Foa_Content_of_CDC-RFA-DP-23-0019.pdf

Centers for Disease Control and Prevention

NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH

PROMOTION

Outcomes Building Capacity to Reduce the Burden of Menthol and Other Flavored Commercial

Tobacco Products in Communities that Experience Health Disparities

CDC-RFA-DP-23-0019

07/06/2023

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- 23-0019. 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:

Outcomes Building Capacity to Reduce the Burden of Menthol and Other Flavored Commercial Tobacco Products in Communities that Experience Health Disparities 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)).

D. Agency Notice of Funding Opportunity Number:

CDC-RFA-DP-23-0019

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

93.387 F. Dates:

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

05/15/2023

2. Due Date for Applications:

07/06/2023 11:59 p.m. U.S. Eastern Standard Time, at www.grants.gov.

3. Due Date for Informational Conference Call:

CDC will conduct a 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 05/23/2023 at 3:00 p.m. US Eastern Standard Time. The conference call information is:

Join ZoomGov Meeting https://cdc.zoomgov.com/j/1602381765?pwd=SFU2UnhGTXZFbFhuSUpBNVN4UHBndz09

Meeting ID: 160 238 1765 Passcode: 2?*cz?1A One tap mobile +16692545252,,1602381765#,,,,*83911472# US (San Jose) +16469641167,,1602381765#,,,,*83911472# US (US Spanish Line)

Dial by your location +1 669 254 5252 US (San Jose) +1 646 964 1167 US (US Spanish Line) +1 646 828 7666 US (New York) +1 415 449 4000 US (US Spanish Line)

+1 551 285 1373 US

+1 669 216 1590 US (San Jose) Meeting ID: 160 238 1765 Passcode: 83911472 Find your local number: https://cdc.zoomgov.com/u/auJdtOi3k

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/reduce-burden-menthol/index.html

G. Executive Summary:

1. Summary Paragraph This Notice of Funding Opportunity (NOFO) seeks to advance health equity through strategic partnerships and community engagement by addressing disparities caused by menthol and other flavored tobacco product marketing and use. This collaboration will 1) promote and support social, economic and community change; 2) educate the public, community leaders, partners, and decision makers on policy, systems, and environmental changes that can prevent and reduce menthol tobacco use; 3) implement culturally appropriate interventions tailored for community needs; and 4) use research, surveillance, and evaluation to measure progress made and inform https://www.grants.gov/ https://cdc.zoomgov.com/j/1602381765?pwd=SFU2UnhGTXZFbFhuSUpBNVN4UHBndz09 https://cdc.zoomgov.com/u/auJdtOi3k https://www.cdc.gov/tobacco/about/foa/reduce-burden-menthol/index.html https://www.cdc.gov/tobacco/about/foa/reduce-burden-menthol/index.html public health action. Over 5 years, this NOFO aims to achieve the following community-based outcomes:

Increased participation, engagement, and mobilization among inclusive and diverse multi-level/ multi-sectoral partners in promoting social, economic, and community changes

Increased knowledge of the harms of menthol and other flavored tobacco use among youth and populations experiencing tobacco-related disparities and increased public support for evidence-based tobacco control interventions

Increased awareness of cessation services and coverage options among populations experiencing tobacco-related disparities

Increased equitable adoption, implementation, and enforcement of policies prohibiting the sale of menthol and other flavored tobacco products, including menthol cigarettes

a. Eligible Applicants:

Open Competition

b. Funding Instrument Type:

CA (Cooperative Agreement)

c. Approximate Number of Awards

d. Total Period of Performance Funding:

$20,000,000

e. Average One Year Award Amount:

$400,000

f. Total Period of Performance Length:

5 year(s)

g. Estimated Award Date:

September 01, 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 the United States, killing more than 480,000 people yearly. Commercial tobacco use contributes to higher rates of premature death and chronic conditions, such as cancer and heart disease. (All references to tobacco use apply to commercial tobacco use and not the traditional use of tobacco by indigenous communities.) More than 16 million Americans are living with a disease or health condition caused by smoking.

Federal law prohibits tobacco manufacturers from marketing cigarettes with “characterizing flavors,” except for menthol- or tobacco-flavored cigarettes. In 2019 and 2020, sales of menthol cigarettes made up 37% of all cigarette sales in the United States—the highest share since 1967 when major tobacco companies were first required to report this information.

https://www.cdc.gov/tobacco/basic_information/menthol/index.htmlStudies of local U.S.

policies show that restricting the sale of flavored tobacco products reduces the proportion of youth who try or use tobacco products. In 2022, the Federal Drug Administration proposed regulations to ban the sale of menthol cigarettes and flavored cigars. Finalization and implementation of such regulations may take time. Public health action to address disparities related to flavored tobacco product use remains necessary to advance health equity.

