reach health communication efforts that were implemented

Plans for updating the Data Management Plan (DMP) as new pertinent information becomes available. If applicable, throughout the lifecycle of the project. Updates to DMP should be provided in annual progress reports. The DMP should provide a description of the data that will be produced using these NOFO funds; access to data;

data standards ensuring released data have documentation describing methods of collection, what the data represent, and data limitations; and archival and long-term data preservation plans. For more information about CDC’s policy on the DMP, see https://www.cdc.gov/grants/additional-requirements/ar-25.html.

Where the applicant chooses to, or is expected to, take on specific evaluation studies, the applicant should be directed to:

Describe the type of evaluations (i.e., process, outcome, or both).

Describe key evaluation questions to be addressed by these evaluations.

Describe other information (e.g., measures, data sources).

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan, including a DMP, if applicable, within the first 6 months of award, as described in the Reporting Section of this NOFO.

Recipients will be required to submit a more detailed Evaluation and Performance Measurement plan within the first 6 months of award, as described in the Reporting Section of this NOFO.

Applicants must provide an evaluation and performance measurement plan that will fulfill the requirements in the CDC Evaluation and Performance Measure section. Applicants must:

Develop an initial evaluation and performance plan to indicate how they will identify progress in implementing program strategies, activities, and achieving program outcomes.

Ensure that the evaluation plan follows the CDC's Framework for Program Evaluation and describes how they will collect data to report on the performance measures.

c. Organizational Capacity of Recipients to Implement the Approach Organizational capacity ensures applicants demonstrate their ability to successfully execute the NOFO strategies and meet the program outcomes. Applicants must describe:

1. Organizational capacity, expertise, and experience to enhance the quality and performance of public health programs, public health data and information systems, public health practice and services, public health partnerships, and public health resources that focus on the prevalence of commercial tobacco use and cancer related health disparities in specific populations.

2. Experience serving the identified population of focus to impact the prevalence of commercial tobacco use and cancer related health disparities through systems-based approaches.

3. Capacity to engage diverse, multi-sector public health partners that advance health equity by addressing SDOH across all 50 states, tribes, territories, communities, jurisdictions, and local levels.

4. Existing, active, multi-sector partners with demonstrated success or experience implementing evidence-based/promising practice based (including policy-based https://www.cdc.gov/grants/additional-requirements/ar-25.html file://cdc.gov/project/ONDIEH_DP18_1808/New%20NOFO/CDC%20Evaluation%20Framework interventions and systems change approaches) strategies which benefit the population of focus.

5. Experience serving the identified population of focus to impact the prevalence of commercial tobacco use and cancer related health disparities and advance health equity by addressing SDOH.

6. Experience serving the identified population of focus to advance health equity by addressing SDOH.

7. Capacity and structures in place to administer a National Network and engage multi sector partners representing national, regional, state, tribal, territory, jurisdictional and/or local level working in commercial tobacco control, comprehensive cancer control, chronic disease prevention, and strategies that advance health equity by addressing SDOH within the identified population of focus.

8. Experience serving the identified population of focus to impact the prevalence of commercial tobacco use and cancer related health disparities.

9. Experience convening diverse, multi-sector partners to promote the use of evidence-based/promising practice based (including policy-based interventions and systems change approaches) approaches and culturally competent strategies for addressing the prevalence of commercial tobacco use and cancer related health disparities in the identified population of focus and intersectional populations.

10. Knowledge and understanding of appropriate methods to reach and engage organizations which serve members of the identified population of focus (and intersectional populations).

11. An existing, active, multi-sector membership that includes partners with demonstrated success implementing culturally appropriate evidence-based/promising practice based (including policy-based interventions and systems change approaches) strategies.

12. The recipient is required to have the infrastructure necessary to establish and maintain a national network that includes organizations addressing commercial tobacco-related and cancer-related health disparities and advancing health equity by addressing upstream

SDOH.

13. The recipient is required to have the infrastructure to establish, administer, and manage a virtual/hybrid community of practice (CoP) that focuses on the SDOH.

14. Experience providing technical assistance and training to NTCP, NCCCP, and/or other CDC-funded initiatives.

15. Experience serving the identified population of focus on strategies that advance health equity by addressing SDOH.

16. Adequate physical space, internet access, and a landline and/or cellular phone to implement the program.

17. Adequate program management and staffing plans with sufficient workforce capacity and competence to accomplish program outcomes. Each staff member's experience and roles should be clearly defined roles. The applicant should include the curriculum vitae/resume for staff listed. The Applicant must name this file "CVs/Resumes" and upload it at www.grants.gov. Management and staffing plans are required, at a minimum, to include:

o Commercial tobacco control program manager focused on commercial tobacco control strategies;

o Comprehensive cancer control program manager focused on comprehensive cancer control strategies;

o Program evaluator; and o Health communications specialist.

18. Adequate performance measurement, evaluation, quality improvement, travel, fiscal management, and financial management procedures and full capacity to manage contracting and procurement efforts, including the ability to write and award subcontracts in accordance with 45 C.F.R. 75, as applicable.

19. Experience in conducting and using needs assessments to work with CDC-funded programs, including the use of assessment findings to improve programmatic activities and ultimately show impact.

20. Ability to attend CDC sponsored training, meetings, events, and other training opportunities.

21. Ability to conduct sustainability planning that assures the implementation of National Network activities are scalable and are proven to be effective beyond the CDC funding cycle.

22. A financial management system that will allow proper funds management and segregation of funds by program and meet the requirements as stated in The Uniform Administrative Requirements, Cost Principles, and Audit Requirements for HHS Awards found at "https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75#se45.1.75_1302"45 CFR 75.302. The financial system should permit the preparation of reports required by general and program-specific terms and conditions; and the tracing of funds to a level of expenditure adequate to establish that such fund have been used according to the Federal statutes, regulations, and the terms and conditions of the Federal award.

d. Work Plan The applicant should provide a detailed work plan for the first year of the period of performance and a high-level work plan for subsequent years. The workplan should include strategies/activities that address the needs of the population of focus. The strategies/activities should be written in SMART (specific, measurable, achievable, realistic, timely) format. The workplan should include evidence-based/promising practice strategies and activities to achieve all outcomes listed in the logic model. No specific work plan format is required, if it is clear how the elements in the work plan crosswalk to the strategies and activities, outcomes, and evaluation and performance measures presented in the logic model and the narrative sections of this NOFO. CDC will provide feedback and technical assistance to recipients to finalize the work plan post-award. A sample work plan format is presented below to show how a traditional work plan aligns with the logic model and narrative. If a particular strategy/activity leads to multiple outcomes, it should be described under each outcome measure. Applicants are not required to use this format. If a different format is used, the same elements of the workplan must be included.

Strategy:

https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75#se45.1.75_1302 https://www.ecfr.gov/cgi-bin/text-idx?node=pt45.1.75#se45.1.75_1302

Responsible Position/Party:

Population(s) of Focus:

Key Deliverables Proposed:

Work Plan Activities

Activity…