This NOFO addresses health disparities caused by menthol and other flavored tobacco product use among U.S. populations who are harmed by them disproportionately. Outcomes for this NOFO are:

Increased participation, engagement, and mobilization among inclusive and diverse multi-level/ multi-sectoral partners in promoting social, economic, and community changes

Increased knowledge of the harms of menthol and other flavored tobacco use among youth and populations experiencing tobacco-related disparities and increased public support for evidence-based tobacco control interventions

Increased awareness of cessation services and coverage options among populations experiencing tobacco-related disparities

Increased equitable adoption, implementation, and enforcement of policies prohibiting the sale of menthol and other flavored tobacco products, including menthol cigarettes

This approach supports a community-based participatory approach and will strengthen community-centered efforts through community coalitions and partnerships. Community engagement, appropriate evidence-based and promising practices that resonate with a community, and a meaningful financial investment are necessary to support steps toward the reduction and elimination of tobacco-related health disparities. Community engagement ensures that efforts to increase health equity are more effective and sustainable. Communities know and understand the programmatic challenges of addressing health disparities in specific populations (mistrust, create barriers to participation, historical and intergenerational trauma).

b. Statutory Authorities This program is authorized under section 317(k)(2) of the Public Health Service Act, 42 U.S.C. § 247b(k)(2), Sec 3(a) Comprehensive Smoking Education Act of 1984 15 U.S.C. § 1341, Sec 301(a) of the Public Health Service Act 42 U.S.C.§ 241(a) and Sec 2(a) Comprehensive Smokeless Tobacco Health Education Act of 1986, 15 U.S.C. § 4401.

c. Healthy People 2030 Tobacco Use

d. Other National Public Health Priorities and Strategies https://www.govinfo.gov/app/details/USCODE-2010-title21/USCODE-2010-title21-chap9-subchapIX-sec387g/summary https://www.ftc.gov/system/files/documents/reports/federal-trade-commission-cigarette-report-2019-smokeless-tobacco-report-2019/cigarette_report_for_2019.pdf https://www.ftc.gov/system/files/documents/reports/federal-trade-commission-cigarette-report-2020-smokeless-tobacco-report-2020/p114508fy20cigarettereport.pdf https://www.cdc.gov/tobacco/basic_information/menthol/index.html https://europepmc.org/article/PMC/PMC8887583 https://europepmc.org/article/PMC/PMC8887583 https://europepmc.org/article/PMC/PMC8887583 https://www.cdc.gov/tobacco/health-equity/index.htm https://stacks.cdc.gov/view/cdc/31217 https://health.gov/healthypeople/objectives-and-data/browse-objectives/tobacco-use

HHS Action Plan to Reduce Racial and Ethnic Health Disparities The Public Health Action Plan to Prevent Heart Disease and Stroke: Ten-Year Update Million Hearts Initiative Ending the Tobacco Epidemic: A Tobacco Control Strategic Action Plan for the US

Department of Health and Human Services E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon General, 2016 (see Call to Action) Surgeon General’s Report on Smoking and Health, The Health Consequences of

Smoking—50 Years of Progress (“A Vision for Ending the Tobacco Epidemic: Toward a Society Free of Tobacco-Caused Death and Disease”

e. Relevant Work This NOFO builds on the community-based disparity requirement in the DP20-2001 National and State Tobacco Control Program.

2. CDC Project Description

a. Approach

Bold indicates period of performance outcome.

CDC-RFA- DP23-0019 Logic Model: Building Capacity to Reduce the Burden of Menthol and Other Flavored Commercial Tobacco Products in Communities that Experience Health Disparities

Bold indicates period of performance outcome.

Strategies and

Activities

Short-term

Outcomes

Intermediate

Outcomes

Long-term Outcomes

Impact Outcomes

Engage diverse partners to promote and support social, economic and community change to increase awareness of the harms of menthol and other flavored tobacco product use and availability of cessation services.

Outcome 1:

Increased participation, engagement, and mobilization among inclusive and diverse multi-level/ multi-sectoral partners in promoting social, economic, and community changes

Outcome 5:

Increased equitable adoption, implementation, and enforcement of policies prohibiting the sale of menthol and other flavored tobacco products, including menthol cigarettes

Outcome 7:

adoption and availability of health care systems changes that promote and support cessation for populations experiencing tobacco-related disparities

Outcome 8:

Reduced

Outcome 9:

Reduction of health disparities associated with the initiation of menthol tobacco product use in youth, the use of menthol tobacco products among adults, and the reduction in exposure to https://www.minorityhealth.hhs.gov/assets/pdf/hhs/HHS_Plan_complete.pdf https://www.nationalforum.org/wp-content/uploads/2018/04/Action-Plan-Ten-Year-Update-April-2014.pdf https://millionhearts.hhs.gov/ https://www.hhs.gov/sites/default/files/ash/initiatives/tobacco/tobaccostrategicplan2010.pdf https://www.hhs.gov/sites/default/files/ash/initiatives/tobacco/tobaccostrategicplan2010.pdf https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf https://www.cdc.gov/tobacco/about/foa/national-state-tobacco-control-program/index.html https://www.cdc.gov/tobacco/about/foa/national-state-tobacco-control-program/index.html

Educate the public, community leaders, partners, and decision makers on policy, systems, and environmental changes that can prevent and reduce menthol tobacco use.

Implement culturally appropriate interventions tailored for community needs to prevent and reduce menthol and other flavored tobacco product use.

Use research, surveillance, and evaluation to measure progress made in reducing tobacco use and menthol tobacco-related disparities and inform public health action.

Outcome 2:

knowledge of the harms of menthol and other flavored tobacco use among youth and populations experiencing tobacco-related disparities and increased public support for evidence-based tobacco control interventions

Outcome 3:

awareness of cessation services and coverage options among populations experiencing tobacco related

Outcome 4:

knowledge and awareness of and increased support for menthol and other flavored tobacco product-related policy and health systems changes, including cessation services, among

Outcome 6:

Increased quit attempts, quit attempts using evidence-based cessation services, and successful cessation among populations experiencing initiation of menthol and other flavored tobacco product use among youth and populations experiencing second-hand smoke and aerosols due to menthol and flavored tobacco product use.

Outcome 10:

Advanced health equity as a result of reduced disparities in tobacco product-related morbidity and mortality policy and decision makers

i. Purpose This NOFO supports recipients working to address health disparities among populations who use menthol and other flavored tobacco products, through coalitions that will 1) promote and support social, economic and community change; 2) educate the public, community leaders, partners, and decision makers on policy, systems, and environmental changes that can prevent and reduce menthol tobacco use; 3) implement culturally appropriate interventions tailored for community needs; and 4) use research, surveillance, and evaluation to measure progress made and inform public health action.

ii. Outcomes Short -Term Outcomes

Increased participation, engagement, and mobilization among inclusive and diverse multi-level/ multi-sectoral partners in promoting social, economic, and community changes

Increased knowledge of the harms of menthol and other flavored tobacco use among youth and populations experiencing tobacco-related disparities and increased public support for evidence-based tobacco control interventions

Increased awareness of cessation services and coverage options among populations experiencing tobacco related disparities

Intermediate Outcome

Increased equitable adoption, implementation, and enforcement of policies prohibiting the sale of menthol and other flavored tobacco products, including menthol cigarettes

iii. Strategies and Activities The strategies and activities in this NOFO are designed to be conducted over a 5-year period of performance in the proposed community(ies). Applicants must select a minimum of one activity per strategy. Recipients are allowed to change or add activities annually. Applicants may not propose additional activities other than what is listed in the NOFO. Recipients may propose additional activities starting in year two. All proposed activities must use local level policy, system and environmental (PSE) approaches that support community level activities/actions.

Strategies that address flavored tobacco products must include menthol. All recipients are required to conduct an equity assessment in the first six months of the cooperative agreement.

Equity assessments are systematic examinations of available data and expert input on how various groups—especially those facing inequity or disparities—are or likely will be affected by a policy, program, or process. They aim to minimize unintended adverse outcomes and maximize opportunities and positive outcomes. A Framework for Assessing Equity in Federal Programs and Policies may be helpful.

Strategy 1: Engage diverse partners to promote and support social, economic and community change to increase awareness of the harms of menthol and other flavored tobacco product use and availability of cessation services.

Seek engagement of partners to implement evidence-based strategies and promising practices that prevent and reduce menthol and other flavored tobacco product use.

Recruit non-traditional partners to collaborate with the community coalition.

Include strategies related to menthol and flavored tobacco product use in community health improvement plans and other similar implementation plans in the community.

Train existing and new partners about the harms of menthol and other flavored tobacco product use, predatory tobacco industry marketing, cessation resources, and options for community change to improve equity.

Strategy 2: Educate the public, community leaders, partners, and decision makers on policy, systems, and environmental changes that can prevent and reduce menthol tobacco use.

Train, inform, and educate the public, community leaders, partners, and decision makers about culturally appropriate strategies and evidence-based policies that reduce and prevent menthol and other flavored tobacco product use.

Promote public discussion throughout the community to increase understanding of the harms of menthol and other flavored tobacco use.

Use data on tobacco industry marketing to inform community discussions with partners, decision makers, and stakeholders.

Train community and youth spokespersons to engage in developing and using appropriate messaging to reach populations most impacted and at risk for menthol and other flavored tobacco product use.

Educate community leaders, partners, and decision makers about equitable enforcement of commercial tobacco control policies that reduce menthol and other flavored tobacco product use.

Strategy 3: Implement culturally appropriate interventions tailored for community needs to prevent and reduce menthol and other flavored tobacco product use

Assess what motivates individuals who use menthol and other flavored tobacco products to make a quit attempt (such as health concerns, concerns about family members, policies in the community).

Employ low-cost counter marketing strategies, including earned and social media strategies.

https://www.mitre.org/sites/default/files/2021-11/prs-21-1292-equity-assessment-framework-federal-programs.pdf https://www.mitre.org/sites/default/files/2021-11/prs-21-1292-equity-assessment-framework-federal-programs.pdf

Provide technical assistance and other support to communities employing policies to reduce menthol and other flavored tobacco product use.

Pilot novel approaches that motivate individuals who use menthol and other flavored tobacco products to seek community based and other available cessation services.

Work with community health care center staff, such as community health workers, nurses, and other traditional and non-traditional providers, to increase access to cessation services including counseling and evidence-based cessation medications.

Use existing public health mass media campaigns and ads related to menthol and other flavored tobacco products (such as Tips From Former Smokers®)

Strategy 4: Use research, surveillance, and evaluation to measure progress made in reducing tobacco use and menthol tobacco-related disparities and inform public health action.

Collect and analyze community-based data (such as surveys, community health needs assessments, readiness assessments, focus groups and other community-participatory means) to increase understanding of most effective culturally appropriate approaches to prevent and reduce menthol and other flavored tobacco product use among youth and adults, including people experiencing tobacco-related disparities.

Evaluate novel approaches and promising practices to reduce menthol and flavored tobacco product use and dependence among populations that use menthol and flavored tobacco products at higher rates or have more exposure to secondhand smoke due to others’ use of menthol and flavored tobacco products.

Share programmatic or research findings, novel surveillance methodologies, promising practices and evaluation results with the Advisory Council, Community Coalition, Community Leaders, other recipients of this NOFO, and/or DP20-2001 National and State Tobacco Control Program through formal and informal channels.

1. Collaborations

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

Recipients are encouraged to collaborate with CDC-funded chronic disease prevention programs to ensure that activities align with ongoing chronic disease prevention efforts. Applicants are required to submit a letter of support from the state, territorial or tribal tobacco control program.

(If the applicant is a tribe a letter should be submitted from their Tribal Health Organization.)

The letter of support should describe how they will collaborate with and/or provide technical assistance to the applicant. The National Tobacco Control Program will be a resource for technical assistance and training as well as sustainability and a potential source for data. The letter must be signed by the Program Manager or Administrator of the CDC-funded program.

Applicants must name the file ‘NTCP_Letter_of_Support’ and upload the letter to www.grants.gov as a part of the application.

CDC-funded chronic disease and health promotion programs include the following:

The recipient must collaborate with the following:

1. National Tobacco Control Program http://www.grants.gov https://www.cdc.gov/tobacco/

2. Networking2Save

The recipient is encouraged, but not required to collaborate with the following:

1. Cancer Prevention and Control

2. Diabetes

3. Good Health and Wellness in Indian Country

4. Heart Disease and Stroke Prevention

5. Nutrition, Physical Activity, and Obesity

6. Racial and Ethnic Approaches to Community Health (REACH)

7. Reproductive Health

8. School Health

9. NCCDPHP Success Stories Library

10. Prevention and Control of Chronic Disease and Associated Risk Factors in the U.S.

Affiliated Pacific Islands, U.S. Virgin Islands, and Puerto Rico

b. With organizations not funded by CDC:

The applicant is required to identify and engage with an existing community coalition to create sustainable community-level change and fulfill activities under this NOFO throughout the entire award period. For the purposes of this NOFO, a community coalition is defined as a community-based formal arrangement of cooperation and collaboration among multi-sector groups or sectors in which each group retains its identity but agrees to work together toward a common goal. The community coalition will facilitate sociodemographic and multi-disciplinary diversity to employ culturally appropriate evidence-based strategies and encourage the use of promising practices and the development of novel approaches, while building and sustaining capacity through technical assistance and training.

Recipients will:

Engage with a community coalition. The coalition should include representatives from the following groups:

o Recipient o Community leaders o Community stakeholders (businesses, employee organizations/unions, community organizations, and governance boards) o Youth and young adult community representative with lived experience of the health inequity being addressed o Adult community representative o Local public health department representative o State public health department representative o Health care professionals (hospital associations, medical societies, individual providers/subject matter experts) o Multi-disciplinary and diverse community partners (health care systems,housing, faith-based organizations, education institutions and businesses)

The recipient must work to strengthen collaborations that support the efforts of a community-based coalition that is working to seek better health for residents, help change local healthcare https://www.cdc.gov/tobacco/stateandcommunity/tobacco-control/coop-agreement/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Ftobacco%2Fstateandcommunity%2Ftobacco_control_programs%2Fcoop-agreement%2Findex.html https://www.cdc.gov/cancer/index.htm https://www.cdc.gov/diabetes/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fdiabetes%2Fhome%2Findex.html https://www.cdc.gov/healthytribes/ghwic.htm https://www.cdc.gov/dhdsp/ https://www.cdc.gov/nccdphp/dnpao/ https://www.cdc.gov/nccdphp/dnpao/state-local-programs/reach/index.htm https://www.cdc.gov/reproductivehealth/index.html https://www.cdc.gov/healthyschools/ https://nccd.cdc.gov/nccdsuccessstories/searchstories.aspx https://www.grants.gov/web/grants/view-opportunity.html?oppId=310165 https://www.grants.gov/web/grants/view-opportunity.html?oppId=310165 practices, and mobilize communities to implement appropriate and feasible, community-specific public health programs to reduce health disparities.

Key partners may include:

Community-based and civic organizations Non-profit and non-partisan community service organizations Tribes, tribal or native serving organizations and health systems, urban Indian organizations Academic institutions, and universities (e.g., Historically Black Colleges and Universities

(HBCUs), Hispanic Association of Colleges and Universities (HACUs), American Indian Higher Education Consortium (AIHEC), Tribal Colleges and Universities (TCUs))

Asian American, Native Hawaiian, and Pacific Islander serving institutions or organizations

Faith-based organizations Public and private non-governmental organizations Correctional facilities and institutions Local governmental agencies and community leaders Local businesses and business community networks and organizations (employers, local chambers of commerce, small business community groups or associations) Labor Unions and other employee organizations Social services providers and organizations, including those that address social determinants of health (community transportation; anti-discrimination organizations;

legal services; service providers for persons with disabilities and local housing authorities)

Health care providers, including community health centers (federally qualified health centers (FQHCs)) and related organizations (health professional organizations, health center associations, and pharmacies)

State Offices of Rural Health (SORH) or equivalent, State Rural Health Associations (SRHAs)

Governmental organizations focused on non-health services (e.g., Coordinating Council on Access and Mobility – Department of Transportation, Supportive housing for the elderly – Housing and Urban Development; Community Development Financial Institutions Fund - Department of the Treasury)

Community Development Corporations Social and Recreational Clubs (501(c)(3), 501(c)(4), 501(c)(7))

Additional Requirements for the Application:

A letter of support from a minimum of two members of the community coalition are required for the application and must include a specific description of their role in support of the proposed work

Letters of support must be named: ‘PartnerName_Letter of Support’ and uploaded as PDFs into www.grants.gov

2. Target Populations

This NOFO addresses the public health needs of populations that are disproportionately affected by disparities related to chronic disease and related risk factors from menthol and other flavored tobacco products. Depending on the needs and priorities of the applicant, these populations may include Black/African American, Hispanic/Latino, American Indian and Alaska Native, Asian/ Asian American, and Native Hawaiian and Pacific Islander people, and other people of color;

lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people; people with disabilities; people who have mental health and substance use diagnoses; women, youth, and people otherwise adversely affected by persistent poverty or inequality.

Applicants should clearly identify the population(s) and the tribe, community, or catchment area they will serve and the data which shows that this population is disproportionately affected.

a. Health Disparities CDC recognizes that social and economic opportunities, health behavior, and the physical environment in which people live greatly impact health outcomes. Health disparities represent preventable differences in the burden of disease, disability, injury, or violence, or in opportunities to achieve optimal health.

This NOFO will address health disparities for those who use menthol and other flavored tobacco products. The NOFO will also engage the community directly through trusted organizations that interact with and serve the community regularly. The relationship between the community and these organizations provides an opportunity for the development of innovative approaches that recognize health beliefs and perceptions about behavior change, and other cultural nuances of the community. Those affected by commercial tobacco-related health disparities often are intentional targets for predatory marketing, leading to use of products and health behaviors that contribute to undesirable health outcomes. A community is a geographical location or setting that can include a city, county, parish, tribe or jurisdiction/sub-jurisdiction that is a significant enough area to allow for population-wide interventions and measurable results and includes a targeted focus to address disparities resulting from the use of menthol and other flavored tobacco products.

Applicants should clearly identify and describe how the target population is impacted by the following:

* The health disparities and inequities from the use of menthol and flavored tobacco products.

* The predatory marketing of commercial tobacco products in their communities; and

*How the proposed strategies and activities can benefit the identified population(s) and tribe, community, or catchment area.

Tobacco-related disparities are created and affected by a complex mix of factors. Social determinants of health, tobacco industry influence, a lack of comprehensive tobacco control policies, and a changing U.S. population can contribute to and maintain tobacco-related disparities. Social determinants of health are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. These disparities can affect populations based on certain factors, including but not limited to the following:

Age Disabilities

Educational attainment Geographic location (e.g., rural/urban) Income (e.g., individual and/or family income, living below poverty index) Behavioral Health Conditions, including mental health conditions and substance use disorders Employment status Race Ethnicity Sex Sexual orientation and gender identity Veteran and active military status

Health equity in tobacco prevention and control is the opportunity for all people to live a healthy, tobacco-free life, regardless of their race or ethnicity, level of education, gender identity, sexual orientation, the job they have, the neighborhood they live in, or whether they live with a disability. With the goal of reducing menthol and other flavored tobacco commercial tobacco use, the recipient will implement strategies that reduce tobacco-related disparities among people who use menthol tobacco.

CDC’s support of community based participatory approaches demonstrates respect for existing communities and cultures and their ability to contribute and solve the problems that they know well, given that effort, along with the appropriate level of financial resources and multi-sector partnership and coalitions, are created and nurtured. All applicants should describe how proposed activities would address tobacco-related disparities and inequities in their populations using CDC Preferred Terms for Select Population Groups & Communities.

iv. Funding Strategy CDC will fund up to 8 awards with an average award amount of $400,000 – $750,000. Funding amounts will be based on consideration of the community size and the scope of the work proposed. See the glossary of this NOFO for the CDC definition of “community”.

b. Evaluation and Performance Measurement

i. CDC Evaluation and Performance Measurement Strategy

Evaluation and performance measurement help demonstrate program accomplishments and strengthen the evidence for program strategies and activities. In consultation with CDC, develop and implement an evaluation plan for selected activities executed to meet the requirements of the NOFO as well as other evaluation questions that may arise, as feasible. The recipient should also work closely with the State Tobacco Control Program. CDC will collaboratively work individually and collectively with recipients to track implementation of recipient strategies and activities and assess progress in achieving NOFO outcomes during the period of performance and will seek to answer the following questions:

To what extent did the recipient create or strengthen an existing coalition/partnership or collaboration which is aimed at reducing the burden of menthol or other flavored tobacco products?

https://ctb.ku.edu/en/table-of-contents/analyze/where-to-start/participatory-approaches/main https://www.cdc.gov/healthcommunication/Preferred_Terms.html

To what extent did the recipient create or enhance the leadership structure needed for decision-making that will support sustained efforts in the community?

To what extent did the recipient create communications methods that are used to increase the knowledge and awareness of harms caused by menthol and other flavored products?

To what extent did the recipient develop a plan of action that is comprehensive, is communicated to the community, and includes policy, systems, or environmental change?

To what extent did recipient efforts increase knowledge of the harms of menthol tobacco use among the selected populations?

To what extent did recipient efforts increase support for evidence-based menthol tobacco-prevention and control interventions and policies among leaders and decision-makers?

To what extent did recipient efforts improve awareness of evidence-based cessation services and coverage options among populations experiencing tobacco-related disparities?

What impact did recipient efforts have on equitable adoption, implementation, and enforcement of menthol tobacco product use prevention and control policies, systems, or environmental change interventions?

What strategies were effective (and not effective) at reaching and improving positive tobacco-related outcomes among the selected populations affected by tobacco-related disparities?

Performance measures developed for this NOFO correspond to the high-level broad strategy categories and outcomes described in the logic model. Recipients will report performance measures annually to CDC, who will also manage and analyze the performance measure data to identify recipient program improvements, respond to broader technical assistance needs, and to report to partners and allies.

DMP is required and applicants will include the following DMP requirements, at a minimum:

A description of the data to be collected or generated in the proposed project.

The standards to be used for the collected or generated data.

Mechanisms for, or limitations to, providing access to the data, including a description for the provisions for the protection of privacy, confidentiality, security, and intellectual property, or other rights.

Statement of the use of data standards that ensure all documentation that describes the method of collection, what the data represent, and

Plans for archiving and long-term preservation of the data, or explaining why long-term preservation and access are not justified; and, Other additional requirements based on the program.

Outcomes Performance Measures

Outcome 1: Increased participation, engagement, and mobilization among inclusive and diverse multi-level/ multi-sectoral partners in promoting social, economic, and community changes.

1. Number and type of multi-level, multi-sectorial organizations and partners participating and their perceived level of commitment

2. The number and type of participants, including frequency of attendance, who are present at coalition/community meetings.

Outcome 2: Increased knowledge of the harms of menthol and other flavored tobacco product use among youth and populations experiencing tobacco-related disparities and increased public support for evidence-based tobacco control interventions.

3. Number and proportion of educational event attendees, stratified by population, reporting an increase in knowledge of the harms of menthol tobacco from pre to post survey.

Outcome 3: Increased awareness of cessation services and coverage options among populations experiencing tobacco related disparities.

4. Proportion of tobacco users who are aware of available cessation services (e.g., FDA-approved cessation medications, state quitlines), overall, and among population groups experiencing tobacco-related disparities.

Outcome 5: Increased equitable adoption, implementation, and enforcement of policies prohibiting the sale of menthol and other flavored tobacco products, including menthol cigarettes.

5. Number and reach of comprehensive local (city, county, or tribal) policies that have been adopted, implemented, and/or enforced to restrict the sale of all menthol and other flavored tobacco products, including menthol cigarettes.

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)

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.

https://www.cdc.gov/grants/additional-requirements/ar-25.html

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

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

Describe key evaluation questions to be addressed by these evaluations.

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

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

c. Organizational Capacity of Recipients to Implement the Approach Upon receipt of award recipients must be able to readily implement this program in the state in which they operate and are located. The applicant’s organizational capacity statement must clearly describe the applicant has the necessary skills and relevant experience to successfully implement the strategies and activities outlined.

Applicant should describe their history of experience using a community-based participatory approach that builds on existing community assets and existing coalitions, allowing for the flexibility necessary to tailor interventions to meet the unique needs of the selected population.

Applicants proposing to work in a state, tribe, locality, or territory other than where the applicant is physically located and operates must provide justification and documentation that demonstrates the capability to execute the requirements of the NOFO without the need for physical proximity to the catchment area.

Recipients are required to demonstrate adequate infrastructure, project management structure and workforce capacity, and expert knowledge of the community through inclusion of community members as employees, volunteers, and/or board members. Recipients are required to have appropriate systems for data collection and evaluation of project performance measures, as well as adequate financial systems to meet federal government procurement requirements and statutes. This includes experience with budget management and administration capacity to establish financial procedures and track, monitor, and report expenditures.

To ensure that applicants are able to readily execute CDC program requirements and meet period of performance outcomes, applicants must describe the following:

A history of working with a multi-disciplinary diverse coalition, engaging and mobilizing communities to address public health issues related to health disparities and capable of affecting community-level change.

Ability to inform and educate the community, general public, local decision makers and community leaders about: 1) the history of specific targeting of the local community with menthol and other flavored tobacco products, 2) the dangers of tobacco use and dependence (with a focus on products containing menthol as a characterizing flavor), 3) second hand smoke (SHS) exposure and related harms, and 4) tobacco-related disparities.

Provide evidence of experience in serving the identified population of focus to reduce the prevalence of menthol and other flavored tobacco use through evidence-based/promising practice-based approaches (including policy-based interventions and systems change approaches).

Understanding of evidence-based commercial tobacco control interventions, promising practices, and culturally appropriate strategies to address use of menthol and other flavored tobacco products.

Ability to develop and maintain a relationship of bi-directional support, mutual respect, acceptance of appropriate technical assistance, and information exchange with the state tobacco control program and/or other health department programs.

Experience engaging communities in public health planning and implementation processes addressing SDOH that improve outcomes for chronic disease, including current activities.

Experience using data to identify populations and tribes, communities, or catchment areas most affected by chronic diseases and SDOH.

Experience implementing strategies and activities in collaboration with multi-sectoral partners to reduce health disparities and improve health equity.

Demonstrates success in addressing health equity through prior implementation of public health community interventions.

Previous experience working with the population(s) and the tribe, community, catchment area they will serve.

Applicants must submit their responses related to CDC program requirements listed above under the file name “Program_Requirements” and upload to www.grants.gov with their application.

CDC requires a full time equivalent to serve as the program manager who will be responsible for the day-to-day management of the implementation of activities.

Applicant must provide an organizational chart, CVs/resumes, position descriptions and project management structure that will be sufficient to meet the goals of the proposed project.

Applicants must name the files "Organizational_Chart," "Resumes," "Position_Descriptions," and "Project_Management_Structure" and upload them to www.grants.gov with their application.

d. Work Plan Applicants must submit a detailed work plan for Year 1 of the award. Additionally, applicants must provide a general summary of work plan strategies and activities for Years 2-5 in narrative form. The Work Plan is part of the 20-page limit allowed for the Project Narrative. This work plan should include activities listed in section iii. Strategies and Activities. Applicants must name this file "Work_Plan" and upload to www.grants.gov with their application. A simple work plan example is provided below.

The work plan should include the following components:

Strategies and Activities Period of Performance Outcome Performance Measures Responsible Party Completion Date http://www.grants.gov

A complete work plan and timeline for the first budget period that describes each proposed strategy and its activities; intended outcomes; staff, partners, contractors and administration staff roles and functions to support implementation of the award; identified measures for relevant outcomes that align with the performance measures, and milestones for accomplishing key tasks for each outcome. The plan must include first year outcomes that are achievable with performance measures consistent with CDC guidance in the NOFO.

A sample work plan format is presented below to show how a traditional work plan aligns with the logic model and narrative.

In this format, the table would be completed for each period of performance outcome. If a particular activity leads to multiple outcomes, it should be described under each outcome measure.

Period of Performance Outcome:

[from Outcomes section and/or logic model]

Outcome Measure:

[from Evaluation and Performance Measurement section]

Strategies and Activities Process Measure

[from Evaluation and Performance Measurement section]

Responsible Position / Party

Completion Date

1.

2.

3.

4.

5.

6.

e. CDC Monitoring and Accountability Approach Monitoring activities include routine and ongoing communication between CDC and recipients, site visits, and recipient reporting (including work plans, performance, and financial reporting).

Consistent with applicable grants regulations and policies, CDC expects the following to be included in post-award monitoring for grants and cooperative agreements:

Tracking recipient progress in achieving the desired outcomes.

Ensuring the adequacy of recipient systems that underlie and generate data reports.

Creating an environment that fosters integrity in program performance and results.

Monitoring may also include the following activities deemed necessary to monitor the award:

Ensuring that work plans are feasible based on the budget and consistent with the intent of the award.

Ensuring that recipients are performing at a sufficient level to achieve outcomes within stated timeframes.

Working with recipients on adjusting the work plan based on achievement of outcomes, evaluation results and changing budgets.

Monitoring performance measures (both programmatic and financial) to assure satisfactory performance levels.

Monitoring and reporting activities that assist grants management staff (e.g., grants management officers and specialists, and project officers) in the identification, notification, and management of high-risk recipients.

f. CDC Program Support to Recipients

Technical Assistance:

The recipient will have access to CDC-sponsored training, including training specific to menthol tobacco products and other commercial tobacco control topics. Recipients will have access to the Technical Assistance providers of the National and State Tobacco Control Program, including the applicants of Networking2Save and Cooperative Agreements of the National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce that are focused on Social Determinants of Health, Health Equity, and Commercial Tobacco Control, including menthol.

Strategic and Technical Advice:

CDC OSH will convene an annual meeting for the recipient to meet with the following:

One OSH funded national network At least one representative from the state tobacco control program At least one OSH subject matter expert At least one non-governmental organization

CDC OSH will fund the meeting and the recipient will need to budget for travel, lodging and per diem.

Recipients must have the ability to attend CDC-sponsored trainings, meetings and events as well other developmental opportunities recommended by CDC (in-person or virtually).

B. Award Information

1. Funding Instrument Type:

CA (Cooperative Agreement) CDC's substantial involvement in this program appears in the CDC Program Support to Recipients Section.

2. Award Mechanism:

U58 - Chronic Disease Control Cooperative Agreement

3. Fiscal Year:

4. Approximate Total Fiscal Year Funding:

$3,000,000

5. Total Period of Performance Funding:

$20,000,000 This amount is subject to the availability of funds.

Estimated Total Funding:

$20,000,000

6. Total Period of Performance Length:

5 year(s) year(s)

7. Expected Number of Awards:

8. Approximate Average Award:

$400,000 Per Budget Period

9. Award Ceiling:

$750,000 Per Budget Period

This amount is subject to the availability of funds.

10. Award Floor:

$3…